Studies have shown that inadequate care, also referred to as abuse, violence, neglect and maltreatment occur in nursing homes in many countries. The aim of this study was to describe the frequency and types of inadequate care committed by staff in nursing homes. Another aim was to investigate if nursing staff reported differently depending on age, education level and years of experience working at nursing homes. A questionnaire survey was conducted among nursing staff (n = 616) in 16 nursing homes in the central part of Norway. Twenty items concerned staff behaviour in forms of acts of inadequate care. The respondents were asked to report how often they had observed colleagues commit acts and how often they themselves had committed such acts. The response rate was 79%. All in all, 91% of the nursing staff reported that they had observed at least one act of inadequate care and 87% reported that they had committed at least one act of inadequate care. Acts of negligent and emotional character were most frequently reported, both as observed and committed. Depending on the higher educational level that the nursing staff had more acts of all types were observed and committed. The oldest staff and those with longest experience at the present nursing home reported more observed and committed acts of physical character than did the others. The extent of inadequate care confirms that this is a common part of activities in nursing homes. Because emotional and negligent acts can be just as harmful as physical acts, more knowledge is needed about the reasons in order to take preventive actions.

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Objective: To view simulation as a learning method in the light of learning theories and to describe the student's reflections and experiences of simulating anaphylaxis during vaccination. Design and Sample:Public health nursing students at a university in Norway simulated scenarios related to anaphylaxis during vaccination of an infant. The aim of the intervention was to facilitate the competence of public health nurses to handle unforeseen events associated with vaccinations. The students wrote reflection notes about their experiences after the simulation. The reflection notes were analyzed using qualitative content analysis. Results:The students experienced simulation as a realistic educational method with feelings of stress in an acute situation. They discovered the importance of cooperation and communication to avoid misunderstandings that could lead to serious failure in the treatment. The students emphasized that simulation gave them a preparation for practice to handle anaphylaxis associated with vaccines. Conclusion:The public health nurse students experienced simulation as a realistic and effective educational method. Simulation made them reflect on the public health nurse's area of responsibility. Kolb's learning theory and Schön's theory of knowledge-in-action, may explain how simulation as a didactic method develops competence to act in a concrete situation of anaphylaxis by vaccination of children. K E Y W O R D Sacute situations, anaphylaxis, public health nurse education, simulation, skills, vaccination

Objective: To gain insight into how continuity of care can increase student midwives’ understanding of midwifery, with emphasis on the promotion of normal pregnancy, childbirth and postnatal period. Design/setting: A pilot project at Sør-Trøndelag University College. Six student midwives provided continuity of care to 58 women throughout their pregnancy, childbirth and postnatal period. The students, under the supervision of a clinical midwife, worked in pairs during the antenatal care, in groups during antenatal classes and individually during childbirth and the home visit. A group interview with the six student midwives, based on a focus group technique, was conducted at the end of the project. Qualitative data were analysed through systematic text condensation. Findings: The findings include three main themes: relational continuity, personal development and health-promoting perspective. By offering relational continuity, the students experienced interdependent trust and partnership. This resulted in personal development based on mastering skills and relational learning. The students became aware of the importance of individual care, holistic care and empowerment and understood midwifery through a health-promoting perspective. Conclusions: To achieve high quality midwifery skills, student midwives would benefit from experiencing relational continuity in their practical studies. This continuity promotes interdependent trust and partnership with the women in their care. Follow up through continuity of care gives the students more meaningful practice and results in personal development for the students and health promotion in midwifery.

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