Embedding research (ER) led by nurses, midwives and allied health professionals (NMAHPs): the NMAHP-ER model.

Background: Previous embedded researcher models have focused predominantly on an individual being a temporary team member and embedded for a project-limited short-term placement.

Aim: To develop an innovative research capacity building model to address the challenges of developing, embedding and sustaining, research led by Nurses, Midwives, and Allied Health Professionals (NMAHPs) in complex clinical environments. This healthcare and academic research partnership model offers an opportunity to support the 'how' of enabling NMAHP research capacity building from within the researchers' clinical area of expertise.

Co-creating system-wide improvement for people with traumatic brain injury across one integrated care system in the United Kingdom to initiate a transformation journey through co-production.

Background And Objective: There is a need for better integration of services across communities and sectors for people living with traumatic brain injury (TBI) to meet their complex needs. Building on insights gained from earlier pilot work, here we report the outcomes of a participatory workshop that sought to better understand the challenges, barriers and opportunities that currently exist within the care pathway for survivors of TBI.

Methods: A diverse range of stakeholders from the acute and rehabilitation care pathway and the health and social care system were invited to participate in a 3-h workshop.

'Guiding Lights for effective workplace cultures': enhancing the care environment for staff and patients in older people's care settings.

While much attention has been given to organisational culture, there has been less focus on workplace culture. Yet workplace culture strongly influences the way care is delivered, received and experienced. An effective workplace culture is crucial for the well-being of individual staff members and teams as well as for patients' experiences and outcomes of care.

A thematic analysis of system wide learning from first wave Covid-19 in the East of England.

Background: The Covid-19 pandemic has created an unprecedented challenge for health and social care systems globally. There is an urgent need for research on experiences of COVID-19 at different levels of health systems, including lessons from professional, organisational and local system responses, that can be used to inform managerial and policy responses.

Methods: This paper presents the findings from a thematic analysis of front-line staff experiences working across the Norfolk and Waveney integrated care system (ICS) in the East of England during April and October 2020 to address the question "What are the experiences and perceptions of partner organisations and practitioners at multiple levels of the health system in responding to COVID-19 during the first wave of the pandemic?" This question was posed to learn from how practitioners, interdependent partner organisations and the system experienced the pandemic and responded.

Contemporary Challenges of Nursing CPD: Time to change the model to meet citizens' needs.

The purpose of this paper is to present the evidence shared with a citizen Consensus panel detailing key issues associated with how nursing CPD can best influence the quality of health and social care experienced by citizens and communities. It presents a summary of contemporary theory, research and evidence of the effectiveness of nursing CPD and outlines four key challenges: (i) how to strengthen the focus on patient experience as the starting point for CPD; (ii) the lack of evidence of CPD effectiveness and accountability in its transfer to practice; (iii) evaluation of CPD effectiveness; and (iv) involving citizens in targeting CPD where it is most needed. It briefly describes the methods used to facilitate public consultation through a citizen Consensus panel as part of a collaborative project with the RCN Strategic Research Alliance in 2020 and outlines 7 themes identified as important by the public for future development.

Factors that optimise the impact of continuing professional development in nursing: A rapid evidence review.

Objectives: Continuing professional development is essential for healthcare professionals to maintain and acquire the necessary knowledge and skills to provide person centred, safe and effective care. This is particularly important in the rapidly changing healthcare context of the Covid-19 pandemic. Despite recognition of its importance in the United Kingdom, minimum required hours for re-registration, and related investment, have been small compared to other countries.

The Venus model for integrating practitioner-led workforce transformation and complex change across the health care system.

Aims And Objectives: The aim of this paper is to present the Venus model for workforce transformation, demonstrating its research origins, theoretical foundations, and practical application for enabling individuals, teams, and services to sustain transformation in the workplace.

Methods: The paper provides a brief synopsis of how the Venus model was generated from four large-scale mixed-method studies embracing workforce transformation, safety culture, integrated facilitation, and continuous professional development.

