Health care assistant and registered nurse dyads, working together and apart - a qualitative study.

Background: This study was undertaken to understand the role of the Health Care Assistants and how they negotiate roles and responsibilities with Registered Nurses in adult acute hospitals.

Methods: The qualitative approach of focused ethnography used non-participant observation and interviews with staff from four acute wards. Field notes and interview data, analysed using NVIVO10, moved data from description through explanation, interpretation and identification of themes.

End-of-life care in the patient's home.

Background: Providing end-of-life care in a patient's home is challenging, especially if the nurse is from a different ethnic background from the patient. Evidence shows that people from an ethnic minority background often experience poorer end-of-life care due to care providers not understanding their care needs.

Aim: To explore the experiences of community nursing staff caring for patients with an ethnic minority background at the end of their life.

Developing a clinical academic career pathway in a Community and Mental Health NHS Trust.

Background: Despite growing evidence of the impact that clinical academic (CA) staff have on patient care and clinical practice, there are disproportionately low numbers of nurses, allied health professionals (AHPs) and other healthcare professionals in CA joint roles, compared to their medical colleagues.

Aim: To describe the initial development of a CA career pathway for nurses, AHPs and other healthcare professionals in a Community and Mental Health NHS Trust.

Methods: Kotter's 8-Step Change Model was used to expand opportunities and research culture across an NHS Trust.

Emergency trauma care during the COVID-19 pandemic: A phenomenological study of nurses' experiences.

Objective: This study aimed to explore nurses' experiences in delivering emergency trauma care during the COVID-19 pandemic at a level I trauma centre in Saudi Arabia.

Methods: A qualitative, descriptive phenomenological design was utilised, in which face-to-face, unstructured interviews were carried out with emergency and trauma nurses at a level I trauma centre in Saudi Arabia. The study included nine registered emergency and trauma nurses who were interviewed twice from February to April 2021.

'': Exploring the experiences of families affected by dementia during the COVID-19 pandemic.

Introduction: When the first national COVID-19 lockdown came into effect in the UK in March 2020, life changed significantly. Some services and social contacts for people with dementia and their families stopped, while others, for example, peer support, moved online. This research explored the experiences of families affected by dementia during the pandemic, specifically those living in the community.

Developing country-specific questions about end-of-life care for nursing home residents with advanced dementia using the nominal group technique with family caregivers.

Objective: We aimed to develop question prompt lists (QPLs) for family caregivers of nursing home residents with advanced dementia in the context of a study involving Canada, the Czech Republic, Italy, the Netherlands, the United Kingdom and Ireland, and to explore cross-national differences. QPLs can encourage family caregivers to ask questions about their relative's end-of-life care.

Methods: We used nominal group methods to create country-specific QPLs.

Parent-led strategies supporting personal well-being when caring for a child with a life-limiting condition: A scoping review.

The objectives of this review were to identify strategies initiated by parents of children with life-limiting conditions to support their own well-being at home and to describe the impact of these strategies on parental well-being. A systematic scoping review was performed using PRISMA-ScR guidelines, identifying 15 relevant studies that fit the inclusion and exclusion criteria. There were no studies that specifically assessed how parents support their own well-being; however, the 15 identified studies did provide pertinent data secondary to the primary aims of each study.

'This Adds Another Perspective': Qualitative Descriptive Study Evaluating Simulation-Based Training for Health Care Assistants, to Enhance the Quality of Care in Nursing Homes.

Much of the UK's ageing population lives in care homes, often with complex care needs including dementia. Optimal care requires strong clinical leadership, but opportunities for staff development in these settings are limited. Training using simulation can enable experiential learning in situ.

Palliative care in Creutzfeldt-Jakob disease: looking back, thinking ahead.

Creutzfeldt-Jakob disease (CJD) is a rare and fatal neurodegenerative disease for which there is no cure. However, it is difficult to diagnose and is unique in that it is both a genetic and transmissible disease. The disease is characterised by symptoms of a rapidly progressive dementia.

Ethical care during COVID-19 for care home residents with dementia.

The COVID-19 pandemic has had a devastating impact on care homes in the United Kingdom, particularly for those residents living with dementia. The impetus for this article comes from a recent review conducted by the authors. That review, a qualitative media analysis of news and academic articles published during the first few months of the outbreak, identified ethical care as a key theme warranting further investigation within the context of the crisis.

Examining the UK Covid-19 mortality paradox: Pandemic preparedness, healthcare expenditure, and the nursing workforce.

Aim: To examine the UK pandemic preparedness in light of health expenditure, nursing workforce, and mortality rates in and relation to nursing leadership.

Background: The Global Health Security Index categorized the preparedness of 195 countries to face a biological threat on a variety of measures, producing an overall score. The United States of America and the United Kingdom were ranked 1st and 2nd most prepared in 2019.

A training needs analysis of admiral nurses to facilitate advance care planning in dementia.

Unlabelled: Education of health and social care professionals is essential in preparation to confidently and effectively support families affected by dementia to undertake advance care planning. This article describes a training needs analysis of Admiral Nurses, dementia specialists, in facilitating advance care planning for future care.

Methods: A questionnaire survey was completed by Admiral Nurses attending end-of-life care masterclasses in 2017 and 2018.

Investigation into attitudes towards older people with dementia in acute hospital using the Approaches to Dementia Questionnaire.

