Entrepreneurial nurses and midwives in the United Kingdom: an integrative review

An online communication skills education program for midwifery students: A quasi-experimental study

BACKGROUND

Communication and entrepreneurship skills, which have a very important place among the 21st century skills, are among the basic skills that a midwife should have.

OBJECTIVE

This study was carried out to investigate the effect of the Communication Skills Education Program on the communication and entrepreneurship skills of the midwifery students.

DESIGN

This study was designed a quasi-experimental study.

SETTINGS

Online.

PARTICIPANTS

First grade Bachelor of Midwifery Science students (n = 117).

METHODS

In this study, the Communication Skills Education Program was given to midwifery students. The Communication Skills Assessment Scale and University Students Entrepreneurship Scale were administered before the education program was implemented (pre-test), when the training program was completed (post-test), and six months after the education program was completed (post-test). Classified data were given in numbers and percentage distribution. Pearson correlation coefficient was used to determine the relationship between the variables. In order to test the significance of the difference between pre-test, post-test and follow-test the repeated measures Analysis of Variance (ANOVA) was performed.

RESULTS

The mean age of the participating students was 19.46 ± 1.74 (min. 18.0, max: 31.0) years. While 8.5 % of the students received training on communication previously, 7.7 % of the students received education on entrepreneurship previously. Statistically significant differences were determined between the scores the students obtained at the pre-test, post-test and follow-up test [F = 224.38, p = .00/F = 325.13, p = .00]. The Bonferroni test performed to find out from which tests the difference stemmed demonstrated that there was a significant difference between the mean scores obtained at all the tests. According to the analysis of the relationship between the mean scores the students obtained from the scales, there was a moderately significant positive correlation only between their pre-test mean scores.

CONCLUSIONS

In conclusion, we determined that the Communication Skills Education Program improved the students' communication and entrepreneurship skills.

Entrepreneurial nurses in the literature: A systematic literature review

AIM

This study explores the main characteristics of entrepreneurial nursing.

BACKGROUND

Nurses have acted entrepreneurially in a multitude of ways since the very beginning of the nursing profession. Still, it is unclear what it means for a nurse to be entrepreneurial. Entrepreneurial nurses are often described inconsistently, by non-inclusive terms not founded in research. There is a need to examine the essence of entrepreneurial nursing roles.

METHOD

I conducted the research as a systematic literature review of 647 documents. Analysing empirical descriptions of entrepreneurial nurses' employment status, contexts, knowledge, activities, barriers and motivations led to the description of two entrepreneurial nursing roles.

RESULTS

The employment status of entrepreneurial nurses represents an important difference in their activities, challenges and motivations.

CONCLUSIONS

Entrepreneurial nurses may act as nurse entrepreneurs or nurse intrapreneurs. These roles are empirically rooted in the field of nursing and theoretically rooted in the field of entrepreneurship.

IMPLICATIONS FOR NURSING MANAGEMENT

Entrepreneurial nurses are influenced by the support they get and the challenges they face in the health care system. Knowing the characteristics of entrepreneurial nurses is important for nurse managers, as they lead employees who may become nurse entrepreneurs or nurse intrapreneurs.

A Consideration of Benefits for Midwives Employed in Public Health Systems and Private Midwifery Practices

BACKGROUND

Benefits add to the total compensation received by midwives for their professional work in global settings. Some benefits are commonly offered as a package by employers as components of employment contracts. Some benefits may be individually negotiated or may be self-funded by midwives who own their own businesses.

PURPOSE

Identify benefits associated with midwifery employment.

METHODS

Benefits data available to certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States were collected in online surveys conducted in 2004, 2007, 2010, and 2014. Benefits types received and benefits cost-sharing for midwives and their families were compared descriptively.

