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In the United Kingdom (UK) simulation learning has been recognised in the form of a regulatory agreement that may replace hours from clinical practice. This integration has become an embedded feature of the preregistration nursing programme at a University in the North of England, along with strategic investment in staff and simulation suites developed to underpin this curriculum change albeit in the absence of sparse empirical evidence, hence the rationale for the study which was designed to explore the relationship between simulation, theory and practice. The study features a thematic analysis of evaluation questionnaires from preregistration student nurses (n=>500) collected over a 2 year period which informed subsequent focus group interviews to explore the themes in more detail. Consistent data findings were the students' positive response to simulation as a learning approach facilitating the application of theory in a safe controlled environment. Students reported that they felt prepared for practice, recognising that simulated learning improved their humanistic and problem solving abilities as well as the development of psychomotor, technical skills, and overall confidence. The theory-practice gap is a recurring narrative in the nursing literature, the findings of this study recognises that simulation offers an opportunity to enact the integration of theory and practice illuminating this relationship in a controlled environment thus, reinforcing the theory-practice relationship for nursing students. In the United Kingdom (UK) simulation learning has been recognised in the form of a regulatory agreement that may replace hours from clinical practice. This integration has become an embedded feature of the pre-registration nursing programme at a University in the North of England, along with strategic investment in staff and simulation suites developed to underpin this curriculum change albeit in the absence of sparse empirical evidence, hence the rationale for the study which was designed to explore the relationship between simulation, theory and practice. The study features a thematic analysis of evaluation questionnaires from pre-registration student nurses (n=>500) collected over a 2 year period which informed subsequent focus group interviews to explore the themes in more detail. Consistent data findings were the students' positive response to simulation as a learning approach facilitating the application of theory in a safe controlled environment. Students reported they felt prepared for practice, recognising that simulated learning improved their humanistic and problem solving abilities as well as the development of psychomotor, technical skills, and overall confidence. The theory-practice gap is a recurring narrative in the nursing literature, the findings of this study recognises that simulation offers an opportunity to enact the integration of theory and practice illuminating this relationship in a controlled environment thus, reinforcing the theory-practice relationship for nursing students...

International studies show that high levels of environmental noise in hospitals disturb sleep. We know little about effective interventions to address this problem. We aimed to review primary research that tested noise-reduction interventions in ward-settings. Design: Systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data Sources: Health-related and acoustic databases searched from inception to 2017 with no language restrictions. Review methods: Experimental, quasi-experimental and observational studies assessing the effect of interventions on patient outcomes and/or environmental noise were included. Results: 834 records were identified with 9 meeting inclusion criteria. Data from 6 studies were pooled. Quality appraisal showed that the level of evidence was generally weak. A random effects meta-analysis determined that a synthesised estimate for the standardised mean difference in total hours sleep (no intervention -intervention) was -0.11 hours (95% CI -0.46 to 0.25 hours; p=0.556), with moderate statistical heterogeneity. A synthesised estimate for the standardised mean difference in awakenings (no intervention -intervention) was 0.05 (95% CI -0.20 to 0.29; p=0.715), with negligible statistical heterogeneity. A random effects meta-analysis determined that a synthesised estimate for the odds ratio for disturbed nights (no intervention: intervention) was 0.75 (95% CI 0.55 to 1.01; p=0.059), with low statistical heterogeneity. Conclusions: Individual studies show that noise reduction interventions are feasible and have the potential to improve patients' sleep experiences. However meta-analyses show insufficient evidence to support their use. Robust studies are required to identify effective interventions to address this significant and ubiquitous problem. AbstractObjective: High levels of environmental noise in hospitals disturbs sleep. We aimed to identify, critically appraise and summarise primary research that reports studies that tested interventions to reduce night-time noise levels in ward-settings. Design: Systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. with no language restrictions. Review methods: Experimental, quasi-experimental and observational study designs assessing the effect of noise reduction interventions on patient outcomes and/or environmental noise levels were included. Two reviewers independently conducted a quality appraisal using a published framework. Results: In total, 834 records were identified with nine studies meeting inclusion criteria. Quality appraisal showed that the level of evidence was generally weak. A range of noise reduction interventions were identified: one study implemented a single intervention, whilst the remainder were complex, multi-faceted interventions. Findings from individual studies showed mixed results but preliminary evidence suggests that noise reduction interventions can reduce environmental noise leve...

Simulation supports the practical learning experience. It will neither take the place of traditional methods of teaching nor replace good practice experience for nursing students, but can support both elements of nurse education.

Cardiovascular HRQoL PROMs have a wide variety of uses and can help clinicians, researchers, managers and policy makers in decision making and provide indicators of clinical and institutional quality and outcomes. New HRQoL PROMs are emerging and their choice and use should be determined by a host of issues, including psychometric properties, acceptability, feasibility and cost.