Delegation of medication administration from registered nurses to non-registered support workers in community care settings: a systematic review with critical interpretive synthesis

Schools often provide medication management to children at school, yet, most U.S. schools lack a full-time, licensed nurse. Schools rely heavily on unlicensed assistive personnel (UAP) to perform such tasks. This systematic review examined medication management among K-12 school nurses. Keyword searches in three databases were performed. We included studies that examined: (a) K-12 charter, private/parochial, or public schools, (b) UAPs and licensed nurses, (c) policies and practices for medication management, or (d) nurse delegation laws. Three concepts were synthesized: (a) level of training, (b) nurse delegation, and (c) emergency medications. One-hundred twelve articles were screened. Of these, 37.5% (42/112) were comprehensively reviewed. Eighty-one percent discussed level of training, 69% nurse delegation, and 57% emergency medications. Succinct and consistent policies within and across the United States aimed at increasing access to emergency medications in schools remain necessary.

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The Meaning and Factors That Influence the Concept of Body Image: Systematic Review and Meta-Ethnography from the Perspectives of Adolescents

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031140 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1140

Author(s):

Glòria Tort-Nasarre ◽

Mercè Pollina Pocallet ◽

Eva Artigues-Barberà

Keyword(s):

Mental Health ◽

Systematic Review ◽

Body Image ◽

Mass Media ◽

Body Dissatisfaction ◽

School Environment ◽

Community Care ◽

Self Management ◽

Mental Health Nurses ◽

Healthy Body

Community care nurses educate adolescents about body image, but their interventions appear to be ineffective. Body dissatisfaction predicts unhealthy behaviors among adolescents. This study aimed to understand the meanings and factors that influence the concept of body image through a systematic review and meta-ethnography of qualitative studies from the perspective of adolescents. Ten studies published from 2009–2019 were identified by a search of relevant systematic databases between September and December 2019. The review followed the seven steps of meta-ethnography developed by Noblit and Hare, including a line-of-argument. The synthesis revealed six themes: self-perception of body image; opinions of friends and colleagues; opinions of family; specific features of the school environment; expectations perceived across the mass-media; and strategies, practices, and self-management of body image. An explanatory model was developed that showed adolescents’ development of body image and the path towards its establishment. In conclusion, these results should be considered to implement strategies to promote a healthy body image in adolescents by community health and mental health nurses.

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Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.745247 ◽

2021 ◽

Vol 12 ◽

Author(s):

Adrian P. Mundt ◽

Sabine Delhey Langerfeldt ◽

Enzo Rozas Serri ◽

Mathias Siebenförcher ◽

Stefan Priebe

Keyword(s):

Systematic Review ◽

Community Care ◽

Integration Of Care ◽

Admission Rates ◽

Expert Opinions ◽

Psychiatric Beds ◽

Occupancy Rates ◽

Mental Health Policies ◽

Bed Numbers

Introduction: Mental health policies have encouraged removals of psychiatric beds in many countries. It is under debate whether to continue those trends. We conducted a systematic review of expert arguments for trends of psychiatric bed numbers.Methods: We searched seven electronic databases and screened 15,479 papers to identify expert opinions, arguments and recommendations for trends of psychiatric bed numbers, published until December 2020. Data were synthesized using thematic analysis and classified into arguments to maintain or increase numbers and to reduce numbers.Results: One hundred six publications from 25 countries were included. The most common themes arguing for reductions of psychiatric bed numbers were inadequate use of inpatient care, better integration of care and better use of community care. Arguments to maintain or increase bed numbers included high demand of psychiatric beds, high occupancy rates, increasing admission rates, criminalization of mentally ill, lack of community care and inadequately short length of stay. Cost effectiveness and quality of care were used as arguments for increase or decrease.Conclusions: The expert arguments presented here may guide and focus future debate on the required psychiatric bed numbers. The recommendations may help policymakers to define targets for psychiatric bed numbers. Arguments need careful local evaluation, especially when supporting opposite directions of trends in different contexts.

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