Conducting integrative reviews: a guide for novice nursing researchers

The impact of midwife/nurse-led psychosocial interventions on parents experiencing perinatal bereavement: An integrative review

BACKGROUND

Perinatal loss is a traumatic event associated with a high risk of parents experiencing negative psychological outcomes. Despite most parents being in regular contact with midwives and nurses during the perinatal period, there is a lack of evidence which hampers these professionals from using effective psychosocial interventions with parents.

AIM

This study aims to synthesise the existing evidence on the types of psychosocial interventions delivered by midwives/nurses for parents with perinatal bereavement, their impacts on bereaved parents' mental health and the experiences of midwives and nurses in delivering psychosocial interventions for parents experiencing perinatal loss.

DESIGN

An integrative review of the literature.

METHODS

Whittemore and Knafl's five-stage integrative review framework guided this review. A systematic literature search of the Medline, PsycINFO, Embase, CINAHL and ASSIA, Cochrane Library and ProQuest databases was conducted from inception to January 2023, with no language or geographical limiters set due to the paucity of research published in this subject area. Two researchers independently screened and reviewed each study's data extraction and methodological quality using the Joanna Briggs Institute and Mixed Method Appraisal Tool. Results were analysed and synthesised using narrative synthesis.

RESULTS

A total of 21 studies met the inclusion criteria. From these, we identified nine types of psychosocial interventions for perinatal bereavement that can be delivered by midwives and nurses. The positive impacts of midwife/nurse-led psychosocial interventions on grief, anxiety, depression posttraumatic stress disorder and other psychosocial outcomes amongst parents experiencing perinatal loss have been demonstrated. In addition, we identified the useful components of these interventions and the experiences of midwives and nurses in delivering psychosocial interventions, thereby highlighting barriers such as lack of knowledge and skills, stressful working environments and inadequate emotional support.

CONCLUSION

Our findings demonstrate that midwife/nurse-led psychosocial interventions have the potential to improve grief, anxiety, depression, posttraumatic stress disorder symptoms and other psychosocial outcomes for parents experiencing perinatal loss. Thus, future research should consider training, workload, time cost and emotional support for midwives/nurses when developing midwife/nurse-led psychosocial interventions for parents with perinatal loss.

REGISTRATION NUMBER

CRD42022369032.

TWEETABLE ABSTRACT

Midwife/nurse-led psychosocial interventions have the potential to improve mental health amongst parents experiencing perinatal loss.

The impact of preceptorship on the newly qualified nurse and preceptors working in a critical care environment: An integrative literature review

BACKGROUND

Preceptorship has been found to be effective in supporting Newly Qualified Nurses (NQNs) during their transition into challenging environments, particularly in addressing issues related to confidence and anxiety. Effective preceptorship is an element of best practice and essential to support NQNs' transition into the critical care setting. However, the impact of preceptorship on NQNs and their preceptors in critical care units is yet to be completely understood.

AIM

To review the impact of preceptorship on NQNs and preceptors working in a critical care environment.

STUDY DESIGN

An integrative literature review of the literature. The review employed Whittemore and Knafl's (2005) five-stage integrative review approach.

METHODS

Three databases (MEDLINE, CINAHL and PsycINFO) were searched for papers published between January 2010 and May 2022. The PRISMA framework was used to guide the search and screening. Thematic analysis was used to extract, organize and analyse the data.

RESULTS

Nine studies were included in this review. Reflective thematic analysis revealed three themes, with four related subthemes. Preceptorship has an impact on the development of the NQNs and preceptors' 'nurturing' relationship. NQNs develop their knowledge, competence and confidence when experiencing supportive preceptorship. Meanwhile, preceptors experience a combination of increased workload and opportunities for learning and professional development as a result of preceptorship.

CONCLUSION

There is evidence of the impact of preceptorship on learning and professional development for both NQNs and preceptors, but this is a complex phenomenon and further research is required to understand this area more fully.

RELEVANCE TO CLINICAL PRACTICE

In nursing practice, it is well-established that Newly Qualified Nurses (NQNs) often face heightened levels of anxiety and a lack of confidence when embarking on their careers, particularly in the demanding and stressful environment of critical care units. This review holds particular significance in the realm of clinical practice as it delves into the pivotal role of preceptorship in nurturing the professional growth and development of NQNs within the challenging domain of critical care. Effective preceptorship, as an essential component of best practice, plays a pivotal role in aiding NQNs' transition into critical care settings.

