Aim
To identify the best evidence on the impact of healthcare organizations' supply of nurses and nursing workload on the continuing professional development opportunities of Registered Nurses in the acute care hospital.

Background
To maintain registration and professional competence nurses are expected to participate in continuing professional development. One challenge of recruitment and retention is the Registered Nurse's ability to participate in continuing professional development opportunities.

Design
The integrative review method was used to present Registered Nurses perspectives on this area of professional concern.

Data sources
The review was conducted for the period of 2001–February 2015. Keywords were: nurs*, continuing professional development, continuing education, professional development, supply, shortage, staffing, workload, nurse: patient ratio, barrier and deterrent.

Review methods
The integrative review used a structured approach for literature search and data evaluation, analysis and presentation. Eleven international studies met the inclusion criteria.

Results
Nurses are reluctant or prevented from leaving clinical settings to attend continuing professional development due to lack of relief cover, obtaining paid or unpaid study leave, use of personal time to undertake mandatory training and organizational culture and leadership issues constraining the implementation of learning to benefit patients.

Conclusion
Culture, leadership and workload issues impact nurses' ability to attend continuing professional development. The consequences affect competence to practice, the provision of safe, quality patient care, maintenance of professional registration, job satisfaction, recruitment and retention. Organizational leadership plays an important role in supporting attendance at continuing professional development as an investment for the future.

Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review.

In children with craniosynostosis, raised intracranial pressure (ICP) and upper airway obstruction (UAO) are both common features. However, potential interactions between UAO and ICP during sleep are poorly understood. The aim of the present study was to compare the levels of ICP during sleep between a group of patients with syndromic craniosynostosis (with facial involvement and consequent UAO) and a group of control patients with isolated unicoronal synostosis (with no facial involvement and normal upper airways). Polygraphic cardiorespiratory sleep studies with continuous monitoring of ICP were performed during unsedated sleep in 13 children with syndromic craniosynostosis and 7 control patients with isolated unicoronal synostosis only. In the syndromic group, UAO was present in 11 out of 13 patients, with 8 out of 13 having frank obstructive sleep apnoea. In contrast, none of the control patients showed signs of UAO during sleep. There was no evidence of central apnoeas in any of the patients studied. Clinical histories taken from parents tended to underestimate the severity of the respiratory problems. Elevated ICP was seen in 10 of the 13 syndromic patients, with borderline raised ICP in the remaining three cases. In contrast, raised ICP was seen in only 3 of the 7 control patients, with borderline raised levels in 2 of the 7. For both patient groups, ICP was higher during active sleep compared to quiet sleep. Multiple regression analysis showed that ICP during active sleep was dependent upon disease severity (unicoronal/ multiple synostosis) and to the baseline ICP level during quiet sleep. Both raised ICP and airway obstruction were more apparent during active sleep. There was a significant correlation between severity of UAO and increased ICP in active sleep. We conclude that obstructive respiratory problems are frequent in the syndromic patients, and can be severe in a large proportion of cases; intracranial hypertension is also frequent in this group. Further studies are required to investigate the possibility of a causal relationship between upper airway obstruction and raised intracranial pressure.

https://erj.ersjournals.com/content/erj/10/2/367.full.pdf

Upper airway obstruction and raised intracranial pressure in children with craniosynostosis

Although pivotal to mentoring success, scant data on mentoring relationships continue to hamper the application of mentoring programs in nursing education. To address this gap and circumnavigate mentoring's context-specific nature, this narrative review analyzes the perspectives and opinions of nurse mentors and mentees. The aim is to identify common themes in their mentoring experiences to better nurture effective mentoring relationships and programs in nursing.

Mentoring in Nursing: An Integrative Review of Commentaries, Editorials, and Perspectives Papers.

Postgraduate nurses' self-assessment of clinical competence and need for further training. A European cross-sectional survey

Motivational factors influencing nurses to undertake postgraduate hospital-based education.

Facilitating the learning of student nurses in the workplace is an integral role of the registered nurse. This article aims to provide an overview of the role and responsibilities of the mentor in supporting pre-registration nursing students in clinical practice. The professional obligations for the mentor to meet the Nursing and Midwifery Council (NMC) standards (NMC, 2008a) will be explored, including the ongoing requirements to keep up to date in mentoring practices. Some of the challenges within the role will be identified, including the importance of recognizing and supporting the failing student. Recent changes to the preparation requirements for sign-off mentors will be discussed. The article concludes by presenting the potential benefits to both the individual and the practice placement provider.

/pdf/roles-and-responsibilities-of-the-student-nurse-mentor-an-jwgidg36j1.pdf

Roles and responsibilities of the student nurse mentor: an update

Nursing and midwifery mentors are fundamental to the process of ensuring future practitioners are adequately prepared and supported during the practice element of their degrees. However, there is evidence to suggest that the infrastructure and support for the mentoring role is not always adequate. This article provides a review of some of the issues including the emotional labour associated with supporting pre-registration students, difficulties in accessing protected learning time for mentoring, and lack of supportive networks for mentors to develop within the role. The authors make recommendations on what is required to ensure that the mentor role is better acknowledged, supported and resourced.

/pdf/support-for-mentors-an-exploration-of-the-issues-4j4bp73qt9.pdf

Support for mentors—an exploration of the issues

Since 1995, registered nurses and midwives have been obliged to develop and maintain a professional portfolio of evidence reflecting the learning activities that they have undertaken and how these have informed and influenced their practice. The aim of this article is to demonstrate that rather then just a retrospective account of continuing professional development activities, a portfolio can be used as a vehicle for engaging in self-assessment and personal development planning. Possible structures and type of evidence are explored and portfolios in the context of gaining accreditation for prior experiential learning, and in particular for those nurses in advanced clinical roles, are discussed.

/pdf/the-use-of-professional-portfolios-and-profiles-for-career-3uaju784yt.pdf

The use of professional portfolios and profiles for career enhancement

Enabling patients, service users and carers to participate in the education of students in the healthcare sector is widely espoused, both in the literature and by professional regulatory bodies. This article focuses on one aspect of this: the issue of patient involvement in the assessment of nursing students in the practice setting. The challenges and complexities that may arise are explored, and recommendations are made for further work in this area.

Involving patients in the assessment of nursing students.

There is increasing recognition that health professionals should engage in continuing professional development and lifelong learning. In addition, planned changes to pre-registration nurse education mean that many registered nurses are considering, or will consider, further academic study. This article aims to demystify academic terminology and provide practical guidance on preparing for and accessing higher education.

Professional development for registered nurses.

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