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Scoping Review of Sexual and Gender Minority Health Research in Ireland

ABSTRACT

Aim

To map existing sexual and gender minority (SGM) health research in Ireland, identify gaps in literature and outline priorities for future research and healthcare. SGM is an umbrella term that includes people who identify as lesbian, gay, bisexual, transgender, queer or intersex and is sometimes abbreviated as LGBTQI+.

Design

A scoping review of peer-reviewed studies published between 2014 and 2024.

Methods

The review followed Joanna Briggs Institute (JBI) guidelines and PRISMA-ScR framework for scoping reviews. Articles were identified through systematic database searches and screened independently by reviewers.

Data Sources

PubMed, PsycINFO, CINAHL and Embase were searched for articles published between January 2014 and April 2024. Sixty studies met inclusion criteria.

Results

The review highlighted a disproportionate focus on gay, bisexual and other men who have sex with men (gbMSM), particularly regarding HIV and sexual health. Mental health research revealed high levels of anxiety, depression and suicidality, largely attributed to minority stress and systemic discrimination. Transgender health studies documented barriers to accessing gender-affirming care and mental health services. Few studies explored experiences of sexual minority women, older SGM individuals or intersex people. Intersectional perspectives on race, disability and socio-economic status were notably absent.

Conclusion

SGM health research in Ireland reflects significant progress in documenting disparities in mental and sexual health. However, there is a lack of representation for some groups. There is also limited attention to intersectionality. Systematic gaps in sexual orientation and gender identity (SOGI) data impede targeted policymaking and service delivery.

Implications for the Profession and/or Patient Care

Findings underscore the need for inclusive, culturally competent healthcare services, better integration of SGM health topics into nursing education, and community-centred interventions. Addressing structural barriers and improving provider competence can enhance equitable healthcare access for SGM populations.

Impact

This review addresses the fragmented state of SGM health research in Ireland, highlighting gaps in representation and systemic issues.

No Patient or Public Contribution

Authorship includes individuals from various sexual and gender minority communities.

Effect of health promotion interventions in supermarkets on dietary variety among Japanese older adults: a protocol for a cluster non-randomised parallel-group comparative trial

Por: Gomi · T. · Motokawa · K. · Shirobe · M. · Iwasaki · M. · Hayakawa · M. · Edahiro · A. · Hirano · H.
Introduction

With an ageing population, prevention of frailty among older adults has become a critical public health issue. Dietary habits are one of the essential components in frailty prevention, which involves promoting changes in dietary behaviours, such as including dietary variety. However, community-level health promotion interventions face significant challenges, including limited spatial access to food, which is important as it is not easy to change the behaviour of older adults. The dissemination of community-level health promotion interventions targeting dietary behavioural changes among older adults remains unclear. Therefore, this study aimed to evaluate the effects of supermarket-based health promotion interventions on dietary variety among older Japanese adults.

Methods and analysis

This study is a cluster non-randomised parallel-group comparative trial involving 15 supermarkets in the Yamanashi and Nagano Prefectures, Japan. Seven supermarkets will be assigned to the intervention group and eight to the control group. The intervention group will receive a health promotion programme consisting of three components to enhance dietary diversity: information, education and support delivery. The intervention design incorporates social marketing strategies, and programme evaluation will be conducted concurrently. Data, including the Dietary Variety Score (DVS) for the primary outcome, will be collected through postal and electronic surveys at baseline and at 1, 2 and 3 years, with the 3-year follow-up serving as the primary endpoint for effectiveness evaluation. Statistical analyses will use a generalised linear mixed model, focusing on changes in the DVS as the primary outcome. Sensitivity and subgroup analyses will be performed to assess the generalisability of the findings.

Ethics and dissemination

The Tokyo Metropolitan Institute for Geriatrics and Gerontology Research Ethics Committee has approved the research protocol (approval number: R23-116). The results will be disseminated through conference presentations and publication in peer-reviewed international journals.

Trial registration number

UMIN000056023.

Assessing Clinical Deterioration in Children With Dark‐Coloured Skin: A Scoping Review

ABSTRACT

Background

Signs of clinical deterioration may appear differently in children with dark-coloured skin. How to assess children in this cohort is currently poorly defined.

