Medicines management for nurses: explaining legal governance.

There are multiple acts of law and case law that govern UK prescribing practice. This article examines three important topics for nurses: the classification and prescribing of controlled drugs, including the meaning of medicine classes and schedules; the prescribing of unlicensed medicines, including the difference between unlicensed and off-license medicines; and negligence in prescribing practice. The article outlines the acts of law that are relevant to each topic and provides examples of significant case law or other legal rulings to demonstrate how the law is relevant to nurses' clinical practice.

Visual analysis of global comparative mapping of the practice domains of the nurse practitioner/advanced practice nursing role in respondent countries.

BACKGROUND: Internationally, there is increasing demand for nurse practitioner (NP) and advanced practice nursing (APN) roles; however, high variability exists in how NP/APN roles are defined and understood. PURPOSE: The aim of this research was to improve our understanding of how the NP/APN is defined globally by: 1) examining role definitions, competencies, and standards of practice for advanced practice nurses internationally; 2) describing from a global perspective the core concepts and common features of NP/APN associated with practice domains; and 3) exploring the utility of text mining and visual analytics in identifying the clustered core concepts common to NP/APN roles organized around the five advanced practice domains of the Strong Advanced Practice Model. METHODS: This article describes the findings of a secondary analysis of an international NP/APN competency mapping project, using innovative text mining and visual analysis techniques to reexamine and summarize the NP/APN role in 19 countries from Africa, Australia, Asia, Europe, and North America. RESULTS: Although weak aggrupation/associations suggest that further work is needed to define the domains of advanced practice with associated model development, visual analysis points to the identification of common concepts and linkages between concepts for each practice domain of advanced practice outlined in the Strong Model. IMPLICATIONS FOR PRACTICE: The secondary text mining and visual analysis presented in this article allows for comparison of core elements between advanced practice role descriptions, standards, and competencies globally to ultimately provide a global perspective on the common features of NP/APN roles and areas where further delineation is required.

Health-related street outreach: Exploring the perceptions of homeless people with experience of sleeping rough.

AIMS: To understand how health-related street outreach is perceived by homeless people with experience of sleeping rough. Specialist nursing and primary care services are expected to provide street outreach but there is no specific guidance on how to deliver it. DESIGN: A qualitative description study. METHOD: Purposive opportunistic sampling was used to recruit participants from three drop-in centres in London. Ten semi-structured interviews were conducted between 4 June 2018 - 28 June 2018 and Braun and Clarke's thematic analysis was used. RESULTS: Health-related street outreach was perceived as being able to offer a human connection that reduced the sense of isolation and exclusion commonly experienced on the street. People with experience of sleeping rough felt it could overcome access barriers and provide a bridge to healthcare services. Crucially the right approach was deemed to be essential and was defined by participants in terms of location, timing, the outreach team, and the verbal and non-verbal styles used by outreach workers. CONCLUSION: Health-related street outreach is a valuable health promotion tool for people experiencing homelessness that should be financially supported by healthcare commissioners and employers. Providers of health-related street outreach must adopt the right approach and the development of guidelines could assist services to achieve this. IMPACT: The findings of this study can inform planning and review of health-related street outreach to ensure that the approach taken by healthcare workers is acceptable to, and based on the views of, the people these services are provided for.

The perceptions of homeless people regarding their healthcare needs and experiences of receiving health care.

AIMS: To understand the perspective of the homeless about their healthcare encounters and how their experiences of receiving healthcare influence their health-seeking behaviour. BACKGROUND: A phenomenological study was undertaken because of the increasing levels of homelessness in the United Kingdom. Most of the current literature is American or Canadian. DESIGN: An interpretive phenomenological inquiry. METHOD: An opportunistic sample of fourteen single homeless adults was recruited from one male hostel and one non-residential day centre. Data collection was done in 2013. Semi-structured audio-recorded interviews were conducted one-to-one. Colaizzi's method for data analysis was used. FINDINGS: Three major themes were identified. Expressed Health Need, Healthcare Experiences and Attitudes to health care. Health problems are recognized by the homeless but the need for intervention is not always prioritised. Obstacles in access to health care in the UK are both perceived (attitudes towards the homeless; previous bad experience) and actual (difficulty in registering with a general practitioner, difficulty travelling to services, being forced to move to new area). Some homeless people feel that they are treated with prejudice and receive substandard care. Positive healthcare experiences were also reported. CONCLUSIONS: Positive and negative healthcare encounters can profoundly affect the homeless. RECOMMENDATIONS: Address apparent inconsistency of care; promote greater interdisciplinary communication and referrals to homeless services from prisons and hospitals; increase the availability of intermediate services; reduce obligation of homeless to move area; research experiences of homeless families.