Now showing 1 - 4 of 4
  • Publication
    A Report of the Review of Undergraduate Nursing and Midwifery Curriculum leading to Registration in Ireland
    This report presents the findings of a comprehensive review of the Undergraduate Nursing and Midwifery Curricula leading to Registration in Ireland (RUN ME) funded by the Nursing and Midwifery Board of Ireland (NMBI). The NMBI, as regulators publish standards and requirements to guide the design, development, delivery and evaluation of the nursing and midwifery registration education programmes. The last review of the nursing and midwifery education curriculum was in 2012, which led to the development of revised standards and requirements in 2016, which were subsequently updated in 2023. The health service has undergone significant reform since the last review of nursing and midwifery curriculum. The implementation of the Sláintecare policy to deliver healthcare as close to a person’s home as possible is evident, in particular with the noticeable emergence of community hubs nationally. The demographics of the population of Ireland and the healthcare workforce has also changed dramatically since that time. One third of nurses and midwives registered in Ireland are non-Irish (NMBI, 2022) and in 2021, 61% (n=3,021) of first-time registrants with NMBI identified as non-European Union citizens (NMBI, 2022). Nursing and midwifery combined remains the largest group of professionals in the workforce.
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  • Publication
    Reconceptualizing children's complex discharge with health systems theory: novel integrative review with embedded expert consultation and theory development
    AIM: To report a novel review to develop a health systems model of successful transition of children with complex healthcare needs from hospital to home. BACKGROUND: Children with complex healthcare needs commonly experience an expensive, ineffectual and prolonged nurse-led discharge process. Children gain no benefit from prolonged hospitalization and are exposed to significant harm. Research to enable intervention development and process evaluation across the entire health system is lacking.DESIGN:Novel mixed-method integrative review informed by health systems theory. DATA SOURCES: CINAHL, PsychInfo, EMBASE, PubMed, citation searching, personal contact. REVIEW METHODS:Informed by consultation with experts. English language studies, opinion/discussion papers reporting research, best practice and experiences of children, parents and healthcare professionals and purposively selected policies/guidelines from 2002-December 2012 were abstracted using Framework synthesis, followed by iterative theory development.RESULTS: Seven critical factors derived from thirty-four sources across five health system levels explained successful discharge (new programme theory). All seven factors are required in an integrated care pathway, with a dynamic communication loop to facilitate effective discharge (new programme logic). Current health system responses were frequently static and critical success factors were commonly absent, thereby explaining ineffectual discharge. CONCLUSION: The novel evidence-based model, which reconceptualizes 'discharge' as a highly complex longitudinal health system intervention, makes a significant contribution to global knowledge to drive practice development. Research is required to develop process and outcome measures at different time points in the discharge process and future trials are needed to determine the effectiveness of integrated health system discharge models.
      963Scopus© Citations 21
  • Publication
    Integrated care for children living with complex care needs: an evolutionary concept analysis
    Children with complex care needs (CCNs) are in need of improved access to healthcare services, communication, and support from healthcare professionals to ensure high-quality care is delivered to meet their needs. Integrated care is viewed as a key component of care delivery for children with CCNs, as it promotes the integration of healthcare systems to provide family and child-centred care across the entire health spectrum. There are many definitions and frameworks that support integrated care, but there is a lack of conceptual clarity around the term. Furthermore, it is often unclear how integrated care can be delivered to children with CCNs, therefore reinforcing the need for further clarification on how to define integrated care. An evolutionary concept analysis was conducted to clarify how integrated care for children with CCNs is defined within current literature. We found that integrated care for children with CCNs refers to highly specialised individualised care within or across services, that is co-produced by interdisciplinary teams, families, and children, supported by digital health technologies. Conclusion: Given the variation in terms of study design, outcomes, and patient populations this paper highlights the need for further research into methods to measure integrated care.
    Scopus© Citations 7  187
  • Publication
    Structured sedation programs in the emergency department, hospital and other acute settings: protocol for systematic review of effects and events
    The use of procedural sedation outside the operating theatre has increased in hospital settings and has gained popularity among non-anesthesiologists. Sedative agents used for procedural pain, although effective, also pose significant risks to the patient if used incorrectly. There is currently no universally accepted program of education for practitioners using or introducing procedural sedation into their practice. There is emerging literature identifying structured procedural sedation programs (PSPs) as a method of ensuring a standardized level of competency among staff and reducing risks to the patient. We hypothesize that programs of education for healthcare professionals using procedural sedation outside the operating theatre are beneficial in improving patient care, safety, practitioner competence and reducing adverse event rates. Electronic databases will be systematically searched for studies (randomized and non-randomized) examining the effectiveness of structured PSPs from 1966 to present. Database searches will be supplemented by contact with experts, reference and citation checking, and a grey literature search. No language restriction will be imposed. Screening of titles and abstracts, and data extraction will be performed by two independent reviewers. All disagreements will be resolved by discussion with an independent third party. Data analysis will be completed adhering to procedures outlined in the Cochrane Handbook of Systematic Reviews of Interventions. If the data allows, a meta-analysis will be performed. This review will cohere evidence on the effectiveness of structured PSPs on sedation events and patient outcomes within the hospital and other acute care settings. In addition, it will examine key components identified within a PSP associated with patient safety and improved patient outcomes. PROSPERO registration number: CRD42013003851.
      167Scopus© Citations 7