Diversity, contradictions, and distinction - A scoping review of honours programmes in nursing.

BACKGROUND: There is a long-standing tradition of honours education in the field of nursing, dating back to the early 1960s in the United States. However, its adoption in European and particularly Scandinavian egalitarian educational contexts is relatively recent. PURPOSE: This scoping review aims to provide an analysis of the global utilisation and distribution of honours education within the field of nursing. METHOD: In this scoping review, we conducted an extensive examination of the existing literature to assess the worldwide implementation of honours education in nursing. We employed a systematic approach to identify key trends, patterns, and commonalities in the use of the honours concept across different regions. RESULTS: Our review reveals three predominant approaches to honours education, primarily concentrated in the Anglo-Saxon world: distinction programmes, add-on-year programmes, and embedded programmes. Regardless of the approach, our findings highlight a consistent lack of robust theoretical foundations, limited documentation supporting the educational impact, and a noticeable absence of standardisation. Instead, honours education appears to serve a symbolic and distinct purpose rather than a purely pedagogical one. CONCLUSION: As the prevalence of honours education continues to rise within continental education systems, it becomes imperative to prioritize further research to ensure the optimal allocation of resources. Addressing the lack of evidence, especially in terms of educational value and theoretical foundations, is crucial for refining and maximizing the potential benefits of honours education in nursing. A more strategic and cohesive approach to developing honours programmes is essential to enhance their effectiveness and alignment with global educational goals.

Content and validation of the Electronic Patient Medication module (EPM)-the administrative in-hospital drug use database in the Capital Region of Denmark.

Aims: Registries on in-hospital drug use are sparse, especially those that can be linked to nationwide registries. In this study, we present and validate the Electronic Patient Medication module (EPM)-the electronic administrative database on in-hospital drug use covering the Capital Region of Denmark. Methods: The research database (EPM-research) is an adaptation of the database underlying the electronic administrative database for in-hospital drug use (EPM-clinic). The validation study was comprised of two sub-studies. Sub-study 1: Accordance of registration between EPM-clinic and EPM-research was investigated by analyzing randomly chosen retrospective patient records. Sub-study 2: Workflows and real-life registration practices were investigated through visits to three different (two medical and one emergency) departments. An observer followed a nurse while dispensing and administering drugs. This information was compared with EPM-research. The primary endpoint for both sub-studies was accordance of generic name between registrations. Secondary endpoints were exact brand name, dose, and time of each administration. Accordance (proportions) with 95% confidence intervals (CI) using the Clopper-Pearson method were calculated. The study was approved by the Danish Data Protection Agency (BFH-2016-058-04906) and the Danish Patient Safety Authority (3-3013-1884/1/). Results: In sub-study 1 227 retrospective drug administrations were reviewed. Accordance of generic name was 100.0% (CI 98.4%-100.0%). In sub-study 2 176 drug administrations were observed of which 173 were recorded with identical generic name, resulting in 98.3% (CI 95.1%-99.6%) accordance of data. Conclusions: Our validation of the EPM-research showed very high accordance. With detailed information on in-hospital drug use, the EPM-research may be a useful tool in pharmacoepidemiological research.

General Practitioners' Barriers Toward Medication Reviews in Polymedicated Multimorbid Patients: How can a Focus on the Pharmacotherapy in an Outpatient Clinic Support GPs?

PURPOSE: The aim of this study was to explore whether general practitioners (GPs) experienced barriers toward medication reviews in polymedicated, multimorbid patients, and how a clinical pharmacologist with a focus on pharmacotherapy can support the GPs in an outpatient clinic. DESIGN: The study was descriptive and exploratory and had a qualitative design with a phenomenological/hermeneutic orientation for the interviews. PARTICIPANTS: The study comprised 14 interviews with 14 different GPs from the Capital Region of Denmark. RESULTS: Three themes emerged from the interviews: (1) The care of patients With polypharmacy is challenged by the lack of professional dialogue and collaboration between GPs and hospital-based clinical pharmacologists, (2) the relationship between the patients with polypharmacy and the GP is characterized by care and individual considerations, and (3) the culture encourages adding medication and inhibits dialogue about medication withdrawal even for patients with polypharmacy. CONCLUSION AND IMPLICATIONS FOR PRACTICE: This study found that the primary barriers toward multimorbid patients with polypharmacy were the need for communication and teamwork with specialists (cardiologists, neurologists, endocrinologists, etc). Often, GPs felt that the specialists at the hospitals were more concerned about following standards and guidelines regarding specific diseases instead of a more holistic patient approach. To improve management of polypharmacy patients, the GPs suggest that a joint force is necessary, a partner-like relationship with greater transparency regarding information transfer, feedback, and shared decision-making, but also more education in the pharmacological field is essential.