Welsh Assembly to introduce legal obligation for safe staffing levels in 2018. (Nursing Management – UK, 2016, 23(5) p.7)

Hospitals in Wales will be legally obliged to implement safe nurse staffing levels from April 2018, the Welsh Assembly has announced.

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Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. (International Journal of Nursing Studies, Nov 2016, vol. 63, p. 213-225)

A large and increasing number of studies have reported a relationship between low nurse staffing levels and adverse outcomes, including higher mortality rates. Despite the evidence being extensive in size, and having been sometimes described as “compelling” and “overwhelming”, there are limitations that existing studies have not yet been able to address. One result of these weaknesses can be observed in the guidelines on safe staffing in acute hospital wards issued by the influential body that sets standards for the National Health Service in England, the National Institute for Health and Care Excellence, which concluded there is insufficient good quality evidence available to fully inform practice.

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Safe staffing levels should be mandatory. (Nursing Standard, Oct 2016, vol. 31 (9); p. 30)

In August, the Welsh assembly said hospitals in Wales will be legally obliged to implement safe nurse staffing levels from April 2018. Scotland are set to follow but not England.

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Pilot testing of the “First You Should Get Stronger” program among caregivers of older adults with dementia. (Archives of Gerontology and Geriatrics, 2016, vol 68, p. 84-89)

In this study, randomized controlled interventional study pattern was used to examine the effects of the “First You Should Get Stronger” program on the caregiving burden and healthy life style behavior of caregivers of dementia patients.  “Zarit Caregiver Burden Scale” and “Healthy Life Style Behavior Scale” were used. The study was completed with 40 caregivers in total with 20 in the intervention group and 20 in the control group. A statistically significant difference was determined between the “Zarit Caregiving Burden Scale” and “Healthy Life Style Behavior Scale” score averages of the intervention group that participated in the “First You Should Get Stronger” program in comparison with those of the control group.
It is important for the healths of caregivers to include similar programs for the caregivers of dementia patients in continuous and regular applications. The results highlight the importance of the “First You Should Get Stronger” program significantly decreased the caregiving burden and significantly developed the healthy lifestyle behaviors of caregivers in the intervention group. Since dementia is a difficult neurological syndrome with patients cared at home, it generally wears out the caregivers significantly. It is suggested that the nurses and healthcare professionals working with dementia patients are evaluated separately and that they carry out caregiving applications within the scope of the “First You Should Get Stronger” program.

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Psychosocial intervention for carers of people with dementia: What components are most effective and when? A systematic review of systematic reviews. (International Psychogeriatrics, 2016, p. 1-13)

Psychosocial interventions for carers of people with dementia are increasingly recognized as playing an important role in dementia care. We aim to systematically review the evidence from existing systematic reviews of psychosocial interventions for informal carers of people with dementia. Thirty-one systematic reviews were identified; following quality appraisal, data from 13 reviews, rated as high or moderate quality, were extracted. Well-designed, clearly structured multi-component interventions can help maintain the psychological health of carers of people with dementia and delay institutionalization of the latter. To be most effective, such interventions should include both an educational and a therapeutic component; delivery through a support group format may further enhance their effectiveness. Successful translation of evidence into practice in this area remains a challenge. Future research should focus on determining the most cost-effective means of delivering effective multi-component interventions in real-world settings; the cost-effective potential of technology-based interventions is considerable.

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Factors of Resilience in Informal Caregivers of People with Dementia from Integrative International Data Analysis. (Dementia and Geriatric Cognitive Disorders, 2016, p. 198-214)

Although caring for a person with dementia can be stressful, some caregivers appear to experience few negative consequences to their well-being. This study aimed to examine what proportion of caregivers demonstrates resilience under different challenging circumstances and to identify factors related to their resilience. Baseline data from 4 studies from the Netherlands and UK among informal caregivers of people with dementia were harmonized and integrated. Caregiver resilience was defined as high levels of psychological well-being despite different types of high caregiving demands.

Being a male caregiver, caring for a female, living apart from your relative, and low caregiver burden were positively related to caregiver resilience. Caregivers have the capacity to demonstrate resilience despite significant challenges. This study demonstrates how harmonization of data from multiple existing studies can be used to increase power and explore the consistency of findings. This contributes to a better understanding of which factors are likely to facilitate caregiver resilience and offers insights for developing services.

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A pilot randomized controlled trial of mindfulness-based stress reduction for caregivers of family members with dementia. (Aging & Mental Health, 2016, 20(11) p. 1157-1166)

The majority of care for those with Alzheimer’s disease and other age-related dementias is provided in the home by family members. To date, there is no consistently effective intervention for reducing the significant stress burden of many family caregivers. The present pilot randomized controlled trial tested the efficacy of an adapted, eight-week mindfulness-based stress reduction (MBSR) program, relative to a near structurally equivalent, standard social support (SS) control condition for reducing caregiver stress and enhancing the care giver-recipient relationship.

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Retaining early career registered nurses: a case study. (BMC Nursing, Oct. 2016)

A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses’ (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs.

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Effects of Nurses’ Perceptions of Actual and Demanded Competence on Turnover Intentions. (Western Journal of Nursing Research, 2016)

With the growing focus on continuous professional development, demands placed on nurses to uphold nursing competence have been increasing. This study examined how nurses with different lengths of clinical experience perceived the relationship between their actual competence and the competence they felt was demanded of them, and how this relationship was related to their turnover intentions. Survey questionnaires were distributed to 1,377 nurses, of whom 765 returned usable completed forms. The results showed that across all the groups of clinical experience, nurses perceived the demanded competence levels to be higher than their actual competence levels. However, turnover intentions were not related to nurses’ perceptions of demanded competence and were negatively related to perceptions of actual competence. The levels of competence demanded should not be considered as threats for nurses. Improving nurses’ competence may reduce their turnover intentions.

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Work-life balance, job satisfaction and nurses retention: moderating role of work volition. (International Journal of Business Excellence, 2016, 10(4))

Retention of competent employees is becoming a huge challenge for organisations and more so for healthcare institutions. The growing shortage of nursing staff and its potential effect on the healthcare industry is of paramount importance. To retain the existing staff and to attract potential new entrants, healthcare organisations have to adopt strategies that would help them in retention. So, creating a balance between work-life is found as one of the suitable practices that when adopted can reduce work related stresses, increase satisfaction and performance. This study investigated the influence of work-life balance on job satisfaction leading to retention. Further, work volition was tested as a moderator between work-life balance and job satisfaction. The study results indicate significant influence of all work volition as a moderator. The study found that job satisfaction had a partial mediation effect on the relationship of work-life balance and retention.

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