RESULTS

More than 90% of respondents employed full-time in 2014 reported that they received at least 1 of 16 types of benefits in their midwifery-related employment. Professional liability insurance, paid vacation (paid holiday), and paid time off for continuing education were the only benefits reported by 75% or more of respondents in each of 4 survey years. Trends over time reported by U.S. CNMs/CMs employed full-time suggest a decrease in employer contributions to benefit costs. Nearly half of all CNM/CM respondents reported not knowing the basis for calculation of their salary and compensation package.

CONCLUSION

Changes appear to indicate increasing employee cost-sharing of benefits packages in recent years for U.S. midwives. Similarities and differences identified for midwives in global settings are discussed, although information on benefits in global settings was limited. Midwives in all settings may gain from education about strategies for negotiation of salary and compensation packages.

Profile and entrepreneurial intention of nursing students: a comparison between Brazil and Chile

ABSTRACT Objective: to identify and compare factors associated with profile, intentions, motivations, and barriers to entrepreneurial behavior of nursing students from Brazil and Chile. Methods: this cross-sectional study was carried out between March and September 2018 including 889 nursing students. A form was used to assess the socio-demographic profile, professional claims, entrepreneurial intentions and motivations. Statistical analysis used Chi-Square and Fisher’s Exact tests, with a 5% significance level, and a simple logistic regression model. Results: there are significant differences between countries in the profile of students and in the motivations studied, but not in professional pretensions and entrepreneurial intentions. Lack of education on the subject reveals itself as an important barrier to entrepreneurship. Conclusion: given the lack of teaching entrepreneurship in undergraduate nursing courses and the characteristics inherent to students, education must be appropriate to different cultures to prepare future professionals for other areas of practice.

Entrepreneurship and Nursing: integrative review

ABSTRACT Objective: To identify the knowledge produced on business entrepreneurship in Nursing. Method: Integrative literature review in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, SCOPUS, Web of Science, PubMed, Medline, Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database (BDENF), Index Psychology and National Information Center of Medical Sciences of Cuba (CUMED). We included available studies in their totality in the period from 2007 to 2017. Results: 22 articles were included. The categories that emerged from the study are the following: Concepts of entrepreneurship in nursing, Profile of the entrepreneur nurse, Business Diversity, Business Management, Barriers to business entrepreneurship in nursing, Support to entrepreneurial nurses and Entrepreneurship in Nursing Undergraduate. Conclusion: There is a need to prepare nurses with adequate skills to increase the capacity to integrate into the labor market and to improve their own well-being and that of society.

Health visitor education for today's Britain: Messages from a narrative review of the health visitor literature

OBJECTIVES

This paper draws on a narrative review of the literature, commissioned to support the Health Visitor Implementation Plan, and aimed at identifying messages about the knowledge, skills, and abilities needed by health visitors to work within the current system of health care provision.

DESIGN

The scoping study and narrative review used three complementary approaches: a broad search, a structured search, and a seminal paper search to identify empirical papers from the health visitor literature for review. The key inclusion criteria were messages of relevance for practice.

DATA SOURCES

378 papers were reviewed. These included empirical papers from the United Kingdom (UK) from 2004 to February 2012, older research identified in the seminal paper search and international literature from 2000 to January 2016.

REVIEW METHODS

The review papers were read by members of the multidisciplinary research team which included health visitor academics, social scientists, and a clinical psychologist managed the international literature. Thematic content analysis was used to identify main messages. These were tabulated and shared between researchers in order to compare emergent findings and to confirm dominant themes.

RESULTS

The analysis identified an 'orientation to practice' based on salutogenesis (health creation), human valuing (person-centred care), and viewing the person in situation (human ecology) as the aspirational core of health visitors' work. This was realised through home visiting, needs assessment, and relationship formation at different levels of service provision. A wide range of knowledge, skills, and abilities were required, including knowledge of health as a process and skills in engagement, building trust, and making professional judgments. These are currently difficult to impart within a 45week health visitor programme and are facilitated through ad hoc post-registration education and training. The international literature reported both similarities and differences between the working practices of health visitors in the UK and public health nurses worldwide. Challenges related to the education of each were identified.