Aim

To explore available information on the assessment of clinical deterioration in children with dark-coloured skin and identify research deficits.

Methods

A scoping review following Arksey and O'Malley and PRISMA-ScR frameworks. Five online databases, grey literature and reference lists of eligible documents were searched. Source titles, abstracts and full texts were screened. Included documents were assessed for level of evidence according to the Joanna Briggs Institute. Data were charted on a pre-defined data collection tool and analysed through descriptive and content analysis.

Results

Out of 2382 documents screened, 37 were included. Document types included 16 quantitative studies, 14 opinion papers, five reviews and two reports. Most sources (21) were low-level evidence. Sixty-six unique terms were used to describe dark-coloured skin. Eighteen documents reported use of a skin classification system, including race/ethnicity, established colour scales, cosmetic references and observer opinion. Twelve focused on newborn hyperbilirubinaemia. Considerations for assessing jaundice, pallor, cyanosis, pulse oximetry, petechiae and signs of shock were reported. Techniques to improve assessment included optimising the environment, identifying baseline skin colour, and involving families and patients in assessment. No documents reported on assessment of mottling or capillary refill time for children with dark-coloured skin.

Linking Evidence to Action

Assessment of clinical deterioration for children with dark-coloured skin is highly relevant to health professional practice. There is an overall deficit in high-quality research. Specific information gaps in assessment are considerations for mottling, capillary refill time, APGAR scoring, and clinical implications of device overestimation of bilirubin and oxygen saturations in children with dark-coloured skin. Health professionals are encouraged to use devices cautiously. Greater accuracy and objectivity are necessary to fill these gaps and support effective detection of signs of clinical deterioration.

Evaluation of the outpatient parenteral antimicrobial therapy (OPAT) service in Malaysian public hospitals: a mixed-methods study protocol

Por: Lim · A. H. · Ab Rahman · N. · Nor · A. N. M. · Misnan · N. A. · Tok · P. S. K.
Introduction

Outpatient parenteral antimicrobial therapy (OPAT) is an innovative approach to manage infections that require extended courses of intravenous antibiotics by enabling patients to receive treatment in an outpatient setting. In Malaysia, there has yet to be a systematic evaluation of the OPAT service. This study aims to describe the safety, clinical indications and treatment outcomes of the OPAT service in Malaysia, assess patients’ satisfaction and experiences and determine the facilitators and barriers associated with the provision of the OPAT service in Malaysia.

Methods and analysis

A mixed-methods approach combining qualitative and quantitative methods will be employed for a comprehensive understanding of the provision of the OPAT service in Malaysian public hospitals. The study consists of four distinct parts: systematic review, retrospective cohort analysis of clinical outcomes, patients’ satisfaction survey and focus group discussions on providers’ experiences. A longitudinal analysis of the clinical outcomes (treatment success/failure, infection cure, adverse events, readmission and mortality) of the OPAT patients’ cohort will be conducted using descriptive and conclusive statistics, in addition to rates of patients’ satisfaction and evaluation of providers’ experiences.

Ethics and dissemination

This study is registered in the National Medical Research Register (NMRR ID-24-00941-2C8) and approved by the Medical Research and Ethics Committee, Ministry of Health Malaysia (Ref: 24-00941-2C8). Written informed consent will be obtained from all participants. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences.

Flight Nurses' Experiences With Interhospital Transportation of Critically Ill Patients

ABSTRACT

Aim

To explore flight nurses' experiences with interhospital transportation of critically ill patients in fixed-wing aircraft.

Design

The study had a qualitative explorative and descriptive design.

Research Methodology

Nine flight nurses working at five different air bases across Norway were interviewed. Systematic text condensation was used to analyse the data. The study was reported according to the COREQ checklist.

Findings

The data analysis resulted in three categories: Flight nurses being one step ahead when preparation for transporting patients in out-of-hospital environments, Flight nurses' strategies for effective and safe patient transport within the aircraft environment, and Flight nurses' need for a structured and organised handover of patients.

Conclusion

The flight nurses emphasised the need for extensive preparation prior to aeromedical transport to enhance patients' safety. The aircraft environment was a challenge that required them to be creative with the limited resources available and to have a well-functioning interprofessional teamwork.

