Nurse independent prescribing: exploring the opportunities and challenges

The Nursing and Midwifery Council states that nurses should be able to demonstrate competence in prescribing practice at the point of registration to be 'prescribing ready'. The aim is to increase the number of nurse independent prescribers and improve access to pharmacological treatments for patients. However, while this policy presents opportunities for nurses to develop their prescribing knowledge and skills, there are also challenges involved in integrating prescribing theory into nurse education and ensuring there are enough suitable mentors available in practice. This article details how the policy of prescribing readiness is being addressed in preregistration nurse education and explores the supervision of nurse prescribing in clinical practice. The author also discusses how best to support the professional development of nurse independent prescribers beyond their initial training.

A novel research competency framework for clinical research nurses and midwives

BACKGROUND

Clinical research nurses and midwives (CRN/Ms) are highly specialised registered nurses. They combine their clinical nursing expertise with research knowledge and skills to aid in the delivery of rigorous, high-quality clinical research to improve health outcomes, the research participant's experience and treatment pathways ( Beer et al 2022 ). However, there is evidence that the transition into a CRN/M role is challenging for registered nurses.

AIM

To discuss the development of a competency framework for CRN/Ms.

DISCUSSION

The authors identified a gap in their organisation for standards that would support the development of CRN/Ms new to the role. The standards needed to be clear and accessible to use while encompassing the breadth of scope of CRN/Ms' practice. The authors used a systematic and inclusive process drawing on Benner's ( 1984 ) theory of competence development to develop a suitable framework. Stakeholders engaged in its development included research participants, inclusion agents and CRN/Ms.

CONCLUSION

The project identified 15 elements that are core to the CRN/M role and the knowledge, skills and behaviours associated with it.

IMPLICATIONS FOR PRACTICE

A large NHS trust has implemented the framework. It is also being shown to national and regional networks. Evaluation is under way.

Evaluation of service user-led workshops in children's palliative care education

Children's nurses report feeling unprepared when caring for children with life-limiting conditions and their families, while the value of including service users in the provision of nursing education is increasingly recognised. This small-scale service evaluation examined the effect on learning of service user-led workshops as part of a module for final-year children's nursing students and post-registration children's nurses. The workshops focused on the experience of children's palliative care and child bereavement from the parents' perspective. Findings from evaluation data indicated high levels of satisfaction with the workshops and identified three themes: safe space, shift in perspective and enhancing practice. A model of service user facilitated learning describes how these themes can enable learning about children's palliative care. This evaluation suggests that the involvement of service users as partners in healthcare education can be transformative, enabling children's nursing students to examine their own perspectives and consider ways to enhance their future practice.

Virtual and online learning during COVID-19: the experience of community children's nursing students

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic resulted in significant changes to education delivery. For many university programmes this has included a move from face-to-face to virtual and online learning and teaching.

AIM

To gain insight into the experiences of students undertaking the community children's nursing specialist practitioner programme during the academic year 2020-21, when most learning and teaching was delivered using virtual and online methods as a consequence of the COVID-19 pandemic.

METHOD

A survey questionnaire containing qualitative and quantitative questions was distributed to 28 students by programme leaders at three universities in England. Seven questionnaires were returned, yielding a 25% response rate.

FINDINGS

Respondents' experience of online and virtual learning was generally positive, with benefits for work-life balance and the opportunity to revisit recorded lectures being particularly well regarded. Loss of opportunity for face-to-face engagement with fellow students and the teaching team were identified as disadvantages.

CONCLUSION

There was strong student support for the provision of more flexible approaches to learning and teaching. Universities should recognise that failure to offer such flexibility could potentially affect recruitment and the viability of courses in the future.

Community children's nursing: developing a bespoke model of post-registration education

Community children's nurses provide a vital service between the hospital and home environment, supporting children, young people and families with their health needs. In the UK, the number of educational pathways providing a specialist practitioner qualification in community children's nursing has declined significantly in recent years. This has left many community children's nursing services with little or no access to educational programmes, despite the rising demand. The four UK governments, together with regulatory bodies such as the Nursing and Midwifery Council, have embarked on ambitious transformation of post-registration career frameworks and standards, the long-term impact of which is uncertain. This article discusses an approach that one community children's nursing service in Scotland took to address these challenges by liaising with a local university and accessing a bespoke advanced practice programme.

