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The COVID-19 pandemic elucidated the importance of infection prevention and control (IPC) in residential aged care homes (RACHs), both on the health and wellbeing of its residents, and the staff and clinicians who care for them. While considerable efforts have been made in Australia to improve IPC both during and in the aftermath of the COVID-19 pandemic, many of these resources remain reliant on evidence originating from hospitals and acute healthcare settings. This research aims to establish the core minimum components that will populate standards for IPC programs and governance (Stream A) and for professional practice and competencies (Stream B) in RACHs. This research will be completed using a sequential three-phase design. In Phase 1, two integrative literature reviews will be completed to synthesise the elements of current global IPC programs and professional competencies in RACHs. In Phase 2, a qualitative analysis of IPC programs and professional practice in Australian RACHs using a combination of surveys and interviews will be completed. Finally, in Phase 3, an e-Delphi will be conducted to collate expert opinion and generate consensus on the minimum components of the IPC program and professionals who administer them in RACHs. The final standards and resources will be collaboratively designed with aged care partners, industry leaders, professional bodies and key Australian health policymakers. These standards seek to empower IPC and aged care staff, not only by ensuring that they are well-equipped with the knowledge and skills to implement effective IPC programs themselves, but also that the organisation is adequately prepared to provide the resources and governance systems. [ABSTRACT FROM AUTHOR]

Professional practice in health and social care is embodied by the practitioners concerned, embedded in practice contexts and creative in nature. It is therefore complex to investigate, understand and develop. Current health and social care contexts can present practitioners with increasingly constraining circumstances and spaces that can feel closed instead of open to exploration and development of practice. The collaborative, critical and creative inquiry methodology presented here was developed among nurses practising in such challenging circumstances. It enables nurses and other health and social care practitioners to reveal, explore and develop their embodied practices, systematically and collaboratively, amid busy daily practice situations. However 'small' the space they are in, the process described here can help practitioners to enlarge their space for becoming. The iterative cycle and the use of participatory arts help illuminate otherwise hidden and difficult to articulate aspects of practice, enable the involvement of stakeholders in coming to new understandings and lead to an expanded view of professional practice and its potential for transformation. The purpose of this paper is threefold. First, to present the methodology, methods and lessons learned during the doctoral study in which this approach was developed. Second, to reveal the professional artistry of facilitating this space for becoming and of supporting professionals to reveal their own and others' professional artistry. Lastly, to offer inspiration and a guide for others considering similar participative inquiry work and to encourage debate and critique of the approach taken. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists in acute practice are increasingly likely to work routinely with people in later life who drink alcohol. Therefore, this knowledge translation study aimed to evaluate the development of a continuing professional development Learn@Lunch programme, designed to enhance awareness and understanding of occupational therapists who work in an acute hospital setting, of drinking alcohol as an occupation in later life. Method: Guided by the Promoting Action of Research Implementation in Health Sciences framework, the continuing professional development programme was developed, and a qualitative evaluation undertaken. This included pre- and post-focus groups with occupational therapists (n = 8) in an acute setting, where the programme was delivered, pre- and post-programme delivery interviews with the research champion recruited from the site, and one interview with the Allied Health Professions Service Lead. Findings: Findings indicate the Learn@Lunch continuing professional development programme enhanced therapist knowledge and understanding of the changing patterns of drinking alcohol in later life. However, practical barriers exist impacting how participants perceived the value and delivery of the programme. Conclusion: Learn@Lunch was an effective continuing professional development programme and supported enhanced knowledge and awareness of drinking alcohol as an occupation in later life, leading to changes in local acute occupational therapy practice. [ABSTRACT FROM AUTHOR]

The article explores the intersection of planetary health and person-centred healthcare practice, emphasizing the need for healthcare systems to address climate change while promoting individual and community well-being. Topics discussed include the principles of person-centred care, the role of nurses in advocating for planetary health, and the integration of sustainable practices into healthcare systems.

