Ann Donohoe - Academia.edu (original) (raw)

Papers by Ann Donohoe

Data extraction tables. Description of data: Data relates to the studies within each of the six c... more Data extraction tables. Description of data: Data relates to the studies within each of the six categories as illustrated in Fig. 2. Integrated and Collaborative Care (n = 33); Home Based Community Nursing (n = 32); Telehealth (n = 15); Transitional Care (n = 9); Non-Professional (n = 10) and Preventative (n = 18); which informed the final four themes which is the subject of this paper. (DOCX 183 kb)

International Journal of Learning and Development, 2021

Linguistic differences between patients and clinicians can result in ineffective and inequitable ... more Linguistic differences between patients and clinicians can result in ineffective and inequitable healthcare delivery. Medical students should therefore be facilitated to develop the requisite knowledge and skills to work effectively within language discordant clinical situations. This paper explores language interpreting processes in an undergraduate medical education programme. The study utilizes a constructivist paradigm incorporating an action research approach. Action Research Cycle 1 (ARC1) examines the use of interpreters during clinical examinations while Action Research Cycle 2 (ARC2) focuses on language translation technology. In Action Research Cycle 3 the data that was generated in ARC 1 and ARC 2 is reviewed in association with international literature to develop a framework for practice. This study demonstrates that language interpreting procedures should be based within a collaborative framework with students, interpreters and educators receiving appropriate educationa...

School of Nursing, Midwifery and Health Systems at University College Dublin., Jul 1, 2018

The aim of this evidence review was to identify a model to guide nursing and midwifery in the com... more The aim of this evidence review was to identify a model to guide nursing and midwifery in the community in Ireland. The evidence will support the work of the Department of Health to inform future policy development. Methods A rigorous systematic search of databases was undertaken to retrieve both empirical and grey relevant and appropriate literature. This process was guided by systematic review methodologies (Higgins & Green 2011; Centre for Systematic Reviews and Dissemination 2008) and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (Moher et al. 2009). Data were extracted and screened for content and quality appraisal by two reviewers. Decisions regarding inclusion and exclusion criteria for nursing and midwifery in the community contexts and services 1 were carried out systematically and transparently. The breadth of evidence from the final papers selected on community nursing was categorised into six broad areas and subsequently synthesized into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing & Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) an Overarching Model. Key Findings Empirical Literature  Community nursing services address diverse healthcare needs of individuals, families and communities across a wide range of healthcare settings inclusive of primary care or community health clinics, GP practices, people's homes, and the interface between primary and secondary healthcare. Community midwifery services where available address maternal and child health inclusive of perinatal care.  The diversity of community nursing is further reflected in the various roles and categories of registered nurses inclusive of health visitors, public health nurses, school nurses, practice nurses, clinical specialist 1 Most evidence related to nursing. Midwifery is noted where applicable. 13 nurses, advanced nurse practitioners and generalist nurses. The title 'community nurse' is also used implying a generalist although this is not always explicit. No variations of the title midwife are evident.  Most interventions involving nurses either as leaders or participants in community based health service innovations are beneficial or, when compared to existing models of provision including medical provision, are at least non-inferior.  The scope of community nursing is such that it encompasses individuals, families and communities across the lifespan but not through a lifespan approach for any one group of registered nurses i.e. the care of different individuals and populations involves specific nurses e.g. health visitors/public health nurses focusing on maternal health and child health welfare and protection, and primary, secondary and tertiary preventative care across the lifespan; clinical nurse specialists focusing on chronic illness management. Community midwifery servives, where they exist, provide antenatal and early postpartum care. The literature on home birth was not reviewed.  