Implications for Clinical Practice

Knowledge about flight nurses' experiences with interhospital transportations could provide a path to standardisation and inform strategies to enhance interprofessional teamwork. Such knowledge could also contribute to humanising nursing practice during the transportation of critical care patients.

Patient or Public Contribution

There were no patient or public contributions.

Psychological Well‐Being and Optimism–Pessimism of the Elderly People in Nursing Home: The Effect of Regular Intergenerational Visitation

ABSTRACT

Aim

This study was conducted to determine the impact of regular visits by Generation Z individuals on the psychological well-being and optimism–pessimism levels of elderly people in a nursing home.

Methods

The study employed a quasi-experimental design with a single group, utilising pre-test and post-test measurements. “Psychological Well-Being Scale,” and the “Optimism-Pessimism Scale-Adult Form” were used. Study reported in accordance with STROBE Checklist.

Results

The participants (n = 201) had a mean age of 72.40 ± 7.72 years, with most residing in the nursing home for over 5 years. A significant difference was observed between the mean psychological well-being scores of participants before and after the visit. Also, there was a significant difference in the optimism–pessimism dimension scores on the Optimism–Pessimism Scale before and after the visit.

Conclusion

It was established that regular intergenerational visits had a beneficial impact on the psychological well-being of the elderly in nursing homes, resulting in an increase in optimism and a reduction in pessimism.

Relevance to Clinical Practice

Intergenerational programs are gaining more and more attention every day due to their potential to benefit young people, older people, and society. Thus, it may be possible to increase the social support levels of the elderly and prevent negative age discrimination.

Systemic indocyanine green administration to detect bile leakage after liver surgery: a prospective clinical trial, using historical controls

Por: Hanaki · T. · Goto · K. · Tokuyasu · N. · Endo · Y. · Sunada · H. · Noma · H. · Kishino · M. · Yagyu · T. · Uchinaka · E. · Murakami · Y. · Miyatani · K. · Kihara · K. · Matsunaga · T. · Yamamoto · M. · Sakamoto · T. · Hasegawa · T. · Fujiwara · Y.
Objective

The aim of this study was to evaluate the clinical impact of intraoperative indocyanine green (ICG) assessment and subsequent interventions on the total bilirubin concentration in postoperative drainage fluid after hepatectomy. Specifically, this study was conducted to determine whether systemic ICG administration and near-infrared (NIR) imaging to detect and address bile leakage (BL) during liver surgery could improve postoperative outcomes in an intervention group compared with a historical control group.

Design

This was a prospective clinical trial with historical controls that involved inverse probability of treatment weighting (IPTW) analysis to adjust for potential confounding biases resulting from nonrandomised treatment assignments.

Setting

Tottori University Hospital, Japan.

Participants

This study included 84 participants who were undergoing hepatectomy. Among these participants, 40 were prospectively enrolled in the intervention group. The remaining 44 participants underwent hepatectomy without ICG-based assessment or interventions and served as historical controls.

Intervention

In the intervention group, 10 mg of ICG was intravenously administered before liver parenchymal dissection. After hepatic dissection, the resection plane was evaluated and treated as necessary via NIR imaging to detect and address BL.

Primary outcome measure

The primary outcome measure was the total bilirubin concentration in the drainage fluid on postoperative day 3 (POD 3).

Results

According to the IPTW analysis, the total bilirubin concentration in the drainage fluid on POD 3 was significantly lower in the intervention group than in the historical control group. The adjusted mean difference was –1.11 mg/dL (95% CI: –1.49 to –0.72; p

Conclusions

Intraoperative ICG administration and assessment effectively lower bilirubin levels in drainage fluid during hepatectomy, potentially reducing the incidence of BL.

Trial registration number

jRCTs061210043.

Development of risk prediction equations for 5-year diabetes incidence using Japanese health check-up data: a retrospective cohort study

Por: Kawasoe · S. · Kubozono · T. · Ojima · S. · Yamaguchi · S. · Higuchi · K. · Miyahara · H. · Tokushige · K. · Miyata · M. · Ohishi · M.
Objectives

This study aimed to develop risk prediction equations for the 5-year incidence of diabetes among the Japanese population using health check-up data. We hypothesised that demographic and laboratory data from health check-ups could predict diabetes onset with high accuracy.

Design

Retrospective cohort study.

