Conectar
To explore healthcare professionals', patients', and family members' experiences of managing regular medications across the perioperative pathway in a specialist cancer hospital in Melbourne.
An exploratory qualitative study using a descriptive-interpretive approach.
Interviews were conducted with 11 patients and seven family members, and focus groups with 10 anaesthetists, seven surgeons, four nurses, and 10 pharmacists (N = 49) between October 2024 and April 2025. Transcripts were analysed using Braun and Clarke's reflexive thematic approach and mapped into the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 human factors framework.
Three interrelated themes were constructed: (1) Work system elements shaping perioperative medication management, encompassing medication and surgical contexts, documentation gaps, reliable medication information, communication infrastructures, roles and responsibilities, and perioperative area resources; (2) Processes influencing medication management practice, characterised by continuity of care at transition points and flagging processes, interdisciplinary collaboration and role interpretation in medication management, patient involvement, family member involvement, and healthcare professional perspectives; and (3) Outcomes of medication management, including patient and organisational outcomes, such as workflow inefficiencies, procedure cancellations, and unplanned readmissions.
Findings indicated that addressing the complexity of perioperative medication safety demands coordinated contributions across multiple professional disciplines. Strengthening interdisciplinary collaboration, clarifying shared responsibilities, embedding structured reconciliation processes at transitions of care, standardizing communication protocols, and involving patients and families are all critical strategies.
This study highlights the need for interdisciplinary coordination and clear role definitions, with nurses as the key contributor, to support collaborative medication decisions in perioperative cancer care.
This study explored challenges in managing regular medications during cancer surgery, offering insights to guide safer practices for perioperative teams, patients, and families in cancer care settings.
COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.
None.
An increasing number of teenagers and young adults (TYA) with chronic conditions and complex needs are transitioning from paediatric to adult services, including admission to intensive care units (ICUs). As these services are often ill-equipped to care for TYA, there is a risk of compromised care. Despite recent guidelines from the UK Paediatric Critical Care and Intensive Care Societies highlighting the importance and urgency of improving ICU transition, current recommendations are not evidence-based and established pathways for ICU transition remain limited.
This mixed-methods research study aims to generate evidence to underpin national policy on transition from paediatric to adult ICUs that will improve clinical care and patient experience. To do this, we will: (1) link and analyse UK national data (years 2017–2024) on paediatric and adult ICU admissions, hospital inpatient, outpatient and emergency care visits and survival status, to determine the clinical characteristics and healthcare resource utilisation from teenage years to early adulthood of people admitted to an ICU as a young person (admission aged 14 and 15), and how these relate to ICU admissions after age 16; (2) conduct semistructured interviews, online forums and surveys with TYA patients, carers and health professionals to understand their experience of transition in ICU services; and (3) synthesise these strands of evidence and use a structured process of stakeholder engagement to propose potential targeted improvements as appropriate.
This study was approved by the East of England - Cambridge South Research Ethics Committee on 1 August 2024 (research ethics committee number 24/EE/0108), and the Health Research Authority Confidentiality Advisory Group (CAG) on 7 October 2024 (CAG number 24/CAG/0068). Study results will be actively disseminated through peer-reviewed journals, conference presentations and accessible lay texts and graphic summaries for the use of charities and patients including those with learning disabilities and neurodevelopmental disorders.
The aim of this study was to determine the feasibility of delivering personalised isometric exercise (IE) for people with stage 1 hypertension. Is it feasible to deliver an isometric wall squat intervention in the National Health Service and what sample size is required to conduct an appropriately powered effectiveness randomised controlled trial (RCT)?
Randomised controlled open-label multicentre feasibility study of IE compared with standard care in unmedicated people with stage 1 hypertension.
Initially, the study aimed to recruit through primary care, but this process coincided with the advent of the COVID-19 pandemic. Therefore, we shifted focus to direct-to-public advertising and delivery in secondary care.
People with unmedicated stage 1 hypertension aged over 18 able to perform IE were included. Patients were excluded if average home systolic blood pressure (sBP)
Intervention participants were randomised (1:1) to either standard lifestyle advice or an individualised isometric wall squat prescription, performed 4x2-min bouts three times a week for 6 months.
We assessed deliverability, attrition, adherence and variance in blood pressure (BP) change.