Nurse-led care embedded in primary care/community settings is a consistent approach to services across the six original categories and four synthesized themes.  The role of the nurse or midwife varies across individual and population groups with more or less emphasis on preventative care, health education, health promotion, case management, and self-management support. Grey Literature  Analysis of literature from 5 countries informed this review, namely, USA, UK, Australia, Canada and The Netherlands. Most literature relates to the UK.  The diversity, scope and role of community nursing evident in the grey literature is similar to that seen in the empirical literature. Community midwifery services are more defined.  Key messages from community nursing and midwifery services are that they are: interdependent on other services and part of an overall integrated health service; comprehensive, accessible, equitable and flexible; caseload and population focused with reference to subgroups (e.g. childbearing women and children, children with illnesses/disabilities, older adults, marginalized groups.); nurse-led or to a limited extent midwife-led, team oriented and collaborative in approach with intra-disciplinary and interdisciplinary working relationships.  Competencies, including the skill set required of community nurses, with specific reference to PHNs are: analytic assessment; cultural competence; programme planning; communication; collaboration; financial planning and management; leadership and systems thinking; policy development; and skill in public health science. Competencies for midwives highlight the importance of cultural competence; communication and collaboration.  The practice of community nurses and midwives needs to be based on discipline specific competencies, professional regulatory standards, values and principles, policy, and a theoretical foundation.  From the review of grey literature it is evident that no relevant major or negative trials were missed. Evidence Synthesis  It is apparent that an integrated and collaborative care model is likely to be more effective than fragmented and segregated services.  Integration involves seamless primary, secondary and tertiary services underpinned by a high degree of collaboration between healthcare professionals in these services, as well as organisational support for integration. The principal point of care needs to be in the primary care setting, close to the person's home and care should be person-centred.  The organisation and delivery of nursing and midwifery care centres primarily around preventative or curative care with a strong emphasis on nurse-led interventions. Box 1: PICOCS framework guiding selection criteria Population: The whole population including (but not exclusively): new mothers, infants and children, adolescents, children with complex needs, including disabilities, older adults, adults with chronic illnesses, adults with mental health issues, people in need of palliative care, vulnerable populations including minority groups, migrants and travelling communities, victims of / those at risk of domestic violence or sexual abuse, school going children and adolescents. Interventions: Any intervention that manages nursing and midwifery care in the community in comparison to no intervention/usual care. Comparator: No intervention/usual or standard care or service delivery/another model or programme of care or integration. Outcomes: Any measures of patient centred, process, service or economic outcomes. Any measures/reporting of barriers and enablers relating to implementation of models of community nursing or midwifery. Any recommendations regarding education, research, service delivery, policy relating to community nursing or midwifery. Contexts: Community based nursing and midwifery services delivering care across a wide variety of settings including GP Practice, home, schools, community and health centres. Added post-hoc: Countries classified as high human development level (UNDP, 2014), Studies: Systematic reviews of reviews, meta-analysis, systematic reviews and randomised controlled studies, meta-synthesis, narrative reviews (Narrative reviews and meta-synthesis were later excluded). In addition, peer reviewed papers, evidence based policy documents or mixed method studies reporting on the implementation or evaluation of programmes/models in Ireland, United Kingdom,

