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Elvidge N, Hobbs M, Fox A, Currie J, Williams S, Theobald K, Rolfe M, Marshall C, Phillips JL. Practice pathways, education, and regulation influencing nurse practitioners' decision to provide primary care: a rapid scoping review. BMC PRIMARY CARE 2024; 25:182. [PMID: 38783189 PMCID: PMC11112961 DOI: 10.1186/s12875-024-02350-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/25/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND/OBJECTIVE Initially established to improve access to healthcare, particularly for primary care, the full potential of the nurse practitioner role is yet to be realised in most countries. Despite this, most countries are working to meet an ageing population's increasing healthcare needs and reduce healthcare costs and access disparities. Achieving these outcomes requires reform at multiple levels, including nurse practitioner practice pathways, education and regulation, and identifying the barriers and facilitators to optimising their primary care role. METHODS A rapid scoping review of nurse practitioner practice pathways, education and regulation inclusive of: (1) a systematic search of Medline and CINAHL for peer-reviewed English language articles, including opinion pieces published between January 2015 and February 2022; and (2) a web-based search of nurse practitioner program entry requirements of International Nurse Regulator Collaborative country members with a protected nurse practitioner title and prescribing rights, plus the Netherlands. The individually summarised search data was integrated and synthesised using Popay's narrative approach. RESULTS Emerging evidence from the included nurse practitioner courses (n = 86) and articles (n = 79) suggests nurse practitioners working in primary care provide safe, effective care and improve healthcare efficiencies. However, different regulatory and educational models are required if the primary care nurse practitioner is to meet growing demand. CONCLUSIONS International variations in entry criteria, curriculum, and regulation shape the global profile of the nurse practitioner primary care workforce and their practice setting. For countries to grow their primary care nurse practitioner workforce to meet unmet needs, different entry requirements, program content and accredited post-registration transitional programs must be urgently considered.
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Affiliation(s)
- Norah Elvidge
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Megan Hobbs
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Amanda Fox
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- Metro North Health, Redcliffe Hospital, Redcliffe, Australia
| | - Jane Currie
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Suzanne Williams
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Karen Theobald
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Melanie Rolfe
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Claire Marshall
- Improving Palliative Care Through Clinical Trials (ImPaCCT), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jane L Phillips
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia.
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
- Improving Palliative Care Through Clinical Trials (ImPaCCT), Faculty of Health, University of Technology Sydney, Sydney, Australia.
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Tan W, Hu Q, Wang C, Li Y, Jiang Y. Outline of nurse prescribing education programs: A scoping review. NURSE EDUCATION TODAY 2023; 131:105941. [PMID: 37690439 DOI: 10.1016/j.nedt.2023.105941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/04/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The role of nurse prescribers is developing rapidly to meet rising health care demands worldwide. However, prescribing is a complex process that requires nurses to receive the proper education. OBJECTIVES To identify what is known in the research field on nurse prescribing education. DESIGN Arksey and O'Malley's five-stage methodological framework was used to guide this scoping review. DATA SOURCES PubMed, Web of Science, CINAHL, Embase, and the Cochrane Library. REVIEW METHODS Databases were searched from inception to December 31, 2022. Data were extracted from papers meeting the inclusion criteria using the data chart and synthesized using a narrative method. RESULTS Seventy-one studies were included in the scoping review. Five education content themes and four education modes were identified. In addition, positive effects of nurse prescribing education and the learning needs of nurses were also found. CONCLUSIONS There is considerable heterogeneity in nurse prescribing education content and mode. This scoping review highlights the benefits of implementing education programs to prepare nurses for prescribing. However, nurses still have some unmet needs for prescribing education. More longitudinal studies and evaluation tools are needed to determine long-term effects. Future nurse prescribing education programs could consider the dual mentorship system, interactive educational activities, and specialized courses to improve the motivation of nurses and the quality of education.