Reducing Violence by Patients against Healthcare Workers at Inpatient Psychiatric Hospitals: An Integrative Review

Violence by patients against healthcare workers is of global concern among both producers and consumers of health care. The US is among the countries with the highest reports of workplace violence, and the majority of the violent incidents occur in healthcare settings. The purpose of this integrative review is to identify, analyze and appraise the best interventions for reducing violence by patients against healthcare workers in adult acute psychiatric hospitals. Additionally, findings from the review inform our recommendations designed to contribute to violence reduction in these settings. We explored the PsycINFO, PubMed, CINAHL and Cochrane Library databases and launched an integrative review using the Johns Hopkins Nursing Evidence-Based Practice Model as a framework and the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. Fifteen records were included in this review using specific inclusion and exclusion criteria. Four themes were identified from the review as providing evidence-based interventions to reduce and mitigate violence against healthcare providers in acute psychiatric hospitals. These were staff attributes, patient characteristics, environmental factors, and staff-patient relationships. These factors interact in a dynamic and complex manner in optimizing the nurse-patient relationship to decrease violence by patients against healthcare workers in inpatient psychiatric settings. The implications of this review are that a multifactorial approach is needed in devising effective strategies to reduce violence in psychiatric settings. The strategies should involve all stakeholders including providers, administrators, and patients.

Innovative Exercise for Nursing PhD Students: Addressing Biases During Integrative Literature Reviews

BACKGROUND

Nursing PhD students face the difficulty of conducting integrative literature reviews that may lead to bias and lack of rigor particularly in the literature search, data evaluation, and data analysis stages. This article describes the development and use of an arts-based learning exercise to identify potential biases and improve on the critical and writing skills of students during the integrative literature review process.

METHOD

The exercise consisted of visits to the university's museum, moderated discussions with nursing faculty and the museum educator, visual analyses of artwork, building art portfolios, and writing assignments. The exercise was modified over 3 years based on student feedback.

RESULTS

Students reported the exercise helped in critical and writing skills, in identifying areas of potential bias, and in enhancing the methodological rigor of the review process.

CONCLUSION

Conducting literature reviews is integral in doctoral nursing education and this innovative exercise can facilitate this process. [J Nurs Educ. 2024;63(X):XXX-XXX.].

An integrative literature review of factors contributing to hypothermia in adults during the emergent (ebb) phase of a severe burn injury

BACKGROUND

During the emergent (ebb) phase (first 72 h), the adult person with a severe burn experiences loss of body heat, decreased metabolism, and poor tissue perfusion putting them at risk of hypothermia, increased morbidity, and mortality. Therefore, timely and targeted care is imperative.

AIM

The aim of this integrative literature review was to develop a framework of the factors contributing to hypothermia in adults with a severe burn injury during the emergent (ebb) phase.

METHODS

An integrative review of research literature was undertaken as it provides an orderly process in the sourcing and evaluation of the literature. Only peer reviewed research articles, published in scholarly journals were selected for inclusion (n = 26). Research rigor and quality for each research article was determined using JBI Global appraisal tools relevant to the methodology of the selected study.

FINDINGS

Contributing factors were classified under three key themes: Individual, Pre-hospital, and In-hospital factors.

CONCLUSION

The structured approach enabled the development of an evidence-based framework identifying factors contributing to hypothermia in adults with a severe burn injury during the emergent (ebb) phase and adds knowledge to improve standardized care of the adult person with a severe burn injury.

The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review

BACKGROUND

Deaths in paediatric intensive care units (PICUs) are not uncommon. End-of-life care in PICUs is generally considered more challenging than other settings since it is framed within a context where care is focused on curative or life-sustaining treatments for children who are seriously ill. This review aimed to identify and synthesise literature related to the essential elements in the provision of end-of-life care in the PICU from the perspectives of both healthcare professionals (HCPs) and families.

METHODS

A systematic integrative review was conducted by searching EMBASE, CINAHL, MEDLINE, Nursing and Allied Health Database, PsycINFO, Scopus, Web of Science, and Google Scholar databases. Grey literature was searched via Electronic Theses Online Service (EthOS), OpenGrey, Grey literature report. Additionally, hand searches were performed by checking the reference lists of all included papers. Inclusion and exclusion criteria were used to screen retrieved papers by two reviewers independently. The findings were analysed using a constant comparative method.