The aim of this evidence review was to identify a model to guide nursing and midwifery in the com... more The aim of this evidence review was to identify a model to guide nursing and midwifery in the community in Ireland. The evidence will support the work of the Department of Health to inform future policy development. Methods A rigorous systematic search of databases was undertaken to retrieve both empirical and grey relevant and appropriate literature. This process was guided by systematic review methodologies (Higgins & Green 2011; Centre for Systematic Reviews and Dissemination 2008) and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (Moher et al. 2009). Data were extracted and screened for content and quality appraisal by two reviewers. Decisions regarding inclusion and exclusion criteria for nursing and midwifery in the community contexts and services 1 were carried out systematically and transparently. The breadth of evidence from the final papers selected on community nursing was categorised into six broad areas and subsequently synthesized into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing & Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) an Overarching Model. Key Findings Empirical Literature  Community nursing services address diverse healthcare needs of individuals, families and communities across a wide range of healthcare settings inclusive of primary care or community health clinics, GP practices, people's homes, and the interface between primary and secondary healthcare. Community midwifery services where available address maternal and child health inclusive of perinatal care.  The diversity of community nursing is further reflected in the various roles and categories of registered nurses inclusive of health visitors, public health nurses, school nurses, practice nurses, clinical specialist 1 Most evidence related to nursing. Midwifery is noted where applicable. 13 nurses, advanced nurse practitioners and generalist nurses. The title 'community nurse' is also used implying a generalist although this is not always explicit. No variations of the title midwife are evident.  Most interventions involving nurses either as leaders or participants in community based health service innovations are beneficial or, when compared to existing models of provision including medical provision, are at least non-inferior.  The scope of community nursing is such that it encompasses individuals, families and communities across the lifespan but not through a lifespan approach for any one group of registered nurses i.e. the care of different individuals and populations involves specific nurses e.g. health visitors/public health nurses focusing on maternal health and child health welfare and protection, and primary, secondary and tertiary preventative care across the lifespan; clinical nurse specialists focusing on chronic illness management. Community midwifery servives, where they exist, provide antenatal and early postpartum care. The literature on home birth was not reviewed.  Nurse-led care embedded in primary care/community settings is a consistent approach to services across the six original categories and four synthesized themes.  The role of the nurse or midwife varies across individual and population groups with more or less emphasis on preventative care, health education, health promotion, case management, and self-management support. Grey Literature  Analysis of literature from 5 countries informed this review, namely, USA, UK, Australia, Canada and The Netherlands. Most literature relates to the UK.  The diversity, scope and role of community nursing evident in the grey literature is similar to that seen in the empirical literature. Community midwifery services are more defined.  Key messages from community nursing and midwifery services are that they are: interdependent on other services and part of an overall integrated health service; comprehensive, accessible, equitable and flexible; caseload and population focused with reference to subgroups (e.g. childbearing women and children, children with illnesses/disabilities, older adults, marginalized groups.); nurse-led or to a limited extent midwife-led, team oriented and collaborative in approach with intra-disciplinary and interdisciplinary working relationships.  Competencies, including the skill set required of community nurses, with specific reference to PHNs are: analytic assessment; cultural competence; programme planning; communication; collaboration; financial planning and management; leadership and systems thinking; policy development; and skill in public health science. Competencies for midwives highlight the importance of cultural competence; communication and collaboration.  The practice of community nurses and midwives needs to be based on discipline specific competencies, professional regulatory standards, values and principles, policy, and a theoretical foundation.  From the review of grey literature it is evident that no relevant major or negative trials were missed. Evidence Synthesis  It is apparent that an integrated and collaborative care model is likely to be more effective than fragmented and segregated services.  Integration involves seamless primary, secondary and tertiary services underpinned by a high degree of collaboration between healthcare professionals in these services, as well as organisational support for integration. The principal point of care needs to be in the primary care setting, close to the person's home and care should be person-centred.  The organisation and delivery of nursing and midwifery care centres primarily around preventative or curative care with a strong emphasis on nurse-led interventions. Box 1: PICOCS framework guiding selection criteria Population: The whole population including (but not exclusively): new mothers, infants and children, adolescents, children with complex needs, including disabilities, older adults, adults with chronic illnesses, adults with mental health issues, people in need of palliative care, vulnerable populations including minority groups, migrants and travelling communities, victims of / those at risk of domestic violence or sexual abuse, school going children and adolescents. Interventions: Any intervention that manages nursing and midwifery care in the community in comparison to no intervention/usual care. Comparator: No intervention/usual or standard care or service delivery/another model or programme of care or integration. Outcomes: Any measures of patient centred, process, service or economic outcomes. Any measures/reporting of barriers and enablers relating to implementation of models of community nursing or midwifery. Any recommendations regarding education, research, service delivery, policy relating to community nursing or midwifery. Contexts: Community based nursing and midwifery services delivering care across a wide variety of settings including GP Practice, home, schools, community and health centres. Added post-hoc: Countries classified as high human development level (UNDP, 2014), Studies: Systematic reviews of reviews, meta-analysis, systematic reviews and randomised controlled studies, meta-synthesis, narrative reviews (Narrative reviews and meta-synthesis were later excluded). In addition, peer reviewed papers, evidence based policy documents or mixed method studies reporting on the implementation or evaluation of programmes/models in Ireland, United Kingdom,

