Nursing and Midwifery - Journal Articles
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Item Implementing Namaste Care in nursing care homes for people with advanced dementia: a systematically constructed review with framework synthesis(BioMed Central Ltd, 2025) Salvi, Serena; Preston, Nancy; Cornally, Nicola; Walshe, Catherine; O’Neill, Roisin; Brazil, Kevin; Reigada, Carla; Payne, Cathy; Soares, Joana; Mali, Jana; Pereira, Sandra Martins; Hernández-Marrero, Pablo; Szczerbińska, Katarzyna; Barańska, Ilona; Shaw, Sally; Chambers, Tracey; Kaasalainen, Sharon; van den Broek, Brenda; van der Steen, Jenny; Olagnero, Jacopo Maria; Di Giulio, Paola; Gonella, Silvia; Albanesi, Beatrice; Hlávka, Jakub; Loučka, Martin; Timmons, Suzanne; Pocknell, Carmen Elise; Hartigan, Irene; Fitzgerald, Serena; Brady, Noeleen; Innovate UK; European CommissionBackground: Namaste Care is an intervention designed to improve the quality of life for people with advanced dementia by providing individualised stimulation and personalised activities in a group setting. Current evidence indicates there may be benefits from this intervention, but there is a need to explore the practical realities of its implementation, including potential barriers, enablers, and how it is delivered within the context of nursing care homes. Objective: To systematically assess the factors involved in implementing Namaste Care for people with advanced dementia in nursing care homes. To provide pragmatic suggestions on how Namaste Care can be delivered in the context of nursing care homes. Design: Systematically constructed review using framework synthesis. Data sources: Comprehensive searches were conducted in Medline, CINAHL, and PsycINFO databases for studies published between 2018 and 2024. Search concepts included “Namaste Care,” “advanced dementia,” and related terms. Review methods: Studies were included if they focused on the use of Namaste Care for people with advanced dementia in nursing care homes. Data extraction and quality assessment were performed by two independent researchers using standardised forms and critical appraisal tools. A framework synthesis of the results was conducted, which involves systematically combining qualitative and quantitative data within a structured analytical framework to identify overarching themes and insights. Findings: Twenty-five studies met the inclusion criteria. Key themes identified were: (1) Frequency and duration of Namaste sessions. (2) Namaste Care environment and personalisation of care. (3) Staff engagement and training needs. (4) Involvement of family members and volunteers. Conclusions: Implementing Namaste Care in nursing care homes presents various challenges but also significant opportunities for enhancing the quality of life for residents with advanced dementia. Addressing key themes such as the frequency and duration of sessions, the environment and personalisation of care, staff engagement and training needs, and the involvement of family members and volunteers is crucial. Specifically, providing tailored training programmes for staff, creating dedicated Namaste Care spaces, and encouraging active family and volunteer participation can facilitate effective integration. By incorporating these pragmatic recommendations, Namaste Care can be sustainably integrated into daily care routines, leading to improved resident well-being, reduced behavioural symptoms, and enhanced caregiver-resident interactions. © The Author(s) 2025.Item Artificially intelligent nursing homes: a scoping review of palliative care interventions(Frontiers Media, 2025-02-11) Ronan, Isabel; Tabirca, Sabin; Murphy, David; Cornally, Nicola; Saab, Mohamad M.; Crowley, Patrice; Science Foundation Ireland; University College CorkIntroduction: The world’s population is aging at a rapid rate. Nursing homes are needed to care for an increasing number of older adults. Palliative care can improve the quality of life of nursing home residents. Artificial Intelligence can be used to improve palliative care services. The aim of this scoping review is to synthesize research surrounding AI-based palliative care interventions in nursing homes. Methods: A PRISMA-ScR scoping review was carried out using modified guidelines specifically designed for computer science research. A wide range of keywords are considered in searching six databases, including IEEE, ACM, and SpringerLink. Results: We screened 3255 articles for inclusion after duplicate removal. 3175 articles were excluded during title and abstract screening. A further 61 articles were excluded during the full-text screening stage. We included 19 articles in our analysis. Studies either focus on intelligent physical systems or decision support systems. There is a clear divide between the two types of technologies. There are key issues to address in future research surrounding palliative definitions, data accessibility, and stakeholder involvement. Discussion: This paper presents the first review to consolidate research on palliative care interventions in nursing homes. The findings of this review indicate that integrated intelligent physical systems and decision support systems have yet to be explored. A broad range of machine learning solutions remain unused within the context of nursing home palliative care. These findings are of relevance to both nurses and computer scientists, who may use this review to reflect on their own practices when developing such technology.Item Treatment effect analysis of the Frailty Care Bundle (FCB) in a cohort of patients in acute care settings(Springer, 2024) Crowe, Colum; Naughton, Corina; de Foubert, Marguerite; Cummins, Helen; McCullagh, Ruth; Skelton, Dawn A.; Dahly, Darren L.; Palmer, Brendan A.; O'Flynn, Brendan; Tedesco, Salvatore; Health Research Board; South South-West Hospital; Science Foundation IrelandPurpose: The aim of this study is to explore the