Mette Grønkjær

Background: Methodological, social and ethical challenges embedded in qualitative research with people with intellectual disabilities call for innovation and approaches that amplify their voices. This paper aims to offer methodological recommendations based on a critical reflection and discussion of the challenges involved in conducting qualitative and inclusive research with people with intellectual disabilities. It focuses on challenges related to inclusion, obtaining consent, conducting participant observations and individual interviews and involvement through an expert panel including people with intellectual disabilities. Method: Inclusive research and critical disability studies inspired the analytical lens applied in the discussion. Results: Researchers are advised to adapt and tailor research methods. This may involve adopting an inclusive approach, establishing prior familiarity, applying multimodal strategies or alternative methods to verbally dominated approaches, such as the sensory‐dialogical approach. Conclusion: This paper contributes to existing research methodologies; however, substantial challenges remain and future methodological developments are needed.

Objective: This scoping review aims to map and describe the use of virtual nursing in acute care hospitals, guided by Donabedian’s model of structure, process, and outcomes. It also seeks to identify key facilitators, barriers, and knowledge gaps relevant to the implementation and adaptation of virtual nursing models. Introduction: Virtual nurses collaborate with bedside nurses in acute care hospitals to deliver inpatient care through telecommunication technologies. Amid widespread nursing shortages, virtual nursing is increasingly viewed as a strategy to address workforce challenges while maintaining care quality and patient safety. An estimated 52% of US hospitals use hybrid models combining virtual and bedside roles. However, evidence of outcomes is limited, and descriptions of virtual nursing are often inconsistent and anecdotal in the literature. While virtual nursing models potentially improve workforce efficiency, support bedside nurses, and improve care standards, their success depends on effective, evidence-informed implementation. Eligibility criteria: This review will include studies involving the care of hospitalized patients by nurses (participants) using virtual nursing for inpatient care (concept) in acute care hospital settings, including surgical, medical, and mixed wards (context). Studies that focus exclusively on critical care, outpatient and primary care, aged and community care, and school nursing will be excluded. Methods: This review will follow the JBI methodology for scoping reviews and will be reported according to PRISMA-ScR. Searches will be conducted in Embase, CINAHL, PubMed, Scopus, and Google Scholar, alongside gray literature from government health departments and nursing regulatory bodies. Two reviewers will independently screen titles and abstracts against the eligibility criteria, followed by full-text screening. Data will be extracted from the included papers by 2 reviewers. The findings will be presented in tabular, visual, and narrative format. Review registration: OSF https://osf.io/e2jfv/

Background: Missed Nursing Care is a global health problem with adverse consequences for patients, nurses and healthcare systems. It occurs when the necessary nursing care is not provided, is only partially provided or is delayed. This study aimed to investigate the prevalence, types and reasons for Missed Nursing Care in Danish hospitals on a national scale.Methods: In a cross‐sectional study, the Danish version of the MISSCARE survey was used to collect data from nursing staff.Results: A total of 3507 nursing staff from 35 regional and university hospitals participated. Nursing staff reported that 44% of nursing care elements were always, frequently or occasionally missed, ranging between 32% and 53% across hospitals. The most frequent missed nursing care elements included ambulation, turning patients, documentation, mouth care, participation in interdisciplinary care meetings, emotional support and patient teaching. The main reasons for Missed Nursing Care were inadequate staffing, unexpected increases in patient volume and acuity, urgent patient situations and high admission and discharge activity.Conclusion: Missed Nursing Care is a prevalent problem in Danish hospitals, with nearly half of the necessary nursing care elements being missed. However, variations between hospitals exist. Fundamental physical and emotional nursing care elements were often missed, while nursing care to prevent critical situations was prioritised. The main reason for Missed Nursing Care was an imbalance between nursing resources, patient volume and acuity. Targeted interventions are needed to address Missed Nursing Care to improve the quality of nursing care and ultimately achieve better outcomes for patients and nursing staff.

Aim: To explore nurses' perceptions of reasons for missed nursing care. Design: A multicentre qualitative descriptive study was undertaken from August 2022 to January 2023. Methods: Interpretive description methodology was used. Individual interviews were conducted with 36 registered nurses and eight licensed practical nurses working in medical, surgical and intensive care units at three public university hospitals in Denmark. Using a semi‐structured interview guide, nurses were asked to share their perceptions of reasons for missed care. The analysis was guided by an inductive thematic approach. Results: The nurses' immediate responses to reasons for missed nursing care circulated around limited time and busyness. However, further analysis unfolded layers of reasons described within three themes: being challenged by workload and patients' diverse care needs; falling short on competencies; and being governed by organisational structures and decisions. Conclusions: The study underlines that reasons for missed nursing care are multiple and complex and extend from an individual to an organisational level. They can therefore not be seen nor targeted isolated. Furthermore, there is a need to draw attention to organisation of care and nurses' clinical decision‐making to ensure that patient's fundamental care needs are met. Implications for the Profession: Reducing missed nursing care calls for interventions that require nurses to change their working practices, roles and value perceptions. This study provides valuable insight into nurses' perspectives on reasons for missed nursing care, which is pertinent for designing interventions targeting missed nursing care. Impact: The study provides insight into nurses' perceptions on reasons for missed nursing care within hospital settings. The findings of the study show that reasons for missed nursing care are multiple and complex and cannot be limited to time and busyness. The findings can be used to inform future interventions aimed at reducing missed nursing care. Reporting Method: The reporting of the study followed the consolidated criteria for reporting qualitative research. Patient or Public Contribution: No patient or public contribution.