International Journal of Learning and Development

Linguistic differences between patients and clinicians can result in ineffective and inequitable ... more Linguistic differences between patients and clinicians can result in ineffective and inequitable healthcare delivery. Medical students should therefore be facilitated to develop the requisite knowledge and skills to work effectively within language discordant clinical situations. This paper explores language interpreting processes in an undergraduate medical education programme. The study utilizes a constructivist paradigm incorporating an action research approach. Action Research Cycle 1 (ARC1) examines the use of interpreters during clinical examinations while Action Research Cycle 2 (ARC2) focuses on language translation technology. In Action Research Cycle 3 the data that was generated in ARC 1 and ARC 2 is reviewed in association with international literature to develop a framework for practice. This study demonstrates that language interpreting procedures should be based within a collaborative framework with students, interpreters and educators receiving appropriate educationa...

BMC Nursing

Background: Successful models of nursing and midwifery in the community delivering healthcare thr... more Background: Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. Methods: A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. Results: The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Conclusion: Use of a conceptual model of nursing and midwifery to inform decision-making in primary/ community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance.

Health Expectations

Epidermolysis bullosa (EB) is the term used to describe a group of rare genetic skin disorders wh... more Epidermolysis bullosa (EB) is the term used to describe a group of rare genetic skin disorders which result in an extreme susceptibility to blister. There are more than 30 subtypes identified, and these are generally categorized into four groups: EB simplex (EBS); dystrophic EB (DEB); junctional EB (JEB); and Kindler syndrome. 1 EBS is considered the mildest form of EB, with blistering focused mainly in the feet and hands. For those with more severe subtypes, pain is a central part of the condition and individuals require daily skin care routines and bandaging on most parts of the body. 2,3 Treatments focus on prevention of blisters, use of appropriate bandages and ointments and support for physical and mental well-being, 4 requiring the services of a wide range of disciplines, such as dermatology, nursing,

Nurse Education in Practice

Procedia - Social and Behavioral Sciences

ABSTRACT

Applied E-Learning and E-Teaching in Higher Education, 2009

Chapter XIII Online Communities of Inquiry in Higher Education Ann Donohoe School of Nursing, Mid... more Chapter XIII Online Communities of Inquiry in Higher Education Ann Donohoe School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland Tim McMahon Centre for Teaching and Learning, University College Dublin, Ireland Geraldine O'Neill Centre for ...

BMC Nursing, Jun 29, 2017

Background: Successful models of nursing and midwifery in the community delivering healthcare thr... more Background: Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. Methods: A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. Results: The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Conclusion: Use of a conceptual model of nursing and midwifery to inform decision-making in primary/ community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance.

Data extraction tables. Description of data: Data relates to the studies within each of the six c... more Data extraction tables. Description of data: Data relates to the studies within each of the six categories as illustrated in Fig. 2. Integrated and Collaborative Care (n = 33); Home Based Community Nursing (n = 32); Telehealth (n = 15); Transitional Care (n = 9); Non-Professional (n = 10) and Preventative (n = 18); which informed the final four themes which is the subject of this paper. (DOCX 183 kb)

International Journal of Learning and Development, 2021

Linguistic differences between patients and clinicians can result in ineffective and inequitable ... more Linguistic differences between patients and clinicians can result in ineffective and inequitable healthcare delivery. Medical students should therefore be facilitated to develop the requisite knowledge and skills to work effectively within language discordant clinical situations. This paper explores language interpreting processes in an undergraduate medical education programme. The study utilizes a constructivist paradigm incorporating an action research approach. Action Research Cycle 1 (ARC1) examines the use of interpreters during clinical examinations while Action Research Cycle 2 (ARC2) focuses on language translation technology. In Action Research Cycle 3 the data that was generated in ARC 1 and ARC 2 is reviewed in association with international literature to develop a framework for practice. This study demonstrates that language interpreting procedures should be based within a collaborative framework with students, interpreters and educators receiving appropriate educationa...

School of Nursing, Midwifery and Health Systems at University College Dublin., Jul 1, 2018