RESULTS

Twenty-one studies met the inclusion criteria. Three elements in end-of-life care provision for children in the PICUs were identified: 1) Assessment of entering the end-of-life stage; 2) Discussion with parents and decision making; 3) End of life care processes, including care provided during the dying phase, care provided at the time of death, and care provided after death.

CONCLUSION

The focus of end-of-life care in PICUs varies depending on HCPs' and families' preferences, at different stages such as during the dying phase, at the time of death, and after the child died. Tailoring end-of-life care to families' beliefs and rituals was acknowledged as important by PICU HCPs. This review also emphasises the importance of HCPs collaborating to provide the optimum end-of-life care in the PICU and involving a palliative care team in end-of-life care.

Oral Health Care Among Women in Perimenopause or Menopause: An Integrative Review

INTRODUCTION

Women in menopause are at a higher risk of developing oral health problems, affecting their overall quality of life. Several studies have identified the role of health care providers in addressing women's oral health needs across various phases of their lives, yet a review in the area of perimenopause and menopause has not been undertaken. Therefore, the aim of this review was to explore current evidence regarding the oral health knowledge, attitudes, and practices of women in perimenopause or menopause and their health care providers. Additionally, guidelines and recommendations to inform strategies for oral health promotion are included.

METHODS

A systematic search was carried out across 5 databases. Inclusion criteria included articles published in English that examined at least one study outcome: oral health knowledge, attitudes, and practices of either women in perimenopause or menopause or of health care providers or guidelines around oral health care. Qualitative, quantitative, mixed-methods, and experimental studies with survey components were included with no restrictions on publication period, quality, or setting.

RESULTS

A total of 12 articles met the inclusion criteria, with a majority being of poor quality and mostly from low-income and middle-income countries. Overall findings indicated that there was a lack of knowledge and limited practices in maintaining oral hygiene and visiting the dentist among women in perimenopause or menopause. Health care providers exhibited poor attitudes in advising the importance of periodic dental check-ups and informing oral health changes during this period. There were also insufficient guidelines to adopt care for women and guide health care providers in their practice.

DISCUSSION

Women in perimenopause or menopause have limited oral health knowledge and unmet oral health needs. Appropriate guidelines and supportive strategies are required to assist health care providers in providing comprehensive care and encouragement to women in perimenopause or menopause to improve their oral health.

Risk Factors for Chronic Non-Communicable Diseases of Long-Haul Truck Drivers during the COVID-19 Pandemic: An Integrative Review

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy, and may have their health affected by living and working conditions. This study analyzed and synthesized scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7363 drivers. The biological risk factors identified were age, gender, race/ethnicity, genetics, and comorbidities, and were considered to be non-modifiable for chronic diseases. The behavioral risks considered to be modifiable were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, and unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the following: number of working hours per day, week, and month; time away from home; risk of musculoskeletal injury; and opportunities for rest, hours of sleep, and access to health services. The results were presented in two categories: (1) biological, behavioral, and environmental risks, and (2) general recommendations to promote physical, cognitive, and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control modifiable risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

Teaching Psychomotor Skills in Undergraduate Nursing Education: An Integrative Review

BACKGROUND

Psychomotor skills, a cognitive and fine motor process, are an essential component to undergraduate nursing education. Currently, no national guidelines exist to guide nursing programs on the best way to educate students to ensure competent and safe practice of psycho-motor skills in the clinical setting. This review sought to determine what methods of education, training, and practice of psychomotor skills enhanced psychomotor skill competency in undergraduate nursing students.

METHOD

An integrative review was conducted to determine teaching and practice strategies to support psychomotor skill competence.

RESULTS

Four significant categories were identified and included (1) simulation; (2) technology; (3) deliberate practice; and (4) theoretical and collaborative instruction. Overall, simulation and technology were found to be the most effective in psychomotor skill competence.

CONCLUSION

Additional research is needed to identify which teaching strategies best support nursing students' long-term knowledge acquisition and competency as they transition into professional practice. [J Nurs Educ. 2024;63(7):421-426.].

