A framework for the implementation of certification procedures in nurse level: a mixed approach study

Perceived value and barriers of nursing specialty certifications among clinical nurses in Saudi Arabia: a cross-sectional study

Introduction

Specialty nursing certifications reflect nurse's knowledge and competence in certain areas. Obtaining certification allows them to advance their careers and enhance patient care standards as their role and scope of responsibility expands. This study aimed to understand how nurses view specialty certification and related challenges in three university hospitals in Riyadh, Saudi Arabia.

Methods

A cross-sectional, correlational design was used. A survey questionnaire (Perceived Value of Certification-12 Tool) was sent through email, and it had one question for each barrier.

Results

The majority of participants valued certification to verify specialist knowledge (93.9%), enhance achievement (82.8%), and increase competence (79.1%). Certification was associated extrinsically with hiring preference (54.7%), recognition from colleagues (52.3%), and professional autonomy (51.7%). The primary barriers were lack of institutional reward (72.7%) and examination cost (64.8%), with not passing earlier being the least mentioned barrier (2%). The biggest obstacles faced by clinical nurses in obtaining certification include limited institutional rewards because their organization did offer incentives, such as promotions or salary bumps. Age and hospital significantly predicted clinical nurses' intrinsic value of certification, while age, gender, nationality, and hospital significantly predicted their extrinsic value. Age and gender significantly influenced their overall perceived value of certification.

Discussion

Overall, nurses in Riyadh recognize the value of certification. However, focused interventions must be implemented to overcome identified challenges and amplify the professional benefits of certification. Recommended measures include implementing tailored support initiatives and financial aid programs to address these barriers. A collaborative approach should be developed to provide support and actively promote the pursuit of nursing certification. Future studies should adopt longitudinal and qualitative designs to evaluate the impact of focused strategies.

Why is hospital discharge so difficult? Reconsidering patient trajectories in theory and practice: Insights from an ethnographic study of transitions in hip fracture care

This paper combines translational mobilisation theory and assemblage thinking to elaborate the patient trajectory concept. Deploying ethnographic research on transitions in hip fracture care in Wales (2014-2016), it describes and explains the structures and logics that condition transition interfaces, how transition infrastructures enact patients and with what effects. Comparative analysis of transition in three distinctive assemblages offers new insights into the challenges of hospital discharge and opportunities for research and improvement.

Mapping research findings on change implementation in nursing practice: A scoping literature review

AIMS

The aim of this study was to map the diverse factors impacting change implementation in nursing practices and investigate different implementation strategies.

DESIGN

Scoping literature review following PRISMA-ScR extension.

METHODS

Data were collected from PubMed, Ebsco, Scopus and ScienceDirect databases from 1990 onwards. Only English peer-reviewed studies reporting an implementation of change in nursing practice were included. Of 9,954 studies, 425 abstracts were scanned and 98 full-text articles were screened. Finally, 28 studies were selected.

RESULTS

A multifaceted approach, with a tailored intervention, was the most effective implementation strategy. Most identified factors were considered systematic, for example resource availability, leadership and knowledge. However, others related to local social and material context were identified in fewer number of studies. These seem to be operational elements for implementation processes. Both types of factors are essential and must be considered for successful implementation.

CONCLUSION

We advocate the development of framework including systematic factors and which capture the local context flexibility.

Assessing the Integrative Framework for the Implementation of Change in Nursing Practice: Comparative Case Studies in French Hospitals

The implementation of healthcare policies in healthcare organizations is a pivotal issue for managers. They generally require a change in professional practices. In previous work, we developed the Integrative Framework for Implementation of change in Nursing Practices (IFINP) to support implementation initiatives for such change in nursing practices. We aimed to assess the generalizability of IFINP in other organizational settings and explore links between strategic and socio-material factors during implementation. We used a comparative qualitative case study at three French hospitals to assess the implementation of certification procedures. Data were collected from 33 semi-structured interviews with managers and nurses. Narratives reflecting actions and interactions were extracted and deductively analyzed using IFINP components. The results showed that the framework was flexible and captured the different aspects of implementation actions and interactions at the three hospitals. Strong interferences were identified between mobilization mechanisms and strategic elements. Interferences were observed mostly between ‘reflexive monitoring and work articulation’, and ‘reflexive monitoring and sense-making’ mechanisms. Leadership was integrated into the different mechanisms, especially the ‘translation’ mechanism. The IFINP facilitated a greater understanding of strategic elements and associated relationships with social and material factors during implementation. It helps to provide a clear definition of the managers’ role when implementing new nurse practices.