‘Our Care through Our Eyes’. Impact of a co-produced digital educational programme on nurses’ knowledge, confidence and attitudes in providing care for children and young people who have self-harmed: a mixed-methods study in the UK

Abstract

Objectives(1) To determine the impact of a digital educational intervention on the knowledge, attitudes, confidence and behavioural intention of registered children’s nurses working with children and young people (CYP) admitted with self-harm.(2) To explore the perceived impact, suitability and usefulness of the intervention.InterventionA digital educational intervention that had been co-produced with CYP service users, registered children’s nurses and academics.SettingA prospective, uncontrolled, intervention study with preintervention and postintervention measurement, conducted at a large acute NHS Trust in the UK.ParticipantsFrom a pool of 251 registered children’s nurses and 98 participants were recruited to complete the intervention (response rate=39%). At follow-up, 52% of participants completed the postintervention questionnaire, with 65% (n=33) of those reporting to have completed the digital educational intervention.Primary outcome measuresAttitude towards self-harm in CYP was measured using a 13-item questionnaire; knowledge of self-harm in CYP was measured through an adapted 12-item questionnaire; confidence in different areas of practice was measured through Likert Scale responses; self-efficacy for working with CYP who have self-harmed was measured through an adapted version of the Self-efficacy Towards Helping Scale; clinical behavioural intention was measured by the Continuing Professional Development Reaction Questionnaire. Semistructured interviews were undertaken with a purposive sample of participants.ResultsFor those who completed the intervention (n=33), improvements were observed in knowledge (effect size, ES: 0.69), confidence, and in some domains relating to attitudes (effectiveness domain-ES: 0.49), and clinical behavioural intention (belief about consequences-ES:0.49; moral norm-ES: 0.43; beliefs about capability-ES: 0.42). Qualitative findings suggest participants experienced skill development, feelings of empowerment and reflection on own practice.ConclusionsThe effect of the intervention is promising and demonstrates the potential it has in improving registered children’s nurse’s knowledge, confidence and attitudes. However, further testing is required to confirm this.

An exploration of predictors of children's nurses’ attitudes, knowledge, confidence and clinical behavioural intentions towards children and young people who self‐harm

“…The study forms part of a larger project and was conducted at a single tertiary children's hospital, colocated in a large acute NHS Trust. Further detail about the study design (Manning, Bean et al., ; Manning, Latif et al., ), intervention development (Latif, Carter, Rychwalska‐Brown, Wharrad, & Manning, ) and outcomes of the intervention (Manning et al., ) from the larger study can be gained from the cited outputs. Ethical approval was received from East Midlands Research Ethics Committee (REC ref: Derby 15/EM/0236), along with research governance clearance from the local National Health Service (NHS) Trust.…”

“…The outcomes collected were attitudes towards self‐harm in CYP, self‐efficacy of caring for CYP who have self‐harmed, knowledge of self‐harm in CYP and behavioural intentions with regard caring for CYP who have self‐harmed. As previously outlined by (Manning et al., ), these outcomes were collected using the following instruments:…”

“…The education and training of the majority of registered children's nurses is at preregistration and undergraduate level (Harrison White & King, ). Training involves a minimum of a three‐year undergraduate curriculum which combines theory and practice hours and culminates in children's nurses registering with the Nursing and Midwifery Council (UK) (Manning et al., ). However, across the UK, the curriculum content and focus can vary according to the higher education institution of study.…”

“…However, across the UK, the curriculum content and focus can vary according to the higher education institution of study. This includes the delivery of education pertaining to the assessment, care and management of CYP with mental health conditions (Manning et al., ). However, the results from this study suggest that receipt of training in the care of CYP who have self‐harmed is associated with improved nurses’ knowledge, attitudes and clinical behavioural intention.…”

Capturing the Real Impact of Clinical Academics in Practice

“…An example of this relates to the growing numbers of children and young people accessing acute paediatric care in mental health crisis with local stakeholder feedback indicating that both patient experience and outcomes required improvement. This has contributed to driving forward clinical care through understanding stakeholders' perspectives (Manning et al, 2015), developing and testing of effective educational resources for staff (Manning et al, 2017), and the development of tools to support staff to make decisions regarding the safety of these children and young people (Carter et al, 2019;Manning et al, 2018).…”