Motivational Interviewing as a Strategy to Improve Adherence in IBD Treatment: An Integrative Review Amidst COVID-19 Disruptions

Aims and Objectives: This review aims to analyze the effectiveness of motivational interviewing (MI) in enhancing therapeutic adherence and compliance in adult patients with inflammatory bowel disease (IBD), especially considering the disruptions caused by the COVID-19 pandemic. Background: IBD, which includes conditions such as ulcerative colitis and Crohn's disease, affects over 10 million people globally. It significantly impacts both physical and psychological well-being, leading to challenges in therapeutic adherence. Only 25-47% of patients with IBD adequately follow prescribed treatments. Design and Methods: An integrative methodology that combines qualitative and quantitative research was utilized, following a 7-step framework. This framework encompasses identifying the research question, devising a search strategy, performing a critical appraisal, summarizing findings, extracting data, conducting an analysis, and drawing conclusions. Results: Poor adherence to therapy among patients with IBD can exacerbate disease progression and result in complications. MI has been identified as a promising approach to improving both adherence and treatment outcomes. Studies, including those predating the COVID-19 pandemic, have demonstrated MI's effectiveness in enhancing adherence among patients with IBD. Conclusions: MI shows promise in enhancing adherence among adult patients with IBD. Although initial results are promising, additional research is needed to thoroughly understand its effectiveness across various clinical contexts. Relevance to Clinical Practice: The findings underscore the potential of MI as an integral component of IBD treatment strategies, suggesting that its implementation could enhance patient-provider interactions and lead to better overall health outcomes.

An integrative review of home care recommendations for women after caesarean section

AIM

To describe home-based care and practices recommended for mothers after caesarean section (CS), existing in the literature.

DESIGN

Systematic review.

METHODS

This integrative literature review was conducted by using Google Scholar, PubMed and Hinari databases from its inception to June 2021. The search included research articles, protocols and guidelines that describe home care practice after CS and assessed for their quality. Synthesis of recommendations from the included literature was classified based on the type of study design, and the review was guided by methodology registered in Prospero (ID CRD42021276905).

RESULTS

A total of 681 literatures were found, and 12 met the criteria. Recommended home care components were divided into four major categories; wound care practice (wound cleaning, drying and bandage change); nutrition (high-protein diet, vitamin C, fibre and balanced diet); exercise (pelvic floor muscle, walking and breathing exercise) and hygiene (bathing and wearing clean clothes). There was limited literature addressing the components of perineal care and home environment. Varying recommendations were found regarding wound cleaning and dressing in the studies done in low- and high-income countries.

Factors influencing communication partners of persons with severe/profound intellectual disability use of augmentative and alternative communication: an integrative review

PURPOSE

To present a synthesis of evidence related to the factors influencing communication partners' use of augmentative and alternative communication with persons with severe/profound intellectual disability.

MATERIALS AND METHODS

An integrative review guided by five steps; problem identification, literature search, data evaluation, data analysis and presentation was undertaken. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, nine databases were searched, 1,342 studies were screened against the eligibility criteria, and 15 studies underwent thematic analysis.

RESULTS

Two themes emerged; (1) Achieving Meaningful Communication and (2) Communication Partners' Preparedness to Use Augmentative and Alternative Communication. Achieving meaningful communication was central to communication partners' use of augmentative and alternative communication and was two-fold. It involved identifying the persons' communication methods and encouraging them to communicate. Communication partners' preparedness also influenced their use of augmentative and alternative communication. This preparedness was impacted by communication partners' preconceived thoughts about and knowledge of augmentative and alternative communication, nurturing their belief in augmentative and alternative communication, and the interpersonal dynamic between network members.

CONCLUSION

Communication partners' use of augmentative and alternative communication is influenced by multiple and complex factors. The findings contribute to the knowledge of the potential factors to be considered to prepare communication partners to use augmentative and alternative communication.

Violence against nurses by patients and visitors in the emergency department: An integrative review

AIM

This integrative review explored violence against emergency nurses by patients/visitors, examining its nature, contributing factors and consequences.

DESIGN

Integrative review.

DATA SOURCES

Articles were obtained from PubMed, CINAHL, EMBASE, Web of Science and PsycInfo databases, up until December 2021.

REVIEW METHODS

26 articles were reviewed, evaluating study quality with the Crowe Critical Appraisal Tool and synthesizing conclusions through theme development and coding.

RESULTS

This review delves into the issue of violence perpetrated against emergency nurses by patients and visitors. It elucidates three overarching themes: the nature of violence, the contributing factors and the consequences of such acts.

CONCLUSION

The findings inform healthcare policy for the development of prevention approaches while identifying research gaps and emphasizing the need for alternative study designs and methodologies.

IMPACT

This review has implications for nursing practice, policymaking and research, emphasizing the need for stakeholder engagement and tailored interventions for at-risk emergency nurses.

