scholarly journals Ethical Problems and Moral Distress in Primary Care: A Scoping Review

2021 ◽  
Vol 18 (14) ◽  
pp. 7565
Author(s):  
Noemi Giannetta ◽  
Giulia Villa ◽  
Federico Pennestrì ◽  
Roberta Sala ◽  
Roberto Mordacci ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Professional Education ◽  
Moral Distress ◽  
Ethical Dilemmas ◽  
Primary Care Settings ◽  
Quantitative Studies ◽  
Ethics Research ◽  
Ethical Conflicts ◽  
Primary Care Nurses

Background: Since 1997, nursing ethics research has focused on solving ethical dilemmas, enhancing decision-making strategies, and introducing professional education. Few studies describe the triggers of ethical dilemmas among primary care nurses. The aim of this study was to explore the moral distress and ethical dilemmas among primary care nurses. Methods: A scoping review was performed following Arskey and O’Malley’s framework. PubMed, CINAHL, PsycINFO, Embase, and Scopus were searched systematically to retrieve relevant titles and abstracts. A temporal filter was applied to focus on the most recent literature (years of 2010–2020). The research was completed on 17 November 2020. Results: Of 184 articles retrieved, 15 were included in the review. Some (n = 7) studies had a qualitative design, and the most productive country was Brazil (n = 7). The total number of nurses involved in quantitative studies was 1137 (range: 36–433); the total number of nurses involved in qualitative studies was 144 (range: 7–73). Three main focus areas were identified: (a) frequent ethical conflicts and moral distress episodes among nurses working in primary care settings; (b) frequent moral distress measures here employed; (c) coping strategies here adopted to prevent or manage moral distress. Conclusion: Further research is needed to examine the differences between moral distress triggers and sources of ethical dilemmas among the different care environments, such as primary care and acute care settings.

scholarly journals What Resources Do NHS Commissioning Organisations Use to Support Antimicrobial Stewardship in Primary Care in England?

Antibiotics ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 158 ◽  
Author(s):  
Rosalie Allison ◽  
Donna M. Lecky ◽  
Elizabeth Beech ◽  
Diane Ashiru-Oredope ◽  
Céire Costelloe ◽  
...  
Keyword(s):  
Primary Care ◽  
Antimicrobial Stewardship ◽  
Professional Education ◽  
Action Planning ◽  
Health Economy ◽  
Medicines Management ◽  
Out Of Hours ◽  
Primary Care Settings ◽  
General Practices ◽  
Primary Care Practitioners

Professional education and public engagement are fundamental components of any antimicrobial stewardship (AMS) strategy. The National Institute for Health and Care Excellence (NICE), Public Health England (PHE), Health Education England (HEE) and other professional organisations, develop and publish resources to support AMS activity in primary care settings. The aim of this study was to explore the adoption and use of education/training and supporting AMS resources within NHS primary care in England. Questionnaires were sent to the medicines management teams of all 209 Clinical Commissioning Groups (CCGs) in England, in 2017. Primary care practitioners in 168/175 (96%) CCGs received AMS education in the last two years. Respondents in 184/186 (99%) CCGs reported actively promoting the TARGET Toolkit to their primary care practitioners; although 137/176 (78%) did not know what percentage of primary care practitioners used the TARGET toolkit. All respondents were aware of Antibiotic Guardian and 132/167 (79%) reported promoting the campaign. Promotion of AMS resources to general practices is currently excellent, but as evaluation of uptake or effect is poor, this should be encouraged by resource providers and through quality improvement programmes. Trainers should be encouraged to promote and highlight the importance of action planning within their AMS training. AMS resources, such as leaflets and education, should be promoted across the whole health economy, including Out of Hours and care homes. Primary care practitioners should continue to be encouraged to display a signed Antibiotic Guardian poster as well as general AMS posters and videos in practice, as patients find them useful and noticeable.

scholarly journals Influence of organisational attributes on registered nurse contributions to well-child care: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e052634
Author(s):  
Suzanne Braithwaite ◽  
Julia Lukewich ◽  
Danielle Macdonald ◽  
Joan Tranmer
Keyword(s):  
Primary Care ◽  
Child Care ◽  
Scoping Review ◽  
Full Text ◽  
Registered Nurse ◽  
Universal Access ◽  
Secondary Analysis ◽  
Inclusion Criteria ◽  
Well Child Care ◽  
Primary Care Settings

