A bachelor's degree for entering the nursing profession: A scoping review for supporting informed health care policies.

Background: Numerous studies have emphasized the relevance of work environment, staffing, and educational level in nursing as determinants of safe, timely, effective, equitable, and efficient patient-centered care. However, an overview of the evidence focusing on the nursing education level is still lacking. Objective: To provide an overview of the existing evidence regarding bachelor's degree as an entry level for the nursing profession. Design: This was a scoping review. Methods: We conducted a systematic search of CINAHL, Medline via PubMed, Cochrane, and Web of Science Core Collection. Additionally, we conducted a free web search using Google and contacted international nursing associations via email. We summarized the evidence narratively. For reporting guidelines, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. Results: We included 10 studies, 12 response letters, 24 position papers, three books, and one webpage. The sources of evidence identified agreed that the inclusion of a higher number of nurses with a bachelor's degree would lead to a higher quality of care. Conclusions: Using a bachelor's degree education as a minimum requirement to enter the nursing profession in the future is essential to generate a respected, competent, and satisfied nursing workforce that can impact the quality and safety of care; and positively influence outcome indicators for patients, nurses, healthcare organizations, and society. Tweetable abstract: Policy makers and healthcare organizations should set bachelor's degrees as standards for registration and entry to nursing.

Aggressive behaviour of persons with dementia towards professional caregivers in the home care setting-A scoping review.

AIMS AND OBJECTIVES: To outline and to examine the current research and grey literature on aggressive incidents of persons with dementia towards professional caregivers in the home care setting. We intended to identify evidence and research gaps in this field. BACKGROUND: Worldwide, around fifty million people are living with dementia. Current research indicates that aggressive behaviour of persons with dementia towards professional caregivers occurs frequently in inpatient settings. However, there has been little research on this phenomenon in the home care setting. DESIGN: The design entails a scoping review using the methodological framework of Arksey and O'Malley and PRISMA-ScR. METHODS: A systematic literature search in five databases and a web search in Google Scholar was conducted. Title and abstract screening and a full-text screening were conducted by two independent authors. A free web search for grey literature was conducted in Google. RESULTS: The search yielded 1,376 hits. A total of seven journal articles met the inclusion criteria. In the free web search, six references were identified for inclusion, resulting in a total of 13 references. We identified the following four themes: (1) aggressive behaviour in the context of dementia, (2) triggering factors of aggressive behaviour in persons with dementia, (3) skills and educational needs and (4) hindrances to solving the problem of aggressive behaviour. CONCLUSIONS: There is a lack of literature on aggressive behaviour of persons with dementia in the home care setting, and various hindrances to solving this problematic behaviour have been identified. RELEVANCE TO CLINICAL PRACTICE: For home caregivers, specific education concerning communication skills and responding to aggressive behaviour may help to deal with the situation. A further approach may involve specific training aimed to improve caregivers' confidence.

Aggressive incidents in home care services and organizational support: A cross-sectional survey in Switzerland.

AIMS: To explore the available organizational structures addressing aggressive incidents towards home care services staff. BACKGROUND: Organizational structures how professional caregivers deal with care recipients' aggressive incidents. METHODS: An explorative cross-sectional survey using the Violence Experienced by Staff (German version revised) and the Impact of Patient Aggression on Carers Scale was conducted. Data from 852 health care professionals in the German-speaking part of Switzerland were collected between July and October 2019. Multiple logistic regression models were used to investigate associations. The STROBE-Checklist was used as the reporting guideline. RESULTS: Organizational support and management support in home care services were generally rated high and found to cause a significant decrease in negative feelings. Some self-rated skills regarding aggression management were linked to a decrease in perceived burden after aggressive incidents, whereas others increased the perceived burden. CONCLUSION: Organizational structures including official procedures for affected professional caregivers should be established in home care services. This should contain efficient reporting systems and aggression management training for the specific setting. IMPLICATIONS FOR NURSING MANAGEMENT: The study highlights the importance of organizational support regarding aggressive incidents in the home care setting as well as of aggression management training.

A systematic review of interventions to improve acute hospital care for people with dementia.

