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3,376 result(s) for "Nurses, Community Health - organization "
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Retaining participants in community-based health research: a case example on standardized planning and reporting
Background Effective strategies for participant retention are critical in health research to ensure validity, generalizability and efficient use of resources. Yet standardized guidelines for planning and reporting on retention efforts have been lacking. As with randomized controlled trial (RCT) and systematic review (SR) protocols, retention protocols are an opportunity to improve transparency and rigor. An RCT being conducted in British Columbia (BC), Canada provides a case example for developing a priori retention frameworks for use in protocol planning and reporting. Methods The BC Healthy Connections Project RCT is examining the effectiveness of a nurse home-visiting program in improving child and maternal outcomes compared with existing services. Participants ( N  = 739) were girls and young women preparing to parent for the first time and experiencing socioeconomic disadvantage. Quantitative data were collected upon trial entry during pregnancy and during five follow-up interviews until participants’ children reached age 2 years. A framework was developed to guide retention of this study population throughout the RCT. We reviewed relevant literature and mapped essential retention activities across the study planning, recruitment and maintenance phases. Interview completion rates were tracked. Results Results from 3302 follow-up interviews (in-person/telephone) conducted over 4 years indicate high completion rates: 90% ( n  = 667) at 34 weeks gestation; and 91% ( n  = 676), 85% ( n  = 626), 80% ( n  = 594) and 83% ( n  = 613) at 2, 10, 18 and 24 months postpartum, respectively. Almost all participants (99%, n  = 732) provided ongoing consent to access administrative health data. These results provide preliminary data on the success of the framework. Conclusions Our retention results are encouraging given that participants were experiencing considerable socioeconomic disadvantage. Standardized retention planning and reporting may therefore be feasible for health research in general, using the framework we have developed. Use of standardized retention protocols should be encouraged in research to promote consistency across diverse studies, as now happens with RCT and SR protocols. Beyond this, successful retention approaches may help inform health policy-makers and practitioners who also need to better reach, engage and retain underserved populations. Trial registration ClinicalTrials.gov , NCT01672060 . Registered on 24 August 2012.
An innovative strategy to increase a professional workforce
Objectives Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attracting new recruits, and accelerating their skills development and experience. In response to the Government’s target of rapidly expanding the number of health visitors in England’s National Health Service, the fast track initiative was launched to recruit newly qualified (fast track) as well as experienced (standard entry) nurses and midwives onto health visiting programmes. This paper evaluates the fast track initiative, from the perspective of fast track and standard entry students, practice teachers and health visitor managers. Methods A mixed methods design was used comprising a questionnaire survey (n = 71 students), semi-structured interviews (n = 37 students), telephone interviews (n = 13 managers) and six focus groups (n = 24 practice teachers). Data were collected between April 2012 and July 2013. Descriptive statistics, t-tests and the Pearson Chi-square test were used to analyse the quantitative data. The qualitative data were analysed thematically. Results Motivations for health visiting as a career choice were similar for fast track and standard entry students, with career progression and interest in health promotion being key motivators. There was consensus that personal qualities and characteristics were more important than experience or qualifications. However, fast track students were significantly less confident about their public health competencies in leadership and management (p < 0.05) and communication (p < 0.02). Practice teachers and managers also reported that fast track students required more intensive supervision particularly at the beginning of the programme. Programme completion including pass rates and academic achievement showed no significant difference by route of entry (p > 0.5). Conclusion Fast tracking offers a useful recruitment strategy in order to expand the health visitor workforce, but longitudinal research is needed to confirm benefits such as retention and career trajectories.
Building the English health visitor workforce as a result of the Health Visitor Implementation Plan 2011–2015: a survey study of career progression and retention for newly qualified health visitors
This study aimed to explore the extent to which health visitors who trained and qualified in both Greater London and the South West of England between September 2011 and January 2016 were employed in health visiting posts and have remained in the profession. In 2011, the UK Government launched the Health Visitor Implementation Plan 'A Call to Action' (Department of Health, 2011) to develop the health visitor workforce by training 4200 health visitors over a four-year period. By April 2015, 4000 additional health visitors were trained, but the total workforce has since fallen back to pre-Implementation Plan size. Data were collected using a survey, completed online by participants. All participants had undertaken a health visitor education programme at one of two participating universities. The survey was distributed in January 2017 and completed by 180 individuals. Quantitative data were analysed using SPSS; association was assessed using individual chi-square tests or Fisher's exact test. Free-text responses were thematically analysed. Most (153; 87%) participants were still working as health visitors. Length of time spent working in the community prior to completing health visitor training was associated with staying in the role ( χ2 (with Fisher's exact test = 7.998, P = .027). Current pay was associated with attrition from the health visitor workforce ( χ2 (with Fisher's exact test) = 67.559, P < .001.). The majority who had left the health visitor role were on higher pay bands in their new post compared to those that had stayed (12; 60%). Bronfenbrenner's (1979) theory of socio-ecological development was used as a framework to interpret the results. While participants made an active choice to join the profession, leaving was influenced more by factors outside their control. To influence health visitor retention, both local and strategic changes are required.
Health visitors' accounts of the impacts of 'Hall 4' on their practice and profession: a qualitative study
The publication of the fourth edition of Health for all children (Hall 4) in 2003 marked a shift in health visiting towards a more targeted service. This paper aims to explore, through the accounts of health visitors, the impacts of this changed policy context for health visiting practice and for the health visiting profession. The study, upon which this paper is based, was a qualitative exploration carried out in one NHS locality with broad socioeconomic diversity. Semi-structured interviews were undertaken with 16 health visitors. The data was analysed using thematic and narrative techniques. In the study health visitors expressed concerns about the impacts of Hall 4 on health visiting practice, particularly in relation to health visiting expertise and the increase focus on child protection work shaping health visiting practice. In conjunction, health visitors'accounts suggest low morale as a profession.The paper concludes that the impacts of future policy change on health visiting practice must be fully considered; and, measures taken to prepare and support health visitors through periods of policy change.
Enrolled nurses take on new roles
Highlights how a practice model in Dunedin allows enrolled nurses to administer haemodialysis at home for patients needing extra support. Explains why Kirsty Booth and Helen Oldham sought this aspect of nursing care and how Kirsty manages her nerves with being sole charge. Talks to another recruit Carol Padgett who expresses her interest in returning to community-based nursing. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
McDonaldising the community nursing workforce
Unite/CPHVA ignited a national debate over the issue of health visitors, school nurses and community nursery nurses wearing uniforms on Facebook recently, following concerns from members that NHS trusts were 'imposing' uniforms on its health visiting staff. The subject generated a buzz among more social-media savvy members, and it was clear the matter was not as clear-cut as some organisations like to believe. The pros and cons of uniforms are complex and incredibly personal and, surprisingly, many of you were split over whether their introduction would be positive for the professions and families or a potentially hazardous move. Predictably, the Facebook poll resulted in the majority of members declaring themselves to be against the introduction of uniforms, although there was only a percentage point in it. Of the school nurses polled -- half of respondents had qualified in the past to years -- the results indicated that this cohort are the most engaged with the uniform issue.