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AnteayerEvidence-Based Nursing

We need more evidence to inform community-based health services for women, and transgender and nonbinary people who experience incarceration

Por: McLeod · K. · Kouyoumdjian · F. G.

Commentary on: Paynter M, Heggie C, Low C, McKibbon S, Martin-Misener R. Community-based models of health care for women, trans and nonbinary people released from prisons: An international scoping review with implications for Canada. J Clin Nurs. 2023 Jul;32(13-14):3277-3294. doi: 10.1111/jocn.16464. Epub 2022 Aug 8.

Implications for practice and research

  • Women, transgender and non-binary people who experience incarceration often have complex healthcare needs and require dynamic, trauma-informed care in the community.

  • Research is needed to understand how to address the diverse health needs of women, transgender and non-binary people leaving prison.

  • Context

    On any given day, approximately 740 000 women and girls1 and an unknown number of transgender, non-binary and gender diverse people are incarcerated globally. Intersecting social and structural factors impact incarceration and healthcare experiences, requiring community-based interventions that address the specific needs of women, transgender and non-binary people leaving prison.

    ...

    It is time for healthcare professionals to engage with social media

    Por: Hundley · V. · Marsh · A.

    Commentary on: Chee RM, Capper TS, Muurlink OT. The impact of social media influencers on pregnancy, birth, and early parenting experiences: A systematic review. Midwifery. 2023 May;120:103623. doi: 10.1016/j.midw.2023.103623. Epub 2023 Feb 19.

    Implications for practice and research

  • Social media is one of the fastest growing commercial determinants of health.

  • Healthcare professionals need a better understanding of social media and its impact.

  • Context

    Social media has rapidly become a key source of advice and support for women during childbirth. The growth of influencers, popular users credited with knowledge and expertise, can be seen in the numerous social posts, blogs, podcasts and videos about pregnancy, birth and parenting. Social media influencers provide responsive and relatable content to their network of followers; but there are concerns about the potential to spread misinformation.1

    Methods

    This systematic literature review2 sought to identify...

    Understanding staff perceptions on adolescent seclusions

    Por: Vidal · C. · Reynolds · E. K.

    Commentary on: Yurtbasi MK, Melvin G, Pavlou C, Gordon M. Staff perspectives on the effects of seclusion in adolescent psychiatric inpatient care. Int J Ment Health Nurs. 2023 Apr;32(2):567–578. doi: 10.1111/inm.13102. Epub 2022 Dec 15.

    Implications for clinical practice and research

  • Nursing staff find adolescent seclusions necessary but also experience related guilt and self-doubt.

  • Seclusion protocols in adolescent psychiatric units should include alternatives to seclusion and debriefing processes.

  • Context

    Seclusions cause distress in patients and lead to negative outcomes, including death. Growing research demonstrates that seclusion rates vary by age, sex, race, diagnosis and personal history of adverse events.1 In fact, seclusion rates among youth are higher than among adults. While research involving staff in adult inpatient psychiatric units demonstrates that staff and patients experience negative reactions,2 more specific research is needed related to staff in adolescent inpatient units, given...

    Enhancing behavioural support through telehealth for family carers and professionals

    Por: Leyser · M.

    Commentary on: Tomlinson SRL, Gore N, McGill P. Family carer and professional perceptions of the potential use of telehealth for behavioural support. J Intellect Disabil Res. 2023;67:531–46. doi: 10.1111/jir.13026.

    Implications for practice and research

  • Telehealth is valuable for behavioural support, especially for family carers facing challenges in accessing in-person services.

  • Healthcare professionals need training to effectively use telehealth platforms for behavioural interventions.

  • Further research is required to explore diverse populations’ perspectives and experiences and evaluate technical barriers, long-term effectiveness and cost-effectiveness of telehealth for behavioural support.

  • Context

    Tomlinson et al1 explored the use of telehealth for behavioural support in individuals with intellectual and developmental disabilities (IDD). They examined the perspectives of family carers and professionals on this approach, considering the need for accessible interventions and the impact of the COVID-19 pandemic.2 3 Telehealth, using digital communication technologies...

    Induction, deduction and abduction

    Por: Barrett · D. · Younas · A.

    Researchers often refer to the type of ‘reasoning’ that they have used to support their analysis and reach conclusions within their study. For example, Krick and colleagues completed a study that supported the development of an outcome framework for measuring the effectiveness of digital nursing technologies.1 They reported completing the analysis through combining ‘an inductive and deductive approach’ (p1), but what do these terms mean? How can these methods of reasoning support nursing practice, and guide the development and appraisal of research evidence?

    This article will explore inductive and deductive reasoning and their place in nursing research. We will also explore a third approach to reasoning—abductive reasoning—which is arguably less well-known than induction and deduction, but just as prevalent and important in nursing practice and nursing research.