Background: Potentially inappropriate medication remains a significant concern in general practices, particularly in the context of overactive bladder (OAB) treatment for individuals aged 65 years and older. This study focuses on the exploration of alternative options for treating OAB and the deprescribing of anticholinergic drugs commonly used in OAB. The research aims to comprehensively evaluate the efficiency of deprescribing through a mixed methods approach, combining quantitative assessment and qualitative exploration of perceptions, experiences, and potential barriers among patients and health care personnel. Objective: This study aims to evaluate the efficiency and safety of the intervention in which health care staff in primary care encourage patients to participate in deprescribing their drugs for OAB. In addition, we aim to identify factors contributing to or obstructing the deprescribing process that will drive more informed decisions in the field of deprescribing and support effective and safe treatment of patients. Methods: The drugs for overactive bladder in primary care (DROP) study uses a rigorous research design, using a randomized controlled trial (RCT) with an embedded sequential explanatory mixed methods approach. All general practices within the North Denmark Region will be paired based on the number of general practitioners (GPs) and urban or rural locations. The matched pairs will be randomized into intervention and control groups. The intervention group will receive an algorithm designed to guide the deprescribing of drugs for OAB, promoting appropriate medication use. Quantitative data will be collected from the RCT including data from Danish registries for prescription analysis. Qualitative data will be obtained through interviews and focus groups with GPs, staff members, and patients. Finally, the quantitative and qualitative findings are merged to understand deprescribing for OAB comprehensively. This integrated approach enhances insights and supports future intervention improvement. Results: The DROP study is currently in progress, with randomization of general practices underway. While they have not been invited to participate yet, they will be. The inclusion of GP practices is scheduled from December 2023 to April 2024. The follow-up period for each patient is 6 months. Results will be analyzed through an intention-to-treat analysis for the RCT and a thematic analysis for the qualitative component. Quantitative outcomes will focus on changes in prescriptions and symptoms, while the qualitative analysis will explore experiences and perceptions. Conclusions: The DROP study aims to provide an evidence-based intervention in primary care that ensures the deprescription of drugs for OAB when there is an unfavorable risk-benefit profile. The DROP study’s contribution lies in generating evidence for deprescribing practices and influencing best practices in health care. Trial Registration: ClinicalTrials.gov NCT06110975; https://clinicaltrials.gov/study/NCT06110975 International Registered Report Identifier (IRRID): DERR1-10.2196/56277

BACKGROUND Potentially inappropriate medication remains a significant concern in general practices, particularly in the context of overactive bladder (OAB) treatment for individuals aged 65 years and older. This study focuses on the exploration of alternative options for treating OAB and the deprescribing of anticholinergic drugs commonly used in OAB. The research aims to comprehensively evaluate the efficiency of deprescribing through a mixed methods approach, combining quantitative assessment and qualitative exploration of perceptions, experiences, and potential barriers among patients and health care personnel. OBJECTIVE This study aims to evaluate the efficiency and safety of the intervention in which health care staff in primary care encourage patients to participate in deprescribing their drugs for OAB. In addition, we aim to identify factors contributing to or obstructing the deprescribing process that will drive more informed decisions in the field of deprescribing and support effective and safe treatment of patients. METHODS The drugs for overactive bladder in primary care (DROP) study uses a rigorous research design, using a randomized controlled trial (RCT) with an embedded sequential explanatory mixed methods approach. All general practices within the North Denmark Region will be paired based on the number of general practitioners (GPs) and urban or rural locations. The matched pairs will be randomized into intervention and control groups. The intervention group will receive an algorithm designed to guide the deprescribing of drugs for OAB, promoting appropriate medication use. Quantitative data will be collected from the RCT including data from Danish registries for prescription analysis. Qualitative data will be obtained through interviews and focus groups with GPs, staff members, and patients. Finally, the quantitative and qualitative findings are merged to understand deprescribing for OAB comprehensively. This integrated approach enhances insights and supports future intervention improvement. RESULTS The DROP study is currently in progress, with randomization of general practices underway. While they have not been invited to participate yet, they will be. The inclusion of GP practices is scheduled from December 2023 to April 2024. The follow-up period for each patient is 6 months. Results will be analyzed through an intention-to-treat analysis for the RCT and a thematic analysis for the qualitative component. Quantitative outcomes will focus on changes in prescriptions and symptoms, while the qualitative analysis will explore experiences and perceptions. CONCLUSIONS The DROP study aims to provide an evidence-based intervention in primary care that ensures the deprescription of drugs for OAB when there is an unfavorable risk-benefit profile. The DROP study’s contribution lies in generating evidence for deprescribing practices and influencing best practices in health care. CLINICALTRIAL ClinicalTrials.gov NCT06110975; https://clinicaltrials.gov/study/NCT06110975 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/56277

Aged care staff in Danish nursing homes feel the pressures of time scarcity acutely. But what does this mean for the well-being of residents? Using the concept "care time" we consider subjective experiences of time to make sense of the multiplicity of temporal experiences in nursing home care. We will show how the temporal structures of a neoliberal institutional care logic is at odds with what residents expect from care time. Finally, drawing on a phenomenological understanding of well-being, we explore how residents' temporal orientation to the present and the past can be drawn on to enhance well-being.