Setting

Data from a health examination in Japan between 2008 and 2016.

Participants

Data were analysed from 31 084 participants aged 30–69 years. The presence of baseline diabetes and endocrine disease was included in the exclusion criteria, as were participants with missing data for the analysis. The study population was randomly divided into derivation and validation cohorts in a 1:1 ratio.

Primary outcome measures

The primary outcome was the incidence of diabetes at the 5-year follow-up, defined as a fasting blood glucose level ≥126 mg/dL, glycosylated haemoglobin A1c (National Glycohemoglobin Standardization Program (NGSP)) ≥6.5%, or initiation of diabetes treatment. Predictor variables included age, sex, body mass index, blood pressure, underlying diseases, lifestyle factors and laboratory measurements. The primary measure was the area under the receiver operating characteristic curve (AUC) for the predictive equations.

Results

In the derivation cohort, diabetes incidence was 5.0%. The prediction equation incorporating age, sex, body mass index, fasting blood glucose and glycosylated haemoglobin A1c showed good discriminatory ability with an AUC of 0.89, sensitivity of 0.81 and specificity of 0.81 in the validation cohort.

Conclusions

The equation with laboratory measures effectively predicted the 5-year diabetes risk in the general Japanese population. It has potential clinical utility for identifying individuals at high risk of diabetes and guiding preventive interventions.

Risk assessment of arteriovenous fistulas focusing on the relationships between the properties of shunted blood flow sounds and a medical/surgical history of hemodialysis patients

by Keiko Tanaka, Keisuke Nishijima, Ken’ichi Furuya, Satoko Shin, Michiaki Kai

The global prevalence of end-stage kidney failure is increasing, with hemodialysis as the primary treatment. An arteriovenous fistula serves as a critical lifeline for patients undergoing hemodialysis, yet its function often deteriorates due to complications such as narrowing or blockage of the blood vessels. This study aimed to clarify the relationships between the sound properties of blood flow through arteriovenous fistulas and a medical/surgical history of patients undergoing hemodialysis by analyzing the distribution of sound frequencies from 100 to 4,000 Hz. Data were collected from 53 patients to identify two key parameters: the time point within one cycle of arteriovenous fistula sounds where the power distribution reached its peak, expressed as a percentage, and the specific frequency where the power was highest within the analyzed range. The results showed that well-functioning arteriovenous fistulas exhibited peak power within the first 25 percent of the sound cycle and the highest power at 200 Hz. In contrast, higher peak percentages and lower power at 200 Hz were associated with surgical interventions due to complications such as narrowing or blockage of the arteriovenous fistula. These findings suggest that the sound properties of arteriovenous fistulas, combined with patient-specific characteristics, may serve as non-invasive indicators of arteriovenous fistula function and help predict the risk of complications. This approach provides valuable insights for improving the management of arteriovenous fistulas and patient outcomes in hemodialysis therapy.

PROtective ileoStomy versus ProtectivE colostomy in anterior Rectal resectIon: study protocol for a multicenter, open-label, randomised conTrolled studY (PROSPERITY)

Por: Koskenvuo · L. · Paajanen · P. · Varpe · P. · Seppälä · T. · Mentula · P. · Haapamäki · C. · Carpelan-Holmström · M. · Carpelan · A. · Lehto · K. · Satokari · R. · Lepistö · A. · Sallinen · V.
Introduction

Loop ileostomy and loop colostomy are both used to form a protective stoma after anterior resection. Evidence regarding which of these two procedures is superior is lacking. Furthermore, no studies comparing changes in the microbiome after loop ileostomy or loop colostomy exist.

Methods and analysis

This multicentre, open-label, superiority, individually randomised controlled trial will include patients who undergo anterior rectal resection with primary anastomosis with a protective stoma. The exclusion criteria are patients who already have a stoma, technical inability to create either type of stoma, aged

Ethics and dissemination

The Ethics Committee of Helsinki University Hospital approved the study (approval number 4579/2024). The findings will be disseminated in peer-reviewed academic journals.

Trial registration

ClinicalTrials.gov, NCT06650085, registered on 20 August 2024. Protocol version: Version 3.0, dated 17 April 2025.