    Inductive reasoning

    Induction, or inductive reasoning, involves the identification of cues and the collection of data to develop general...

    Starting at the top: culture change has the potential to advance the patient participation agenda in Iranian hospitals

    Por: Tobiano · G. · Chaboyer · W.

    Commentary on: Sarkhosh S, Abdi Z, Ravaghi H. Engaging patients in patient safety: a qualitative study examining healthcare managers and providers' perspectives. BMC Nurs. 2022 Dec 29;211,:374. doi: 10.1186/s12912-022-01152-1.

    Implications for practice and research

  • Without a shift in organisational culture, patient participation in patient safety may continue to be haphazard in Iranian hospitals.

  • Researchers should consider and report the impact of gender when investigating patient participation in care.

  • Context

    Despite Iran’s economic crisis, brought on by sanctions, years of war and improper government resource management, Iranian healthcare is now considered among the finest in the Eastern Mediterranean region.1 There are satisfactory secondary and tertiary hospitals, and progress towards eradication of contagious, maternal and neonatal disorders has been made.1 Internationally, patient participation in hospital safety activities is advocated, such as patients detecting and reporting symptoms, side effects and hospital issues, to...

    Advanced Clinical Practitioners (ACPs) have a significant impact on patient outcomes and healthcare services

    Por: Wood · A. F. · Hyde · R.

    Commentary on: Mann C, Timmons S, Evans C, Pearce R, Overton C, Hinsliff-Smith K, Conway J. Exploring the role of advanced clinical practitioners (ACPs) and their contribution to health services in England: A qualitative exploratory study. Nurse Educ Pract. 2023 Feb;67:103546. doi: 10.1016/j.nepr.2023.103546. Epub 2023 Jan 24.

    Implications for practice and research

  • Workforce planning needs focus on the level of practice required for service demand and not ‘what role is needed’. Planners must appreciate the contributions and limitations of practice different advanced clinical practitioners (ACPs) bring.

  • Research is needed to move beyond capturing the advancement of roles to exploring changes, in practice and education, and evaluating the improvements made, particularly with advanced practice (AP) regulation being reviewed by the Nursing and Midwifery Council (NMC).

  • Context

    Advanced Practice (AP) is a phenomenon which in the last century may be traced back to the post second...

    Home fall hazard assessments effective in high-risk fallers but more information needed on effects of assistive technologies

    Por: Sharma · Y. · Iaboni · A.

    Commentary on: Clemson L, Stark S, Pighills AC, Fairhall NJ, Lamb SE, Ali J, Sherrington C. Environmental interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2023 Mar 10;3(3):CD013258. doi: 10.1002/14651858.CD013258.pub2

    Implications for practice and research

  • Home fall hazard assessments are shown to be effective in fall prevention among community-dwelling older adults at higher risk of falls. Future work should investigate the feasibility of implementing these interventions in practice settings.

  • It is uncertain whether assistive technologies can prevent falls in community-dwelling older adults, thus further research is needed.

  • Context

    Nearly 30% of older adults aged 65 years and older fall each year.1 While falls are multifactorial and include both intrinsic and environmental factors, ‘accidental’ falls, such as trips and slips related to environmental hazards, are very common reasons provided for a fall.2 Identifying effective...

    Strategies to integrate culturally and linguistically diverse nurses into foreign healthcare systems: its everybodys business

    Por: Chun Tie · Y.

    Commentary on: Kamau S, Koskenranta M, Kuivila H, et al. Integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments: an umbrella review. Int J Nurs Stud 2022;136:104377. doi: 10.1016/j.ijnurstu.2022.104377. Epub 2022 Oct 10.

    Implications for practice and research

  • Healthcare organisations must invest resources for effective integration of culturally and linguistically diverse (CALD) nurses.

  • Research on nurse integration must evaluate CALD nurse’s needs, goals, and prospects for retention.

  • Context

    Kamau et al’s1 study context includes primary, secondary and community care settings. Integration strategies to support transition of culturally and linguistically diverse (CALD) nurses into foreign healthcare environments is essential. Kamau and colleagues confirm the complex nature of organisational socialisation, adaptation and integration of CALD nurses into dynamic healthcare systems.

    Methods

    The authors1 reviewed databases for systematic or integrative reviews...

    Prison is a barrier to high-quality, comprehensive midwifery care

    Por: Paynter · M. J.

    Commentary on: Abbott L, Scott T, Thomas H. Experiences of midwifery care in English prisons. Birth. 2023 Mar;50(1):244-251. doi: 10.1111/birt.12692. Epub 2022 Nov 12.

    Implications for practice and research

  • Incarceration presents barriers to best midwifery practices, restricting patient choice in care provider and place of birth. Midwives play an important role advocating for incarcerated patients.