Experiences of a community of research practice: a service evaluation

BACKGROUND

A community of research practice (CRP) was established to increase research capacity and provide learning opportunities and networking for healthcare practitioners, working within a Children's Care Group. The CRP aimed to engage research-interested practitioners in research to develop their skills and confidence, encourage networking, and build research capacity.

AIM

To report the results of a service evaluation that was undertaken to review the CRP's value in practice.

DISCUSSION

Thematic analysis revealed four themes - 'positive environment', 'confidence', 'professional development' and 'networking' - highlighting benefits from the CRP, alongside the challenges encountered.

CONCLUSION

This article highlights the significant contribution of CRP for practitioners in the context of an innovative organisation with a supportive culture.

IMPLICATIONS FOR PRACTICE

A CRP empowers healthcare practitioners to engage with research while in clinical practice, enabling increased research confidence, and the development of research skill and knowledge and enhanced networking. CRP can potentially influence recruitment and retention.

Providing interprofessional education for pre and post-registration nurses

During an episode of care, a patient may be attended by a variety of healthcare professionals. In addition, healthcare service provision can be complex, and patients may feel that elements of their care have been missed or delayed due to inadequate collaboration and communication between the staff involved. Interprofessional education (IPE) involves students from two or more professions learning about each other's roles and skills. Increasing calls for integrated and joined-up healthcare services mean that staff will be increasingly required to collaborate with colleagues, with the aim of providing joined-up care. This article explains the background to IPE, how it can be implemented in practice and the barriers that nurses should consider to ensure effective implementation.

Staff education by the critical care outreach team: evaluating the effect of a study day on nurses' knowledge levels

Critical care outreach teams were developed in the UK from the early 2000s onwards in response to evidence that the management of severely ill patients on hospital wards before admission to the intensive care unit was frequently suboptimal. Most hospitals in the UK have some form of CCOT, which is usually composed of senior nurses with extensive critical care experience. One of the goals of CCOTs is to provide educational support to staff to enhance their skills at recognising and managing deteriorating patients. However, the evidence regarding the effects of CCOTs is conflicting. This article describes a service evaluation conducted at an acute NHS trust in England to assess the effects of educational sessions designed and delivered by the local CCOT. The CCOT offered a study day on non-invasive ventilation for patients with type 2 respiratory failure to a group of ten nurses from different clinical areas. A pre-and post-study day questionnaire showed that all participants had increased knowledge levels at the end of the study day. If positive effects of CCOT-led study days on nurses' knowledge were consistently demonstrated, these study days could be considered as a practical and effective method of meeting the learning needs of nurses.

Evaluating a new trauma and critical care management course for nurses

A new practical-based course for nurses on the management of major trauma has been developed using high-level simulation and moulage to deliver education based on established trauma competencies. The Nurse Trauma and Critical Care course was developed by nurses with input from the Anaesthesia Trauma and Critical Care group and has been accredited by the Royal College of Surgeons. This article describes the development of the course and discusses the findings of a course evaluation that aimed to measure candidates' confidence and knowledge after completion.

Learning and leadership in advanced dementia care

This article, part of a series in Nursing Older People exploring the nursing care of people living with advanced dementia, considers learning and leadership. It outlines learning opportunities about advanced dementia and what developments are needed. The need for strong leadership at all levels and settings is explored along with the challenges of educating those who care for the person with advanced dementia. It also outlines educational opportunities and programmes before illustrating how one nurse leads advanced dementia care in practice.

Clinical academic research internships for nurses, midwives and allied health professionals: a qualitative evaluation

BACKGROUND

Nurses, midwives and allied health professionals are integral to research, yet rarely engage simultaneously in research and clinical practice. Clinical academic internships offer a route for accessing academic research training.

AIM

To determine facilitators and barriers to nurses' participation and engagement in research internships, and to suggest improvements for future programmes.

DISCUSSION

The experiences of ten health professional research interns were explored, using a method based on a synthesis between grounded theory and content analysis. Four categories emerged: integrating clinical and research aspirations; support - or lack of it; the hidden curriculum; and the legacy effect. Respondents identified facilitators and barriers to engagement in these categories, including unforeseen challenges.