NO PATIENT OR PUBLIC CONTRIBUTION

This project was an integrative review of the literature therefore no patient or public contribution was necessary.

WHAT ALREADY IS KNOWN

Violence by patients and visitors in healthcare settings, especially in emergency departments, has garnered considerable attention.

WHAT THIS PAPER ADDS

This review specifically examines violence-targeting emergency department nurses from patients and visitors, assessing its characteristics, contributing factors and consequences.

IMPLICATIONS FOR PRACTICE/POLICY

The findings will guide stakeholder engagement in developing interventions to support vulnerable emergency nurses.

Exploring in-person self-led debriefings for groups of learners in simulation-based education: an integrative review

BACKGROUND

Facilitator-led debriefings are well-established for debriefing groups of learners in immersive simulation-based education. However, there has been emerging interest in self-led debriefings whereby individuals or groups of learners conduct a debriefing themselves, without the presence of a facilitator. How and why self-led debriefings influence debriefing outcomes remains undetermined.

RESEARCH AIM

The aim of this study was to explore how and why in-person self-led debriefings influence debriefing outcomes for groups of learners in immersive simulation-based education.

METHODS

An integrative review was conducted, searching seven electronic databases (PubMed, Cochrane, Embase, ERIC, SCOPUS, CINAHL Plus, PsychINFO) for peer-reviewed empirical studies investigating in-person self-led debriefings for groups of learners. Data were extracted, synthesised, and underwent reflexive thematic analysis.

RESULTS

Eighteen empirical studies identified through the search strategy were included in this review. There was significant heterogeneity in respect to study designs, aims, contexts, debriefing formats, learner characteristics, and data collection instruments. The synthesised findings of this review suggest that, across a range of debriefing outcome measures, in-person self-led debriefings for groups of learners following immersive simulation-based education are preferable to conducting no debriefing at all. In certain cultural and professional contexts, such as postgraduate learners and those with previous debriefing experience, self-led debriefings can support effective learning and may provide equivalent educational outcomes to facilitator-led debriefings or self-led and facilitator-led combination strategies. Furthermore, there is some evidence to suggest that self-led and facilitator-led combination approaches may optimise participant learning, with this approach warranting further research. Reflexive thematic analysis of the data revealed four themes, promoting self-reflective practice, experience and background of learners, challenges of conducting self-led debriefings and facilitation and leadership. Similar to facilitator-led debriefings, promoting self-reflective practice within groups of learners is fundamental to how and why self-led debriefings influence debriefing outcomes.

CONCLUSIONS

In circumstances where simulation resources for facilitator-led debriefings are limited, self-led debriefings can provide an alternative opportunity to safeguard effective learning. However, their true value within the scope of immersive simulation-based education may lie as an adjunctive method alongside facilitator-led debriefings. Further research is needed to explore how to best enable the process of reflective practice within self-led debriefings to understand how, and in which contexts, self-led debriefings are best employed and thus maximise their potential use.

Strategies employed by developed countries to facilitate the transition of internationally qualified nurses specialty skills into clinical practice: An integrative review

BACKGROUND

Recruitment of internationally qualified nurses as a labour source is a long-standing human resource strategy being implemented to address the current and increasing global nursing shortage. Internationally qualified nurses transitioning into the health workforce of developed countries following immigration often possess specialty skills. A lack of a clear pathway of specialty skill utilisation makes recognising and using these specialty skills complex for many nurses. The ability for nurses to transition between countries and maintain specialty practice demands immediate attention in the current atmosphere of the global pandemic and the predictions to recruit more specialist nurses from overseas.

AIM

To identify and synthesise strategies taken by various developed countries in transitioning specialist internationally qualified nurses into practice.

METHODS

An integrative review was conducted to identify common themes, patterns, and best practices in order to inform policy development and improve the successful integration of internationally qualified nurses into the healthcare systems of developed countries. The study employed the Whittemore and Knafl five-stage integrative review approach. To conduct a comprehensive search, four electronic databases, namely Medline, CINAHL Complete, ProQuest Health, and EMBASE, were systematically searched in October 2021. The search was updated in March 2022 to ensure the inclusion of the most recent literature. Additionally, Google Scholar was utilised to avoid overlooking any important articles. Prior to the full-text review, three reviewers independently evaluated titles and abstracts. The included papers' quality was determined using the JBI critical appraisal tools.

