Increasingly, the challenges associated with such time-bound definitions of ECRs are being acknowledged. Many bodies which offer funding for ECRs (eg, see
For ECRs, there is some excellent information available to help guide you in your careers.
There are free and accessible resources available such as Concordat to Support the Career Development of Researchers and the Research funding bodies also provide a wealth of advice and resources see, for example,
Nursing research often tests complex interventions. For example, the intervention may be delivered by different nurses, with varying levels of seniority and expertise and in diverse geographical locations. The efficacy (can it work) or effectiveness (does it work in the real world) of complex interventions is often evaluated within randomised controlled trials (RCTs). The most recent UK Medical Research Council (MRC) guidance
‘Moral distress’ is described by Jameton as ‘...aris[ing] when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’ (p. 6). Moral distress may cause nurses to question their career choice, and to feel disempowered and unhappy in their work. This may have a negative impact on the physical and mental well-being of nursing staff, leading to burnout and high staff turnover. Nurses in the first 5 years of their career (early career nurses) may be particularly at risk of experiencing moral distress as they make the stressful and challenging transition from student to qualified practice. The purpose of the review is to synthesise the literature regarding moral distress in the first 5 years of qualified practice.
Providing maternity care that is trauma informed, respectful, supportive and promotes patient autonomy, agency and cultural beliefs may encourage lower rates of freebirth.
More research is needed to articulate motivations for freebirth among diverse populations and translate trauma informed and respectful maternity care principles across systems and service providers.
Unassisted childbirth (outside a hospital facility with no professional attendant) is common in low-income and middle-income countries (LMICs), where barriers to access and poverty delimit engagement in maternity healthcare services. However, even in high-income countries (HICs) where maternity healthcare services are more attainable, a small percentage of birthing people are choosing unassisted birth, a...]]>
Healthcare providers should focus on improving knowledge around breastfeeding guidelines and the benefits of breast feeding for mothers in low socioeconomic status (SES) groups. Focusing research on breastfeeding intention (rather than rates) in low SES groups may help to improve breastfeeding outcomes as breastfeeding intentions are a significant predictor of breastfeeding initiation.
Breastfeeding sets the foundation for healthy growth and development, with many recognised benefits for both infant and maternal health. Thus, socioeconomic disparities in breastfeeding—which are widely reported in the USA and many other Western countries
Women with a history of recurrent miscarriages, infertility, or stillbirths should be informed of their increased risk of early or premature or menopause. Future studies should aim to evaluate whether a tailored counselling and management strategies considering this risk can improve patient outcomes and overall quality of care.
Menopause is a significant milestone for women, marking the permanent cessation of menstruation after 12 months of amenorrhoea. The onset of menopause is influenced by various factors, including genetics, lifestyle and...]]>
Wholesome eating diets can be customised to align with person’s culinary traditions and tastes in accordance with the Dietary Guidelines for Americans to decrease the mortality risk. Provide updated scientific evidences on the benefits of maintaining a healthy diet throughout the life course to take appropriate strategies and policies.
Healthy eating patterns play a prominent role in preserving public health. The association between dietary patterns with the mortality risk has been investigated in numerous countries.
Improving cardiovascular health may contribute to a higher and healthier life expectancy. Healthcare professionals may prioritise cardiovascular health promotion and support patients in adopting healthy behaviours.
The problem addressed in this study is the contribution of cardiovascular risk factors to a healthier life expectancy.
Leadership action by prioritising clinical research activities and introducing a range of clinician engagement strategies for research can lead to better staff retention and patient care. Implementation of clinician engagement strategies needs further research to clarify and enhance key benefits for staff and patients.
There is a growing body of international research evidence highlighting the benefits of clinicians’ research engagement and documenting associated barriers and facilitators.
Revising the ‘safe working hours policy’, limiting overtime, and developing fatigue management systems are vital approaches for managing nurses’ fatigue and reducing medication administration errors (MAEs). Future research should use large-scale studies and diverse approaches of data collection to better report registered nurses’ (RNs) fatigue’s impact on MAEs.
Preventing MAEs is a top priority to ensure patient safety. The presence of fatigue among RNs has been recognised as a growing factor in the occurrence of MAEs.
Multi-faceted interventions are key in addressing various influences on nurses’ healthy eating beyond individual choices. Rigorous studies are needed to assess multi-level socio-ecological interventions’ effectiveness on nurses’ eating habits.
Nurses, despite playing a significant role in healthcare, have been found to possess poor dietary habits and face elevated rates of chronic illnesses. A recent systematic review by Marko and colleagues explored factors influencing healthy eating among nurses in hospital settings. Barriers included high accessibility of unhealthy foods, high costs and lack of storage/preparation facilities. Enablers included proximity to healthy options, roster planning and structured workplace programmes. Supportive networks were an interpersonal enabler, while work culture and...]]>
Prioritising policies targeting social determinants of health is crucial for improving early-life health outcomes. Public involvement in policy prioritisation is vital for equitable and effective policies. Investing in comprehensive evaluations using harmonised and accessible administrative data is necessary to understand long-term effects of policy effectiveness.
