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• Experienced registered nurses who are employed as nurse navigators provide effective co-ordinated care to people living with multiple chronic conditions. • Nurse navigators effectively use value-based care to help reconnect patients who have lost trust in the health service, to reconnect with their interdisciplinary teams. • Nurse navigators provide individualized, authentic care, which is more than the sum of hospital avoidance. Nurse navigators are an emerging workforce providing care to people with multiple chronic conditions. The role of the navigators is to identify patients requiring support in negotiating their health care. A critical discourse analysis was used to examine qualitative data collected from nurse navigators and consenting navigated patients to identify key indicators of how nurse navigators do their work and where the success of their work is most evident. Nurse navigators help patients who have lost trust in the health system to re-engage with their interdisciplinary health care team. This re-engagement is the final step in a journey of addressing unmet needs, essential to hospital avoidance. Nurse navigators provide a continuum of authentic and holistic care. To acknowledge the true value of nurse navigators, their performance indicators need to embrace the value-added care they provide. [ABSTRACT FROM AUTHOR]

Pregnant women in prisons are recognised as a marginalised group. However, there is a limited understanding of the women's unique maternity needs and how correctional institutions and maternity service providers respond to these needs. The aims of the review are threefold. 1. Identify pregnant women's needs during the antenatal, birthing and postnatal periods in prison. 2. Examine how the pregnant incarcerated women's needs are met by the correctional institutions. 3. Explore what maternity services are available and how these services are provided. An integrative literature review was undertaken. A comprehensive search strategy using seven electronic databases resulted in the retrieval of 363 articles. Of them, 32 peer-reviewed studies met the final selection criteria and were included in this review which utilised the Critical Appraisal Skills Program tools and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. Thematic analysis identified universal themes. Three dominant themes emerged related to the experience of pregnant women in prison: (1) risks and vulnerability factors; (2) prison enablers and supports; and (3) prison barriers. Extant research on risks and vulnerability factors is disproportionate to research examining how prisons can enable or obstruct responding to the women's perinatal needs. Limited research on the midwifery support available to the women in prison is available. Significantly, only two out of 32 reviewed papers include research directly conducted with the pregnant women in prison. Pregnant women in prisons have complex needs. More research is required to understand how prisons can enhance the pregnancy experience by engaging pregnant women in prisons as research participants. [ABSTRACT FROM AUTHOR]

High-risk pregnancy, or one with escalating complexities, requires the inclusion of numerous health professions in care provision. A strategy of midwife navigators to facilitate the smooth transition across models of care and service providers has now been in place in Queensland, Australia, for over twelve months, and a formal review process will soon begin. Navigators are experienced nurses or midwives who have the expertise and authority to support childbearing women with chronic or complex problems through the health system so that it is co-ordinated and they can transition to self-care. This includes ensuring a logical sequence in tests and procedures, providing education, or facilitating access to specialist care. The navigator evaluation included a review of existing models of care that support women with chronic and complex needs during their pregnancy. This paper describes the integrative literature review that explored the transitioning of care models. The review followed formal Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, utilised the Critical Appraisal Skills Program tools and analysed a final 33 papers, published from 2000 onwards in professional, peer-reviewed journals and databases. Four key themes of communication, context, visibility and frames were identified, discussed in depth, and considered in the current body of knowledge. The outcomes refer clearly to 'property rights' or turf protected by invisible fences and gatekeeping by midwives and other health professionals. This review may inform development of future frameworks and practice review to better address the needs of pregnant women. [ABSTRACT FROM AUTHOR]

In this study, we tested the feasibility of using a narrative inquiry - three-dimensional space inquiry to elicit the experiences of an adult family member who shared her journey of care and advocacy for her husband situated in a dementia care unit. The voices of family members are rarely heard in relation to their experiences about being included in or making decisions about their loved one's care. Shared decision-making has been an important patient-centred approach to nursing care since the 1990s; however, it is often not a reality in aged care facilities. An interview was conducted with one adult family member using the three-dimension space that is inspired by narrative theorists to analyse the narrative. Three themes were identified in the responses: communication between staff and family, staffing in the dementia care unit, and loss of voice and shared decision making. Results of this study indicate that narrative inquiry supports the telling of personal experiences around a problem and then using that information to raise awareness of those issues that are not always heard but which are essential for change in health care policy and practice. • Ignoring and not informing adult family members leads to feelings of anger, sadness, hopelessness, and frustration. • Ineffective communication, inadequate staffing, and loss of voice of adult family members affect shared decision-making. • Hearing adult family members' voices can support the improvement of policy, education, and practices in RACFs. [ABSTRACT FROM AUTHOR]

