Claudia Huber’s research while affiliated with HES-SO University of Applied Sciences and Arts Western Switzerland and other places

Aim To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation. Design A secondary explorative analysis of a cross‐sectional survey. Methods The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1‐year follow‐up between each year. The participants were 533 bachelor‐prepared nursing graduates. Results The student nurses' overall expectations included the following top two prioritized aspects: ‘contributing to something important’ and ‘adequate time to spend with patients’. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in ‘adequate time to spend with patients’, ‘work–life balance’ and experiencing ‘good management’. Conclusion The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work–life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft‐cited shortage of nurses. Implications for the Profession and/or Patient Care The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay. Impact Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing. The results can be used internationally as a benchmark and as a basis for introducing potential interventions for nurse retention. Reporting Method This study was reported following the Standardized Reporting of Secondary Data Analyses Checklist. Patient or Public Contribution There were no patient or public contributions. Trial and Protocol Registration This study has not been registered.

The integration of self-management education and support into the routine diabetes care is essential in preventing complications. Currently, however, there is no consensus on how to conceptualise integration in relation to self-management education and support. Therefore, this synthesis presents a framework conceptualising integration and self-management. Methods Seven electronic databases (Medline, HMIC, PsycINFO, CINAHL, ERIC, Scopus and Web of Science) were searched. Twenty-one articles met the inclusion criteria. Data were synthesised using principles of critical interpretive synthesis to build the conceptual framework. The framework was presented to 49 diabetes specialist nurses working at different levels of care during a multilingual workshop. Results A conceptual framework is proposed in which integration is influenced by five interacting components: the programme ethos of the diabetes self-management education and support intervention (content and delivery), care system organisation (the framework in which such interventions are delivered), adapting to context (the aspects of the people receiving and delivering the interventions), interpersonal relationship (the interactions between the deliverer and receiver of the intervention), and shared learning (what deliverer and receiver gain from the interactions). The critical inputs from the workshop participants related to the different priorities given to the components according to their sociolinguistic and educational experiences, Overall, they agreed with the conceptualisation of the components and their content specific to diabetes self-management education and support. Discussion Integration was conceptualised in terms of the relational, ethical, learning, contextual adapting, and systemic organisational aspects of the intervention. It remains uncertain which prioritised interactions of components and to what extent these may moderate the integration of self-management education and support into routine care; in turn, the level of integration observed in each of the components may moderate the impact of these interventions, which may also apply to the impact of the professional training. Conclusion This synthesis provides a theoretical framework that conceptualises integration in the context of diabetes self-management education and support in routine care. More research is required to evaluate how the components identified in the framework can be addressed in clinical practice to assess whether improvements in self-management education and support can be effectively realised in this population.

Zusammenfassung. Die interprofessionelle Zusammenarbeit ist ein Merkmal für eine gute und effiziente Gesundheitsversorgung, in der mehrere verschiedene Berufsgruppen in der Patientenbetreuung kompetent zusammenarbeiten. Ein dazu notwendiger erster Schritt ist die interprofessionelle Ausbildung, um verschiedene Professionen für die Zusammenarbeit in der späteren Berufspraxis vorzubereiten. Gemeinsame Ausbildungsgänge tragen dazu bei, ein Versorgungsteam zu befähigen, angepasst und wirkungsvoll auch auf individuelle und lokale Gesundheitsbedürfnisse zu reagieren.

Aim To describe diabetes nurses’ perspectives on the impact of the COVID‐19 pandemic on people with diabetes and diabetes services across Europe. Methods An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks. Results Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n=504) and 48% (n=873) of diabetes nurses felt the COVID‐19 pandemic had impacted ‘a lot’ on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased ‘a lot’: anxiety 82% (n=1486); diabetes distress 65% (n=1189); depression 49% (n= 893); acute hyperglycaemia 39% (n=710); and foot complications 17% (n=323). Forty‐seven percent (n=771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self‐management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID‐19 pandemic by 31% (n=499), 63% (n=1,027) and 34% (n=551), respectively. Conclusion The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID‐19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID‐19 situation continues we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.