RESULTS

This study included 10 papers, comprising three studies and seven reports. However, none of these documents provided information on how internationally qualified nurses could transfer their specialty skills acquired overseas to developed countries after immigrating. The guidelines and policies reviewed only offered generic advice on becoming a specialist nurse. Although some countries mentioned that post-graduate qualifications were not mandatory for nurse specialists, the majority of documents in this review emphasised the need for a national framework of education at level eight or higher (equivalent to a post-graduate level) to attain the status of a nurse specialist. Moreover, the included documents did not provide clear information on whether an international specialisation degree would be recognised during the registration process. As a result, confusion persists regarding the requirement of post-graduate qualifications for nurses aiming to specialise and the recognition of international specialisation degrees during the registration process.

DISCUSSION

The lack of consistency in defining nurse specialty and the skill transferability among institutions and state borders were evident in this review. According to all the 10 documents analysed, developed countries appear to have minimum policies on the transfer of internationally qualified nurse's specialty skills. Recommendations for policymakers, employers, and aspirant migrants have been proposed. Limited research has been done on how developed countries used their internationally qualified nurses' overseas-acquired specialist skills after immigration, indicating a lack of a distinct specialist skill transition pathway.

CONCLUSIONS

This review presents data to support the need for greater research in this area to better utilise the abilities that internationally qualified nurses bring from their home country and put them to constructive use in the host country, especially in the context of a global pandemic.

The learning experiences of student nurses in the perioperative environment: An integrative literature review

OBJECTIVES

For the Student Nurse placement in the perioperative environment provides an opportunity to observe and engage in preoperative, intraoperative, and immediate postoperative care of the surgical patient. To date no synthesis of empirical studies has been undertaken to ascertain the learning impact of the perioperative experience. The objectives of this review were to identify and synthesise the literature on the learning experiences of student nurses within the perioperative environment.

DESIGN

An integrative review that followed Whittemore and Knafl's (2005) framework.

DATA SOURCES

Studies published between 2012 and 2022 were identified via a comprehensive search of the following databases: CINAHL, Medline (OVID), Medline (Pubmed), Medline (EBSCO), EMBASE, PsychINFO, ISI Web of Science and SCOPUS.

REVIEW METHODS

The review was reported in line with the Preferred Reporting for Systematic Reviews and Meta-Analysis (PRISMA). The initial search located 1475 Articles. After screening and checking for eligibility 17 articles were selected. These were critically appraised using the Critical Appraisal Skills Programme (CASP). The papers were analysed and reported in a narrative synthesis.

RESULTS

Seventeen studies met the inclusion criteria for the review. Three categories with five sub categories were identified including: Learning opportunities, Appreciation for perioperative role and intent to return and Factors influencing student learning.

CONCLUSIONS

A large variety of student learning occurs within the perioperative clinical environment. Students viewed staff nurses as positive role models in an environment that posed opportunities and challenges for student learning. Anxiety and stress in an unfamiliar environment were commonly mentioned with students offering recommendations to improve their experience.

Interventions to reduce interpersonal stigma towards patients with a mental dysregulation for ambulance and emergency department healthcare professionals: review protocol for an integrative review

INTRODUCTION

Worldwide, there is an increase in the extent and severity of mental illness. Exacerbation of somatic complaints in this group of people can result in recurring ambulance and emergency department care. The care of patients with a mental dysregulation (ie, experiencing a mental health problem and disproportionate feelings like fear, anger, sadness or confusion, possibly with associated behaviours) can be complex and challenging in the emergency care context, possibly evoking a wide variety of feelings, ranging from worry or pity to annoyance and frustration in emergency care staff members. This in return may lead to stigma towards patients with a mental dysregulation seeking emergency care. Interventions have been developed impacting attitude and behaviour and minimising stigma held by healthcare professionals. However, these interventions are not explicitly aimed at the emergency care context nor do these represent perspectives of healthcare professionals working within this context. Therefore, the aim of the proposed review is to gain insight into interventions targeting healthcare professionals, which minimise stigma including beliefs, attitudes and behaviour towards patients with a mental dysregulation within the emergency care context.

METHODS AND ANALYSIS

The protocol for a systematic integrative review is presented, using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A systematic search was performed on 13 July 2023. Study selection and data extraction will be performed by two independent reviewers. In each step, an expert with lived experience will comment on process and results. Software applications RefWorks-ProQuest, Rayyan and ATLAS.ti will be used to enhance the quality of the review and transparency of process and results.