CONCLUSIONS

The breadth and scope of knowledge, skills, and abilities required by health visitors make a review of current educational provision desirable. Three potential models for health visitor education are described.

Iranian entrepreneur nurses' perceived barriers to entrepreneurship: A qualitative study

Background:

To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses’ perceived barriers to entrepreneurship, in order to identify the existing barriers.

Materials and Methods:

This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews.

Results:

As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business.

Conclusions:

The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.

Why health visiting? Examining the potential public health benefits from health visiting practice within a universal service: a narrative review of the literature

INTRODUCTION

There is increasing international interest in universal, health promoting services for pregnancy and the first three years of life and the concept of proportionate universalism. Drawing on a narrative review of literature, this paper explores mechanisms by which such services might contribute to health improvement and reducing health inequalities.

OBJECTIVES

Through a narrative review of empirical literature, to identify: (1) What are the key components of health visiting practice? (2) How are they reflected in implementing the universal service/provision envisaged in the English Health Visitor Implementation Plan (HVIP)?

DESIGN

The paper draws upon a scoping study and narrative review.

REVIEW METHODS

We used three complementary approaches to search the widely dispersed literature: (1) broad, general search, (2) structured search, using topic-specific search terms, (3) seminal paper search. Our key inclusion criterion was information about health visiting practice. We included empirical papers from United Kingdom (UK) from 2004 to February 2012 and older seminal papers identified in search (3), identifying a total of 348 papers for inclusion. A thematic content analysis compared the older (up to 2003) with more recent research (2004 onwards).

RESULTS

The analysis revealed health visiting practice as potentially characterized by a particular 'orientation to practice.' This embodied the values, skills and attitudes needed to deliver universal health visiting services through salutogenesis (health creation), person-centredness (human valuing) and viewing the person in situation (human ecology). Research about health visiting actions focuses on home visiting, needs assessment and parent-health visitor relationships. The detailed description of health visitors' skills, attitudes, values, and their application in practice, provides an explanation of how universal provision can potentially help to promote health and shift the social gradient of health inequalities.

CONCLUSIONS

Identification of needs across an undifferentiated, universal caseload, combined with an outreach style that enhances uptake of needed services and appropriate health or parenting information, creates opportunities for parents who may otherwise have remained unaware of, or unwilling to engage with such provision. There is a lack of evaluative research about health visiting practice, service organization or universal health visiting as potential mechanisms for promoting health and reducing health inequalities. This paper offers a potential foundation for such research in future.

The potential of social enterprise to enhance health and well-being: a model and systematic review

In recent years civil society organisations, associations, institutions and groups have become increasingly involved at various levels in the governance of healthcare systems around the world. In the UK, particularly in the context of recent reform of the National Health Service in England, social enterprise - that part of the third sector engaged in trading - has come to the fore as a potential model of state-sponsored healthcare delivery. However, to date, there has been no review of evidence on the outcomes of social enterprise involvement in healthcare, nor in the ability of social enterprise to address health inequalities more widely through action on the social determinants of health. Following the development of an initial conceptual model, this systematic review identifies and synthesises evidence from published empirical research on the impact of social enterprise activity on health outcomes and their social determinants. Ten health and social science databases were searched with no date delimiters set. Inclusion and exclusion criteria were applied prior to data extraction and quality appraisal. Heterogeneity in the outcomes assessed precluded meta-analysis/meta-synthesis and so the results are therefore presented in narrative form. Five studies met the inclusion criteria. The included studies provide limited evidence that social enterprise activity can impact positively on mental health, self-reliance/esteem and health behaviours, reduce stigmatization and build social capital, all of which can contribute to overall health and well-being. No empirical research was identified that examined social enterprise as an alternative mode of healthcare delivery. Due to the limited evidence available, we discuss the relationship between the evidence found and other literature not included in the review. There is a clear need for research to better understand and evidence causal mechanisms and to explore the impact of social enterprise activity, and wider civil society actors, upon a range of intermediate and long-term public health outcomes.