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Affiliation(s)
- Wei Tan
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Qin Hu
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Cong Wang
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yijing Li
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yan Jiang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
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Kalfsvel LS, Peeters LEJ, Hoek K, Bethlehem C, van der Sijs IH, van der Kuy PHM, van den Broek WW, Versmissen J, van Rosse F. Does formative assessment help students to acquire prescribing skills? Eur J Clin Pharmacol 2023; 79:533-540. [PMID: 36811671 PMCID: PMC9945830 DOI: 10.1007/s00228-023-03456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/14/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Formative assessments can help motivate students and ease students' learning through feedback. There is a pressing need for improvement of clinical pharmacotherapy (CPT) education since junior doctors make many prescribing errors. The aim of this study was to determine whether a formative assessment with personalized narrative feedback helps medical students to increase their prescribing skills. METHODS This retrospective cohort study was conducted among masters' medical students at Erasmus Medical Centre, The Netherlands. Students made a formative and a summative skill-based prescription assessment, both during clerkships as part of their regular curriculum. Errors in both assessments were categorized by type and possible consequence and compared with each other. RESULTS A total of 388 students made 1964 errors in the formative assessment and 1016 in the summative assessment. Most improvements after the formative assessment were seen for mentioning the weight of a child on the prescription (n = 242, 19%). Most new and repeated errors in the summative assessment were missing usage instructions (n = 82, 16% and n = 121, 41%). CONCLUSIONS This formative assessment with personalized and individual narrative feedback has helped students to increase the technical correctness of their prescriptions. However, errors repeated after the feedback were predominantly errors showing that only one formative assessment has not yet enhanced the clinical prescribing enough.
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Affiliation(s)
- L S Kalfsvel
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands.
| | - L E J Peeters
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands
| | - K Hoek
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands
| | - C Bethlehem
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands
| | - I H van der Sijs
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands
| | - P H M van der Kuy
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands
| | - W W van den Broek
- Erasmus MC, University Medical Center Rotterdam, Institute of Medical Education Research Rotterdam, Rotterdam, The Netherlands
| | - J Versmissen
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, The Netherlands
| | - F van Rosse
- Erasmus MC, University Medical Center Rotterdam, Hospital Pharmacy, Rotterdam, The Netherlands
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Cognitive preceptorship: An emerging nurse practitioner role transition to practice model. J Prof Nurs 2022; 39:194-205. [DOI: 10.1016/j.profnurs.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 10/19/2022]
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Sormunen M, Heikkilä A, Salminen L, Vauhkonen A, Saaranen T. Learning Outcomes of Digital Learning Interventions in Higher Education: A Scoping Review. Comput Inform Nurs 2021; 40:154-164. [PMID: 34347644 DOI: 10.1097/cin.0000000000000797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Implementing digital technologies has become a policy priority worldwide among all types of education. The COVID-19 pandemic has further accelerated educational institutions' efforts to reorganize their teaching and introduce new digital learning technologies. Although using digital technologies in higher education, including nursing, is considered a modern and innovative way of teaching and learning, uncertainty exists concerning these technologies' actual usefulness in achieving positive learning outcomes. The aim of this scoping review was to examine the current evidence related to the effects of using digital technologies on learning outcomes in higher education. The authors searched five electronic databases for relevant studies and used a scoping review method to analyze and synthesize the evidence. Eighty-six articles from six disciplines met the selection criteria. As a key finding, the outcomes of the interventions were mainly positive. Increased professional knowledge, skills, and attitudes reflect the advancement of professional competence. Academic, collaborative, and study skills, in turn, contribute to general competence development. Our findings suggest that digital technology has the potential to improve learning in various disciplines.