The aim of this evidence review was to identify a model to guide nursing and midwifery in the com... more The aim of this evidence review was to identify a model to guide nursing and midwifery in the community in Ireland. The evidence will support the work of the Department of Health to inform future policy development. Methods A rigorous systematic search of databases was undertaken to retrieve both empirical and grey relevant and appropriate literature. This process was guided by systematic review methodologies (Higgins & Green 2011; Centre for Systematic Reviews and Dissemination 2008) and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (Moher et al. 2009). Data were extracted and screened for content and quality appraisal by two reviewers. Decisions regarding inclusion and exclusion criteria for nursing and midwifery in the community contexts and services 1 were carried out systematically and transparently. The breadth of evidence from the final papers selected on community nursing was categorised into six broad areas and subsequently synthesized into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing & Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) an Overarching Model. Key Findings Empirical Literature  Community nursing services address diverse healthcare needs of individuals, families and communities across a wide range of healthcare settings inclusive of primary care or community health clinics, GP practices, people's homes, and the interface between primary and secondary healthcare. Community midwifery services where available address maternal and child health inclusive of perinatal care.  The diversity of community nursing is further reflected in the various roles and categories of registered nurses inclusive of health visitors, public health nurses, school nurses, practice nurses, clinical specialist 1 Most evidence related to nursing. Midwifery is noted where applicable. 13 nurses, advanced nurse practitioners and generalist nurses. The title 'community nurse' is also used implying a generalist although this is not always explicit. No variations of the title midwife are evident.  Most interventions involving nurses either as leaders or participants in community based health service innovations are beneficial or, when compared to existing models of provision including medical provision, are at least non-inferior.  The scope of community nursing is such that it encompasses individuals, families and communities across the lifespan but not through a lifespan approach for any one group of registered nurses i.e. the care of different individuals and populations involves specific nurses e.g. health visitors/public health nurses focusing on maternal health and child health welfare and protection, and primary, secondary and tertiary preventative care across the lifespan; clinical nurse specialists focusing on chronic illness management. Community midwifery servives, where they exist, provide antenatal and early postpartum care. The literature on home birth was not reviewed.  Nurse-led care embedded in primary care/community settings is a consistent approach to services across the six original categories and four synthesized themes.  The role of the nurse or midwife varies across individual and population groups with more or less emphasis on preventative care, health education, health promotion, case management, and self-management support. Grey Literature  Analysis of literature from 5 countries informed this review, namely, USA, UK, Australia, Canada and The Netherlands. Most literature relates to the UK.  The diversity, scope and role of community nursing evident in the grey literature is similar to that seen in the empirical literature. Community midwifery services are more defined.  Key messages from community nursing and midwifery services are that they are: interdependent on other services and part of an overall integrated health service; comprehensive, accessible, equitable and flexible; caseload and population focused with reference to subgroups (e.g. childbearing women and children, children with illnesses/disabilities, older adults, marginalized groups.); nurse-led or to a limited extent midwife-led, team oriented and collaborative in approach with intra-disciplinary and interdisciplinary working relationships.  Competencies, including the skill set required of community nurses, with specific reference to PHNs are: analytic assessment; cultural competence; programme planning; communication; collaboration; financial planning and management; leadership and systems thinking; policy development; and skill in public health science. Competencies for midwives highlight the importance of cultural competence; communication and collaboration.  The practice of community nurses and midwives needs to be based on discipline specific competencies, professional regulatory standards, values and principles, policy, and a theoretical foundation.  From the review of grey literature it is evident that no relevant major or negative trials were missed. Evidence Synthesis  It is apparent that an integrated and collaborative care model is likely to be more effective than fragmented and segregated services.  Integration involves seamless primary, secondary and tertiary services underpinned by a high degree of collaboration between healthcare professionals in these services, as well as organisational support for integration. The principal point of care needs to be in the primary care setting, close to the person's home and care should be person-centred.  The organisation and delivery of nursing and midwifery care centres primarily around preventative or curative care with a strong emphasis on nurse-led interventions. Box 1: PICOCS framework guiding selection criteria Population: The whole population including (but not exclusively): new mothers, infants and children, adolescents, children with complex needs, including disabilities, older adults, adults with chronic illnesses, adults with mental health issues, people in need of palliative care, vulnerable populations including minority groups, migrants and travelling communities, victims of / those at risk of domestic violence or sexual abuse, school going children and adolescents. Interventions: Any intervention that manages nursing and midwifery care in the community in comparison to no intervention/usual care. Comparator: No intervention/usual or standard care or service delivery/another model or programme of care or integration. Outcomes: Any measures of patient centred, process, service or economic outcomes. Any measures/reporting of barriers and enablers relating to implementation of models of community nursing or midwifery. Any recommendations regarding education, research, service delivery, policy relating to community nursing or midwifery. Contexts: Community based nursing and midwifery services delivering care across a wide variety of settings including GP Practice, home, schools, community and health centres. Added post-hoc: Countries classified as high human development level (UNDP, 2014), Studies: Systematic reviews of reviews, meta-analysis, systematic reviews and randomised controlled studies, meta-synthesis, narrative reviews (Narrative reviews and meta-synthesis were later excluded). In addition, peer reviewed papers, evidence based policy documents or mixed method studies reporting on the implementation or evaluation of programmes/models in Ireland, United Kingdom,

