Managing volunteers who support patients with dementia or cognitive impairment on acute hospital wards: the NURTURe model.

Volunteers are widely used to support patients with dementia or cognitive impairment on acute hospital wards. However, it appears that traditional volunteer management models do not fully address the challenges posed by managing volunteers in that setting. In a study of the use of volunteers in the care of people with dementia and cognitive impairment on acute hospital wards, interviews with a range of stakeholders revealed challenges regarding the environment, role and image of volunteers. Based on the study findings, an alternative model for managing volunteers on acute hospital wards was developed. This article describes the study and discusses the development of this alternative approach, the NURTURe model.

Personal and family-related factors on willingness to volunteer among undergraduate medical students during COVID-19 pandemic in Saudi Arabia: a cross-sectional study.

OBJECTIVE: This study aimed to describe personal and family-related factors affecting undergraduate students' willingness to volunteer during the pandemic. This cross-sectional study was conducted on undergraduate medical students at Qassim University in Saudi Arabia through an online survey. PATIENTS AND METHODS: A pre-validated online questionnaire on willingness to volunteer during the pandemic was distributed through various messenger groups and social media. The questionnaire comprised two sections to collect demographics and how likely the volunteers work during the pandemic in different circumstances. The distribution of these parameters was reported by frequency and proportion for categorical variables. In addition to descriptive analytics, a chi-square test was used to compare key explanatory parameters between the low and high likelihood of volunteering. Data were analysed using IBM SPSS statistical software (version 25, Armonk, NY, USA). RESULTS: There was a high likelihood of willingness (60.7%) to volunteer among undergraduate medical students. However, there was no statistically significant difference in baseline parameters like gender, academic year, age (in years), marital status, children, and elderly dependents between the high and low likelihood of volunteer (p >0.05). However, a statistically significant difference indicated the best description of one's living arrangement between volunteers' high and low probability (p<0.05). CONCLUSIONS: Our findings suggested that undergraduate medical students can be motivated to volunteer effectively in this pandemic by ensuring personal and family protection. This is vital to optimally redistribute the work burden and effectively channelize the workforce during a pandemic situation.

Percepções de um grupo de voluntários frente ao trabalho com pacientes oncológicos / Perceptions of a group of volunteers of the work with oncological patients

Este estudo teve como objetivo analisar a percepção de um grupo de voluntários frente ao trabalho com pacientes oncológicos. Trata-se de uma pesquisa descritiva-exploratória, com abordagem qualitativa. A população do estudo foi constituída por voluntários do Expresso Alegria. Foram selecionados voluntários que vão frequentemente às visitas hospitalares, pelo menos uma vez ao mês e que não estejam em fase de treinamento. A coleta de dados ocorreu após a aprovação do Comitê de Ética em Pesquisa, por meio de um questionário aberto. A investigação foi realizada em três etapas: reunião com o responsável do Expresso Alegria; abordagem individual para formalização do convite e coleta de dados. Foram entrevistados nove participantes. Para interpretação, os dados foram submetidos à análise de conteúdo de Bardin. A partir dos resultados foram elaboradas três categorias empíricas. O estudo apresentou a importância do trabalho voluntário no tratamento dos pacientes oncológicos, levando alegria, conforto e humanização ao ambiente. (AU)

This study aimed to analyze the perception of a group of volunteers regarding the work with cancer patients. It is a descriptive-exploratory research, with a qualitative approach. The study population consisted of volunteers from Expresso Alegria. The volunteers selected were those who frequently go to hospital visits, at least once a month, and who are not undergoing training. Data collection took place after approval by the Research Ethics Committee, through an open questionnaire. The investigation was carried out in three stages: meeting with the head of Expresso Alegria; individual approach to formalize the invitation and collect data. Nine participants were interviewed. For interpretation, data were submitted to Bardin's content analysis. From the results, three empirical categories were elaborated. The study showed the importance of voluntary work in the treatment of cancer patients, as they bring joy, comfort and humanization to the environment. (AU)

A nurse-led youth volunteering project to support older people on acute hospital wards.