• When the philosophy of woman-centred care is not maintained, this places a woman with a complex pregnancy at risk of 'falling through the gaps' between maternity services, models of care and health providers. • Professional power differentials provoke professional boundary tensions and create barriers to woman-centred care in maternity services. • Organisational and siloed approaches to maternity care create barriers for midwives to provide woman-centred care. • Midwifery models of care intend to push the marker on the power continuum towards autonomy giving control of childbearing experiences back to the woman. Midwifery philosophy and practice is grounded in providing woman-centred care. The available evidence was reviewed to better understand how to provide Woman-centred midwifery care in complex pregnancy situations. Complexity in this context is defined as psychosocial or biomedical risk factors that place the mother and/or her baby at increased risk for adverse outcomes. A comprehensive integrative review was undertaken to identify peer reviewed research in English over the last 5 years. The quality of the studies was assessed using the Critical Appraisal Skills Programme Tool. Published studies which discussed enablers and barriers to woman-centred care for pregnant women with complex needs. 13 papers met the inclusion criteria for this review. This review identifies that Organisational and Professional power differentials create barriers to woman-centred care and provoke professional boundary tensions. For a woman with a complex pregnancy, this places her at risk for 'falling through the gaps' between maternity services, models of care and health providers. Women, birth and midwifery care are still largely constrained within a biomedical model of maternity care. Whilst barriers to woman-centred care have been identified, for women with complexity in pregnancy there appear to be few solutions when care requires multi-specialist input and crossing the boundaries and silos of healthcare. [ABSTRACT FROM AUTHOR]

An estimated 18.1 million new cancer cases (excluding nonmelanoma skin cancers) were diagnosed worldwide in 2020. Despite a rising incidence of cancers worldwide, in developed countries with strong healthcare systems, survival rates are improving as a result of early detection, improved treatments and survivorship care (World Health Organisation (WHO), 2021). Whilst living longer, cancer survivors are often living with side effects of treatment, including chemotherapy related cognitive impairment, often termed "chemobrain". An integrative review of contemporary literature answering the research question how does chemotherapy affect cognitive function? was undertaken utilising three computerised databases CINAHL, Medline and PUBMED, between 2015 and 2021. Data was thematically analysed to identify themes within published literature. Thematic analysis identified four broad themes within the literature regarding chemotherapy induced cognitive impairment. Identified themes included; cognition as part of a complex scenario, proof of existence and searching for the cause, learning to play the game and timing of cognitive impairment. Aggressive treatment with chemotherapy in the adjuvant setting has drastically improved the survival of cancer patients. Subsequent to aggressive treatments, side effects such as cognitive impairment have presented, which may persist in the long term. Despite the exact aetiology of chemotherapy induced cognitive impairment being largely unknown, the consequences of the condition are impacting cancer survivors and their quality of life. • Review of chemotherapy related cognitive impairment. • Long term side effects of chemotherapy. • Quality of life impacted by chemotherapy related cognitive impairment. [ABSTRACT FROM AUTHOR]

Nursing practice is a dynamic and constantly changing field within healthcare, with well-documented challenges to maintaining a suitably skilled workforce to meet the needs of the community it serves. Undergraduate nursing education provides the mandatory minimum requirements for professional registration. Each nursing program has clearly stated graduate attributes, qualities that their graduates will possess on graduation. The aim of this paper is to stimulate discussion about graduate attributes for nurses, a transferrable set of specific attributes that make nursing graduates work ready. This paper focuses on identifying specific attributes, the embedding of those attributes in nursing education, particularly through role modelling, with the aim of producing a future workforce that is knowledgeable, compassionate and con dent. The graduate attributes are likened to the qualities sought by the characters in 'The Wizard of Oz'; brains, heart and courage and the learning process as the 'Yellow Brick Road'. There is a relative lack of discussion about role modelling by nurse educators for nursing students, a potentially undervalued learning experience that we believe must be brought to the forefront of discussions pertaining to undergraduate nursing education and achieving graduate outcomes. [ABSTRACT FROM AUTHOR]

Summary: The transition of nursing education from the hospital setting to the university sector over recent decades has opened dialog about who is guiding the development of nursing students' professional identity. In addition, there is ongoing debate over real or perceived gaps between nursing student learning in the university and the clinical area, how this translates into professional behaviors and how well students make the transition between the two settings. This paper presents the findings of an integrative literature review into the topic of role modeling in undergraduate nursing education. This review was conducted to identify and appraise research findings about role modeling of professional behaviors for undergraduate nursing students. Literature reviewed from 2000 onwards assesses what is currently known about role modeling of undergraduate nursing students. A systematic search of the databases of CINAHL, Scopus and PubMed from 2000 onwards resulted in the selection of 33 articles for deeper analysis. Two clear themes emerged from the literature, the first relating to nurse clinicians as role models for students during clinical placements and the second relating to nurse academics as role models in the academic setting. Findings from this integrative literature review show an imbalance in the recognition of the role modeling of professional behaviors in the clinical versus the academic setting. Nurses in academic settings have more contact with the students over their period of study and as such, the significance of nurse academics as student role models requires further investigation. [Copyright &y& Elsevier]