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Affiliation(s)
- Marjorita Sormunen
- Author Affiliations: Faculty of Health Sciences, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio (Dr Sormunen); Faculty of Medicine, Department of Nursing Science, University of Turku, and Director of Nursing Excellence, Hospital District of Southwest Finland, Turku (Dr Heikkilä); Faculty of Medicine, Department of Nursing Science, University of Turku, Turku University Hospital, Turku (Dr Salminen); and Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio (Drs Vauhkonen and Saaranen)
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Sormunen M, Saaranen T, Heikkilä A, Sjögren T, Koskinen C, Mikkonen K, Kääriäinen M, Koivula M, Salminen L. Digital Learning Interventions in Higher Education: A Scoping Review. Comput Inform Nurs 2021; 38:613-624. [PMID: 32520782 DOI: 10.1097/cin.0000000000000645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This scoping review was undertaken to synthesize and describe research related to digital learning interventions in higher education, focusing on technological outcomes. Five electronic databases were searched, and 86 articles were included in the review. The data related to positive and negative technological outcomes and authors' suggestions were analyzed using inductive content analysis. The articles represented six disciplines across six continents and included quantitative (n = 65), qualitative (n = 3), and mixed-methods (n = 18) intervention studies. For positive technological outcomes, digital formats of learning were considered effective and participatory forms of learning in a majority of the articles. The students appreciated individualized and self-paced learning, and the digital form increased their motivation to learn. Automatized technical solutions that enabled learning and teaching had several advantages, and digital learning was believed to save the resources of students, teachers, and organizations. For negative technological outcomes, the technical difficulties in using the digital devices or platforms were described the most, and a need for resources was identified. Feedback from teachers was considered important from positive and negative viewpoints. Authors' suggestions for future digital teaching and learning as well as related interventions consisted of various activities, resources, environments, and methods.
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Affiliation(s)
- Marjorita Sormunen
- Author Affiliations: Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio (Drs Sormunen and Saaranen); Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio (Dr Sormunen); Department of Nursing Science, Faculty of Medicine, University of Turku (Drs Heikkilä and Salminen); Faculty of Sport and Health Sciences, University of Jyväskylä (Dr Sjögren); University of Stavanger, Faculty of Health Science, Department of Caring and Ethics and Åbo Akademi, Faculty of Pedagogy and Welfare Studies, Department of Caring Science, Turku (Dr Koskinen); Research Unit of Nursing Science and Health Management, University of Oulu (Drs Mikkonen and Kääriäinen); Medical Research Center Oulu, Oulu University Hospital and University of Oulu, and The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki (Dr Kääriäinen); and Faculty of Social Sciences, University of Tampere (Dr Koivula), Finland
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Clemmons AB, Alexander M, DeGregory K, Kennedy L. The Hematopoietic Cell Transplant Pharmacist: Roles, Responsibilities, and Recommendations from the ASBMT Pharmacy Special Interest Group. Biol Blood Marrow Transplant 2017; 24:914-922. [PMID: 29292057 DOI: 10.1016/j.bbmt.2017.12.803] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/26/2017] [Indexed: 12/14/2022]
Abstract
Pharmacists are increasingly recognized as an essential member of the multidisciplinary team for hematopoietic cell transplant (HCT) patients. However, until recently, their educational background, required training, and potential roles have not been well described. Therefore, the purpose of this manuscript is to provide supporting evidence for the HCT Clinical Pharmacist Role Description, which has been endorsed by several organizations including the American Society for Blood and Marrow Transplantation. This document provides justification for the various roles pharmacists fulfill with respect to medication management, transitions of care, patient and provider education, policy development, quality improvement, and research. Furthermore, evidence supporting the value, financially and otherwise, HCT pharmacists provide is reviewed. Pharmacists in the HCT setting are encouraged to report on novel practice models and potential impact of their services to increase awareness and utilization of HCT pharmacists.
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Affiliation(s)
- Amber B Clemmons
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, Georgia; Department of Pharmacy, Augusta University (AU) Medical Center, Augusta, Georgia.
| | - Maurice Alexander
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, North Carolina
| | - Kathlene DeGregory
- Department of Pharmacy, University of Virginia Health System, Charlottesville, Virginia
| | - LeAnne Kennedy
- Department of Pharmacy, Wake Forest Baptist Health, Winston Salem, North Carolina
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