OBJECTIVE: To explore patients\' and community nurses\' perceptions and experiences of shared decision-making in the home.
METHODS: Integrative review.
METHODS: CINAHL, British Nursing Index, Psycinfo, Medline and Social Services Abstracts were searched for qualitative, quantitative and mixed methods papers published between 1 December 2001 and 31 October 2023.
METHODS: A systematic search of electronic databases was undertaken using defined inclusion criteria. The included papers were appraised for quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. Relevant data were extracted and thematically analysed.
RESULTS: Fourteen papers comprising 13 research studies were included. Patients attached great importance to their right to be involved in decision-making and noted feeling valued as a unique individual. Communication and trust between the patient and nurse were perceived as fundamental. However, shared decision-making does not always occur in practice. Nurses described tension in managing patients\' involvement in decision-making.
CONCLUSIONS: The findings demonstrate that although patients and community nurses appreciate participating in shared decision-making within the home, there are obstacles to achieving a collaborative process. This is especially relevant when there are fundamentally different perspectives on the decision being made. More research is needed to gain further understanding of how shared decision-making plays out in practice and to understand the tensions that patients and nurses may experience.
UNASSIGNED: This paper argues that shared decision-making is more than the development of a relationship where the patient can express their views (though of course, this is important). Shared decision-making requires acknowledgement that the patient has the right to full information and should be empowered to choose between options. Nurses should not assume that shared decision-making in community nursing is easy to facilitate and should recognize the tensions that might exist when true patient choice is enabled.
CONCLUSIONS: This paper demonstrates how the idea of shared decision-making needs to be explored in the light of everyday practice so that challenges and barriers can be overcome. In particular, the tensions that arise when patients and nurses do not share the same perspective. This paper speaks to the potential of a gap surrounding shared decision-making in theory and how it plays out in practice.
UNASSIGNED: The reporting of this review was guided by the 2020 guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Page et al., 2021).
UNASSIGNED: This review was carried out as part of a wider study for which service users have been consulted.

UNASSIGNED: There are numerous publications on inpatient medication errors. However, little focus is given to medication errors that occur at home.
UNASSIGNED: To describe and analyse the types of medication errors among community-dwelling patients following their discharge from an acute care hospital in Singapore.
UNASSIGNED: This is a retrospective review of a \'good catch\' reporting system from December 2018 to March 2022. Medication-related errors were extracted and analysed.
UNASSIGNED: A total of 73 reported medication-related error incidents were reviewed. The mean age of the patients was 78 years old (SD=9). Most patients managed their medications independently at home (45.2%, n=33). The majority of medications involved were cardiovascular medications (51.5%, n=50). Incorrect dosing (41.1%, n=39) was the most common medication error reported. Poor understanding of medication usage (35.6%, n=26) and lack of awareness of medication changes after discharge (24.7%, n=18) were the primary causes of the errors.
UNASSIGNED: This study\'s findings provide valuable insights into reducing medication errors at home. More attention must be given to post-discharge care, especially to preventable medication errors. Medication administration and management education can be emphasised using teach-back methods.

Palliative care in community contexts is undergoing significant change as a result of public policy and new models of care, which link health promotion principles with palliative care practices. These models support the creation of partnerships between formal care structures and the communities in which care is provided. Given the central role of nurses in the institutional delivery of palliative care, particularly in the home, it is important to provide a systematic description of the activities of nurses that fall within the principles of health promotion. The objective was to describe the diverse range of nursing activities for health promotion that are provided in the palliative home care setting. This is an integrative review. Fifty-five studies listed in the MEDLINE, CINAHL and EMBASE databases, and published between 1999 and December 2022, were identified. Data analysis and presentation of the results were guided by Kellehear\'s Health-Promoting Palliative Care (HPPC) model. Six themes were identified to describe nursing activities for health promotion in the context of palliative home care: creating a meaningful relationship, supplying medical information, promoting self-care throughout the trajectory, providing emotional support, involving professional or community services and supporting change. The findings point to nurses focusing more on the individual context and on direct care. The relationship with communities in which they work remains unidirectional. However, some HPPC principles are relevant to nursing activities through the contextualization of nurses\' actions and their moral responsibility to work towards the respect of patient\'s values. Being poorly described, how nurses can truly engage their practice towards health-promoting principles, such as the enhancement of support and control over their lives for people living with serious illness, still requires further empirical research.