Geriatric Nutritional Risk Index and In‐Hospital Mortality and Costs in Older Inpatients With and Without Cancer: A Retrospective Observational Study

ABSTRACT

Aims

To explore the association of the Geriatric Nutritional Risk Index (GNRI) with in-hospital mortality and costs in older inpatients and to compare these associations between cancer and non-cancer patients to inform clinical practice.

Design

Retrospective observational study.

Methods

A hospital-based study was conducted in Southwest China between January 2018 and December 2020. Demographic, clinical, laboratory and anthropometric data of inpatients aged 65 and over, along with hospitalisation deaths and costs, were collected through the Hospital Information System of a general hospital and its affiliates. GNRI was calculated at admission to assess nutritional risk. Marginal structural models and stratified analyses estimated hospitalisation outcomes for older inpatients with and without various types of cancer across different nutritional risk grades.

Results

Among 37,267 participants, in-hospital mortality and costs increased with higher nutritional risk. Older inpatients with major nutritional risk had significantly higher mortality and costs than those with no nutritional risk. Older cancer inpatients with major nutritional risk had the highest mortality and costs, significantly exceeding those of non-cancer inpatients. For each cancer type, increased nutritional risk was associated with higher in-hospital mortality and costs. Respiratory cancer inpatients with major nutritional risk had the highest mortality, while digestive cancer inpatients had the highest costs.

Conclusion

Higher GNRI-assessed nutritional risk was associated with increased in-hospital mortality and costs in older inpatients, with stronger associations observed in cancer patients compared to non-cancer patients. Integrating GNRI into routine nursing practice could have significant clinical and economic benefits by promoting early nutritional screening in patient care and targeted interventions to reduce mortality and healthcare costs in high-risk populations.

Implications for the Profession and/or Patient Care

Integrating GNRI assessment into routine patient care can effectively identify patients at high risk for in-hospital mortality and costs, allowing for timely nutritional support to enhance patient outcomes. GNRI, as a simple and globally applicable tool, can be integrated into diverse healthcare settings, providing an effective method for nutritional risk screening in older patients. When applying GNRI in clinical nursing and medical practice, special consideration should be given to the presence and type of cancer, as cancer patients with severe nutritional risk may benefit the most from targeted interventions.

Impact

What problem did the study address? This study investigated the association between GNRI-assessed nutritional risk and in-hospital mortality and costs in older inpatients. It further examined whether these associations differ between cancer and non-cancer patients and among different cancer types to improve clinical application.

What were the main findings? The study found that higher nutritional risk assessed by GNRI was associated with increased in-hospital mortality and costs in older inpatients. These associations were stronger in older cancer patients compared to non-cancer patients, with respiratory cancers showing the highest mortality and digestive cancers incurring the highest costs. These findings emphasise the important role of nutritional screening using GNRI in patient care with varying clinical profiles and informing nursing and medical strategies globally, particularly in resource-limited settings.

Where and on whom will the research have an impact? The findings are relevant to older inpatients in hospital settings worldwide, particularly those with cancer, as well as to nurses and healthcare professionals. GNRI provides a practical and easily implementable tool for them to assess nutritional risks upon admission and guide timely nutritional support strategies based on clinical profiles including cancer presence and type in older inpatients. Incorporating GNRI into routine nursing care, nurses and healthcare professionals will be better equipped to address nutritional risks, ultimately improving patient care and optimising clinical and economic outcomes for older patients.

Reporting Method

We have adhered to relevant EQUATOR guidelines, specifically following the STROBE (strengthening the reporting of observational studies in epidemiology) guidelines for reporting this observational study.

Patient or Public Contribution

No public contribution was required in the design or conduct of this research. Patients contributed through data collected from the Hospital Information System, which was used for analysis.

Determinants of Professional Commitment Among Nurses in Turkey: The Role of Workplace Incivility

ABSTRACT

Aim

To measure workplace incivility and professional commitment among nurses, explore how these factors relate to nurses' individual and professional characteristics, and identify the key factors influencing professional commitment.

Design

Cross sectional, descriptive correlational design.

Methods

This study was conducted with 479 nurses working at a public university hospital in Turkey between May 2023 and June 2023. This study followed the Reporting of Observational Studies in Epidemiology Guideline.