The aim of this evidence review was to identify a model to guide nursing and midwifery in the com... more The aim of this evidence review was to identify a model to guide nursing and midwifery in the community in Ireland. The evidence will support the work of the Department of Health to inform future policy development. Methods A rigorous systematic search of databases was undertaken to retrieve both empirical and grey relevant and appropriate literature. This process was guided by systematic review methodologies (Higgins & Green 2011; Centre for Systematic Reviews and Dissemination 2008) and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (Moher et al. 2009). Data were extracted and screened for content and quality appraisal by two reviewers. Decisions regarding inclusion and exclusion criteria for nursing and midwifery in the community contexts and services 1 were carried out systematically and transparently. The breadth of evidence from the final papers selected on community nursing was categorised into six broad areas and subsequently synthesized into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing & Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) an Overarching Model. Key Findings Empirical Literature  Community nursing services address diverse healthcare needs of individuals, families and communities across a wide range of healthcare settings inclusive of primary care or community health clinics, GP practices, people's homes, and the interface between primary and secondary healthcare. Community midwifery services where available address maternal and child health inclusive of perinatal care.  The diversity of community nursing is further reflected in the various roles and categories of registered nurses inclusive of health visitors, public health nurses, school nurses, practice nurses, clinical specialist 1 Most evidence related to nursing. Midwifery is noted where applicable. 13 nurses, advanced nurse practitioners and generalist nurses. The title 'community nurse' is also used implying a generalist although this is not always explicit. No variations of the title midwife are evident.  Most interventions involving nurses either as leaders or participants in community based health service innovations are beneficial or, when compared to existing models of provision including medical provision, are at least non-inferior.  The scope of community nursing is such that it encompasses individuals, families and communities across the lifespan but not through a lifespan approach for any one group of registered nurses i.e. the care of different individuals and populations involves specific nurses e.g. health visitors/public health nurses focusing on maternal health and child health welfare and protection, and primary, secondary and tertiary preventative care across the lifespan; clinical nurse specialists focusing on chronic illness management. Community midwifery servives, where they exist, provide antenatal and early postpartum care. The literature on home birth was not reviewed.  Nurse-led care embedded in primary care/community settings is a consistent approach to services across the six original categories and four synthesized themes.  The role of the nurse or midwife varies across individual and population groups with more or less emphasis on preventative care, health education, health promotion, case management, and self-management support. Grey Literature  Analysis of literature from 5 countries informed this review, namely, USA, UK, Australia, Canada and The Netherlands. Most literature relates to the UK.  The diversity, scope and role of community nursing evident in the grey literature is similar to that seen in the empirical literature. Community midwifery services are more defined.  Key messages from community nursing and midwifery services are that they are: interdependent on other services and part of an overall integrated health service; comprehensive, accessible, equitable and flexible; caseload and population focused with reference to subgroups (e.g. childbearing women and children, children with illnesses/disabilities, older adults, marginalized groups.); nurse-led or to a limited extent midwife-led, team oriented and collaborative in approach with intra-disciplinary and interdisciplinary working relationships.  Competencies, including the skill set required of community nurses, with specific reference to PHNs are: analytic assessment; cultural competence; programme planning; communication; collaboration; financial planning and management; leadership and systems thinking; policy development; and skill in public health science. Competencies for midwives highlight the importance of cultural competence; communication and collaboration.  The practice of community nurses and midwives needs to be based on discipline specific competencies, professional regulatory standards, values and principles, policy, and a theoretical foundation.  From the review of grey literature it is evident that no relevant major or negative trials were missed. Evidence Synthesis  It is apparent that an integrated and collaborative care model is likely to be more effective than fragmented and segregated services.  Integration involves seamless primary, secondary and tertiary services underpinned by a high degree of collaboration between healthcare professionals in these services, as well as organisational support for integration. The principal point of care needs to be in the primary care setting, close to the person's home and care should be person-centred.  The organisation and delivery of nursing and midwifery care centres primarily around preventative or curative care with a strong emphasis on nurse-led interventions. Box 1: PICOCS framework guiding selection criteria Population: The whole population including (but not exclusively): new mothers, infants and children, adolescents, children with complex needs, including disabilities, older adults, adults with chronic illnesses, adults with mental health issues, people in need of palliative care, vulnerable populations including minority groups, migrants and travelling communities, victims of / those at risk of domestic violence or sexual abuse, school going children and adolescents. Interventions: Any intervention that manages nursing and midwifery care in the community in comparison to no intervention/usual care. Comparator: No intervention/usual or standard care or service delivery/another model or programme of care or integration. Outcomes: Any measures of patient centred, process, service or economic outcomes. Any measures/reporting of barriers and enablers relating to implementation of models of community nursing or midwifery. Any recommendations regarding education, research, service delivery, policy relating to community nursing or midwifery. Contexts: Community based nursing and midwifery services delivering care across a wide variety of settings including GP Practice, home, schools, community and health centres. Added post-hoc: Countries classified as high human development level (UNDP, 2014), Studies: Systematic reviews of reviews, meta-analysis, systematic reviews and randomised controlled studies, meta-synthesis, narrative reviews (Narrative reviews and meta-synthesis were later excluded). In addition, peer reviewed papers, evidence based policy documents or mixed method studies reporting on the implementation or evaluation of programmes/models in Ireland, United Kingdom,