  • Prison staff misunderstand midwifery and conceptualise access to care as a reward for good behaviour. Future research should assess outcomes of alternatives to incarceration.

  • Context

    Women continue to be one of the fastest growing populations experiencing incarceration, with significant consequences for their newborns and children. Despite international and national requirements for equivalent care to what is available in community, existing research in the field of prison perinatal health has found delays and gaps in care and poor neonatal outcomes associated with pregnancy in prison.1 This study by...

    A call to all nurses from transgender people: treat me as a whole person; I am more than my gender identity

    Por: Kuzma · E. K. · Yingling · C.

    Commentary on: Mikovits JC. "I don't feel like I'm a person": Nursing knowledge of transgender care through the lens of transgender people. J Adv Nurs. 2022 Sep;78(9):3012–3024. doi: 10.1111/jan.15308. Epub 2022 Jun 1.

    Implications for practice and research

  • Nurses have an ethical imperative to provide patient-centered care that honours all aspects of one’s identity, including gender identity.

  • Further research is needed to better understand the healthcare experiences of transgender people of intersecting identities and those with varying economic resources.

  • Context

    Transgender people experience numerous health inequities due to societal discrimination and stigma.1 Within healthcare, the oppression and discrimination that drive these inequities are reinforced by individuals with implicit and explicit biases and the system with structural barriers to accessible care. Nurses need to be able to provide patient-centred care to all patients. Yet, most nursing programmes do not fully prepare nurses to...

    NHS England long-term workforce plan: Can this deliver the workforce transformation so urgently needed or is it just more rhetoric?

    Por: Twycross · A. · Wray · J.

    The long-awaited NHS England workforce plan1 (the plan) was launched in June 2023 by the Prime Minister (Rishi Sunak) and NHS England CEO (Amanda Pritchard) and heralded as:

    The first comprehensive workforce plan for the NHS, putting staffing on a sustainable footing and improving patient care. It focuses on retaining existing talent and making the best use of new technology alongside the biggest recruitment drive in health service history.1

    This is a laudable aim, but can this ambitious plan really deliver the actions needed to transform the long-term future of this critical workforce?

    Workforce planning is crucial to the success of the National Health Service (NHS) and has been notable by its absence in recent decades. The publication of this plan could be seen as a step in the right direction. Workforce planning requires2:

  • Data analysis of the current workforce and...

  • Improving consensus-based evidence from Delphi studies with coproduced qualitative research

    Por: Ding · D. · Nguyen · B.

    Commentary on: Monforte J, Davis C, Saleem S, Smith B. Moving on From the Delphi Study: The Development of a Physical Activity Training Programme Prototype Through Co-produced Qualitative Research. Qual Health Res. 2022 Nov;32(13):1952–1964. doi: 10.1177/10497323221126535. Epub 2022 Sep 14.

    Implications for practice and research

  • Dialogical inquiry, which aims to facilitate people hearing themselves and others in collaborative and non-hierarchical settings, is compatible with the practice of coproduction.

  • A Delphi study alone may be insufficient for informing the design of educational programmes, curriculum or policy agenda. Additional follow-up qualitative interviews should be conducted to rectify, improve and expand on consensus-based knowledge.

  • Context

    Regular physical activity is critical to the health and well-being of people living with disabilities (PLWD).1 PLWD are often unable to be as active as they want due to various obstacles, such as a lack of safe and suitable environments,...

    Womens perceptions of risk, safety and autonomy drive what we (providers and society) consider non-normative choices in pregnancy and childbirth

    Por: Benyamini · Y.

    Commentary on: Madeley AM, Earle S, O'Dell L. Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature. Midwifery. 2023 Jan;116:103532. doi: 10.1016/j.midw.2022.103532. Epub 2022 Oct 30

    Implications for research and practice

  • Nurses should strive to understand women’s needs, past experiences and sociocultural background as a basis for discussing their choices in a non-judgemental way.

  • Research on non-normative choices in childbearing should include ethnic and sexual minorities, and evaluate protocols for sensitive, women-centred discussion of birthing choices.

  • Context

    Preferences about childbirth range along a wide continuum from physiological, sometimes even unassisted births, to caesarean sections by maternal request. Despite this wide range, most births in the western world take place in medical settings, making it in practice a medical event, reflecting society’s and health professionals’ views of risk and safety that define birth choices which are considered normative....

    One-third of nurses intend to leave their job because of the COVID-19 pandemic

    Por: de Cordova · P. B. · Reilly · L.

    Commentary on: Ulupınar F, Erden Y. Intention to leave among nurses during the COVID-19 outbreak: A rapid systematic review and Meta-Analysis. J Clin Nurs. 2022 Nov 27. doi: 10.1111/jocn.16588. Epub ahead of print.

