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Background: The critical care outreach service (CCOS) was established in a large teaching hospital in the West of Ireland in 2014 to provide an extension of CCOS between the intensive care unit (ICU) and the wards outside ICU. With the everincreasing pressure on ICU resources, CCOS seems to offer an additional service to patients who are critically ill and deteriorating in hospital wards. Aim:The aim of this study is to explore ward nurses' experiences and perceptions of the CCOS.Study design: A qualitative descriptive methodology aimed to obtain a descriptive account of ward nurses' experiences of the CCOS. Data were collected using semistructured interviews. Twelve nurses from the West of Ireland participated in the study. Braun and Clarke's six-step thematic analysis was used to analyse the data.Results: Three core themes identified in this study included clinical support and decision-making; sharing knowledge and skills, and communication. All 12 nurses identified the positive impacts that they felt the current outreach service provided to them on a daily basis.Conclusions: Study findings indicate that nurses value the role of the CCOS in supporting the care of the critically ill and deteriorating patients at ward level. The CCOS has become invaluable to the ward nurses in their daily practice especially at a time when resources are lacking and patient acuity is on the rise.

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Background Irish Travellers are a small indigenous group representing 0.7% of the population in Ireland (Irish Central Statistics Office, 2018). They have a "shared history, culture and traditions, including, historically, a nomadic way of life," (Irish Department of Justice and Equality, 2017, p. 9) and were recognized as a distinct ethnic group in Ireland during March 2017. Travellers are among one of the most disadvantaged groups in Ireland, with poor general health and lower life expectancy than the general population (Irish Department of Justice and Equality, 2017). There are lifelong positive effects from breastfeeding (Victoria et al., 2016), yet few Traveller women in Ireland breastfeed. Ireland has lower breastfeeding rates in comparison to other countries (Irish Health Service Executive [HSE], 2016). Exclusive breastfeeding at hospital discharge was most recently recorded at 49%, while any breastfeeding was recorded at 60% (HSE, 2018a). Breastfeeding initiation is defined as "ever breastfed" and exclusive breastfeeding as occurring when "the infant receives only breast milk to the exclusion of other beverages or solid food" (Rasmussen, Felice, O'Sullivan, Garner, & Geraghty, 2017, p. 512). A very small percentage of women from the Irish Travelling community breastfeed, although data are extremely limited for this group. No up-todate studies have been undertaken to estimate breastfeeding rates among Traveller women in Ireland. The most recent study was undertaken by Hamid, Daly and Fitzpatrick (2011) and they reported that 2.2% of Irish Traveller women (N = 508) initiated breastfeeding. However, as this study is now several years old, its relevance is uncertain. While there are several factors that contribute to the extremely low breastfeeding rates among women from the Travelling community in Ireland, the postponement of the initiation of breastfeeding for high-risk screening for Classical Galactosemia (CG) is a distinct factor. CG is an autosomal recessive (Welling et al., 2017), inherited metabolic disorder (Broomfield, Brain, & Grunewald, 2015). CG (also known as Galactose-1-phosphate uridyltransferase deficiency) is the most common strain of this disorder and results in abnormal galactose tolerance (Zinn, 2015). The worldwide incidence of CG varies from one in 19,000 to one in 44,000 (Welling et al., 2017). The incidence of CG in Ireland is high at one in 19,500 (Irish National Centre for Inherited Metabolic Disorders, 2018), while the incidence among infants from the Irish Traveller community is extremely high at approximately 1:450 (HSE, 2018b). CG results in infants' inability to break down galactose, one of two sugars that form lactose present in human and animal milk (HSE, 2018b). Early diagnosis is required as complications from this condition can be detrimental to infants' health 864977J HLXXX10.