UNASSIGNED: Dependency-related skin injuries (DRSI) occur in people who need a high level of support to carry out day-to-day activities. Owing to the ageing population, the number of people at risk of DRSI is increasing. Most wound care is performed by nurses in the community. This scoping review aimed to identify the extent of literature on nursing care for patients with or at risk of developing DRSI living in their own home.
UNASSIGNED: A scoping review was conducted.
UNASSIGNED: A total of 28 studies met the inclusion criteria and four main themes emerged: features of the community setting; wound types, causes and management; prevention strategies around aetiology and holistic care; care management and local wound care.
UNASSIGNED: Although most wounds occur in and are treated in the community, there is a paucity of research on wounds in this setting. The care of patients with DRSI in the community is complex and prevention according to the individual aetiology of each lesion is the key factor in wound care.

UNASSIGNED: compassion fatigue is a phenomenon in areas of nursing practice such as oncology, ICU, palliative care, hospice, and dementia care, but less so among community nurses (Joinson, 1992). A gap in enquiry exists around CN and compassion fatigue around end-of-life patient care.
UNASSIGNED: a scoping review with narrative analysis of selected literature on compassion fatigue in nursing using CINHAL, ProQuest, Science Direct, and the Cochrane Library.
UNASSIGNED: whilst no specific studies were located on compassion fatigue and UK community nurses. Australian, Spanish, and Taiwanese studies report of environment, care relationship duration, resources and poor organisational support being linked to a likelihood of developing compassion fatigue.
UNASSIGNED: compassion fatigue is under-researched in community nursing and merits further enquiry to understand the challenges posed by providing end-of-life care.

OBJECTIVE: This review sought to discover how community nurses globally provide palliative care, with specific focus on how they manage the personal and professional stressors associated with caring for dying clients in the home.
METHODS: An integrative review methodology was used to gain insight into how community palliative care is delivered worldwide.
BACKGROUND: The provision of home palliative care by community nurses gives clients the ability to spend their final days in familiar surroundings. Research has focussed on the provision of palliative care in the inpatient setting, with little known about the community setting.
METHODS: Data were collected through a literature search, then a critical analysis approach was used to evaluate the strengths of palliative care literature by analysing recurrent themes to stimulate further research on the topic.
METHODS: The following databases were used to conduct the literature search: CINAHL, Medline, Pubmed, Scopus, Ovid.
RESULTS: The results highlighted the importance of building a skilled palliative community nursing workforce and the need to offer specialised palliative care training to nurses, particularly around difficult conversations and service coordination.
CONCLUSIONS: The literature identified the challenges implicit within the community nursing role in delivering palliative care, but it did not identify the factors that enhance the nurses\' ability to manage the stressors associated with this role. The input of nurses must be sought to understand the development of resilience.
UNASSIGNED: Community palliative care nursing requires time spent with clients and family members who are suffering, therefore predisposing nurses to stress. Effort must be made to provide palliative care nurses with support to enhance professional resilience.

Background: There is a paucity of evidence regarding the contribution of generalist community nursing to palliative care. Aim: The aim of this study was to identity the proportion of patients referred to a generalist community nursing service who meet the criteria for palliative care need and explore key aspects of their management. Methods: A retrospective case note review of people known to a generalist community nursing service was undertaken to identify people with palliative care needs. Results: Of the 1284 people enrolled in the community nursing service, 21.1% (n=271) were identified as having palliative care needs, of which most (82.7%; n=224) had a non-cancer illness. However, palliative care need was largely unrecognised in the referrals to community nursing and there was little evidence of a palliative approach being integrated into nursing care. Conclusions: Nursing has a significant role in the provision of generalist palliative care in the community. However, research is needed to identify the barriers community nurses experience identifying needs and providing palliative care. A focus on education and support in implementing screening tools, which may assist community nurses in recognising needs and delivering palliative in the generalist setting, is urgently needed.

