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Cardiac rehabilitation effectively reduces mortality and enhances the quality of life for individuals with cardiovascular disease. Despite that, individuals’ engagement in cardiac rehabilitation remains low. Considering the significant contributions of individuals’ self-management of cardiovascular disease to their progress, it is essential to understand the personal factors that influence engagement in cardiac rehabilitation. This scoping review aims to identify and map personal factors that influence cardiac rehabilitation engagement with a specific focus on the subjective experiential dimensions of personal factors (cognitive, emotional, and behavioural). It also aims to explore interventions targeting personal factors to increase cardiac rehabilitation engagement. This review will be reported using the PRISMA-ScR checklist following the Joanna Briggs Institute (JBI) methodology. It will include peer-reviewed articles published in English from January 2004, excluding grey literature. Studies reporting adult populations aged 18 and over with cardiovascular disease and addressing personal factors or interventions to increase cardiac rehabilitation engagement, will be included. Databases for the searches will include PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus, and Web of Science. The data extraction is developed by the reviewers based on JBI guidelines and relevant literature, the form will detail the characteristics of included publications, personal factors influencing cardiac rehabilitation engagement, and intervention characteristics. The data analysis will summarise descriptively the key features of the included studies and interventions, the Patient Health Engagement Model will guide the categorisation of personal factors into cognitive, emotional, and behavioural aspects, with other personal factors organised as emerging other relevant factors themes. The findings of this review will provide important evidence support for researchers, clinicians and policy makers to promote participation in cardiac rehabilitation. Within the constraints of medical and human resources, attention to personal factors can maximise the individual’s role in cardiac rehabilitation and self-management, contributing to the efficient allocation and use of resources.

Background A review of key learnings from the response to the COVID-19 pandemic in nursing homes in Ireland can inform planning for future pandemics. This study describes barriers and facilitators contributing to COVID-19 outbreak management from the perspective of frontline teams. Methods A qualitative study involving ten online focus group meetings was conducted. Data was collected between April and June 2023. The focus group discussions explored the views, perceptions and experiences of COVID-19 Response Team (CRT) members, clinical/public health experts who worked with them, and care professionals who worked in frontline managerial roles during the pandemic. All nine Community Healthcare Organisations and six Public Health Areas in Ireland were represented. Inductive reflexive thematic analysis was carried out using NVivo Pro 20. Results In total, 54 staff members participated in focus group meetings. Five themes were developed from a thematic analysis that covered topics related to (1) infection prevention and control challenges and response to the pandemic, (2) social model of care and the built environment of nursing homes, (3) nursing home staffing, (4) leadership and staff practices, and (5) support and guidance received during the pandemic. Conclusions The response to the COVID-19 pandemic has resulted in a steep learning curve, internationally and in Ireland. Preparing better for future pandemics not only requires changes to infection control and outbreak response but also to the organisation and operation of nursing homes. There is a great need to strengthen the long-term care sector’s regulations and support around staffing levels, nursing home facilities, governance, use of technology, infection prevention and control, contingency planning, and maintaining collaborative relationships and strategic leadership. Key findings and recommendations from the Irish example can be used to improve the quality of care and service delivery at local, national, and policy levels and improve preparedness for future pandemics, in Ireland and internationally.

Increasing pressure on limited healthcare resources has necessitated the development of measures promoting early discharge and avoiding inappropriate hospital (re)admission. This systematic review examines the evidence for interventions in acute hospitals including (i) hospital-patient discharge to home, community services or other settings, (ii) hospital discharge to another care setting, and (iii) reduction or prevention of inappropriate hospital (re)admissions. Academic electronic databases were searched from 2005 to 2018. In total, ninety-four eligible papers were included. Interventions were categorized into: (1) pre-discharge exclusively delivered in the acute care hospital, (2) pre- and post-discharge delivered by acute care hospital, (3) post-discharge delivered at home and (4) delivered only in a post-acute facility. Mixed results were found regarding the effectiveness of many types of interventions. Interventions exclusively delivered in the acute hospital pre-discharge and those involving education were most common but their effectiveness was limited in avoiding (re)admission. Successful pre- and post-discharge interventions focused on multidisciplinary approaches. Post-discharge interventions exclusively delivered at home reduced hospital stay and contributed to patient satisfaction. Existing systematic reviews on tele-health and long-term care interventions suggest insufficient evidence for admission avoidance. The most effective interventions to avoid inappropriate re-admission to hospital and promote early discharge included integrated systems between hospital and the community care, multidisciplinary service provision, individualization of services, discharge planning initiated in hospital and specialist follow-up.