Results

In this study, nurses reported experiencing a moderate level of workplace incivility (120.44 ± 32.09), with patients and visitors identified as the primary sources. Nurses also demonstrated moderate levels of professional commitment (72.00 ± 11.04). According to the multiple regression analysis, willingly choosing the profession, job satisfaction, and workplace incivility were found to significantly influence professional commitment. A key finding of the study was the negative impact of workplace incivility on professional commitment.

Conclusion

The most notable finding of this study underscores the critical importance of preventing workplace incivility and increasing job satisfaction as key strategies for enhancing professional commitment.

Implications for the Profession and/or Patient Care

Nurse managers should implement practices and procedures to reduce workplace incivility, promote a culture of civility in clinical nursing environments, and improve working conditions to enhance job satisfaction. It is anticipated that these measures will lead to an increase in nurses' professional commitment.

Patient or Public Contribution

No Patient or Public Contribution.

Potential consequences of phototoxicity on cell function during live imaging of intestinal organoids

by Yuki Yokoi, Ryu Nakamura, Shuya Ohira, Shota Takemi, Tokiyoshi Ayabe, Kiminori Nakamura

Live imaging visualizes the structure, dynamics, and function of cells and tissues to reveal the molecular mechanisms, and has contributed to the advancement of life science. In live imaging, it has been well known that there is a trade-off between higher-resolution analysis and cell damage caused by light illumination, i.e., phototoxicity. However, despite the risk of unknowingly distorting experimental results, phototoxicity is an unresolved issue in live imaging because overall consequences occurring inside cells due to phototoxicity remains unknown. Here, we determined the molecular process of phototoxicity-induced cell damage systematically under low- and high-dose light illumination conditions by analyzing differential gene expression using RNA-sequencing in a three-dimensional organoid of small intestinal epithelial cells, enteroid. The low-dose light illumination already induced various abnormalities in functional molecules involved in the response to reactive oxygen species generated by the excitation of fluorescent dyes, intracellular metabolism, mitosis, immune responses, etc., at mRNA expression level. Together with the behavior toward apoptosis caused by high-dose light illumination, the light dose-dependent progression of intracellular damage was revealed. About visible impairment of intestinal epithelial function, failures in both the structure-forming ability of enteroids and Paneth cell granule secretion were observed under high-dose light illumination, while the drug efflux was not disturbed despite abnormal drug efflux transporter mRNA expression. Based on the gene expression profiles, we comprehensively clarified phenomena in the cells at mRNA level that cannot be recognized both morphologically and functionally during live imaging, further providing a new insight into the risk of phototoxicity. This study warns from the aspect of mRNA expression that awareness of phototoxic artifacts is needed when analyzing cellular function and the mechanism in live imaging.

Update to the essential genomic nursing competencies and outcome indicators

Abstract

Introduction

Genomic healthcare applications have relevance to all healthcare professionals including nursing, and most evidence-based clinical applications impact the quality and safety of healthcare. To guide nursing genomic competency initiatives, the Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics were established through a process of consensus in 2005. A 2009 update incorporated outcome indicators consisting of specific areas of knowledge and clinical performance indicators, to help support academic integration. Almost 20 years have elapsed since these competencies were first established, yet incorporating the competencies into general and specialty scope and standards of nursing practice is inconsistent, competency integration into curricula is highly uneven, continuing education in genomics for nurses is limited, and the genomic capacity of the nursing workforce remains low. These deficits have persisted despite substantial advances in genomic technology which substantially reduced costs and increased evidence-based clinical applications, including direct to consumer genomic tests, the integration of genomics into evidence-based guidelines, and evidence that genomics impacts the quality and safety of healthcare.

Design

The aim of this project was to update and achieve consensus on genomic competencies applicable to all registered nurses. This was a mixed methods study.

Methods

The update to the competencies was performed based first on a literature review to update the competencies based on the current state of the evidence. Using the updated content, a modified Delphi study was conducted with registered nurse panelists from clinical, academic, and research settings. Once consensus was achieved, the competencies were made available through the American Nurses Association for public comment. Public comments were then reviewed and integrated as needed.

Results

The literature review resulted in a transition from genetics to genomics, given the reduction in costs, which resulted in an expansion of the scope of testing in both the germline and somatic contexts. Two Delphi rounds were required to reach consensus prior to the public comment period. Public comments were solicited through the American Nurses Association, and each comment was reviewed by the authors and addressed as indicated.