Young people volunteering on acute hospital wards can provide extra support to older patients, for example with eating and drinking, with mobilising and with therapeutic activities. This extra support can reduce nurses' workload while providing older people with opportunities to interact and engage. For the young people involved, volunteering can improve their skills and confidence, as well as providing opportunities for career development. Nurses are well-placed for developing and managing volunteer services due to their leadership, clinical skills and experience. This article describes a volunteer project where young people aged 16 years and above support older people on acute hospital wards in an NHS trust in England. The project was designed and managed by a nurse using the NURTURe model, a framework for planning, developing and organising volunteer services to support older patients on acute hospital wards.

Volunteers as members of the stroke rehabilitation team: a qualitative case study.

OBJECTIVES: Clinicians are facing increasing demands on their time, exacerbated by fiscal constraints and increasing patient complexity. Volunteers are an essential part of the many healthcare systems, and are one resource to support improved patient experience and a mechanism through which to address unmet needs. Hospitals rely on volunteers for a variety of tasks and services, but there are varying perceptions about volunteers' place within the healthcare team. This study aimed to understand the role of volunteers in stroke rehabilitation, as well as the barriers to volunteer engagement. DESIGN: A qualitative case study was conducted to understand the engagement of volunteers in stroke rehabilitation services within a complex rehabilitation and continuing care hospital in Ontario, Canada. PARTICIPANTS: 28 clinicians, 10 hospital administrators and 22 volunteers participated in concurrent focus groups and interviews. Organisational documents pertaining to volunteer management were retrieved and analysed. RESULTS: While there was support for volunteer engagement, with a wide range of potential activities for volunteers, several barriers to volunteer engagement were identified. These barriers relate to paid workforce/unionisation, patient safety and confidentiality, volunteer attendance and lack of collaboration between clinical and volunteer resource departments. CONCLUSIONS: An interprofessional approach, specifically emphasising and addressing issues related to key role clarity, may mediate these barriers. Clarity regarding the role of volunteers in hospital settings could support workforce planning and administration.

'It's not what they were expecting': A systematic review and narrative synthesis of the role and experience of the hospital palliative care volunteer.

BACKGROUND: Volunteers make a major contribution to palliative care but little is known specifically about hospital palliative care volunteers. AIM: The aim of this study was to understand the role and experience of hospital palliative care volunteers. DESIGN: Systematic review and narrative synthesis. DATA SOURCES: CINAHL, Embase, Medline, PsycINFO, PubMed and three dissertation databases were searched from inception to June 2019. A forward and backward search of included papers in key journals was also undertaken. Records were independently assessed against inclusion criteria by authors. Included papers were assessed for quality, but none were excluded. RESULTS: In total, 14 papers were included. Hospital palliative care volunteers were mostly female, aged above 40 years, and training varied considerably. Volunteers faced unique challenges in supporting dying patients due to the nature of hospital care, rapid patient turnover and the once-off nature of support. Volunteer roles were diverse, with some providing hands-on care, but most focused on 'being with' the dying patient. Volunteers were appreciated for providing psychosocial support, seen as complementary to, rather than replacing the work of health professionals. Given volunteers were often required to work across multiple wards, establishing positive work relationships with health professionals was challenging. Divergent views about whether the volunteer was part of or external to the team impacted volunteers' experience and perceptions of the value of their contribution. CONCLUSION: Hospital palliative care volunteers face unique challenges in supporting terminally ill patients. Volunteer support in hospital settings is possible and appropriate, if sufficient support is available to mitigate the challenges associated with complex, high-acuity care.

Physical activity in hospitalised older people: the feasibility and acceptability of a volunteer-led mobility intervention in the SoMoVe™ study.

OBJECTIVES: to determine the feasibility and acceptability of a volunteer-led mobility intervention to improve activity levels of older inpatients. DESIGN: pre-post mixed methods study. SETTING: acute medical wards for older people. PARTICIPANTS: one hundred inpatients aged ≥70 years who were mobile prior to hospitalisation: 50 participants were recruited before and 50 after the intervention was established. Twenty-five participants (patients, nurses, therapists and volunteers) were interviewed to determine the acceptability of the intervention. INTERVENTIONS: twice daily volunteer-led mobility and bedside exercises. MAIN OUTCOME MEASURES: the feasibility of delivering a volunteer-led mobility intervention, including the recruitment, training and retention of volunteers and the acceptability of the intervention to patients and healthcare professionals. Secondary outcome measures included objectively measured daily step count, length of stay, 30-day readmission and any adverse events. RESULTS: seventeen volunteers were recruited, 16 completed training and 12 were retained. Fifty participants (mean age 86 years) received the intervention, with a median daily step count of 912 steps (interquartile range [IQR] 295-1824) compared to the baseline group (n = 50, mean age 87 years) of 636 steps (IQR 298-1468). No adverse events were reported. The intervention was acceptable to patients and staff. Facilitating factors of the intervention included the social aspect of the intervention and perceived benefits by stakeholders. Barriers identified included the busy clinical environment and lack of awareness of the intervention among staff. CONCLUSIONS: it was feasible to deliver a volunteer-led mobility intervention including the recruitment, training and retention of volunteers. The intervention was safe and acceptable to healthcare professionals and patients.