Background/Objectives Leadership is central to the development of effective workplace cultures and as such should be viewed as a practice that is relational, exercised through a process of mutual and reciprocal influence. Person-centred leadership is an approach to leadership that supports a way of being that is authentic, prioritising values lived out in action. However, there is an increasing recognition that leadership development has not been impactful in relation to workplace culture. This paper reports on the ongoing evaluation of an innovative development programme (Queen's Nurse Development Programme), the overall aim of which was to illuminate the participants' experiences of engaging in transformative learning and development and identify the technical and transformative outcomes arising. The programme focused on developing leadership capacity for societal change and maximising the health impact of community nursing leaders. Methods The methodological framework for evaluation was underpinned by a Collaborative Critical Creative Inquiry. Twenty community nurses were selected to undertake the programme during 2020. The collection and analysis of data was consistent with the Collaborative Critical Creative Inquiry and was conducted as a one-day workshop, with participants engaged in a cycle of creative hermeneutic analysis. Results A total of seven themes were identified, including: sense of belonging; personal growth; developing new skills; finding voice; importance of self-care; and creating a safe place. This illuminated how the transformative learning and development processes within this programme were experienced and how these enabled participants to explore how they influence their practice and workplace. It is the journey with self that generates a sense of belonging and enables personal growth and the ability to care for self and others. Conclusions The key learning from this innovative development programme is the importance of focusing on the attributes of practitioners and the key building blocks for knowing, being, and becoming a person-centred practitioner. [ABSTRACT FROM AUTHOR]

Background: Person-centredness, a global movement in healthcare, is consistent with international developments in healthcare policy. It is important to have instruments to measure person-centred care. The Person-Centred Practice Inventory-Staff (PCPI-S) is an internationally recognized instrument that aims to measure how healthcare staff experience person-centred practice. Aim: To perform the cultural adaptation and psychometric testing of a Spanish version of the PCPI-S (PCPI-S (Sp)). Method: A two-stage research design was implemented as follows: (1) the translation and cultural adaptation of the PCPI-S from English to Spanish using the "Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice"; (2) a quantitative cross-sectional survey for the psychometric evaluation of the PCPI-S. Test–retest reliability was evaluated using the Kendall tau concordance coefficient, internal reliability was assessed through the ordinal theta (OT) coefficient, and confirmatory factor analysis was performed to examine the theoretical measurement model. Results: A Spanish version of the PCPI-S was obtained. There were no significant difficulties in the translation process or the consulting sessions. A sample of 287 healthcare professionals participated in the study at least once. All the items showed at least a fair level of test–retest reliability. The OT scores were adequate (>0.69). The model showed good to adequate levels of fit: CFI = 0.89, SRMR = 0.068; RMSEA = 0.060 with CI90% (0.056–0.063). Conclusions: The Spanish translation of the PCPI-S was psychometrically valid when tested with Spanish healthcare professionals. This instrument will help identify professionals' perceptions of person-centred practice, track the evolution of this practice over time, and assess interventions aimed at improving person-centred practice. [ABSTRACT FROM AUTHOR]

Aim: To explore patient and family narratives about their recognition and response to clinical deterioration and their interactions with clinicians prior to and during Medical Emergency Team (MET) activations in hospital. Background: Research on clinical deterioration has mostly focused on clinicians' roles. Although patients and families can identify subtle cues of early deterioration, little research has focused on their experience of recognising, speaking up and communicating with clinicians during this period of instability. Design: A narrative inquiry. Methods: Using narrative interviewing techniques, 33 adult patients and 14 family members of patients, who had received a MET call, in one private and one public academic teaching hospital in Melbourne, Australia were interviewed. Narrative analysis was conducted on the data. Results: The core story of help seeking for recognition and response by clinicians to patient deterioration yielded four subplots: (1) identifying deterioration, recognition that something was not right and different from earlier; (2) voicing concerns to their nurse or by family members on their behalf; (3) being heard, desiring a response acknowledging the legitimacy of their concerns; and (4) once concerns were expressed, there was an expectation of and trust in clinicians to act on the concerns and manage the situation. Conclusion: Clinical deterioration results in an additional burden for hospitalised patients and families to speak up, seek help and resolve their concerns. Educating patients and families on what to be concerned about and when to notify staff requires a close partnership with clinicians. Implications for the Profession and/or Patient Care: Clinicians must create an environment that enables patients and families to speak up. They must be alert to both subjective and objective information, to acknowledge and to act on the information accordingly. Reporting Method: The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting. Patient or Public Contribution: The consumer researcher was involved in design, data analysis and publication preparation. [ABSTRACT FROM AUTHOR]

