Kathleen Stoddart

Influenza is a common and potentially serious viral infection. The Joint Committee of Vacination and Immunisation recommended that the seasonal influenza programme should be expanded in 2012 to include all children from the ages of 2–17 years in the UK. In NHS Forth Valley, the implementation of the influenza immunisation programme was presided over by multi-agency group including school nursing. School nurses provide a vital input to the immunisation of children and in response to the challenges presented by the introduction of the programme, the school nursing service implemented a weekend delivery model in pilot areas in NHS Forth Valley. The model is person-centred and geared towards the priorities of public health and protection. The model is also underpinned by minimising disruption to normal school nursing and education service workloads and to families. Strategies to support an accesible and family-friendly immunisation service have been identified and now need further translation into practice.

Person-centred, safe and effective care is at the heart of delivering the fundamentals of care. Patients, the public and the nursing profession want high quality of care to be assured. Today there are many challenges to achieving this ambition reliably and consistently. This article reports a nursing team’s experience of implementing ‘care and comfort’ rounds over time. The means of implementation is detailed plus the evidence to support the quality improvement achieved. The evidence includes measures of incidence of slips trip and falls, call buzzer use and patient experience data. The results show that the implementation of care and comfort rounds led to proactive rather than reactive nursing care being delivered; the number of patient falls was reduced; the use of call buzzers was reduced; patient experience was enhanced; a more controlled environment was provided for patients and staff satisfaction in care delivery was increased

To investigate the experience and views of senior charge nurses in relation to the implementation of a national clinical leadership policy. The role of the senior charge nurse in providing clinical leadership is evolving. However, recent evidence suggests that research is needed to inform the development of leadership and quality improvement and to connect them. Data were collected using an electronic survey to all senior charge nurses in one locality and semi-structured interviews with a subsample of respondents. Fifty (54%) senior charge nurses responded to the survey and nine were interviewed. Senior charge nurses reported mainly positive perceptions of clinical leadership, clinical team performance and improvement of care delivery for patients following the leadership programme implementation. Themes related to confidence, quality improvement and team performance were generated. 'Leading Better Care' was reported to enhance senior charge nurse clinical leadership, with some development needed to link the details of change management with the wider strategic direction. Nurse managers may wish to ensure that their clinical leaders have clarity of role in order to inspire confidence. Some challenges were noted in achieving improvement in quality and it is possible that if improvement in quality is the cornerstone of patient-centred care then it needs to be placed centrally in workload considerations.

The patient-nurse relationship is a traditional concern of healthcare research. However, patient-nurse interaction is under examined from a social perspective. Current research focuses mostly on specific contexts of care delivery and experience related to medical condition or illness, or to nurses’ speciality. Consequentially, this paper is about the social meanings and understandings at play within situated patient-nurse interaction in the community practice setting in a transforming healthcare service.

This article describes a study that set out to explore the interaction between patients and nurses in community practice settings, in order to understand the social meanings and understandings brought to the interaction and at play within it. Method: The study used a grounded theory methodology with traditional procedures. Driven by constant comparative analysis, data were collected by non-participant observation and informal and semi-structured interviews in four community health centres. Eighteen patients and 18 registered practice nurses participated. Results: Negotiation was found to be a fundamental process in patient–nurse interaction. Navigation, socio-cultural characteristics and power and control were found to be key properties of negotiation. The negotiation processes for developing understanding required patients and nurses to draw upon social meanings and understandings generated from within and beyond their current interaction. Conclusion: Social meanings and understandings created within and beyond the health-care setting influence negotiation. The developmental nature of negotiation in interaction is an important dimension of the patient– nurse relationship in community practice.