A global approach to promoting research and evidence-based practice for community nurses.

Community health nurses world-wide provide health promotion and preventative care, support and guidance as well as clinical care for people with long-term conditions or needing acute care at home and end-of-life care, across all age groups. The importance of health care in the community has been growing globally as health systems recognise both the economic and human need for people to remain in their communities rather than in hospital. Research in community nursing provides evidence to support policy, practice and education. This article describes the global contribution that the International Collaboration for Community Health Nursing makes towards disseminating evidence that could improve the lives and health of communities.

Three perspectives on the co-location of maternity services: qualitative interviews with mothers, midwives and health visitors.

Maternity policy in England has recommended the establishment of Community Hubs, where health-care professionals who care for women during and after pregnancy are co-located and can provide care collaboratively. The aim this paper is to explore midwives,' health visitors' and postnatal women's experiences and views of co-location of midwifery and health visiting services and collaborative practice. In total 15 midwives, 17 health visitors, and 29 mothers participated in a semi-structured interview, either via phone or face-to-face. Transcripts were analyzed thematically. Participants reported how care is currently provided in numerous settings, with home visits especially well liked. Co-location was perceived to be of benefit, however some mothers were not convinced of its necessity, suggesting that integrated services are more important than co-located services. Health-care professionals recognized that co-location aids but does not automatically improve interprofessional collaboration. These findings highlight the need for careful consideration before implementing co-located maternity services. Community Hubs may be apromising strategy to improve care for women and their families but to provide interprofessional care and collaboration appropriate managerial and organizational support is needed. With this support, midwives and health visitors have the potential to deliver the best care possible for women and their families.

Women's views on contact with a health visitor during pregnancy: an interview study.

AIM: To explore recent mothers' views of the health visiting antenatal contact in England. BACKGROUND: English health visitors are mandated to be in contact with all women in the third trimester of pregnancy. The aim of this antenatal contact is to assess the needs of the family before the birth and support preparation for parenthood. Recent data show that this contact is provided fragmentarily and not always face-to-face. More information on how women view this contact could inform service provision. METHODS: Twenty-nine mothers with a baby less than 1 year old were recruited via social media and word of mouth. Having had antenatal contact with a health visitor was not a requirement to participate in the study. Women took part in face-to-face or phone interviews and all recordings were transcribed verbatim. Data were analysed using systematic thematic analysis. FINDINGS: Eleven women had contact with a health visitor during pregnancy: nine through a home visit, one via a letter and one via a phone call. The remaining 18 women were asked about what they would have wanted from an antenatal contact. Three themes were identified: relationship building, information provision, and mode and time of contact. Some participants who had experienced a home visit reported building rapport with their health visitor before the postnatal period, but not everyone had this experience. Women reported requesting and receiving information about the health visiting service and the role of the health visitor. Finally, women suggested different modes of contact, suggesting a letter or that the information about health visiting could be provided by a midwife. A few women preferred a home visit. These study findings show women were unclear regarding the aim of the health visitor antenatal contact. As such, the contact is unlikely to reach its full potential in supporting parents-to-be.

Midwifery students in health visitor placements: the importance of student-mentor relationships.

OBJECTIVE: The aim of this study was to explore midwifery students and health visitor practice mentors experiences of a health visiting placement for midwifery students, focusing on the student-mentor relationship. DESIGN: Interview study SETTING: East London, United Kingdom PARTICIPANTS: Eighteen students and eighteen mentors were invited to take part in an interview. Ten midwifery students (55.5%) and fifteen health visitor practice mentors (83.3%) took part in interviews or provided information via email. Thematic analysis was used to analyse findings. FINDINGS: The main study finding was that students reported valuing practice mentors who took the time to get to know them, were welcoming and enthusiastic and planned their time in advance. The mentors in turn spoke highly of the students who were keen and enthusiastic about the placement, but noted that not all students had appeared interested. KEY CONCLUSIONS: The findings from this small interview study show that taking time to make the students feel welcome was important to facilitate a student-mentor relationship. Another important factor in whether a student enjoyed their placement was the mentors' advance planning.

Development of a self-management package for people with diabetes at risk of chronic kidney disease (CKD).

Kidney disease progression in diabetes can be slowed by strict blood pressure and blood sugar control, prescription of medicines that modify the renin-angiotensin system and lifestyle changes, such as smoking cessation. This paper describes the development of a self-management package for people with diabetes at risk of kidney damage. This multi-method study entailed a literature review, case-finding of all patients with diabetes and microalbuminuria in six family practitioner (FP) surgeries and interviews with 15 patients at high-risk of progressive kidney disease. Results identified 23% of the study population (n = 1946) at risk of kidney damage, within a population with 3.14% incidence of diabetes. The most important finding from the interviews was that although most people had some understanding of the possible risk of kidney disease, they had little idea of exactly how they could control the condition themselves. This study highlights the importance of incorporating self-management tools in the care and management of patients with diabetes in primary care.