The document discusses the importance of person-centered care in medication management for individuals living with dementia. Person-centeredness emphasizes building healthful relationships, respecting individual autonomy, and involving patients and their carers in decision-making. Shared decision-making is crucial in medication management, but its implementation faces challenges, including limited involvement of individuals from vulnerable populations. The document highlights the need for creating person-centered cultures, developing comprehensive decision aids, and providing clear clinical guidelines to enhance person-centered medication management for people with dementia. [Extracted from the article]

Introduction: Research suggests that services are not effectively providing suitable assistive technology for people with dementia. There is a need to understand the challenges facing practitioners to identify where service changes should be focussed to improve this situation. Method: This study used an online survey to explore the experiences of 41 occupational therapists working with people with dementia, and/or assistive technology. Eight participants subsequently agreed to participate in online discussion groups. Group discussions were transcribed and checked. Data responses from group discussions and open questions in the survey were analysed thematically using the person-centred framework to identify domains supporting or obstructing effective assistive technology service delivery. Results: Forty-one occupational therapist participants described challenges to providing person-centred assistive technology services. These included restricted access to assistive technology interventions, limited knowledge regarding developments in the field, variable funding, unsupportive systems, limited relevant training and difficulties working across health and social care sectors. Conclusion: There is a need to revise the systems surrounding the provision of assistive technology for people with dementia. Occupational therapists need access to training relative to this field, and systems need to be adapted to support the provision of person-centred care by widening access to assistive technology. [ABSTRACT FROM AUTHOR]

Patient and public involvement and engagement (PPIE) is an increasingly important component of research conduct to enhance processes and potential for impact, yet is rarely critically interrogated. This paper draws on Foucauldian analysis to highlight the disciplinary powers and tensions arising in PPIE. The paper draws on a nested evaluation interview study with three PPIE members and eight academics, who had been involved in an implementation science study focused on palliative care. PPIE members were involved in the whole study and are co‐authors of this article. Through shared values and commitments to the study, a team culture of equality was developed. Yet while power was dispersed and taken‐up by all team members, in so doing a self‐governance approach within the team was developed. The pace and focus of discussions was at times more subjugating than co‐production. Identities and positions were porous; the simplistic division of 'academic' and 'PPIE' did not stand up to scrutiny, with an increasing blurring of boundaries as people's experiences and insights changed over time. Continual, subtle, negotiations of roles, inputs and identities were manifest throughout the project. PPIE in research involves subtle, complex and ongoing disciplinary practices enacted by all members of the team. [ABSTRACT FROM AUTHOR]

Purpose of Review: Invasive urodynamics are currently used to diagnose disorders of bladder function. However, due to patient discomfort as well as artifacts induced by catheters and non-physiologic filling, less invasive screening tools that can improve diagnostic information, such as ultrasound are required. The purpose of this review is to assess different modalities of ultrasound as applied to functional bladder imaging. This information will help guide future studies in the use of ultrasound during urodynamics. Recent Findings: Recently, multiple studies have employed ultrasound to evaluate bladder volume, wall thickness, shape, vibrometry, elastography, compliance, biomechanics, and micromotion during urodynamics. These new techniques have used both 2D and 3D ultrasound techniques to evaluate bladder changes during filling. Continued research is needed to confirm ongoing findings prior to widespread incorporation into clinical practice. Summary: This review demonstrates the potential use of ultrasound as an adjunct to urodynamics for the diagnostic evaluation of functional bladder disorders. [ABSTRACT FROM AUTHOR]