International Journal of Learning and Development

Linguistic differences between patients and clinicians can result in ineffective and inequitable ... more Linguistic differences between patients and clinicians can result in ineffective and inequitable healthcare delivery. Medical students should therefore be facilitated to develop the requisite knowledge and skills to work effectively within language discordant clinical situations. This paper explores language interpreting processes in an undergraduate medical education programme. The study utilizes a constructivist paradigm incorporating an action research approach. Action Research Cycle 1 (ARC1) examines the use of interpreters during clinical examinations while Action Research Cycle 2 (ARC2) focuses on language translation technology. In Action Research Cycle 3 the data that was generated in ARC 1 and ARC 2 is reviewed in association with international literature to develop a framework for practice. This study demonstrates that language interpreting procedures should be based within a collaborative framework with students, interpreters and educators receiving appropriate educationa...

BMC Nursing

Background: Successful models of nursing and midwifery in the community delivering healthcare thr... more Background: Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. Methods: A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. Results: The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Conclusion: Use of a conceptual model of nursing and midwifery to inform decision-making in primary/ community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance.

Health Expectations

Epidermolysis bullosa (EB) is the term used to describe a group of rare genetic skin disorders wh... more Epidermolysis bullosa (EB) is the term used to describe a group of rare genetic skin disorders which result in an extreme susceptibility to blister. There are more than 30 subtypes identified, and these are generally categorized into four groups: EB simplex (EBS); dystrophic EB (DEB); junctional EB (JEB); and Kindler syndrome. 1 EBS is considered the mildest form of EB, with blistering focused mainly in the feet and hands. For those with more severe subtypes, pain is a central part of the condition and individuals require daily skin care routines and bandaging on most parts of the body. 2,3 Treatments focus on prevention of blisters, use of appropriate bandages and ointments and support for physical and mental well-being, 4 requiring the services of a wide range of disciplines, such as dermatology, nursing,

Nurse Education in Practice

Procedia - Social and Behavioral Sciences

ABSTRACT

Applied E-Learning and E-Teaching in Higher Education, 2009

Chapter XIII Online Communities of Inquiry in Higher Education Ann Donohoe School of Nursing, Mid... more Chapter XIII Online Communities of Inquiry in Higher Education Ann Donohoe School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland Tim McMahon Centre for Teaching and Learning, University College Dublin, Ireland Geraldine O'Neill Centre for ...

BMC Nursing, Jun 29, 2017

Background: Successful models of nursing and midwifery in the community delivering healthcare thr... more Background: Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. Methods: A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. Results: The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Conclusion: Use of a conceptual model of nursing and midwifery to inform decision-making in primary/ community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance.