'This Adds Another Perspective': Qualitative Descriptive Study Evaluating Simulation-Based Training for Health Care Assistants, to Enhance the Quality of Care in Nursing Homes

Implementation and Impact of a Lifting Cushion for Care Home Residents Who Have Fallen

INTRODUCTION

Falls are a global public health problem and the second leading cause of death from unintentional injury. Globally, approximately 30%-50% of people living in nursing or residential care homes fall each year. Falls have an impact on quality of life and morbidity. Prevention of falls is gold standard care. When falls do occur, implementation of safe strategies to help the person rise is required. Structured risk assessment and the use of a 'lifting' cushion are one such strategy.

AIMS

To evaluate the impact of the lifting cushion on management of falls and assess barriers and facilitators to staff use of the lifting cushion in 18 care homes.

METHODS

Two-phase study involving (i) capturing quantitative pre- and post-cushion implementation data along with comparison of means testing and (ii) theoretically underpinned qualitative semi-structured interviews to explore barriers and facilitators to cushion implementation with inductive and deductive data analysis.

RESULTS

The cushion was used a total of 32 times out of 567 post-implementation recorded falls (6% of all falls). Barriers and facilitators to cushion use aligned to the Theoretical Domains Framework include knowledge, skills and confidence, emotion, beliefs about safety and decision processes, environmental context and resources and social influences.

CONCLUSION

The lifting cushion was poorly adopted. Identified barriers to adoption would not be addressed using routine train and cascade processes. We identified facilitators that could be enhanced to promote uptake. Theoretically underpinned implementation strategies, tailored to assess determinants, are known to be more effective; however, this approach has rarely been used in care homes. We have demonstrated a structured approach to implementation of cushion use; this may be transferable to other care home practices.

IMPLICATIONS FOR PRACTICE

Cae home leaders should be aware that giving information alone will not change practice. Implementation or improvement strategies will be more effective.

Virtual reality-based dementia educational programmes for formal and informal caregivers of people with dementia: A scoping review

AIM

To map evidence of the existing virtual reality-based dementia educational programmes and the effects of these educational programmes on dementia formal and informal caregivers.

DESIGN

A scoping review.

METHODS

A comprehensive search of nine databases was conducted to find studies from the inception of the databases to October 2023. Two authors independently screened the titles and abstracts related to the eligibility criteria. Full texts of potentially relevant studies were read by one author and checked by a second. Data extraction and synthesis using NVivo 12 were undertaken by one author and checked by two other authors.

RESULTS

Nineteen studies published between 2002 and 2022. The four randomised controlled studies and five qualitative studies were of moderate to good methodological quality. The 10 quasi-experimental studies were of weak to moderate quality. Fifteen virtual reality-based educational programmes had a positive influence on formal and informal caregivers, including improving caregivers' perceptions changing attitudes towards people with dementia, while the nursing competence of formal caregivers did not improve in short term. Educational programmes that covered dementia-related information and care strategies better improved the knowledge level of dementia formal and informal caregivers.

CONCLUSIONS

The qualitative and quantitative studies of moderate to good quality included in this study support the idea that virtual reality-based dementia educational programmes may be a safe and effective way and have potential benefits for improving knowledge, perceptions, attitudes and nursing competence.

IMPACT

This scoping review will provide an emerging teaching model for formal and informal caregivers of people with dementia and help them better understand the types and the influence of virtual reality-based dementia educational programmes.

REPORTING METHOD

PRISMA-ScR.

NO PATIENT OR PUBLIC CONTRIBUTION

Not required as this review in accordance with the aim to map existing literature from the dementia formal and informal caregivers' perspective.

Translation, validation and psychometric properties of the Albanian version of the Nurses Professional Competence Scale Short form

BACKGROUND AND AIM

The primary aim of this study was the translation and psychometric validation of the Albanian Nurse Professional Competence Scale Short Form (A-NPCS-SF) for further application in Albanian healthcare settings.

METHODS

The multiphase design used to develop the A-NPCS-SF comprised (1) cultural and linguistic validation, (2) content and face validity, and (3) construct validity.

RESULTS

The A-NPCS-SF showed adequate content validity. Confirmatory factor analysis supported the six-factor structure of the A-NPCS-SF to explain the data obtained from the nurses.