Background Nursing process quality care metrics and indicators are quantifiable measures of the nursing care delivered to clients. They can be used to identify and support nurses’ contribution to high quality, safe, client care and are lacking in specialist intellectual disability nursing. In a national Nursing Quality Care-Metrics project for Irish intellectual disability services, a set of nursing quality care process metrics and associated indicators were established for intellectual disability services. Methods A two-stage design approach was undertaken; a broad scoping review of the literature and a modified Delphi consensus process. The Delphi included a four round e-Delphi survey and a consensus meeting. Four hundred one intellectual disability nurses working in Ireland were recruited for the surveys and 20 stakeholders attended the consensus meeting. Results From the review, 20 existing and 16 potential intellectual disability nursing metrics were identified for nurses to prioritise in the e-surveys. After the four survey rounds, 12 intellectual disability nursing metrics and 84 associated indicators were identified. Following the consensus meeting, these were reduced to 12 metrics and 79 indicators. Conclusions This first set of intellectual disability nursing process metrics and associated indicators has been identified for implementation in practice. These metrics while developed in Ireland have international relevance and their application and appropriateness in practice needs to be evaluated.

Enrichment, defined as \"the process of endowing caregiving with meaning or pleasure for both the caregiver and care recipient\" can support relationships between people living with dementia (PLWD) and their caregivers. This study aims to explore (1) the types of psychosocial interventions that may enrich relationships between dementia caregiving dyads, and (2) the components within these psychosocial interventions that may contribute to enrichment. A scoping review was conducted based on the Joanna Briggs Institute framework. We operationalized and contextualized core elements from Cartwright and colleagues' enrichment model, which was also used to guide the review. Five electronic databases were searched. Psychosocial intervention components contributing to enrichment were identified and grouped within each core element. Thirty-four studies were included. Psychosocial interventions generating enrichment among dyads mainly involved supporting dyadic engagement in shared activities, carer education or training, or structural change to the environment around PLWD. Intervention components contributing to the enrichment of dyadic relationships were identified within \"acquired symbolic meaning\", \"performing activity\", and \"fine tuning\". Dyadic communication support and skill-building were common contributors to enrichment. Our findings may inform the planning and development of interventions to enrich dyadic relationships in the context of dementia. In formal caregiving contexts, future interventions may consider dedicating space for relationships to build and grow through positive interactions. In informal caregiving contexts, existing relationships should be considered to better support dyads engage in positive interactions.

Introduction The use of digital assistive technologies by and for people living with dementia is promising for supporting social health and advocated as a partial solution to growing prevalence worldwide. A state-of-the-art position paper published in 2017 identified challenges regarding digital assistive technologies, around five themes: development, usability, (cost-)effectiveness, implementation and ethics. This systematic review summarizes progress on the challenges found in 2017, and persisting or emerging challenges. Methods A systematic review of systematic reviews was conducted, focused on studies published after 2016. The inclusion criteria required that the target group included, at least in part, people with dementia living in the community and that the technologies aimed to support social health. For the five themes, literature searches were conducted in Medline, CINAHL, PsycINFO, and Embase databases. Results A total of 112 reviews were included, covering various applications such as smart homes, care robots, exergaming and everyday technologies. No applications of artificial intelligence were included. The challenges included personalization of applications (development); limited use of standardized methods (usability); insufficient quantity and quality of randomized controlled trials (cost-effectiveness); overly high expectations of assistive technologies (implementation); and the need for more equitable access to technologies (ethics). Conclusion Much research has been conducted since the 2017 state of the art position paper. While some challenges identified at that time remain relevant, others have been addressed, and new challenges have emerged. Future research should prioritize emerging artificial intelligence applications; the development of integrated assistive technologies; evaluation using robust methods and meaningful outcomes; and the promotion of more accessible and inclusive technologies.

Aim To describe the development of a guidance framework to assist nurses and midwives in selecting nursing and midwifery care process metrics and indicators for use in practice. Background Process metrics are measures of care provision activities by nurses and midwives. Methods Phase 1 was a rapid review assessment of the literature conducted to identify an initial framework. Six electronic databases were searched with Google Scholar and reference tracking performed. Phase 2 was expert review of the developing framework by nursing and midwifery experts in practice, academia and an international expert in quality care metrics. Results The literature assessment yielded 28 papers with 59 metric attributes identified. From this, a six‐domain framework was developed. Following expert review, the framework was reduced to four domains: “Process Focused,” “Important,” “Operational” and “Feasible.” Conclusions This is the first framework specifically to guide nurses and midwives in selecting nursing and midwifery process metrics and indicators.

Early identification of frailty can prevent functional decline. Although multiple frailty screens exist for use in Emergency Departments (EDs), few are validated against diagnostic standards such as comprehensive geriatric assessment. To examine the diagnostic accuracy of ED screens for frailty, scientific databases were searched for prospective diagnostic accuracy test studies from January 2000 to September 2022. Studies were assessed for risk of bias using QUADAS-C. Psychometric properties were extracted and analysed using R. Six studies involving 1,663 participants describing seven frailty screening instruments (PRISMA-7, CFS, VIP, FRESH, BPQ, TRST, and ISAR), representing 13 unique data points, were included. The mean age of participants ranged from 76 to 86 years. The proportion that was female ranged from 45 to 60%. The pooled prevalence rate of frailty was high at 59%. The pooled estimate for sensitivity was 0.85 (95% CI: 0.76–0.91) versus 0.77 (95% CI: 0.62–0.88) for specificity. Pooled accuracy based on area under the ROC curve was 0.89 (95% CI: 0.86–0.90). Although few studies were found, limiting the ability to conduct a meta-analysis of individual instruments, available frailty screens can accurately diagnose frailty in older adults attending the ED. As specificity was comparatively low, additional assessment may be required to identify those requiring inpatient management or onward community referral. Further study is therefore required.

This descriptive, cross‐sectional study aimed to identify whether having a chronic leg ulcer (CLU), in addition to diabetes, contributed to frailty in individuals ≥65 years old. It also explored the associations between frailty, pre‐frailty and other factors. 125 participants aged ≥65 attending outpatient clinics in Ireland were categorised into three groups: (1) diabetes‐only and no CLU, (2) CLU‐only and no diabetes, and (3) diabetes and CLU. Frailty status was identified using the Groningen Frailty Indicator (GFI) and the Physical Frailty Phenotype (PFP). The mean age was 76.09 ± 7.31. Overall, 90 (72%) had diabetes, and 89 (71.2%) had CLU in the past 6 months. While 124 (99.2%) were frail according to the GFI, 122 (97.6%) were either physically frail (n = 40, 32%) or pre‐frail (n = 82, 65.6%) based on the PFP. There was no difference between the three groups regarding general frailty status (p > 0.05). However, being aged ≥75, having CLU and having CLU in addition to diabetes were associated with frailty severity (p < 0.05). Slow gait, inability to go to the toilet and dress/undress independently were the common factors contributing to frailty. Age, comorbidities and CLU were associated with frailty severity. Incorporating multidimensional frailty screening into regular clinic visits for older adults with CLU is recommended.

To evaluate effects of a PRECEDE-PROCEED Model based, nurse-delivered Ergonomic Risk Management Program (ERMP) in the aim of reducing musculoskeletal symptoms of intensive care unit (ICU) nurses. This pre-test post-test design for non-equivalent control groups study comprised 72 ICU nurses from two hospitals. A randomised sampling was done through the study population. The ERMP was delivered as an intervention including 26weeks of follow-up. Data was collected by “Descriptives of Nurses and Ergonomic Risk Reporting Form”, “Rapid Upper Risk Assessment Form (RULA)”, “ICU Environment Assessment Form” and “Personal interviews form”. There was no difference between sociodemographic characteristics, work and general health conditions within intervention and control group. One month after the intervention, nurses had significant decrease in their total RULA scores during bending down and patient repositioning movements as 1.40 and 0.82, respectively. Six months after the ERMP, the mean total RULA scores of nurses during the patient repositioning was 4.39±1.49 which meant “immediate further analyses and modifications recommended”. After all, pain intensity scores, medication use due to pain, and RULA ergonomic risk scores were significantly decreased, while exercise frequency was increased. The ERMP was effective to increase exercise frequency and to decrease musculoskeletal pain and ergonomic risk levels of ICU nurses.