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  • Publication
    Conceptualising a model to guide nursing and midwifery in the community guided by an evidence review
    Background: Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. Methods: A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. Results: The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Conclusion: Use of a conceptual model of nursing and midwifery to inform decision-making in primary/community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance.
      251Scopus© Citations 2
  • Publication
    The impact of COVID-19 on health systems, mental health and the potential for nursing
    Coronovirus (COVID-19) has emerged as the first global pandemic in the twenty-first century (Anderson et al., 2020). COVID-19 is an infection from the new coronavirus Severe Acute Respiratory Syndrome CoVid-2 (SARS-CoV-2). Historically, coronaviruses only caused infections in animals. To date, we know of at least seven that have transferred to human beings. Most of these corona-related infections have caused mild symptoms. However, two, the Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) have proved more severe and resulted in deaths (Ludwick & Zarbock, 2020). Political and health systems’ responses to COVID-19 have demanded extraordinary public health measures at a population level to respond to modifiable factors such as opportunity and transmission (Kucharski, 2020). Globally, the COVID-19 pandemic has imposed significant restrictions on social contact. In Ireland, a series of targeted social movement measures were implemented from March 27th, 2020. These included practices such as social distancing and cocooning for people over 70 years and those with various morbidities. Responses have also been focused on mass population based testing, isolation of those who are positive, contact tracing and social isolation of contacts. While the mental health impacts of this pandemic are not fully clarified, it is reasonable to project that there will be unintended, yet enduring impacts in the context of individual mental health, population health as well as impacts on the way health services are delivered in the medium term until a vaccine is isolated.
      156Scopus© Citations 19