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To explore staff and patient perception of the newly co-developed wearable monitoring system (WMS), including acceptability of use in clinical practice.
Pragmatic qualitative descriptive study.
Semi-structured interviews were conducted with 12 patient participants and eight staff members between June 2023 and August 2024, and were analysed thematically.
Three themes were identified, building on previous qualitative work around the use of WMS on hospital wards. The first theme—centralised continuous monitoring enhances care—explores how WMS provides staff with a means to provide safe, efficient care with the ability to see the vital signs away from the patient. Patients reported feeling safer, knowing they were being monitored when staff were not at the bedside. The second theme—human connection at the bedside—considers how both patients and staff emphasised that the system should not replace nurse/patient interactions and face-to-face care, even though it provided patients with a stronger sense of independence. The final theme—system usability and integration into care—focuses on use of the system in clinical practice and implications for the future.
Wearable monitoring systems have the potential to support nurses to provide safer, more efficient care, whilst providing reassurance to patients. However, centralised monitoring should not replace face-to-face clinical contact, and careful consideration should be given to who would benefit most from the technology.
This study extends existing knowledge of the impact of WMS from being a tool to enhance patient safety to an intervention to improve nurse efficiency and patient experience, within the context of a high-demand surgical ward.
Patients and members of the public were involved in study design and data collection. Their contributions included participating in advisory groups, ensuring the research addressed patient-relevant priorities.
The debate about whether health visiting, a specialist community public health nursing role, is at the level of advanced practice nurse has gone on for more than a decade. There is little empirical evidence that the role matches the traditional role of an advanced practice nurse, although many of the attributes of advanced practice nursing such as prescribing rights, managing complex cases, caseloads with undifferentiated need and advanced assessment and decision-making are certainly present.
The current study aimed to develop, refine and test the Health Visiting Advanced Practice Scale to assess the scope of advanced practice of UK health visitors.
A cross-sectional and methodological scale validation design, following classical test theory.
The design consisted of three phases; the first involved scale development including item generation, phase two assessed the content validity index, and the third phase involved a cross-sectional survey to establish construct validity, content validity, and internal consistency reliability, and conduct exploratory and confirmatory factor analysis.
The initial 44-item scale underwent iterative exploratory and confirmatory factor analyses, leading to a refined 5-factor structure with 29 items covering domains such as family-centred care, leadership, prescribing, diagnostic reasoning, and professional practice. This final version demonstrated strong reliability and construct validity in the EFA but mixed fit indices in the CFA, supporting both internal consistency and validity of the scale.
The final scale offers a rigorously validated tool for assessing advanced practice among UK health visitors, capturing core domains such as family-centred care, leadership, prescribing, and diagnostic reasoning. By bridging theoretical frameworks with real-world practice, it fills a critical gap in evaluating and supporting the professional scope of this public health nursing specialty.
These findings provide valid and reliable insights for measuring and improving health visitors' advanced practice and developing future professional policies.
No patient or public contribution.
STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies.
Background
The state of New Jersey has a large Black/African American (AA) versus White racial disparity in infant mortality and educational level at childbirth. This disparity, measured by rate ratio, increases with greater maternal education among varied racial–ethnic groups. The nature of this disparity measured by rate differences has not been explored.
Objectives
Infant birth and mortality data were used to examine whether racial or ethnic disparities in infant mortality increased with greater maternal education, comparing rate differences and rate ratios. Racial and ethnic variations in the association between maternal education and infant mortality were examined.
Methods
Data were from the New Jersey State Health Assessment Data for all New Jersey births between 2014 and 2018 stratified by race and ethnicity, maternal education, and infant mortality (n = 481,333). R software was used to create a data set and estimate additive and multiplicative interactions, rate differences, and rate ratios for infant mortality by maternal race/ethnicity and educational levels among four racial–ethnic groups.
Results
Infant mortality was significantly greater for Black/AA and Hispanic mothers than for White mothers. At all educational levels, Black/AA mothers had the highest prevalence of infant mortality compared to other racial or ethnic groups. Rate differences in infant mortality showed a decrease in Black/AA–White differences for mothers with a high school education or less compared to mothers with a college degree. However, rate ratios showed an increase in Black/AA–White ratio with increasing education levels for mothers with high school education or less than mothers with a college degree. Risk ratios comparing infant mortality for Black/AA versus Hispanic or Asian mothers showed more than a twofold greater risk at all education levels for Black/AA infants. Finally, college-educated Black/AA mothers had significantly higher rates of infant mortality than White or Hispanic mothers with a high school education or less.
Discussion/Implications
Black/AA mothers with a college degree had a higher infant mortality rate than White, Hispanic, or Asian mothers with a high school education or less. Future research should address contextual/systemic contributors to this disparity. 
FreshRSS 