The findings of this review emphasized the role of nurse educators in enhancing hand hygiene competence in nursing students. Implementation of empirically tested strategies such as utilizing multidimensional interventions, scenario-based hand hygiene simulation activities and hand hygiene education programmes that would enhance nursing students' hand hygiene knowledge and compliance is an asset. Hospital and nursing administrators should ensure continuous support and monitoring to guarantee that hand hygiene programmes are institutionalized in every healthcare setting by every healthcare worker.

Aim To examine experienced registered nurses' motivations for choosing agency work, their experiences and perceptions of agency nursing and how they meet their regulatory professional development obligations. Background Agency registered nurses are employed by healthcare organizations to meet staffing shortfalls and contain costs. Methods Using an integrative review framework, four databases (CINAHL, Medline, Embase and Scopus) were systematically searched between 2000 and 2017: study selection followed the Preferred Reporting Items for Systematic reviews and Meta‐analyses. Results Our search identified 491 sources. From these, two primary qualitative sources were included in this review. Four themes were identified: orientation, allocation of the agency nurse, isolation in clinical practice and lack of education opportunities. Conclusion Given the limited literature on agency nurses and how to support them, further research is required on this subject. Implications for Nursing Management Support for agency nurses is necessary, so they can seamlessly integrate with the healthcare team to provide safe patient care. This review may assist managers to identify strategies to effectively engage and support agency registered nurses in the acute care nursing team. The gaps identified highlight the need for further research to explore agency nurses' motivations, and support needs to inform future strategic workforce planning.

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Rising numbers of students are required to address the forecast nursing shortage. Health services are challenged to release experienced nursing staff to become supervisors in clinical supervision models and preceptorship models require significant investment in registered nurse education for effectiveness. One health service in southeast Queensland, Australia, developed an innovative clinical education model that draws upon the strengths of supervision and preceptor models, and is consistent with the Dedicated Education Unit model, without the dedicated university and prescribed attendance requirements. Using an iterative qualitative approach and learning circle methods, the aim was to determine feasibility of the model, using information gathered from clinical facilitators, who were the key implementers. Model feasibility was found to be dependent upon three key activities undertaken by the facilitators: align stakeholder expectations with the new model, clarify roles and responsibilities within clusters, and develop strategies for collecting information about student performance. The experience of implementing the model has raised further questions about how students, newly qualified nurses and registered nurses learn in localised work units and what practice pedagogies can be developed to support learning from, as well as improve practice. Highlights • The need for more nurses has increased the number of student and newly qualified nurses 4 • Traditional clinical supervision and preceptorship are not sustainable • The Dedicated Education Unit does not work for health services with multiple education partners • The health service led, Clinical Clusters Education Model, provides a viable alternative to support learning for higher student numbers • Learning circles present a useful change management strategy

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