Ros Kane

A systematic review of the experiences and perceptions of the newly qualified nurse in the United Kingdom

AIM A systematic literature review of the experiences and perceptions of newly qualified nurses in the UK during the transition from student to staff nurse. BACKGROUND It has been widely recognised that newly qualified nurses experience a period of transition. Over the past decade there has been radical reorganisation of nurse education in the UK which has raised issues of preparation for practice. DATA SOURCES Searches were made of the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE. METHODS A systematic review was carried out. Papers were critically reviewed, relevant data were extracted and synthesised. RESULTS Four themes were identified from the empirical evidence base: transition and change, personal and professional development, pre-registration education, preceptorship and support. CONCLUSION Transition remains a stressful experience for newly qualified nurses in the UK. Reasons include an increase in personal and professional development, changes in pre-registration education and lack of support once qualified. RECOMMENDATIONS Further research is needed to address the current situation in relation to the transition period including pre-registration education, preparation for practice and support in both primary and secondary care.

Teenage conceptions, abortions, and births in England, 1994–2003, and the national teenage pregnancy strategy

BACKGROUND The aim of this study was to quantify the change in the number of conceptions and abortions among women younger than 18 years in England in relation to the governments national teenage pregnancy strategy. METHODS We undertook geographic analysis of data for 148 top-tier local authority areas. The main outcomes were changes in under-18 conceptions, abortions, and births between the 5-year period before implementation of the strategy (1994-98) and the period immediately after implementation (1999-2003). FINDINGS The number of teenage conceptions peaked in 1998, then declined after the implementation in 1999 of the teenage pregnancy strategy. Under-18 conception rates fell by an average of 2.0% (95% CI 1.8 to 2.2) per year between 1998 and 2003, below the rate needed to achieve the target of 50% reduction by 2010. The net change between 1994-98 and 1999-2003 was a fall in conceptions of 3.2% (2.6 to 3.9) or 1.4 per 1000 women aged 15-17 years, a rise in abortions of 7.5% (6.5 to 8.6) or 1.4 per 1000, and a fall in births of 10.6% (9.9 to 11.3) or 2.8 per 1000. The change in the number of conceptions was greater in deprived and more rural areas, and in those with lower educational attainment. The change was greater in areas where services and access to them were poorer, but greater where more strategy-related resources had been targeted. INTERPRETATION The decline in under-18 conception and birth rates since 1998 and evidence that the declines have been greatest in areas receiving higher amounts of strategy-related funding provides limited evidence of the effect of Englands national teenage pregnancy strategy. The full effect of local prevention will be clear only with longer observation, and substantial further progress is needed to remedy Englands historically poor international position in teenage conceptions.

Clinical practice models in nursing education: implication for students' mobility.

BACKGROUND In accordance with the process of nursing globalization, issues related to the increasing national and international mobility of student and qualified nurses are currently being debated. Identifying international differences and comparing similarities for mutual understanding, development and better harmonization of clinical training of undergraduate nursing students is recommended. AIMS The aim of the study was to describe and compare the nature of the nursing clinical practice education models adopted in different countries. METHODS A qualitative approach involving an expert panel of nurses was adopted. The Nominal Group Technique was employed to develop the initial research instrument for data collection. Eleven members of the UDINE-C network, representing institutions engaged in the process of professional nursing education and research (universities, high schools and clinical institutes), participated. Three data collection rounds were implemented. An analysis of the findings was performed, assuring rigour. RESULTS Differences and homogeneity are reported and discussed regarding: (a) the clinical learning requirements across countries; (b) the prerequisites and clinical learning process patterns; and (c) the progress and final evaluation of the competencies achieved. CONCLUSIONS A wider discussion is needed regarding nursing student exchange and internalization of clinical education in placements across European and non-European countries. A clear strategy for nursing education accreditation and harmonization of patterns of organization of clinical training at placements, as well as strategies of student assessment during this training, are recommended. There is also a need to develop international ethical guidelines for undergraduate nursing students gaining international experience.

Sex and relationship education and the media: an analysis of national and regional newspaper coverage in England

Newspapers are recognised as a major source of factual information. The media representation of issues related to teenage pregnancy is important to policy makers and those delivering related interventions. This is particularly so in relation to issues which may be seen as sensitive by the public, such as sex and relationship education (SRE). Despite general recognition of the importance of the media in communicating to the public, there is an absence of satisfactory tools with which to evaluate newspaper reports, particularly so in the field of SRE. In this paper we present a systematic examination of newspaper articles related to SRE from September 2000 to September 2002, in the national and regional press in England. Our analysis has highlighted some important distinctions between newspaper type, spokesperson and region. This paper concludes that a pro‐active strategy of directly contacting high circulation newspapers with a view to positively influencing the tone of relevant articles and reports would be of considerable benefit to those involved in SRE, teenage pregnancy and related interventions.

