Journal of clinical nursing
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To optimise care of deteriorating patients, healthcare organisations have implemented rapid response systems including an "afferent" and "efferent" limb. Afferent limb behaviours include monitoring vital signs and escalating care. To strengthen afferent limb behaviour and reduce adverse patient outcomes, the National Early Warning Score was implemented in the UK. There are no published reports of how National Early Warning Score guidance has translated into trust-level deteriorating patient policy and whether these documents provide clear, actionable statements guiding staff. ⋯ Numerous clinical staff are required for an effective response to patient deterioration. To mitigate role confusion, local policy writers should provide clear specification of the actor. As the behaviours are time-sensitive, clear specification of the time frame may increase actionability of policy statements for clinical staff.
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Adults with moderate-to-severe traumatic brain injury (TBI) may have immediate and chronic cognitive impairments that require use of specific nursing strategies. Nurses must be knowledgeable about strategies to use to accommodate these impairments. However, available clinical guidelines and research lack information to direct nonacute nursing management of cognition, limiting guidance for nurses when developing their care plans. The purpose of this study was to investigate strategies nurses use when caring for patients with moderate-to-severe TBI who have cognitive impairments. ⋯ Findings provide foundational knowledge on strategies nurses use when caring for patients with TBI who have cognitive impairments, which could be used to direct evidence-based nursing care of this patient population.
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To explore the experiences and processes of advance care planning (ACP) discussions in older residents of a long-term care institution. ⋯ Healthcare professionals could address the concept of good death, deliver information for their concerns and promote communication with family members.
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Observational Study
Exploring women's health care experiences through an equity lens: Findings from a community clinic serving marginalised women.
To explore how marginalised women perceive and rate equity-oriented health care at a primary care clinic using items that evaluate patients' experiences of care. ⋯ The results of this study illustrate the importance of establishing trusting relationships, tailoring care, and using a nondiscriminatory approach when working with women who experience negative judgements when seeking care.
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To explore how community nurses experience the collaboration with general practitioners and specialist palliative home care team nurses in palliative home care and the perceived factors influencing this collaboration. ⋯ The study findings uncovered critical knowledge gaps in interprofessional collaboration in palliative home care. Insights are relevant for and related to professional well-being and workplace learning.