Education for entrepreneurship in nursing

The different types of entrepreneurship, including social entrepreneurship and intrapreneurship, and the importance of social entrepreneurship skills in the changing world of health care are discussed. The term social intrapreneurship is introduced to characterise the many nurses introducing change and enhancing care working within the NHS. The strategy for development of entrepreneurship education within one region of the UK is presented and its integration into a pre-registration nursing programme is the main focus of this paper. The process of integration of skills in the changing world of health care is discussed. The strategy for development of entrepreneurship is presented under the headings of the NICENT (Northern Ireland Centre for Entrepreneurship) @ Ulster Integration Model: Awareness and Understanding; Interpretation; Contextualisation; Integration (Theoretical Content); Integration (Assessment); Validation/Revalidation; Implementation; and Review and Reflection. The most important stages were the first two in which nursing academic staff came to realise the relevance of the topic to nursing and the interpretation and translation into 'nurse-speak' of the business terminology to alleviate the initial rejection of entrepreneurship as of no relevance to nursing.

The consultant nurse - expert practitioner and much more

The consultant nurse (CN) role is usually described in terms of four domains devised by the Department of Health - clinical practice, education and training, leadership, and research and service development. This study set out to explicate the diversity and complexity of CN roles in an NHS trust; to describe aspects of extraordinary practice and to identify perceived differences between this role and other advanced practice roles. Accounts were written by six CNs and subjected to concept mapping to facilitate identification of extraordinary practice. Four themes emerged: entrepreneurial activity and innovation; clinical autonomy and role dynamism; influential national and international research conduct; consultancy and education across discipline boundaries. These included descriptions of higher order skills that surpass usual requirements of 'expert' or 'advanced' practice. Comparisons with other advanced practice roles are drawn from the literature and data collected in this study. Differences between the roles have implications for sustainability.

What are scoping studies? A review of the nursing literature

BACKGROUND

Scoping studies are increasingly undertaken as distinct activities. The interpretation, methodology and expectations of scoping are highly variable. This suggests that conceptually, scoping is a poorly defined ambiguous term. The distinction between scoping as an integral preliminary process in the development of a research proposal or a formative, methodologically rigorous activity in its own right has not been extensively examined.

AIMS

The aim of this review is to explore the nature and status of scoping studies within the nursing literature and develop a working definition to ensure consistency in the future use of scoping as a research related activity.

DESIGN

This paper follows an interpretative scoping review methodology.

DATA SOURCES

An explicit systematic search strategy included literary and web-based key word searches and advice from key researchers. Electronic sources included bibliographic and national research register databases and a general browser.

RESULTS

The scoping studies varied widely in terms of intent, procedural and methodological rigor. An atheoretical stance was common although explicit conceptual clarification and development of a topic was limited. Four different levels of inquiry ranging from preliminary descriptive surveys to more substantive conceptual approaches were conceptualised. These levels reflected differing dimensional distinctions in which some activities constitute research whereas in others the scoping activities appear to fall outside the remit of research. Reconnaissance emerges as a common synthesising construct to explain the purpose of scoping.

CONCLUSIONS

Scoping studies in relation to nursing are embryonic and continue to evolve. Its main strengths lie in its ability to extract the essence of a diverse body of evidence giving it meaning and significance that is both developmental and intellectually creative. As with other approaches to research and evidence synthesis a more standardized approach is required.

Challenging times ahead

The global economic challenges will not only affect the banks but also healthcare staff and their patients. Indeed, no-one will be unaffected. At this moment community nurses are not being properly reimbursed for the cost of using their cars to deliver care in the home as the price of petrol rises ever higher and older people are counting the cost of ever rising energy and food costs. Additionally there will be less extra money available to fund public services as the government attempts to balance its expenditure against tax receipts without further increasing government debt.