Sexuality education in different contexts: limitations and possibilities

Purpose – Sexuality education is a controversial and contested issue that has evoked wide debate on the question of its aims, contents, methods, pedagogy and desired outcomes. This editorial aims to provide a brief commentary, positioning the contributions to this Special Issue of Health Education within the research landscape concerning sexuality education in schools internationally. Design/methodology/approach – The idea for this Special Issue was born in Odense, Denmark, in October 2012, during the 4th European Conference of Health Promoting Schools. The Conference Programme and the debates during the sessions demonstrated the need for a wider discussion of sexuality education, particularly within the framework of the health-promoting school. There was recognition of the need to endorse positive and wide socio-ecological views of health, including sexual health and a critical educational approach to sexuality education. The conference delegates and the members of the Schools for Health in Europe Resear...

Staff training in integrated sexual health services

Coordination of family planning and GUM services has the potential to boost the effectiveness of both The move towards integration of family planning and genitourinary medicine (GUM) services (that is, the reorganisation of the two specialties, strategically and in terms of setting, in a more client centred approach) has recently been gathering momentum in the United Kingdom. Providers of family planning services are increasingly being urged to adopt a broader remit in respect of their clients’ needs for STI and HIV prevention and treatment,1 as are providers of STI services in respect of their clients’ contraceptive needs. Although fully integrated sexual health services are still comparatively rare, a growing number of family planning services provide STI diagnosis and treatment and a growing number of GUM clinics provide contraceptive services.2,3 The trend may be accelerated as a result of the government’s sexual health strategy,4 in England. The systematic evaluation of three pilot “one stop shops” is likely to provide more robust evidence on the acceptability and effectiveness of integrated services which, if favourable, could provide the impetus to further expansion. In theory, the case for an integrated approach to sexual health service provision is compelling. Control of fertility and of sexually transmitted infection share common characteristics. The choice of contraceptive method may have implications for transmission of infectious agents and the presence of infection has consequences for fertility. The two services also share potential clients. Studies of GUM clinic attenders have shown a high proportion to be at risk of pregnancy5–9 and studies of family planning clinics attenders show sizeable proportions to be at risk of infection.7,10,11 There is also evidence that service users prefer a one stop service providing coordinated sexual health care.7,12,13 Advocates of integration claim that …

NON RANDOMISED CONTROL STUDY OF THE EFFECTIVENESS OF A NOVEL PAIN ASSESSMENT TOOL FOR USE BY PARAMEDICS

Background Eighty percent of patients presenting to ambulance services present with pain. Pain is sometimes inadequately assessed and treated. Effective pain management can improve patient outcomes and experience. Previous qualitative research suggested that numerical verbal pain scores, usually used to assess pain in the ambulance setting, were poorly understood. We developed a new tool, the ‘Patient Reported Outcome Measure for Pain Treatment’ (PROMPT), to address this need. Initial testing showed that PROMPT had reliability and (face, content and predictive) validity. We aimed to investigate the effectiveness of PROMPT. Methods We used a non-randomised control group design in adult patients with chest pain or injury treated by intervention paramedics using PROMPT compared with control paramedics following usual practice for pain outcomes (reduction in pain score, use of analgesia). Routine data from electronic patient records were used to measure outcomes. We collected baseline rates of outcomes in patients treated by intervention and control paramedics, in a seven month period one year previously, to adjust for secular trends. The study was conducted in East Midlands Ambulance Service. We used regression analysis to compare groups for differences in pain score change and use of analgesics correcting for baseline rates and demographic differences. Results Twenty-five intervention paramedics used PROMPT (of 35 who were trained in its use) treating 300 patients over a seven month period. Data for these and 848 patients treated by 106 control paramedics were entered into SPSS and STATA12 for analysis. Mean reductions in pain score ( p<0.001) and use of analgesics was significantly greater (p<0.001) in patients managed by paramedics using PROMPT compared with those receiving usual care after adjusting for patient age, sex, clinical condition and baseline rates. Conclusion Use of the PROMPT resulted in greater reductions in pain score and increased use of analgesics compared with usual care.