Flourishing is the highest good of all persons, but hard to achieve in complex societal systems. This challenge is borne out through the lens of the global nursing shortages with its focus on the supply of nurses to meet health system demands. However, nurses and midwives spend a significant part of their lives at work and so the need to pay attention to the conditions that facilitate flourishing at work is important. Drawing on ancient and contemporary philosophies, as well as critical, creative and embodied ways of knowing, enabling a flourishing practice ecosystem will be explored in this paper. [ABSTRACT FROM AUTHOR]

The article discusses the current state of nursing philosophy of doctorate (PhD) programs in Australia, highlighting the challenges and necessary advancements to ensure sustainable research leadership in nursing. Topics include the need for a steady stream of doctoral students, the importance of improving doctoral supervision quality, and the push for greater integration of nursing research into multidisciplinary teams to address global health issues.

The article focuses on the need for a whole-systems approach to person-centred care in cardiovascular treatment. Topics include the distinction between patient-centred and person-centred care, the importance of considering clinician attributes and the practice environment, and the need for a broader socio-political context in cardiovascular care models.

Older adults have multiple medical and social care needs, requiring a shift toward an integrated person‐centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person‐centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy‐three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People‐Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro‐ and meso‐levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro‐level interventions, and (4) importance of transitioning from person‐ to people‐centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers' scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real‐world challenges encountered in this field. [ABSTRACT FROM AUTHOR]

Background: Person-centred healthcare focuses on placing the beliefs and values of service users at the centre of decision-making and creating the context for practitioners to do this effectively. Measuring the outcomes arising from person-centred practices is complex and challenging and often adopts multiple perspectives and approaches. Few measurement frameworks are grounded in an explicit person-centred theoretical framework. Aims: In the study reported in this paper, the aim was to develop a valid and reliable instrument to measure the experience of person-centred care by service users (patients)–The Person-centred Practice Inventory-Care (PCPI-C). Methods: Based on the 'person-centred processes' construct of an established Person-centred Practice Framework (PCPF), a service user instrument was developed to complement existing instruments informed by the same theoretical framework–the PCPF. An exploratory sequential mixed methods design was used to construct and test the instrument, working with international partners and service users in Scotland, Northern Ireland, Australia and Austria. A three-phase approach was adopted to the development and testing of the PCPI-C: Phase 1 –Item Selection: following an iterative process a list of 20 items were agreed upon by the research team for use in phase 2 of the project; Phase 2 –Instrument Development and Refinement: Development of the PCPI-C was undertaken through two stages. Stage 1 involved three sequential rounds of data collection using focus groups in Scotland, Australia and Northern Ireland; Stage 2 involved distributing the instrument to members of a global community of practice for person-centred practice for review and feedback, as well as refinement and translation through one: one interviews in Austria. Phase 3: Testing Structural Validity of the PCPI-C: A sample of 452 participants participated in this phase of the study. Service users participating in existing cancer research in the UK, Malta, Poland and Portugal, as well as care homes research in Austria completed the draft PCPI-C. Data were collected over a 14month period (January 2021-March 2022). Descriptive and measures of dispersion statistics were generated for all items to help inform subsequent analysis. Confirmatory factor analysis was conducted using maximum likelihood robust extraction testing of the 5-factor model of the PCPI-C. Results: The testing of the PCPI-C resulted in a final 18 item instrument. The results demonstrate that the PCPI-C is a psychometrically sound instrument, supporting a five-factor model that examines the service user's perspective of what constitutes person-centred care. Conclusion and implications: This new instrument is generic in nature and so can be used to evaluate how person-centredness is perceived by service users in different healthcare contexts and at different levels of an organisation. Thus, it brings a service user perspective to an organisation-wide evaluation framework. [ABSTRACT FROM AUTHOR]

