The rapidly growing number of older people with increasingly complex needs places pressure on quality of care and thereby presents a need for innovation in nursing homes. The aim of this review was to provide a comprehensive overview of the current state of evidence for the importance of leadership in innovation processes in nursing homes. A systematic search was conducted. Titles and abstracts were screened for relevance, data from full texts were extracted and reduced and quality appraisal was performed. Content analysis resulted in two categories: organizational factors associated with innovation and leadership characteristics in innovation, constructing the overall theme, ‘leadership: a key to successful innovations’. The innovations described in the included studies transform the underlying values of organizational culture. The review shows that participative, involving and innovative leadership is the key to success in innovation processes.

Norwegian legislation governing the use of force seems to provide decision guidance with the potential to reduce uncertainty and moral stress if the clinicians' legal competence had been greater.

Leaders' responsibilities in community health care for older people need to strike a balance between ethical principles in the management of limited resources.

No abstract

Aim To explore first‐year student nurses’ lived experience of learning in clinical placement in nursing homes. Background Nursing homes traditionally represent students’ first clinical placement sites during nurse education, and nursing home residents’ care needs can provide opportunities for student nurses to acquire both fundamental and specialised nursing skills. In clinical placements, students have opportunities to apply and integrate theoretical knowledge, practical skills and ethical competence in a clinical setting. Design A qualitative design with a hermeneutic phenomenological approach was employed and reported in accordance with the COREQ guidelines. Methods The study was undertaken at three nursing homes affiliated with one Norwegian university. Close observation (173 h) and in‐depth individual interviews (n = 7) with first‐year student nurses were conducted to explore their lived experience of learning. Data analysis was guided by van Manen’s hermeneutic phenomenological approach. Results The essential meaning of the phenomenon of learning in clinical placements in a nursing home setting is characterised by four themes: (1) navigating a new and complex learning context, (2) being emotionally affected when facing sickness and frailty, (3) having a vital need for support and guidance and (4) being engaged in learning. Conclusions The findings are discussed against the backdrop of educational learning theory. Learning in clinical placements in nursing homes is a multi‐faceted and complex phenomenon related to the students’ lived experience on the contextual, relational and individual levels. Overall, our findings demonstrate that learning in clinical placements is part of the process of professional identity development. Relevance to clinical practice The clinical practice arena should emphasise emotional support for student nurses, enhance their self‐directed reflection and explicitly focus on the essence of nursing in nursing homes.