    Implications for practice and research

  • During COVID-19, nurses experienced stress, anxiety and fear. Psychological support will help retain staff.

  • Further longitudinal studies on the long-term psychological impacts of the pandemic are needed.

  • Context

    The impact of the COVID-19 pandemic on nurses was unprecedented with high volumes of critically ill patients. This strain on direct care nurses included an increased workload, long hours, separation from family, potential exposure and patient death.1 These factors impacted nurses’ psychological well-being and led to increased reports of nurses intending to leave their jobs. This rapid systematic review and meta-analysis aimed to synthesise the literature of rate of nurses’ intent to leave their job from...

    Experiences of newly registered nurses transitioning from nursing student to registered nurse: a qualitative systematic review

    Por: Brady · J. · Tatterton · M. J.
    Background and purpose

  • This is a summary of See et al.1

  • Newly registered nurses experience high levels of emotional exhaustion, stress and burnout, with high attrition rates in the first-year post-qualification.

  • The purpose of this review was to consolidate the available evidence on the experiences of newly registered nurses transitioning from the role of student nurse to that of registered nurse.

  • Methods

    Results and areas for future research

  • Thirty-one studies were included in the review, comprising thirty qualitative and one mixed-method study.

  • A total of 452 newly registered nurses were enrolled across the studies from Australia, Canada, Singapore, England, Nepal, Netherlands, Pakistan and Taiwan.

  • Four themes were identified: knowledge deficit, overwhelming clinical practice, importance of workplace support and the meaning of ‘being a nurse’.

  • Twenty-four studies discussed how newly graduated registered nurses experienced anxiety,...

  • Resources page

    Por: Wray · J.

    This edition of the Evidence Based Nursing (EBN) resources page is focused on further information to support the editorial by Alison Twycross and Jane Wray ‘NHS (National Health Service (NHS) England Long-term Workforce Plan: Can this deliver the workforce transformation so urgently needed or is it just more rhetoric?’

    EBN has published a number of commentaries that provide useful additional information relating to the UK NHS workforce.

  • Collaboration between universities and nursing placement providers is essential to ensure the well-being of the future nursing workforce %7C Evidence-Based Nursing (bmj.com) Dr Anne Mills highlights the importance of joint initiatives between educational settings and placement providers to promote student nurse well-being.

  • Supporting positive workplace cultures focused on staff well-being is discussed in; Negative workplace behaviour: nurses’ power games, blame culture and incivility-why nurses do not care for each other %7C Evidence-Based Nursing (bmj.com)...

  • Oxygen supplementation above a low-flow nasal cannula in patients with COVID-19 may improve arterial oxygen levels but not breathlessness

    Por: Prakash · J. · Sahay · N.

    Commentary on: Poncin W, Baudet L, Braem F, Reychler G, Duprez F, Liistro G, Belkhir L, Yombi JC, De Greef J. Systems on top of nasal cannula improve oxygen delivery in patients with COVID-19: a randomized controlled trial. J Gen Intern Med 2022;37(5):1226–32. doi: 10.1007/s11606-022-07419-2. Epub 8 Feb 2022.

    Implications for practice and research

  • The adverse consequences of continuous exposure to high concentrations of oxygen must be considered before instituting prolonged oxygen therapy in patients with COVID-19.

  • Hypoxaemia is significant in patients with COVID-19, and isolated arterial oxygen pressure (PaO2) improvement may not necessarily translate into any significant survival benefit nor relieve the distress of breathlessness.

  • Context

    Oxygen therapy is important in COVID-19 management. The low-flow nasal cannula (NC) has some drawbacks. The patient’s peak inspiratory flow rate requirements are not met due to significant leakage around the source. A need to improve oxygen...

    Stigmatisation and workplace violence against healthcare workers: the need for evidence-based preventive strategies

    Por: Chowdhury · S. R.

    Commentary on: Saragih ID, Tarihoran DETAU, Rasool A, Saragih IS, Tzeng HM, Lin CJ. Global prevalence of stigmatization and violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. J Nurs Scholarsh. 2022;54(6):762–71. doi: 10.1111/jnu.12794. Epub 12 Jul 2022.

    Implications for practice and research

  • Health administrators and policymakers should appropriately address issues of stigmatisation and violence against healthcare workers through strategic planning that considers the unique nature of the workplace as well as local culture to ensure better healthcare for the patients.

  • Future research should focus on synthesising evidence-based preventive strategies and management protocols to avert the escalation of stigmatisation and violence towards healthcare workers during catastrophic public health crises.

  • Context

    Violence in the workplace is a common issue in healthcare settings. However, since the beginning of the COVID-19 pandemic, there has been an increase in the number of reports in...

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