"They take a lot of pressure off us": Volunteers reducing staff and family care burden and contributing to quality of care for older patients with cognitive impairment in rural hospitals.

OBJECTIVES: 1Explore the ability of trained volunteers to provide person-centred care focusing on nutrition/hydration support, hearing/visual aids and activities in rural hospitals for older patients with dementia and/or delirium. 2Explore the impacts and challenges of volunteer care for family carers and hospital staff. METHODS: Staff were surveyed about their confidence, stress and satisfaction at 6 months post-implementation. Focus groups with staff and interviews with families explored program successes, challenges and enabling factors. RESULTS: Volunteers integrated themselves into the care team, providing person-centred care, increased safety and quality of care for patients and a reduced burden for staff and families. Key enablers were clear processes for screening, training and supporting volunteers. Key challenges included initial role delineation, staff/volunteer trust and sustainability. CONCLUSION: The program is reported by families and staff as being effective in addressing the main barriers to providing person-centred care for older adults with cognitive impairment in rural acute hospitals.

The effect of volunteers' care and support on the health outcomes of older adults in acute care: A systematic scoping review.

AIM: To examine the available evidence on the effects of care and support provided by volunteers on the health outcomes of older adults in acute care services. BACKGROUND: Acute hospital inpatient populations are becoming older, and this presents the potential for poorer health outcomes. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline are associated with increased risk of health care-related harm, such as falls, delirium and poor nutrition. To minimise the risk of health care-related harm, volunteer programmes to support patient care have been established in many hospitals worldwide. DESIGN: A systematic scoping review. METHODS: The review followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR) (File S1). Nine databases were searched (CINAHL, MEDLINE, EMBASE, Cochrane, Scopus, Web of Science, PubMed, ScienceDirect and JBI) using the following key terms: 'hospital', 'volunteer', 'sitter', 'acute care', 'older adults', 'confusion', 'dementia' and 'frail'. The search was limited to papers written in English and published from 2002-2017. Inclusion criteria were studies involving the use of hospital volunteers in the care or support of older adult patients aged ≥ 65 years, or ≥ 50 years for Indigenous peoples, with chronic health conditions, cognitive impairment and/or physical decline or frailty, within the acute inpatient settings. RESULTS: Of the 199 articles identified, 17 articles that met the inclusion criteria were critically appraised for quality, and 12 articles were included in the final review. CONCLUSIONS: There is evidence that the provision of volunteer care and support with eating and drinking, mobilising and therapeutic activities can impact positively upon patient health outcomes related to nutrition, falls and delirium. Further robust research is needed to determine the impact of volunteers in acute care and the specific care activities that can contribute to the best outcomes for older adults. RELEVANCE TO CLINICAL PRACTICE: Volunteers can play a valuable role in supporting care delivery by nurses and other health professionals in acute care services, and their contribution can improve health outcomes for older adults in this setting.

O trabalho do clown voluntário: uma investigação sobre intervenções lúdicas por meio da arte em um hospital filantrópico de Florianópolis (SC) / The work of the volunteer clown: an investigation about ludic interventions through art in a philanthropic hospital of Florianópolis (SC)

Esta pesquisa, descritivo-exploratória, com abordagem qualitativa dos dados, objetivou descrever e refletir sobre a organização e o desenvolvimento das intervenções realizadas por cinco clowns voluntários, com pacientes idosos em um hospital filantrópico as percepções destes voluntários sobre suas intervenções. Foram realizadas seis observações com auxílio de uma matriz de observação sistemática e aplicadas entrevistas semiestruturadas com dois clowns. Os dados foram tratados por meio de elementos da técnica de análise de conteúdo. Evidenciou-se que a conversa, a música e o teatro constituem-se instrumentos potencializadores das manifestações lúdicas e artísticas utilizados pelo grupo; a relação dos voluntários com conteúdos artísticos e lúdicos durante a infância foi fundamental no processo da construção do ser clown e na atuação no contexto hospitalar; a autonomia no grupo e no hospital é fundamental para trabalhar a especificidade de cada clown.

