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Workplace disclosure of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) identity by healthcare employees is an understudied area and existing reviews of LGBTQ+ disclosure in the healthcare sector focus on patient perspectives, overlooking the unique challenges that healthcare professionals encounter. The aim of this study was to conduct a systematic review and meta-synthesis of existing qualitative studies exploring disclosure experiences of LGBTQ+ healthcare employees.
The literature search integrated current research from 2011 to March 2023 and focused on qualitative studies exploring disclosure experiences of LGBTQ+ healthcare professionals. Ovid served as the primary platform for literature searches, supplemented by forward and backward citation tracking and additional searches in academic databases such as Google Scholar and Scopus. The studies underwent quality evaluation using the Critical Appraisal Skills Programme 2022 checklist and were synthesised using thematic analysis.
The findings revealed seven studies with five prominent themes: (1) risk associated with disclosure, (2) making the decision to disclose, (3) cost of non-disclosure, (4) cost of disclosure and (5) benefit of disclosure. Additionally, five critical factors of disclosure were identified: level, scope, time, elements and method. Finally, the risk–benefit analysis underscored the dilemma and balance between authenticity and conformity, largely influenced by pervasive heteronormativity, resulting in a significant mental toll.
The findings must be interpreted considering certain limitations, such as the lack of generalisability of studies. However, the findings emphasise the critical need for cultivating trusting and accepting healthcare work environments for LGBTQ+ staff.
Medication administration errors are high-risk patient safety issues that could potentially cause harm to patients, thereby delaying recovery and increasing length of hospital stay with additional healthcare costs. Nurses are pivotal to the medication administration process and are considered to be in the position to recognize and prevent these errors. However, the effectiveness of interventions implemented by nurses to reduce medication administration errors in acute hospital settings is less reported.
To identify and quantify the effectiveness of interventions by nurses in reducing medication administration errors in adults' inpatient acute hospital.
A systematic review and meta-analysis was conducted up to 03/24. Six databases were searched. Study methodology quality assessment was conducted using the Joanna Briggs Institute (JBI) critical appraisal tools, and data extraction was conducted. Meta-analysis was performed to combine effect sizes from the studies, and synthesis without meta-analysis was adopted for studies that were not included in the meta-analysis to aggregate and re-examine results from studies.
Searches identified 878 articles with 26 studies meeting the inclusion criteria. Five types of interventions were identified: (1) educational program, (2) workflow smart technologies, (3) protocolised improvement strategy, (4) low resource ward-based interventions, and (5) electronic medication management. The overall results from 14 studies included in meta-analysis showed interventions implemented by nurses are effective in reducing medication administration errors (Z = 2.15 (p = 0.03); odds ratio = 95% CI 0.70 [0.51, 0.97], I 2 = 94%). Sub-group analysis showed workflow smart technologies to be the most effective intervention compared to usual care. Findings demonstrate that nurse-led interventions can significantly reduce medication administration errors compared to usual care. The effectiveness of individual interventions varied, suggesting a bundle approach may be more beneficial. This provides valuable insights for clinical practice, emphasizing the importance of tailored, evidence-based approaches to improving medication safety.
PRISMA guided the review and JBI critical appraisal tools were used for quality appraisal of included studies.
Globally, up to 15% of children and adolescents experience a mental health (MH) condition. In the UK, an increasing number of children and young people (CYP) are presenting to acute paediatric settings (paediatric emergency departments and paediatric medical wards) with MH issues. However, the literature suggests that the MH support available in acute paediatric settings is insufficient and unsafe in England. A key principle in NHS England’s plan for joint working to support CYP with MH needs in acute paediatric settings is for care to be personalised to the needs of CYP. However, there is a paucity of research that explores the needs of ethnic minority CYP with MH issues in acute paediatric settings, and recent research has highlighted racial disparities in the accessibility and outcomes of MH services for CYP. This is significant as MH issues in childhood are associated with lifelong inequalities in health, employment, education and mortality outcomes in later life. We aim to explore how, why and under what circumstances acute paediatric settings support (or do not support) ethnic minority CYP to access appropriate MH support, and to develop a refined programme theory for the important contextual factors and mechanisms that can influence whether acute paediatric settings support ethnic minority CYP in accessing appropriate MH support.
This review will use the realist approach developed by Pawson and Tilly which involves six steps: (1) Clarifying the scope of the review, (2) Searching for evidence, (3) Selecting and appraising the primary studies, (4) Extracting and organising the data, (5) Analysing and synthesising the findings and (6) Disseminating the findings. We will search OVID Medline, PsycINFO, CINAHL and SCOPUS. Relevant data will also be sought through snowballing and backward citation searching on included studies, seeking document recommendations from relevant professionals, and grey literature searches on Grey Matters, Health Management Information Centre and Google Scholar. The search will cover documents published from database inception. Documents featuring Black and/or Mixed-Black CYP with MH issues in acute paediatric settings will be included. Documents that do not separately report the results of CYP (
This realist review will only involve secondary data, so ethical approval will not be required. The developed programme theory will be disseminated through the advisory group, peer-reviewed publications, discussions with relevant stakeholders and presentations at relevant research conferences and community events. Additionally, the theory will inform a primary realist evaluation study where the theory will be tested and refined further.
PROSPERO, CRD420251009912.
To explore levers and barriers to providing culturally responsive care for general practice nurses (GPNs) using normalization process theory.
A self-administered online cross-sectional survey.
A participatory co-designed adapted version of the normalization of complex interventions measure (NoMAD) validated tool was distributed to a convenience sample of GPNs between December 2022 and February 2023. The sample comprised of GPNs working in general practice services in Ireland (n = 122). Data were analysed using descriptive and analytical statistics (Pearson correlations) and principles of content analysis. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).
GPNs in this study indicated their familiarity with, acknowledged the importance of and were committed to, providing culturally responsive care. However, implementing culturally responsive care in daily practice was problematic due to insufficient education and training, scarcity of resources and supports and a lack of organizational leadership. Subsequently, GPNs experience difficulties adapting everyday practices to respond appropriately to the care needs of culturally and linguistically diverse (CaLD) patients.
This analysis highlights the necessity of exploring the intricacies of factors that influence capabilities and capacity for providing culturally responsive care. Despite demonstrating awareness of the importance of providing nursing care that responds to the needs of CaLD patients, GPNs do not have full confidence or capacity to integrate culturally responsive care into their daily work practices.
Using normalization process theory, this study elucidates for the first time how GPNs in Ireland make sense of, legitimize, enact and sustain culturally responsive care as a routine way of working. It illuminates the multitude of micro-level (individual), meso-level (organizational) and macro-level (structural) factors that require attention for normalizing culturally responsive care in general practice services.
The study question was identified in a participatory research prioritization for Irish research about migrant health that involved migrants in the process.
FreshRSS 