Reducing early-life health inequalities is a critical challenge amid the COVID-19 socioeconomic impact.
Emergency department staff self-identified the need for training in the care of youth who identify as LGBTQ+ to close a gap in knowledge and clinical preparedness. Intervention studies, using evidence-based science, are needed to improve competency and advance health equity for LGBTQ+ youth.
Individuals who identify as LGBTQ+ report discrimination in healthcare settings.
In a review of inclusion of non-English speaking (NES) participants, 9% of research articles included NES participants, which may impact study generalisability. Research teams, research networks/databases, regulatory authorities and journals that disseminate study findings share responsibility for adequate inclusion of NES participants in research.
Non-English speakers (NES) and limited English proficiency (LEP) populations are growing.
Medication errors can occur throughout many complex steps. Children are exposed to a higher risk of harm than adults when it comes to medication errors. High-quality evidence for interventions that reduce medication errors in children on rounds is lacking.
King et al conducted a systematic review of interventions aimed at reducing medication errors during inpatient rounds in children’s hospitals.
Consideration of patients' life experiences, which aids in examining their feelings and patient’ experiences. Future research should further investigate the phenomenological approach in diverse healthcare contexts.
The transition from hospital to home treatment for patients with diabetic retinopathy (DR) is the subject of a study by Zhang and colleagues. The authors attempt to comprehend the substance of this phenomenon a shift towards patient-centric healthcare research by using a phenomenological method.
The descriptive phenomenology method was used to implement this...]]>
Measures to promote smoking cessation should go beyond brief counselling to include intensive counselling with pharmacotherapeutic support, such as varenicline, which are cost-effective. Future research is needed to study to what extent the results obtained here are reproducible in other healthcare settings.
Smoking cessation in stroke survivors is associated with a reduction in vascular events and death.
In patients calling the emergency medical system for acute chest pain without ST-segment elevation, prehospital risk stratification using validated risk scores and point-of-care (POC) cardiac troponin measurement by emergency nurses or paramedics can result in substantial cost savings. The safety of this strategy needs confirmation by sufficiently powered prospective randomised clinical trials.
Acute chest pain is one of the most common reasons for emergency system activation and transfer to the emergency department (ED).
AI assistants could be used to draft responses for physicians and nurses, potentially addressing a key element of burn-out. Further research is needed to assess the impact of communication on healthcare outcomes and should incorporate patient evaluations and feedback.
In the setting of increasing adoption of virtual healthcare and the surge in electronic patient messages, there has been a higher workload for physicians and nurses, contributing to burnout and potentially terse, unanswered or unhelpful patient messages. Given these challenges, there is a need to explore innovative solutions...]]>
Integrating social prescribing (SP) in primary care increases opportunities to deliver holistic care and facilitate clinic-community partnerships. Research examining the effect of SP on prediabetes-related clinical outcomes is needed.
Recent data suggest that 464 million adults worldwide have pre-diabetes and are at increased risk for type 2 diabetes (T2D).
Timely identifying selfcare behaviour patterns over time may reduce the risk of hospital readmissions in patients with heart failure (HF). Further research studies are required to examine the effects of every 3–6 months self-care intervention on hospital readmissions among patients with HF.
Unplanned readmissions within 30 days and 6 months postdischarge are notably common in patients with HF.
The introduction of artificial intelligence (AI)-based decision support systems (DSS) in mental healthcare is at a very early stage. For DSS to be relevant and cost-effective, clinicians must participate at all stages of development, from project specification to evaluation.
This integrative review
This literature review provides synthesised evidence to evaluate and improve the clinical practice of pro re nata (PRN) medication in mental healthcare organisations. Further research focused on exploring grey literature would offer additional perspectives and broaden the current clinical practices of PRN utilisation.
PRN refers to unscheduled medication used to manage acute symptoms. PRN is commonly used in mental healthcare, but literature suggests that its use is not always based on evidence. This review offers knowledge for developing evidence-based PRN practice. The nurses play a crucial role in PRN administration, including assessing patients’ needs for medication, following prescribed indications and instructions, as...]]>
Ensuring routine postrestraint-focused clinical supervision, experiential training for forensic mental health nurses involved in rebuilding therapeutic relationships postphysical restraint, effective debriefing and positive role modelling from senior staff is needed. Studies on models to combine goals of the therapeutic relationship and maintain safety are needed, besides establishing the effectiveness of different methods to facilitate a therapeutic relationship.