This descriptive-exploratory research, with qualitative data approach, objected describe and reflect about the organization and development of interventions performed by five volunteer clowns with elderly patients in a philanthropic hospital of Florianópolis (SC). It was also sought analyze their perceptions about the interventions. Six observations were performed using a systematic matrix and also were applied a semi-structured interview with two clowns. The data were treated using elements of the content analysis technique. It was evidenced that conversation, music and theater are great instruments for development of the ludic and artistic manifestations used by the group; the relation of volunteers with artistic and recreational contents, during childhood, was fundamental on the building process of the "being clown" and acting in hospital context, also autonomy is fundamental to work to work the specificity of each clown on that specific scenario.

Volunteer Involvement in Advance Care Planning: A Scoping Review.

CONTEXT: Volunteer involvement may support organizations to initiate and operationalize complex interventions such as advance care planning (ACP). OBJECTIVES: A scoping review was conducted to map existing research on volunteer involvement in ACP and to identify gaps in current knowledge base. METHODS: We followed the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines. The review included studies of any design reporting original research. ACP was defined as any intervention aimed at supporting people to consider and communicate their current and future health treatment goals in the context of their own preferences and values. Studies were included if they reported data relating to volunteers at any stage in the delivery of ACP. RESULTS: Of 11 studies identified, nine different ACP models (initiatives to improve uptake of ACP) were described. Most of the models involved volunteers facilitating ACP conversations or advance care directive completion (n = 6); and three focused on ACP education, training, and support. However, a framework for volunteer involvement in ACP was not described; the studies often provided limited detail of the scope of volunteers' roles in ACP, and in three of the models, volunteers delivered ACP initiatives in addition to undertaking other tasks, in their primary role as a volunteer navigator. Increased frequency of ACP conversation or documentation was most commonly used to evaluate the effectiveness of the studies, with most showing a trend toward improvement. CONCLUSIONS: Current literature on volunteer involvement in ACP is lacking a systematic approach to implementation. We suggest future research should focus on person-centered outcomes related to ACP to evaluate the effectiveness of volunteer involvement.

A Community Hospital NICU Developmental Care Partner Program: Feasibility and Association With Decreased Nurse Burnout Without Increased Infant Infection Rates.

BACKGROUND: Volunteers can provide staff-directed sensory inputs to infants hospitalized in the NICU, but research on volunteer programs is limited. PURPOSE: To evaluate the feasibility of a developmental care partner (DCP) program in a level III NICU and determine its relationship with provider burnout and infant infection rates. METHODS: DCPs were trained to provide sensory input to infants, based on the behavioral cues observed by the occupational therapists and nursing staff, in medically stable infants. Feasibility was assessed by documenting the process of training and utilizing volunteers, as well as tracking duration and frequency of DCP visits. Staff burnout measures were assessed using the Maslach Burnout Inventory Human Services Survey (MBI-HSS) before and after implementation. Infant infection rates before and after the introduction of volunteers were compared. RESULTS: Seventy-two volunteers were interested, and 25 (35%) completed the DCP competencies and provided sensory exposures to 54 neonates, who were visited an average of 8 times (range 1-15). Twelve (48%) DCPs did once-per-week visits, and 9 (36%) did at least 50 contact hours. MBI-HSS scores for staff emotional exhaustion (P < .001) and depersonalization (P < .006) were lower after DCP implementation. There were no differences in infant infection rates before and after DCP implementation (Fisher exact P = 1.000). IMPLICATIONS FOR PRACTICE: Volunteer-based DCP programs may be feasible to implement in community hospitals and could help reduce staff emotional exhaustion and depersonalization without increasing the incidence of infant infections. IMPLICATIONS FOR RESEARCH: Future research on NICU volunteer programs with larger sample sizes and different infant populations is warranted.