CONCLUSION

Formal support is necessary but is insufficient for fostering engagement and maximising benefits. Participation must be supported by colleagues and enabled by institutional structures. The potential effects of internships on engagement with research is considerable but requires collaboration between all stakeholders.

IMPLICATIONS FOR PRACTICE

Deeper institutional engagement is needed so that internship opportunities are fully supported by all colleagues and practically enabled by institutional structures. Future schemes should attempt to promote opportunities to collaborate through group projects to reduce researchers' isolation.

Why undertake a clinical academic internship? A novice researcher's reflection

BACKGROUND

This article offers a reflection by a novice researcher undertaking an integrated clinical academic internship with the National Institute for Health Research and Health Education England.

AIM

To offer insight into research internships, and demonstrate the benefits and challenges encountered.

DISCUSSION

Exposure to research while remaining in clinical practice gives nurses the opportunity to increase their knowledge, develop research skills and network. Associated challenges include feeling like a novice, balancing the demands of clinical practice and research, and the development of new skills.

CONCLUSION

Internship programmes can create health systems in which practitioners also undertake research but there are associated challenges.

IMPLICATIONS FOR PRACTICE

Research internships offer nurses insight and exposure to a world of research that may previously have been invisible to them; they can act as a platform for nurses to develop clinical academic careers.

Transcription, analysis, interpretation and translation in cross-cultural research

BACKGROUND

A study was conducted with Malaysian nurses who had studied on an Australian or UK transnational higher education post-registration top-up nursing degree programmes taught by 'flying faculty'.

AIM

To reflect on the transcription, analysis, interpretation and translation of data in this cross-cultural study.

DISCUSSION

The findings of this study show how these nurses developed personally and professionally despite challenges, which enabled them to attain a western degree.

CONCLUSION

Some important aspects of cross-cultural research need to be considered when conducting studies and presenting their findings, as cultural values continue to affect society.

IMPLICATIONS FOR PRACTICE

The discussion provided will assist novice researchers, nurse research and clinical practice and reviewers of scientific articles when conducting cross-cultural research.

Exploring the characteristics of effective communicators in healthcare

Nurses require effective communication and interpersonal skills to provide optimal care, and to ensure that patients and their families and carers have a positive experience of receiving care. The new Nursing and Midwifery Council standards of proficiency for registered nurses, and for nurse education and training, published in May 2018, recognise that future nurses will be practising in increasingly complex roles and environments. This article identifies the essential communication skills that will be required by nurses in the future, summarising the characteristics of a modern nurse communicator. It also suggests various approaches that nurses can use to develop their communication skills.

Safeguarding of vulnerable adults training: assessing the effect of continuing professional development

AIM

This article provides an insight into the effect of safeguarding of vulnerable adults continuing professional development (SOVA-CPD) training for nurses.

METHOD

51 participants were recruited from three different cohorts of SOVA-CPD training that had been delivered in east England. A 50-item questionnaire was designed to gather participants' views on their acquisition of knowledge and skills, and perceived changes in practice, and to allow them to describe how they have changed how they work due to the training.

RESULTS

Participants agreed overwhelmingly that the SOVA-CPD had enhanced their competency and skills so that their patients' care could improve. However, despite the benefits that some participants described, the potential positive effects of SOVA-CPD were curtailed by the challenges participants experienced in making changes in their practice settings.

CONCLUSION

The study highlights several benefits of SOVA-CPD for nurses, including the benefits to patient care of a CPD learning environment for practitioners. It suggests that employers should provide environments in which staff who have undertaken SOVA-CPD can trigger and sustain changes to improve patient care.

Non-technical skills required to recognise and escalate patient deterioration in acute hospital settings

Recognising patient deterioration is a vital nursing role. Observation based on vital signs and early warning scores are mandatory for all adult patients in acute hospital care and are the first steps in identifying deterioration. However, they rely on users' understanding of the significance of the results they find and their ability to escalate to senior colleagues if necessary. This article examines the non-technical skills nurses require to recognise and escalate patient deterioration. Itexplores and analyses the literature on this topic and suggests there is a need for greater focus on situational awareness in nurse training and in healthcare in general, as this is linked to improved patient safety.