Results: The Venus model has five stems and identifies key integrated skill sets pivotal to successful transformation, which are interdependent: Being able to facilitate an integrated approach to learning, development, improvement, knowledge translation, inquiry, and innovation-drawing on the workplace itself as an influential resource; Being a transformational and collective leader building relationships that encourage curiosity, creativity, and harnessing the talents of all not just a few; Being a skilled practice developer focused on achieving the key values of being person-centred, and the ways of working that are collaborative, inclusive, and participative; Applying improvement skills that enable small step change using measurement wisely to focus on measuring what is valued as well as evaluating positive progress; and, finally Facilitating culture change at the micro-systems level while being attuned to the organizational and systems enablers required to support this.

Developing an integrated career and competence framework for a whole systems approach to urgent and emergency care delivery.

Background: The impact of crowding in emergency departments on patient safety, staff wellbeing, residents' education and performance of the wider healthcare systems is a global concern. Attention to whole systems healthcare strategies to improve service efficiency is growing, but staff are not well prepared to deliver care across organizational boundaries. Our study aimed to develop an integrated career and competence framework for whole systems urgent and emergency care.

A realist synthesis of effective continuing professional development (CPD): A case study of healthcare practitioners' CPD.

Background: Continuing professional development (CPD) in healthcare is fundamental for making sure frontline staff practice safely and effectively. This requires practitioners to update knowledge and skills regularly to match the changing complexity of healthcare needs. The drive towards using limited resources effectively for service improvements and the need for a flexible workforce necessitate a review of ad hoc approaches to CPD.

Developing standards for an integrated approach to workplace facilitation for interprofessional teams in health and social care contexts: a Delphi study.

Integration of health and social care forms part of health and social care policy in many countries worldwide in response to changing health and social care needs. The World Health Organization's appeal for systems to manage the global epidemiologic transition advocates for provision of care that crosses boundaries between primary, community, hospital, and social care. However, the focus on structural and process changes has not yielded the full benefit of expected advances in care delivery.

Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.

Background: Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery.

Making the complexity of community nursing visible: the Cassandra project.

The need to effectively promote safe staffing levels in community settings challenges commissioners and providers of services to find rigorous methods of capturing workforce evidence that can be systematically used to shape effective services and skill mix for the future. This article presents a brief review of current approaches and challenges to measuring community nursing workload activity in England. Specifically, it shows phase 1 pilot results using the Cassandra Matrix activity tool and review of ongoing developments and progress to demonstrate scalability for national implementation.

Educating advanced level practice within complex health care workplace environments through transformational practice development.

Over the past 20 years health care reform has influenced the development of advanced level practitioner roles and expectations. How advanced level practitioners work to survive the highly stimulating, yet sometimes overwhelming aspects of balancing high quality provision with political reform agendas, amidst economic constraint is considered. Transformational approaches (encompassing education and practice led service development) can provide, promote and 'provoke' a harnessing of complex issues workplace environment to produce creative solutions.

Leadership and responsive care: principle of Nursing Practice H.

This is the final article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle H, the need for leadership among staff and the provision of care that is responsive to individuals' needs.

Person-centred care: Principle of Nursing Practice D.

This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle D, the provision of person-centred care.

Principles of nursing practice: development and implementation.

This article, the first in a nine-part series, describes the development of the recent Principles of Nursing Practice initiative. It provides an overview of the Principles, the objectives that informed them and the challenges experienced in their development.

Nursing talent.

In the first of a new series, the nature and characteristics of nursing expertise are explored.

Leadership role of Consultant Nurses working with Older People: a co-operative inquiry.

Aims: The aim of the co-operative enquiry undertaken was to explore how the leadership component of the Consultant Nurse for Older People role was reflected in day-to-day working.

Background: Leadership is one of the four key elements of the Consultant Nurse role and is the key mechanism for achieving and embedding transformation in practice. However, within the role of the Consultant Nurse this area has not been explored in detail.