BACKGROUND: Oral health is a critical issue for public health and poor oral health is associated with significant chronic health conditions and lower quality of life. There has been little focus on providing oral health care to people who receive care in their own homes, despite the high risk of poor oral health in older people. Nurses practicing in the community are well placed to deliver this care, but little is known about how to build this capability through education or training interventions.
METHODS: A scoping review methodology was employed to find and review studies of oral health interventions involving populations of people receiving care in their own home or those nurses who deliver this care. The research question asked what previous research tells us about oral health interventions delivered by nurses in the community. Data was extracted for four areas: setting and type of intervention, patient outcomes, changes to nursing practice and implementation and process evaluations of interventions.
RESULTS: Two thousand eighty papers were found from the searches, and only nine were ultimately deemed eligible for inclusion in the review. Included studies spanned community nursing for older people (n = 3) and health visiting or community nursing for children and infants (n = 6). Patient outcomes were generally positive, but this is based on a low level of evidence. Changes to practice including increased oral health care administered by nurses were found, but this required professional support to be sustainable.
CONCLUSIONS: This review has found that there is a clear gap in the research around interventions designed to be used by community nurses to improve oral health care for people receiving care in their own homes. The results also suggest that any future intervention must make use of a participatory, co-design approach and consider the complex setting of nursing practice in the community and the barriers to delivering this care, such as time pressure and lack of prior experience.

The first scoping review is to map and synthesize the stressors, problems and coping strategies surrounding the health issues of migrant domestic workers.
Scoping review using Arksey and O\'Malley\'s five-stage framework.
Ten electronic databases were systematically searched by keywords for literature published between January 1995 and December 2019. Data were extracted into tables and collated and summarized into themes for presentation.
Twenty-seven reports were included in the final review. Analysis revealed that stressors to health included abuse, poor health service accessibility, ongoing financial hardship despite demanding working conditions and social isolation. Physical and mental health problems were identified for which migrant domestic workers largely depended on social networks and religion to cope with stressors and health problems. Training para-professional peer leaders of migrant domestic workers by community nurses and including them in interprofessional teams is a possible way for nurses to promote their health and well-being.

OBJECTIVE: To explore what is known about knowledge, attitudes and beliefs that influence hand hygiene practices in in low- and middle-income Caribbean and Latin American countries.
BACKGROUND: With the emergence of infectious diseases such as the recent COVID-19 pandemic, handwashing is key to preventing communicable diseases as they disproportionately affect populations in low-income countries. While hand hygiene is known to be the single most effective method for avoiding the transmission of infection, little is known about the beliefs and practices of individuals in these regions.
METHODS: Following PRISMA 2020 Checklist, an integrative review of studies published from 2008-2020 was conducted (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Whittemore and Knafl\'s method was used to review the literature. Six databases were searched, and the Johns Hopkins Evidence Based Rating Scale was used for study appraisal.
RESULTS: The review yielded 18 studies conducted across Latin America. Poor handwashing practices are influenced by various factors including inadequate education and training, cultural beliefs, lack of resources and substandard government regulations. Communicable diseases and other diarrheal illnesses were highly prevalent, especially after a major disease outbreak.
CONCLUSIONS: Future post-disaster campaigns aimed at improving hand hygiene and handwashing practices should focus on beliefs and attitudes to affect behaviour change since there was a higher disease susceptibility during those times. Barriers to proper hand hygiene include false attitudes such as, washing hands only after touching bodily fluids/patient contact or not washing hands at all after open defecation.
CONCLUSIONS: Researchers working with populations in Latin America and the Caribbean should partner with local community health workers to improve compliance to recommended hand hygiene practices.