ETHICS AND DISSEMINATION

No ethical approval or safety considerations are required for this review. The proposed review will be submitted to a relevant international journal. Results will be presented at relevant medical scientific conferences.

PROSPERO REGISTRATION NUMBER

CRD42023390664 (https://www.crd.york.ac.uk/prospero/).

Facilitating intergenerational learning between older people and student nurses: An integrative review

AIM

To examine the literature on intergenerational learning between older people and student nurses.

BACKGROUND

Intergenerational activities offer opportunities for intergenerational learning and help reduce ageism. There are several older person/school children intergenerational learning initiatives. However, there is less known about how intergenerational learning occurs in nurse education programmes outside of service provision.

METHODS

Whittemore and Knafl's (2005) integrative review framework was used to guide the review process. Population, intervention, context and outcome (PICO) was used to develop the review question, search strategy and inclusion/exclusion criteria. Database (CINAHL, Cochrane library, Medline, PubMed, Scopus and PsychInfo) searches and hand searching occurred from 2012 to 2023. Screening, appraisal and data extraction was undertaken according to Prisma guidelines.

RESULTS

Nine papers were included (North American (n = 5), Canadian (n = 1) Chinese (n = 2), Taiwanese (n = 1)). Mixed methods designs were included. Four themes were identified: 1) Seeing beyond first glance; 2) Connecting and getting to know each other; 3) Learning together; and 4) Challenges for intergenerational learning.

CONCLUSION

This review demonstrates the relevance of intergenerational learning in nurse education and highlights the importance of embedding initiatives which will promote and support mutual learning. Innovative intergenerational initiatives enable students to explore their underlying attitudes and views in a way that they may not be able to in the more traditional service and care giving learning situations.

Nurses' perceptions and experiences of robotic assisted surgery (RAS): An integrative review

AIM

To identify and review published literature on the perceptions and experience of nurses working with RAS.

BACKGROUND

Robotic assisted surgery (RAS) is rapidly becoming accepted as the elite modality for surgery since its introduction in the 1980 s, more recently there has been a rising trend of use with several specialities operating using this technology. The role of nurses in perioperative care has been described as maintaining the momentum of the patient's journey. Patients undergoing RAS require nursing care throughout their journey, therefore knowledge of nurses' experiences and perceptions of RAS is important to identifying nurse education and development needs.

DESIGN

Integrative literature review DATABASE SOURCES: Databases searched for peer reviewed studies included CINAHL, Academic Search Complete, EMBASE, Scopus, ADA Psycinfo, Medline.

REVIEW METHODS

A comprehensive database search was conducted following PRISMA guidelines. Six databases were searched with 523 screened for eligibility. Ten studies were included in the review seven qualitative and three quantitative.

RESULTS

Ten studies were identified, critically appraised and synthesised using thematic analysis. All studies were conducted with nurses in the perioperative environment. Key findings were that nurses education regarding RAS is limited with more emphasis placed on surgeon education and training. There was evidence that nurses experienced a lack of education, training and information as barriers to their role which subsequently raised their stress levels.

CONCLUSION

Evidence suggests a clear need for education and training for nurses working with RAS. In addition, nurses working with RAS provide care preoperatively, intraoperatively, postoperatively and post discharge in the community. However, no research has been conducted with nurses outside of the perioperative environment. Further research is required to understand the experiences and perceptions of nurses working with RAS patients in all care settings to identify their education and development needs.

Requirements for implementing a 'just culture' within healthcare organisations: an integrative review

PURPOSE

To identify requirements for implementing a 'just culture' within healthcare organisations.

METHODS

Using Whittemore and Knafl's methodology for integrative reviews, we searched PubMed, PsychInfo, Cumulative Index of Nursing and Allied Health Literature, ScienceDirect, Cochrane Library and ProQuest Dissertations and Theses. Publications were considered eligible when reporting requirements for implementing a 'just culture' within healthcare organisations.

RESULTS

After screening for inclusion and exclusion criteria, 16 publications were included in the final review. Four main themes were identified: leadership commitment, education and training, accountability and open communication.

CONCLUSION

The themes identified in this integrative review provide some insight into the requirements for implementing a 'just culture' within healthcare organisations. To date, most of the published literature on 'just culture' is theoretical in nature. Additional efforts are needed to conduct research to explore further what requirements must be addressed in order to successfully implement a 'just culture' which is needed to promote and sustain a culture of safety.