IntroductionUniversal access to preventative healthcare is essential to children’s health. Registered nurses (RN) are well positioned to deliver well-child care within primary care settings; however, RN role implementation varies widely in this sector and the scope of literature that examines the influence of organisational attributes on nursing contributions to well-child care is not well understood. The aim of this scoping review is to identify the scope and characteristics of the literature related to organisational attributes that act as barriers to, or facilitators for RN delivery of well-child care within the context of primary care in high-income countries.Methods and analysisThe Joanna Briggs Institute scoping review methodology will be used to conduct this review. Databases that will be accessed include Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE and Embase. Inclusion criteria includes articles with a focus on RNs who deliver well-child care in primary care settings. Literature that meets this inclusion criteria will be included in the study. Covidence software platform will be used to review citations and full-text articles. Titles, abstracts and full-text articles will be reviewed independently by two reviewers. Any disagreements that arise between the reviewers will be resolved through discussion, or with an additional reviewer. Data will be extracted and organised according to the dimensions outlined in the nursing care organisation conceptual framework (NCOF). Principles of the ‘best fit’ framework synthesis will guide the data analysis approach and the NCOF will act as the framework for data coding and analysis.Ethics and disseminationThis scoping review will undertake a secondary analysis of data already published and does not require ethical approval. Findings will be disseminated via peer-reviewed publications and conference presentations targeting stakeholders involved in nursing practice and the delivery of well-child care.Trial registration detailsBraithwaite, S., Tranmer, J., Lukewich, J., & Macdonald, D. (2021, March 31). Protocol for a Scoping Review of the Influence of Organisational Attributes on Registered Nurse Contributions to Well-child Care. https://doi.org/10.17605/OSF.IO/UZYX5.

scholarly journals Selection of depression measures for use among Vietnamese populations in primary care settings: a scoping review

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Jill Murphy ◽  
Elliot M. Goldner ◽  
Charles H. Goldsmith ◽  
Pham Thi Oanh ◽  
William Zhu ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Primary Care Settings ◽  
Selection Of

scholarly journals Generating situations of Moral Distress in Primary Care Nurses

2019 ◽  
Vol 72 (1) ◽  
pp. 35-42
Author(s):  
Priscila Orlandi Barth ◽  
Flávia Regina Souza Ramos ◽  
Edison Luiz Devos Barlem ◽  
Heloíza Maria Siqueira Rennó ◽  
Laura Cavalcanti de Farias Brehmer ◽  
...  
Keyword(s):  
Primary Care ◽  
Working Conditions ◽  
Professional Practice ◽  
Moral Distress ◽  
Structured Interview ◽  
Political Values ◽  
Moral Content ◽  
Primary Health ◽  
Primary Care Nurses ◽  
Professional Health

ABSTRACT Objective: To analyze the situations generating Moral Distress in Primary Care nurses from different regions of Brazil. Method: Qualitative research, with 13 nurses of the Brazilian Primary Health Care, through a semi-structured interview and submitted to the Discursive Textual Analysis, with the resources of the software ATLAS.ti 7.0. Results: They are presented in four categories, relating the Moral Distress to the professional; health services; users and conflicts in professional practice. Final Considerations: By assuming ethical and political values as guides to their action, nurses give greater visibility to the moral content of many problems and weaknesses that could be seen only by the bias of working conditions.

scholarly journals Strategies to promote the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in healthcare settings: a scoping review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kelli Thoele ◽  
Laura Moffat ◽  
Stephanie Konicek ◽  
Monika Lam-Chi ◽  
Erica Newkirk ◽  
...  
Keyword(s):  
Primary Care ◽  
Brief Intervention ◽  
Scoping Review ◽  
Implementation Strategies ◽  
Implementation Process ◽  
The United States ◽  
Healthcare Settings ◽  
Primary Care Settings ◽  
Implementation Outcomes ◽  
Prevention And Treatment

Abstract Background Screening, brief intervention, and referral to treatment (SBIRT), is an approach for the prevention and treatment of substance use disorders, but is often underutilized in healthcare settings. Although the implementation of SBIRT is challenging, the use of multi-faceted and higher intensity strategies are more likely to result in the successful incorporation of SBIRT into practice in primary care settings. SBIRT may be used in different healthcare settings, and the context for implementation and types of strategies used to support implementation may vary by setting. The purpose of this scoping review is to provide an overview regarding the use of strategies to support implementation of SBIRT in all healthcare settings and describe the associated outcomes. Methods A scoping review was conducted using CINAHL Complete, HealthBusiness FullTEXT, PsycINFO, PubMed, and Embase to search for articles published in English prior to September 2019. The search returned 462 citations, with 18 articles included in the review. Two independent reviewers extracted data from each article regarding the theory, design, timeline, location, setting, patient population, substance type, provider, sample size and type, implementation strategies, and implementation outcomes. The reviewers entered all extracted data entered into a table and then summarized the results. Results Most of the studies were conducted in the United States in primary care or emergency department settings, and the majority of studies focused on SBIRT to address alcohol use in adults. The most commonly used strategies to support implementation included training and educating stakeholders or developing stakeholder interrelationships. In contrast, only a few studies engaged patients or consumers in the implementation process. Efforts to support implementation often resulted in an increase in screening, but the evidence regarding the brief intervention is less clear, and most studies did not assess the reach or adoption of the referral to treatment. Discussion In addition to summarizing the strategies used to increase reach and adoption of SBIRT in healthcare settings, this scoping review identified multiple gaps in the literature. Two major gaps include implementation of SBIRT in acute care settings and the application of implementation theories to inform healthcare efforts to enable use of SBIRT.

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