CONCLUSIONS

The A-NPCS-SF showed evidence of validity and reliability in measuring four professional competencies. Having an appropriate scale in Albanian for professional competence self-assessment by nurses constitutes an essential step in measuring these competencies.  (www.actabiomedica.it).

Clinical simulation in health education: a systematic review

Objective

To summarize the most recent scientific evidence on the usefulness and implementation of simulation training programs for health science students.

Methods

A search and systematic review were conducted of the literature through the use of the PRISMA guidelines using the terms MESH Simulation AND healthcare AND Professional Training, including 42 articles.

Results

The bibliometric analysis revealed that most of the studies were local in nature, that is, conducted in a single center, or in a few centers in the same region, from the English-speaking world, and using a mixed methodology with pre/post-test measurements. As for the educational aspects, most of the studies were conducted at universities or in the area of continuous education, used multidisciplinary teams as the student target, and used role-playing games as the simulation method. Also, these programs were especially successful in the acquisition of competencies, such as teamwork, communication, and trust.

Conclusion

Clinical simulation is a teaching methodology implemented in the last twenty years, mainly in English-speaking countries; it utilizes techniques for its execution and assessment that have been validated in contrasted in many scientific studies, and lastly, it was also observed that it is useful for providing training on general competencies for multidisciplinary groups.

Simulation-based training for continuing professional development within a primary care context: a systematic review

BACKGROUND

Given the increasing complexity of tasks transferred to primary care, discipline-specific educational opportunities are required for those working within this context. Simulation-based training (SBT) is widely applied within a hospital setting, underpinned by extensive research. However, little is known about the transfer of simulations' utility to primary care. This systematic review sought to determine which SBT approaches are adopted for continuing professional development within primary care and appraise their impact.

METHODS

Medline, Embase, CINAHL and Web of Science databases were searched, with additional articles obtained through secondary searching. Eligible studies employed and evaluated a simulation-based educational intervention for fully qualified healthcare professionals, working within primary care. Included studies were quality assessed using the Mixed Methods Appraisal Tool (v18) and their findings narratively synthesised.

RESULTS

Forty-nine studies were included, sampling 4,601 primary care health professionals. Studies primarily adopted a quantitative design and demonstrated variable quality. Simulation approaches comprised standardised patients (n = 21), role-play (n = 14), virtual (n = 6), manikin (n = 5) and mixed manikin/standardised patients (n = 3). Efficacy was evaluated across Kirkpatrick levels and demonstrated a positive impact for knowledge-, skills- and attitude-based outcomes, though this was limited in select studies.

DISCUSSION

SBT has been adopted in the education of the spectrum of health professionals working within primary care, with the most common approach being standardised patients. Simulation delivers an acceptable and effective educational method, demonstrating a positive impact across various learning objectives. Further research assessing the impact at an organisational- and patient-level is required.

Effects of a Brief E-Learning Resource on Sexual Attitudes and Beliefs of Healthcare Professionals Working in Prostate Cancer Care: A Pilot Study

Sexual issues and treatment side effects are not routinely discussed with men receiving treatment for prostate cancer, and support to address these concerns is not consistent across settings. This study evaluates a brief e-learning resource designed to improve sexual wellbeing support and examine its effects on healthcare professionals' sexual attitudes and beliefs. Healthcare professionals (n = 44) completed an online questionnaire at baseline which included a modified 12-item sexual attitudes and beliefs survey (SABS). Follow-up questionnaires were completed immediately after the e-learning and at 4 weeks. Data were analysed using one-way, repeat measures ANOVAs to assess change in attitudes and beliefs over time. Significant improvements were observed at follow-up for a number of survey statements including 'knowledge and understanding', 'confidence in discussing sexual wellbeing' and the extent to which participants felt 'equipped with the language to initiate conversations'. The resource was seen as concise, relevant to practice and as providing useful information on potential side effects of treatment. In brief, e-learning has potential to address barriers to sexual wellbeing communication and promote delivery of support for prostate cancer survivors. Practical methods and resources should be included with these interventions to support implementation of learning and long-term changes in clinical behaviour.