Vulnerabilidade programática

Objetivo: analisar, conceitualmente, a vulnerabilidade programática com identificação de seus antecedentes, atributos e consequentes. Método: modelo de análise conceitual segundo metodologia de Walker e Avant. Foram etapas, I. seleção do conceito: vulnerabilidade programática; II. determinação dos objetivos: análise do uso do conceito; III. identificação de usos do conceito: estudo de revisão integrativa (buscou-se a expressão não controlada “programmatic vulnerabilty” nas bases de dados embase, web of science e Medline via pubmed e nos repositórios de artigos Biblioteca Virtual em Saúde e Scielo); IV. determinação dos atributos: análise dos registros da etapa III; V. identificação do caso modelo e casos adicionais: construção com base nos atributos e um caso contrário; VI. identificação de antecedentes e consequentes: painel de dados para elaboração de fenômenos antes e depois da vulnerabilidade programática; VII. referência empíricas: definições operacionais extraídas dos registros. Resultados: 20 registros foram incluídos na análise do conceito. Identificaram-se as variações do termo e os significados mais presentes e caracterizadores da vulnerabilidade programática, sendo a dimensão programática e acesso à saúde as mais frequentes. Foi construído o caso modelo. Os antecedentes, atributos e consequentes foram agrupados em quadro por similitude, no qual referências empíricas do conceito foram indicadas. Conclusão: a vulnerabilidade programática tem elementos discursivos importantes, sendo sua principal característica a falta de consultas disponibilizadas (antecedente), insuficiência/dificuldade no acesso à saúde (atributo) e evolução da doença (consequente).

The Impact of Colleague Suicide and the Current State of Postvention Guidance for Affected Co-Workers: A Critical Integrative Review

People bereaved by suicide are affected psychologically and physically and may be at greater risk of taking their own lives. Whilst researchers have explored the impact of suicide on family members and friends, the area of colleague suicide has been neglected and postvention guidance for supporting surviving colleagues is often poorly developed. This critical integrative review explored the impact of colleague suicide on surviving co-workers and reviewed postvention guidance for workplaces. Systematic searches found 17 articles that met the inclusion criteria. Articles were appraised for quality and extracted data were analysed using a thematic network method. Article quality was moderate. Two global themes were developed: impact of a colleague suicide comprised themes of 'suicide loss in the workplace'; 'professional identities and workplace roles'; 'perceptions of professional uniqueness'; and 'professional abandonment and silencing'. Postvention following a colleague suicide comprised 'individualised responses'; 'the dual function of stigma'; and 'complex pressure on managers'. A unifying global network 'after a colleague suicide' describes the relationships between all themes. A series of disconnects between existing postvention guidance and the needs of impacted workers are discussed. This review demonstrates the need for robust, systemic postvention for colleagues impacted by the complex issue of colleague suicide.

Exploring the role of the second-level regulated nurse in the Australian nursing workforce: An integrative review

BACKGROUND

The enrolled nurse is the second-level regulated nursing role in Australia, with similar roles in other Organisation for Economic Co-operation and Development countries. A plethora of reports and research papers indicate that this role is seen as integral but under scrutiny by the nursing profession and government bodies. Despite changes such as national accreditation and registration requirements there is a lack of role clarity and delineation, especially between the registered nurse and enrolled nurse roles. As a key nursing role there is the need to ensure it is understood and used to its potential in the nursing workforce.

AIM

To explore key issues that may impact the role of the EN in the Australian nursing workforce.

DESIGN

An integrative review.

METHODS

A seven-step framework was used to review peer-reviewed research papers, scholarly and published government documents, grey literature and government data.

RESULTS

The review identified three themes from 24 documents: understanding the enrolled nurses' scope of practice, standardised practice, and career development.

DISCUSSION

It is posited that a lack of understanding of the enrolled nurses' scope of practice creates confusion between the nursing roles and a lack of standardised practice. There is also an expectation that the enrolled nurses' career progression is to become a registered nurse, which is supported by the high dual registrations. Collectively these factors contribute to the enrolled nurse not feeling valued. Similar challenges to the equivalent role are found internationally.

CONCLUSION

The literature demonstrates a lack of understanding of the enrolled nurse role by the nursing profession. Further work is required to better understand the role and its place in the Australian nursing workforce.

IMPACT STATEMENT

Better understanding of the enrolled nurses' role and its place in the nursing workforce is needed to progress this role.