IE was found to be easily deliverable to all participants. At 6 months, 34% had withdrawn. Of those who completed IE, 85% of their sessions were at the correct intensity, meeting our retention criterion for success. Variance in BP change was 14.4 mm Hg. The study was not powered to show a difference in BP between groups; however, BP reductions were seen in the intervention group at all study time points compared with baseline. There were no adverse events related to study participation.
We met our a priori recruitment criteria which allowed us to calculate a sample size (n=542) for a full RCT. The results demonstrate good acceptability and adherence rates to the treatment protocol. Our results show a signal towards a consistent sBP reduction in the IE group compared with baseline.
NCT04936022 (
To assess the acceptability and perceived feasibility of integrating a co-designed nurse-led model of contraception and medication abortion care within rural and regional general practices.
Qualitative exploratory design utilising Sidani and Braden's indicators of acceptability and feasibility.
We conducted semi-structured interviews with 12 practice nurses, 8 general practitioners and 3 practice managers who currently or previously worked in rural, regional or remote general practice. Participants were recruited purposively through social media, partner organisation newsletters and snowballing. During the interview, participants were presented with an overview of the co-designed model of care and asked specific questions to gain feedback on its acceptability and perceived feasibility. Data were analysed in NVivo using template analysis and iterative categorisation. Findings were mapped according to Sidani and Braden's indicators of acceptability and feasibility.
Three overarching themes were identified: nurses are acceptable providers, factors influencing the feasibility of the model and factors supporting greater feasibility of the model. Participants found the nurse-led model acceptable, describing nurses as suitable and sometimes preferred providers of long-acting reversible contraception and abortion care in rural and regional settings. They also perceived the model as feasible, citing similarities to existing care processes such as infant immunisations and chronic disease management, contributing to its feasibility. However, contextual factors such as the need to adapt the model to each clinic and patient's unique needs, foster strong general practitioner–practice nurse professional relationships and ensure that staff have shared values and adequate training for contraception and abortion provision were described as critical for feasibility.
Overall, participants found the nurse-led model of care to be acceptable and feasible for implementation in rural and regional general practices. This perception carries important implications for policy and practice, highlighting the need for supportive policies to enhance the effectiveness of such models across Australian general practice.
Our findings emphasise the need for initiatives aimed at addressing inadequate funding for nurse-led care, improving documentation of this care, enhancing understanding among general practitioners and nurses regarding the scope of practice for practice nurses, and overcoming training barriers specific to rural areas. These measures are essential for enabling nurse-led models of contraception and medication abortion to function effectively in practice.
This paper is reported according to the consolidated criteria for reporting qualitative research (COREQ) guidelines.
Two consumer representatives contributed to the development of the co-design methodology as members of the ORIENT Intervention Advisory Group Governance Committee.
To synthesise and map current evidence on nurse and midwife involvement in task-sharing service delivery, including both face-to-face and telehealth models, in primary care.
This scoping review was informed by the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews.
Five databases (Ovid MEDLINE, Embase, PubMed, CINAHL and Cochrane Library) were searched from inception to 16 January 2024, and articles were screened for inclusion in Covidence by three authors. Findings were mapped according to the research questions and review outcomes such as characteristics of models, health and economic outcomes, and the feasibility and acceptability of nurse-led models.
One hundred peer-reviewed articles (as 99 studies) were deemed eligible for inclusion. Task-sharing models existed for a range of conditions, particularly diabetes and hypertension. Nurse-led models allowed nurses to work to the extent of their practice scope, were acceptable to patients and providers, and improved health outcomes. Models can be cost-effective, and increase system efficiencies with supportive training, clinical set-up and regulatory systems. Some limitations to telehealth models are described, including technological issues, time burden and concerns around accessibility for patients with lower technological literacy.
Nurse-led models can improve health, economic and service delivery outcomes in primary care and are acceptable to patients and providers. Appropriate training, funding and regulatory systems are essential for task-sharing models with nurses to be feasible and effective.
Nurse-led models are one strategy to improve health equity and access; however, there is a scarcity of literature on what these models look like and how they work in the primary care setting. Evidence suggests these models can also improve health outcomes, are perceived to be feasible and acceptable, and can be cost-effective. Increased utilisation of nurse-led models should be considered to address health system challenges and improve access to essential primary healthcare services globally.
This review is reported against the PRISMA-ScR criteria.
No patient or public contribution.
The study protocol is published in BJGP Open (Moulton et al., 2022).
FreshRSS 