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Filter by:The international mobility of the nursing workforce is increasing. One nurse out of every eight now works in a country where they were not born or trained. International nurses play a vital role in the NHS. This study focuses on the workplace experiences of international nurses who have trained outside of the EU. In recent years there have been increasing numbers of nurses from outside of the European Union (EU) registering to work in the UK, notwithstanding the number of nurses from European countries continues to decline as the UK prepares to leave the EU. There is currently a global shortage of nurses. Drivers for UK recruitment of international nurses are founded in shortages of nurses related to increased health care demand, emphasis on safe staffing levels, expenditure on agency nurses and too few commissions for nurse training places, meaning that not enough nurses are entering the NHS. These factors are further exacerbated by staff retention levels and high staff turnover. Nurses' motives to leave their home countries are complex, and gaps in our understandings remain. Possible drivers for migrating to the UK or "pull factors" may include career progression, postgraduate training opportunities, work environment, sensitive employment policies, and economic benefits which enable nurses to send money back to their home countries, while "push" factors have been identified as limited education, lack of health care resources, dangerous working conditions and political instability.
Audit and feedback (A&F) aims to improve practices by providing professionals with a summary of their performance. A major limitation to its effectiveness is a persistent intention-action gap following the feedback that prevents the translation of planned actions into concrete changes in practice. In nursing, the lack of coordination within nursing teams contributes to this gap and therefore limits their capacity for action. The objective of this study is to evaluate the effects of an A&F intervention enhanced with an action support component on the primary care nursing teams' capacity to improve performance compared to a standard A&F intervention. A pragmatic cluster randomised controlled trial with analysis of implementation fidelity will be conducted. Four nursing organizations will receive standard A&F, while the other four will receive A&F with a support component. We will measure performance using clinical administrative data from an electronic database based on wound care episodes. Performance indicators will be measured 3 times: at the beginning of the study (T1), after 6 months (T2) and after 12 months (T3). The feedback meetings will take place between times 1 and 2, then between times 2 and 3. The intervention group will receive the support component in the form of structured focus groups in addition to the feedback meetings. Changes in rates of seven nursing-sensitive indicators (continuity, planning and adjusting of the treatment plan, initial assessment, education, frequency and number of consultations and duration of episodes) will be measured to evaluate the effects of A&F on performance. The results are expected to inform of the effectiveness of A&F in order to improve its design and deployment. The potential impact on the improvement of practices is significant, considering that wound care is one of the main conditions in primary care for which nursing staff have a high degree of autonomy.