Forensic mental health nurses (FMHNs) are expected to manage potentially serious levels of risk while maintaining a proportionate balance between therapeutic care and potentially restrictive security.
Implications for practice and research
Clients’ medical data and trauma histories should be supplemented with information on their strengths to promote a holistic and integrated understanding of their lived experiences. Research is needed to better understand the extent to which trauma-informed care (TIC) principles are taught to nursing students so that they understand how to apply TIC in different healthcare settings.
There is growing support for the delivery of trauma-informed care (TIC) in diverse clinical, organisational and community settings.
Death education courses (DECs) prepare healthcare students to manage future relationships with end-of-life (EOL) patients and their relatives. It would be better for DECs to use active methodologies, for example, creative arts therapies and constructivist and narrative techniques. Research should longitudinally monitor students who have completed a DEC to check their levels of willingness to work in palliative care and their levels of work satisfaction versus burn-out in both the EOL and other hospital wards after they become healthcare professionals.
Many healthcare practitioners suffer from a lack of competence in death...]]>
Massive open online course (MOOCs) can improve health professionals (HPs)’ knowledge and nutritional care skills for malnutrition in older adults efficiently. Implementation science studies are necessary to effectively change HPs’ behaviours and attitudes towards malnutrition by considering organisational, cultural and self-efficacy aspects. Future research should focus on identifying effective strategies for implementing evidence-based nutritional care for older adults, emphasising HPs’ attitudes and self-efficacy.
Malnutrition is a prevalent condition among older adults in acute hospital settings that can result in adverse clinical outcomes such as increased pressure ulcer development, reduced wound healing, increased infections and higher mortality rates.
Nurse educators and policymakers can draw valuable insights from these findings to shape evidence-based strategies for enhancing cultural competence in nursing education, ultimately contributing to the provision of culturally sensitive and effective healthcare services. The unexpected decline in cultural sensitivity and effectiveness levels as students approach graduation raises intriguing questions about the factors influencing these dynamics. Longitudinal studies are recommended to provide a comprehensive understanding of how cultural competence evolves over the course of nursing education.
When intercultural competence is comprehensively addressed in providing healthcare services, it positively influences patients’ satisfaction levels, participation in care and safety.
Nurses can promote self-determination of people with severe and profound intellectual disabilities through relationship building and learning to read a person’s communication cues to determine their preferences. Future research should use an ecological approach to optimise environments for self-determination and consistent measures to strengthen the evidence base.
Self-determination is a key dimension of quality of life for people with intellectual disabilities, that is, acting freely and willfully to make things happen in one’s own life.
Future research could explore and test the efficacy of gender-specific fall prevention protocols. In practice, understanding that there are gender-based risk factors for falls would assist and prompt nurses and health professionals to perform assessments or interventions to specifically mitigate those risks
Falls are an incredibly common issue among older adults, with potentially serious downstream consequences. Suh et al (2023) aimed to explore not only the prevalence of falls but also the factors relating to age, gender and falls. It is well established that there are gender differences in the prevalence of falls, however, the reasoning is not fully understood. This study was conducted to address the paucity in...]]>
People with dementia show a higher incidence of falls four years before diagnosis. There is a growing evidence of life-style risk factors for developing dementia in later life. Further research is needed of the behavioural risks to developing dementia and interventions to mitigate those risks.
The incidence of falls increases with age with approximately a third of people over the age of 65 years experiencing one or more falls a year. These falls can result in significant injuries, such as a fracture or even death. Dementia is largely a condition associated with age and there is a growing interest and body of research that explores the...]]>
Digital legacy could be incorporated into advance care planning policies in practice, with explicit inclusion in advance care planning documents. Further research is required to explore the diverse facets of digital legacies within various patient populations and cultural backgrounds.
The rapid growth of technology, including increased internet access and smartphone usage, has made digital legacy management an important aspect of end-of-life care. Digital legacy refers to the digital assets and online presence that individuals leave behind after they pass away.
Clinicians must communicate with young adults (YAs) throughout their disease course about end-of-life care preferences, including place-of-death. Future research must explore YAs’ preferences for place-of-death.
Young adults (YAs) with serious illnesses report wanting choices in their end-of-life care.
Multidimensional measurement of cancer-related fatigue in clinical practice may contribute to coping strategies based on the assumption that it affects physical, emotional and cognitive domains. More effective and family-informed interventions are needed in future research to improve cancer-related fatigue management.
Most types of fatigue cannot be directly observed; therefore, its importance and treatment are often overlooked. Cancer-related fatigue (CRF) and its treatment differs greatly from the fatigue experienced by the general population. Previous studies have shown that comprehensive support tailored to the individual’s priorities can positively encourage appropriate management of CRF. Planning CRF self-management interventions is crucial...]]>