The aim of this study was to provide an overview of interventions targeting hospital care of patients with dementia. We conducted a systematic review, including interventional study designs. We searched five electronic databases, conducted a hand search and performed citation tracking. To assess risk of bias, we used Cochrane Collaboration's tool, ROBANS and AMSTAR. We narratively summarized the outcomes. The findings of twenty studies indicated a broad range of interventions and outcomes. We categorised the interventions into eight intervention types. Educational programmes were the most reported intervention type and resulted in improved staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were effective in improving some patient-related outcomes. However, current evidence is insufficient to declare which interventions are effective in improving dementia care in acute hospitals. Future research should focus on relevant patient and family caregiver outcomes and must consider the complexity of the interventions when evaluating them.

Factors associated with aggressive behaviour in persons with cognitive impairments using home care services: A retrospective cross-sectional study.

AIM: This study aimed to investigate the frequency of documented aggression, on the part of cognitively impaired individuals, against health professionals in home care services and to highlight related factors. DESIGN: A retrospective cross-sectional study was conducted using data obtained from the nursing documentation of six home care service organizations in Switzerland. METHODS: We analysed the nursing documentation of 1,186 clients in six home care services, between July 2019-September 2019, using the Cohen-Mansfield Agitation Inventory. We conducted a factor analysis as well as a descriptive data analysis and logistic regression using IBM SPSS Statistics. RESULTS: A factor analysis revealed in five factors, of which three represented aggressive behaviour in the sample. These factors were physically aggressive behaviour, verbally aggressive behaviour and importunate behaviour. Aggressive incidents, documented in the nursing records of 14.7% of clients in our sample, tended to be associated with cognitive, communication and mobility difficulties. IMPACT STATEMENT: This retrospective cross-sectional survey gives an overview of the frequency and forms of documented aggressive behaviour on the part of persons with cognitive impairments towards health professionals in home care services. One of the motivating factors for this study was the awareness that aggressive behaviour on the part of clients may stress health professionals in various ways which in turn may have an impact on the quality of care provided. The study revealed that healthcare specialists, rather than more qualified general or psychiatric nurses, were routinely assigned to assisting such clients and therefore specific educational and training interventions for these specific group of staff are indicated.

Experience of aggressive behaviour of health professionals in home care services and the role of persons with dementia.

AIMS: To explore the view of health professionals on the form and frequency of aggressive behaviour of clients against health professionals in home care services. DESIGN: An explorative cross-sectional survey was conducted. METHODS: We conducted a survey using the Survey of Violence Experienced by Staff German version Revised (SOVES-G-R) and the Impact of Patient Aggression on Carers Scale (IMPACS). A convenience sample of 852 healthcare professionals from German-speaking Switzerland participated. Data collection was conducted between July-October 2019. Data were analysed descriptively using IBM SPSS Statistics. RESULTS: Of the health professionals, 78.9% (N = 672) experienced aggressive behaviour since they worked in home care services. The most frequent aggressive behaviour was verbal aggression (75.6%, N = 644), while the most common predisposing factor was restriction in cognitive ability (71.3%, N = 67). Fear, burden and impairment of nursing relationship were common consequences of aggressive behaviour.

Persons with dementia as internet users: what are their needs? A qualitative study.

AIMS AND OBJECTIVES: The aim of this study was to identify the needs and expectations of persons with dementia regarding dementia-related information on the internet concerning content, presentation, navigation, language and design. BACKGROUND: Research on internet-related needs of persons with dementia is lacking. However, the importance of the internet as a source of health information is increasing. To improve health literacy and to ensure participation in therapy decisions, target group-specific health information is necessary, especially for persons with chronic conditions like dementia. DESIGN: We conducted a qualitative interview study between April 2019 and April 2020 in the German-speaking part of Switzerland. To report the study, we used the COREQ checklist. METHODS: We analysed the interview data using content analysis according to Mayring. RESULTS: Four interviews with five persons with dementia took place. We identified two main themes: (1) 'use of media and changing needs' and (2) 'information about dementia on the internet'. The first theme is related to changing user habits due to progressing dementia. The second theme is focussed on requirements concerning design and content. Critical reception and assessment of internet-based information are also addressed. CONCLUSIONS: Information should be adapted to the course of disease. Opportunities and positive aspects should also be mentioned. The presentation should be well-structured. Health professionals might support persons with dementia in searching and interpreting internet-based information. RELEVANCE TO CLINICAL PRACTICE: Website operators should consider specific needs of persons with dementia regarding design and content. Involving persons with dementia in the development of website content and design could be an opportunity for better meeting their needs.