Background: Health care professionals have poor recognition of cognitive impairment among older patients and often have difficulties in providing care for people with dementia in acute hospitals. There are also reported high levels of stigma and negative staff attitudes towards people with dementia.

Methodology: A one-time survey of staff working on acute medical and orthopaedic wards of five District Health Boards in New Zealand using the 'Approaches to Dementia Questionnaire'; a 19-item Questionnaire that aims to capture two attitudinal domains (Hope and Person-Centredness), towards people with dementia.

Prison Nurses' Professional Identity.

In the United Kingdom, health and justice services nurses are a diverse group working across a range of contexts and settings such as police custody, sexual assault referral centers, young offenders' institutes, and prisons and probation. Recruitment and retention to the specialist field of health and justice services nursing, specifically prison nursing, is problematic in the United Kingdom. In this article, we consider the background to the current situation in prison nursing and summarize some of the existing literature and research relating to this specialty to raise, for discussion and debate, issues that are pertinent to the concept of professional identity and professionalism.

Advance care planning for older people: The influence of ethnicity, religiosity, spirituality and health literacy.

In this discussion paper we consider the influence of ethnicity, religiosity, spirituality and health literacy on Advance Care Planning for older people. Older people from cultural and ethnic minorities have low access to palliative or end-of-life care and there is poor uptake of advance care planning by this group across a number of countries where advance care planning is promoted. For many, religiosity, spirituality and health literacy are significant factors that influence how they make end-of-life decisions.

Advance care planning in dementia: recommendations for healthcare professionals.

The process of advance care planning in dementia is far from straightforward; as dementia progresses, the ability to consider future thoughts and actions becomes compromised, thus affecting decision-making abilities. Family carers find themselves increasingly in a position where they need to inform, or directly make, decisions on behalf of the person with dementia. This article discusses the context and importance of a palliative care approach and recommends rationales and strategies for healthcare professionals to support families affected by dementia to better plan for their future care.

Advance care plans in dementia: user-centred design.

Objectives: Historically, dementia has not been recognised as a life-limiting condition or one that may benefit from a palliative approach to its care. There are many challenges in providing palliative and end-of-life care to this group of people, some of which may be reduced through advance care planning (ACP) to support people with dementia to have a greater influence on their care at end of life. ACP has been defined as a process of discussing and recording of wishes, values and preferences for future care and treatment held between an individual, family members and their care provider(s) that takes effect when the person loses capacity.

Managing risk during care transitions when approaching end of life: A qualitative study of patients' and health care professionals' decision making.

Background: Increasing importance is being placed on the coordination of services at the end of life.

Aim: To describe decision-making processes that influence transitions in care when approaching the end of life.

Design: Qualitative study using field observations and longitudinal semi-structured interviews.

The challenges in caring for morbidly obese patients in Intensive Care: A focused ethnographic study.

Background: Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges. However little is known about the care of these patients in intensive care.

Objective: To explore medical and nursing practices and attitudes in intensive care when caring for critically ill morbidly obese patients.

How do we enhance undergraduate healthcare education in dementia? A review of the role of innovative approaches and development of the Time for Dementia Programme.

Objectives: Traditional healthcare education, delivered through a series of time-limited clinical placements, often fails to deliver an understanding of the experiences of those with long-term conditions, a growing issue for healthcare systems. Responses include longitudinal integrated clerkships and senior mentor programmes allowing students' longer placements, continuity of contact and opportunities to learn about chronic illness and patient experience. We review their development and delivery in dementia and present the Time for Dementia (TFD) Programme, a novel 2-year interdisciplinary educational programme.

Redefining the patient-carer model at end of life.

Context: While the patient-carer dyad has been broadly described, there is little exploration of patient-carer models in use.

Aim: To explore types of patient-carer models in use for those with advanced and progressive disease.

Methods: Qualitative interviews were undertaken with patients at risk of dying in the next year and their carers across three sites (residential care home, medical assessment unit, general medical unit).

'And so I took up residence': The experiences of family members of people with dementia during admission to an acute hospital unit.

It is estimated that a quarter of acute hospital beds are in use by older people with dementia at any one time. Little empirical research has been carried out that has specifically examined the day-to-day input of family members into the care of people with dementia during an acute hospital admission. In this article, we present the results of analysis of interviews with 26 family members of people with dementia about their experiences of supporting an admission of a person with dementia to an acute hospital unit in New Zealand.

Ethical dilemmas faced by hospice nurses when administering palliative sedation to patients with terminal cancer.

Objective: Palliative sedation is a method of symptom management frequently used in hospices to treat uncontrolled symptoms at the end of life. There is a substantial body of literature on this subject; however, there has been little research into the experiences of hospice nurses when administering palliative sedation in an attempt to manage the terminal restlessness experienced by cancer patients.

Method: Semistructured interviews were conducted with a purposive sample of seven hospice nurses who had cared for at least one patient who had undergone palliative sedation within the past year in a hospice in the south of England in the United Kingdom.

Managing social awkwardness when caring for morbidly obese patients in intensive care: A focused ethnography.

Background: Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges in the intensive care setting. These are resultant from specific physiological responses to critical illness in this population and the nature of the interventional therapies used in the intensive care environment. An additional challenge arises for this population when considering the social stigma that is attached to being obese.