Aim: The aim of this was to psychometrically adapt and evaluate the Tilburg Frailty Indicator to assess frailty among older people living in Slovenia's community and nursing home settings. Design: A cross- cultural adaptation and validation of instruments throughout the cross- sectional study. Methods: Older people living in the community and nursing homes throughout Slovenia were recruited between March and August 2021. Among 831 participants were 330 people living in nursing homes and 501 people living in the community, and all were older than 65 years. Results: All items were translated into the Slovene language, and a slight cultural adjustment was made to improve the clarity of the meaning of all items. The average scale validity index of the scale was rated as good, which indicates satisfactory content validity. Cronbach's α was acceptable for the total items and subitems. Conclusions: The Slovenian questionnaire version demonstrated adequate internal consistency, reliability, and construct and criterion validity. The questionnaire is suitable for investigating frailty in nursing homes, community dwelling and other settings where older people live. Impact: The Slovenian questionnaire version can be used to measure and evaluate frailty among older adults. We have found that careful translation and adaptation processes have maintained the instrument's strong reliability and validity for use in a new cultural context. The instrument can foster international collaboration to identify and manage frailty among older people in nursing homes and community-dwelling homes. Reporting Method: The Strengthening the Reporting of Observational Studies in Epidemiology checklist for reporting cross-sectional studies was used. No Patient or Public Contribution: No patient or public involvement in the design or conduct of the study. Head nurses from nursing homes and community nurses helped recruit older adults. Older adults only contributed to the data collection and were collected from nursing homes and community dwelling. [ABSTRACT FROM AUTHOR]

Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

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Critical creativity is a paradigmatic synthesis linking critical social science with creative and ancient traditions. Our haiku summarises the essence of this three part paper. "Heavy feet of stone" describes the rationale for our creation of critical creativity. "Seeking transformation" sets out the background and methodology for our inductive, methodological development. "Dancing rocks and flows" unfolds a new methodological framework for action-oriented, transformational practice development and research that is concerned with human flourishing for those who engage in such work, as well as those for whom the work is intended. Through interplay of story, metaphor, poetry and critical dialogue, we present our methodological development approach for critical creativity and the evolving methodological framework. Within the framework, we focus on conditions and principles that enable our worldview of critical creativity to be used in action research and practice development. (Contains 5 notes and 7 figures.)

Action learning is being increasingly utilised as a strategy to underpin practitioner focused development and research projects in healthcare generally and nursing in particular. Whilst facilitators of and participants in action learning have a variety of resource materials to guide their practice and participation, there continue to be few systematic and/or evaluative accounts of the experience of participating in action learning for potential action learning participants to draw upon. This paper attempts to address this agenda. The paper presents an interpretive evaluation of the experience of nurses participating in action learning as the learning strategy underpinning a 3-year emancipatory practice development/practitioner research programme. In particular, the paper focuses on the experience of "joining a learning set". This focus has been adopted as the theory of action learning emphasises the principle of "voluntariness", but yet action learning is increasingly being pre-prescribed as a component of development and research programmes. Such was the case with the programme reported on in this paper. The paper describes an approach used to evaluate learning that was adopted in this programme and in particular the initial evaluation stage that focuses on participants' feelings about joining an action learning set. The data collection and analysis processes are described and the key themes arising from the analysis ("self-preservation" versus "development of self") discussed. It is concluded that working with principles of enlightenment is essential to successful action learning and the transformation of workplace cultures. (Contains 2 figures and 1 table.)

Action Learning is now a well established strategy for reflective inquiry in healthcare. Whilst a great deal is know about action learning there has been inadequate research on the process of learning that takes place, and the impact that this holds for individuals, groups or organisations. This article reports on the findings of 15-month action learning program based in a special care nursery. A realistic evaluation of the program uncovered individual and group journeys and provide evidence that action learning is an effective strategy in practice development. (Contains 2 tables and 1 figure.)

This article examines the case for the use of the creative arts in the process of designing, conducting, analyzing, and disseminating evaluations. The authors argue that using the creative arts in the process of evaluation evokes different ways of knowing and understanding the values of a program. The insights gained offer a unique addition to evaluation methodology. This not only broadens the perspective of what counts as evaluation knowledge but also creates opportunities for participants to engage in the process of valuing. The article also explores the challenges this perspective presents demonstrating--for example, how artistic knowing may be represented, claims to validity established, and methodological rigor ensured in integrating creative approaches in evaluation designs. The authors illustrate the case for the use of the arts in the evaluation process with examples from their own professional practice contexts in education, nursing, and health.