Conclusion

The Essentials of Genomic Nursing: Competencies and Outcome Indicators constitute the minimum competency in genomics required of all registered nurses regardless of the level of academic training, role, or specialty.

Clinical Relevance

Evidence-based genomic applications span the entire healthcare continuum and, therefore, are relevant for all registered nurses regardless of academic training, role, practice setting, or clinical expertise. These competencies serve as the guide for the minimum requirements for registered nurse practice as well as guide curricula and continuing education for all registered nurses, including but not limited to administrators, educators, nursing leaders, practicing nurses, and researchers.

Youth, caregiver and healthcare professional perspectives on planning the implementation of a trauma‐informed care programme: A qualitative study

Abstract

Aims

To explore youth, caregiver and staff perspectives on their vision of trauma-informed care, and to identify and understand potential considerations for the implementation of a trauma-informed care programme in an inpatient mental health unit within a paediatric hospital.

Design and Methods

We applied the Interpretive Description approach, guided by complexity theory and the Implementation Roadmap, and used Applied Thematic Analysis methods.

Findings

Twenty-five individuals participated in individual or group interviews between March and June 2022, including 21 healthcare professionals, 3 youth and 1 caregiver. We identified two overarching themes. The first theme, ‘Understanding and addressing the underlying reasons for distress’, related to participants’ understanding and vision of TIC in the current setting comprising: (a) ‘Participants’ understanding of TIC’; (b) ‘Trauma screening and trauma processing within TIC’; (c) ‘Taking “a more individualized approach”’; (d) ‘Unit programming’; and (e) “Connecting to the community”. The second theme, ‘Factors that support or limit successful TIC implementation’ comprises: (a) ‘The need for a broad “cultural shift”’; (b) ‘The physical environment on the unit’; and (c) ‘Factors that may limit successful implementation’.

Conclusion

We identified five key domains to consider within trauma-informed care implementation: (a) the centrality of engagement with youth, caregivers and staff in trauma-informed care delivery and implementation, (b) trauma-informed care core programme components, (c) factors that may support or limit success in implementing trauma-informed care within the mental health unit and (d) hospital-wide and (e) the importance of intersectoral collaboration (partnering with external organizations and sectors).

Impact

When implementing TIC, there is an ongoing need to increase clarity regarding TIC interventions and implementation initiatives. Youth, caregiver and healthcare professional participants shared considerations important for planning the delivery and implementation of trauma-informed care in their setting. We identified five key domains to consider within trauma-informed care implementation: (a) the centrality of relational engagement, (b) trauma-informed care programme components, (c) factors that may support or limit successful implementation of trauma-informed care within the mental health unit and (d) hospital-wide and (e) the importance of intersectoral collaboration. Organizations wishing to implement trauma-informed care should consider ongoing engagement with all relevant knowledge user groups throughout the process.

Reporting Method

Standards for Reporting Qualitative Research (SRQR).

Patient or Public Contribution

The local hospital research institute's Patient and Family Advisory Committee reviewed the draft study methods and provided feedback.

Clinical Knowledge Model for the Prevention of Healthcare-Associated Venous Thromboembolism

imageKnowledge models inform organizational behavior through the logical association of documentation processes, definitions, data elements, and value sets. The development of a well-designed knowledge model allows for the reuse of electronic health record data to promote efficiency in practice, data interoperability, and the extensibility of data to new capabilities or functionality such as clinical decision support, quality improvement, and research. The purpose of this article is to describe the development and validation of a knowledge model for healthcare-associated venous thromboembolism prevention. The team used FloMap, an Internet-based survey resource, to compare metadata from six healthcare organizations to an initial draft model. The team used consensus decision-making over time to compare survey results. The resulting model included seven panels, 41 questions, and 231 values. A second validation step included completion of an Internet-based survey with 26 staff nurse respondents representing 15 healthcare organizations, two electronic health record vendors, and one academic institution. The final knowledge model contained nine Logical Observation Identifiers Names and Codes panels, 32 concepts, and 195 values representing an additional six panels (groupings), 15 concepts (questions), and the specification of 195 values (answers). The final model is useful for consistent documentation to demonstrate the contribution of nursing practice to the prevention of venous thromboembolism.
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