This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital.

ObjectiveTo explore patient involvement in the implementation of infection prevention and control (IPC) guidelines and associated interventions.DesignScoping review.MethodsA methodological framework was followed to identify recent publications on patient involvement in the implementation of IPC guidelines and interventions. Initially, relevant databases were searched to identify pertinent publications (published 2013–2018). Reflecting the scarcity of included studies from these databases, a bidirectional citation chasing approach was used as a second search step. The reference list and citations of all identified papers from databases were searched to generate a full list of relevant references. A grey literature search of Google Scholar was also conducted.ResultsFrom an identified 2078 papers, 14 papers were included in this review. Our findings provide insights into the need for a fundamental change to IPC, from being solely the healthcare professionals (HCPs) responsibility to one that involves a collaborative relationship between HCPs and patients. This change should be underpinned by a clear understanding of patient roles, potential levels of patient involvement in IPC and strategies to overcome barriers to patient involvement focusing ontheprofessional–patient relationship (eg, patient encouragement through multimodal educational strategies and efforts to disperse professional’s power).ConclusionsThere is limited evidence regarding the best strategies to promote patient involvement in the implementation of IPC interventions and guidelines. The findings of this review endorse the need for targeted strategies to overcome the lack of role clarity of patients in IPC and the power imbalances between patients and HCPs.

Abstract:There is an increasing focus on promoting person-centred systems across continuing care settings, emphasizing the need to enhance the quality of life of older adults. Life story books (LSB) can provide a holistic view of older adults, promote relationship-centred care and enhance person-centred care. The process of developing LSB involve collecting and recording aspects of a person's life both past and present. The purpose of this study was to engage residents in developing life story books in a nursing home setting and then to explore the narratives and documented life story books with residents and their families. A qualitative descriptive exploratory design was utilized for the study. Five residents and three family carers participated. Focus groups were tape recorded and thematically analyzed and a review of the LSB was conducted. The central themes from the data analysis related to the social construction of people's lives, social roles and religious values, relationships and loss, and sense of self.

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Sunshine Circles is a teacher-led group process using social-relationship principles from Theraplay®. This study, conducted across 6 preschool sites in the midwestern United States, was the first to examine empirical outcomes against a control group for this program. Students in these teacher-led, play-based groups improved significantly compared with controls in social-emotional skills, behavioral regulation, problem-solving, and fine motor control. Specific improvements occurred in domains of managing feelings, cooperation, accepting limits, peer interactions and friendships, and solving social problems. Furthermore, structured teacher observation measurements yielded data indicating improvement in teacher classroom performance. Interviews with teachers confirmed that the intervention subjectively increased classroom cohesion, improved teacher–student relationships, and improved overall classroom behavior. These findings have implications for both classroom best practice and teacher education.

BackgroundLeadership is a key component for infection prevention and control and plays an important role in the implementation of guidelines on healthcare-associated infections. A body of literature exists on healthcare workers’ perspectives on implementing these types of guidelines; however, there is a paucity of data on the leadership perspectives on implementation. This study aims to contribute to the evidence base of leadership perspectives.ObjectiveTo explore the implementation of National Clinical Guidelines pertaining to methicillin-resistant Staphylococcus aureus and Clostridium difficile from the leadership angle.SettingHealthcare organisations.ParticipantsClinical and non-clinical leaders.DesignThis research used a mixed-methods approach comprising qualitative individual interviews (n=16) and quantitative surveys (n=51) underpinned by the integrated Promoting Action on Research Implementation in Health Services framework.ResultsLeaders recognise the value and innovation of guidelines to support clinical practice. However, they describe barriers to implementation that prevent the full uptake of guidelines, for example, guidelines may present an ideological approach to care which differs from the contextual reality of clinical practice where resources and time are not always available.ConclusionThis research highlighted that guidelines are complex interventions in complex organisations, perhaps leadership could help overcome the challenges posed by this complexity. Leadership may allow a systematic approach to all aspects of implementation despite the variety of challenges faced at different stages of implementation and sustainability of uptake of guidelines over time.

Constipation is a common problem affecting many older people's quality of life. The aim of the study was to describe and compare the frequency of use of laxative medication in Irish adults, aged 65 years and older, from the community and a long-term care setting. Participants (n=207) were part of the Irish ELDERMET project. The project aims to find out how diet and lifestyle influence, and are influenced by, the bacteria in the gut, and how this knowledge can be used to promote health in older Irish people. It has recruited over 450 people, aged 65 and older, and will use the information gathered from the extensive proforma to develop recommendations, as well as functional foods/functional food ingredients specifically designed to promote and support health in older populations. Data were collected between June 2008 and April 2010 using a survey questionnaire. A quantitative descriptive correlational design was used. Analysis was conducted using PASW Statistics 18.0. Participants in long-term care received a greater number of both laxatives and prescribed medications than community-dwelling participants. Increased polypharmacy was also seen in participants taking laxatives, with participants in long-term care significantly (p<0.001) more likely to take multiple laxatives. Nurses are in a key position to develop proactive approaches to the prevention and treatment of constipation.