feasibility of using machine learning approaches to objectively differentiate the mobilization patterns, measured via accelerometer sensors, of patients pre- and post-intervention. Methods: The intervention tested the implementation of a Frailty Care Bundle to improve mobilization, nutrition and cognition in older orthopedic patients. The study recruited 120 participants, a sub-group analysis was undertaken on 113 patients with accelerometer data (57 pre-intervention and 56 post-intervention), the median age was 78 years and the majority were female. Physical activity data from an ankle-worn accelerometer (StepWatch 4) was collected for each patient during their hospital stay. These data contained daily aggregated gait variables. Data preprocessing included the standardization of step counts and feature computation. Subsequently, a binary classification model was trained. A systematic hyperparameter optimization approach was applied, and feature selection was performed. Two classifier models, logistic regression and Random Forest, were investigated and Shapley values were used to explain model predictions. Results: The Random Forest classifier demonstrated an average balanced accuracy of 82.3% (± 1.7%) during training and 74.7% (± 8.2%) for the test set. In comparison, the logistic regression classifier achieved a training accuracy of 79.7% (± 1.9%) and a test accuracy of 77.6% (± 5.5%). The logistic regression model demonstrated less overfitting compared to the Random Forest model and better performance on the hold-out test set. Stride length was consistently chosen as a key feature in all iterations for both models, along with features related to stride velocity, gait speed, and Lyapunov exponent, indicating their significance in the classification. Conclusion: The best performing classifier was able to distinguish between patients pre- and post-intervention with greater than 75% accuracy. The intervention showed a correlation with higher gait speed and reduced stride length. However, the question of whether these alterations are part of an adaptive process that leads to improved outcomes over time remains.Item Staff experiences of working with children and adolescents engaging in behaviours that challenge in mental health and paediatric inpatient environments: A qualitative exploratory study across four European countries(Taylor & Francis, 2024-11-26) Goodwin, John; O'Malley, Maria; O'Donovan, Aine; Allen, Stephanie; Curtin, Margaret; Goulding, Ryan; Groen, Gunter; Heffernan, Sinead; Ivanova, Svetla; Korhonen, Joonas; Jörns-Presentati, Astrid; Kostadinov, Kostadin; Lalova, Valentina; O'Mahony, James; Petrova, Gergana; Vainio, Ville; Lahti, Mari; Erasmus+There has been a recent global increase in the number of young people experiencing mental health challenges in both child and adolescent mental health settings and acute paediatric settings. In many of these settings, restrictive practices are used to manage behaviours that challenge, such as aggression and violence. However, little is known about staff’s experiences with responding to behaviours that challenge in these settings. A qualitative descriptive design was adopted, with participants engaging in 1:1 interviews or focus groups in Ireland, Finland, Germany, and Bulgaria. Data were analysed using reflexive thematic analysis. Four themes were identified: (1) the importance of establishing a safe, therapeutic environment, (2) identified antecedents to behaviours that challenge, (3) how staff respond to behaviours that challenge, and (4) the needs of staff when maintaining a safe, therapeutic environment. Consideration needs to be given to the environments where young people are cared for, with an emphasis placed on safe, comfortable, therapeutic spaces to reduce behaviours that challenge. Staff should be better trained in trauma-informed practice, and both staff and service users should be provided with opportunities to de-brief following episodes of restrictive practices, with a focus on enhancing and maintaining therapeutic relationships.Item Trends, causes and factors associated with primary Postpartum Haemorrhage (PPH) in Ireland: A review of one million hospital childbirths(Elsevier, 2024-08-21) Fitzgerald, Imelda; Corcoran, Paul; McKernan, Joye; O'Connell, Rhona; Greene, Richard A.Objective: To analyse temporal trends for primary Postpartum Haemorrhage (PPH), Major Obstetric Haemorrhage (MOH) between 2005 and 2021 and to examine the causes and factors contributing to the risk of PPH during 2017–2021. Methods: International ICD-10-AM diagnostic codes from hospital discharge records were used to identify cases of PPH. Temporal trends in PPH and MOH incidence were illustrated graphically. Poisson regression was used to assess the time trends and to examine factors associated with the risk of PPH during 2017–2021. Results: A total of 1,003,799 childbirth hospitalisations were recorded; 5.6% included a diagnosis of primary PPH. Risk increased almost fourfold from 2.5% in 2005 to 9.6% in 2021. The ICD-10 AM code for other immediate primary PPH was recorded for 85% of PPH cases in 2017–2021 whereas a diagnosis of uterine inertia/atony was associated with just 3.6% of the cases. Respectively, trauma-related, tissue-related and thrombin-related causes were associated with one third, 4.2% and 0.5% of cases. A wide range of factors relating to the woman including comorbidities, mode of delivery, labour-related interventions and associated traumas increased risk of PPH but placental complications, especially morbidly adherent placenta, were strong risk factors. Conclusions: Improvement in detection and anticipation of placental complications may be effective in addressing the increasing trend of PPH, however, the trends of increasing C-sections and other interventions may also need to be addressed while staff education and quality improvement projects will have a role to play.