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Ylimäki S, Oikarinen A, Kääriäinen M, Pölkki T, Mikkonen K, Holopainen A, Kaakinen P, Kanste O, Meriläinen M, Jansson M, Immonen K, Tuomikoski AM. Advanced practice nurses' evidence-based healthcare competence and associated factors: A systematic review. J Clin Nurs 2024; 33:2069-2083. [PMID: 38413769 DOI: 10.1111/jocn.17075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/21/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Evidence-based healthcare (EBHC) enables consistent and effective healthcare that prioritises patient safety. The competencies of advanced practice nurses (APNs) are essential for implementing EBHC because their professional duties include promoting EBHC. AIM To identify, critically appraise, and synthesise the best available evidence concerning the EBHC competence of APNs and associated factors. DESIGN A systematic review. DATA SOURCES CINAHL, PubMed, Scopus, Medic, ProQuest, and MedNar. METHODS Databases were searched for studies (until 19 September 2023) that examined the EBHC competence and associated factors of APNs were included. Quantitative studies published in English, Swedish and Finnish were included. We followed the JBI methodology for systematic review and performed a narrative synthesis. RESULTS The review included 12 quantitative studies, using 15 different instruments, and involved 3163 participants. The quality of the studies was fair. The APNs' EBHC competence areas were categorised into five segments according to the JBI EBHC model. The strongest areas of competencies were in global health as a goal, transferring and implementing evidence, while the weakest were generating and synthesising evidence. Evidence on factors influencing APNs' EBHC competencies was contradictory, but higher levels of education and the presence of an organisational research council may be positively associated with APNs' EBHC competencies. CONCLUSION The development of EBHC competencies for APNs should prioritise evidence generation and synthesis. Elevating the education level of APNs and establishing a Research Council within the organisation can potentially enhance the EBHC competence of APNs. IMPLICATIONS FOR THE PROFESSION We should consider weaknesses in EBHC competence when developing education and practical exercises for APNs. This approach will promote the development of APNs' EBHC competence and EBHC implementation in nursing practice. REGISTRATION, AND REPORTING CHECKLIST The review was registered in PROSPERO (CRD42021226578), and reporting followed the PRISMA checklist. PATIENT/PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Saija Ylimäki
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Wellbeing Services County of North Ostrobothnia, Oulaskangas Hospital, Oulainen, Finland
| | - Anne Oikarinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
- Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
| | - Tarja Pölkki
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Arja Holopainen
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
- Nursing Research Foundation, Helsinki, Finland
- WHO Collaborating Centre for Nursing, Helsinki, Finland
| | - Pirjo Kaakinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Outi Kanste
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Merja Meriläinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
| | - Miia Jansson
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Kati Immonen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- 2M-IT Oy, Turku, Finland
| | - Anna-Maria Tuomikoski
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
- Wellbeing Services County of North Ostrobothnia, Oulu University Hospital, Oulu, Finland
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Bavikatte A. Enhancing Stoma Care Education for Junior Doctors: A Comprehensive Teaching Series. Cureus 2024; 16:e58014. [PMID: 38606025 PMCID: PMC11007581 DOI: 10.7759/cureus.58014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Colorectal stomas are prevalent in surgical wards and demand careful medical attention, particularly in stoma management. Junior doctors play a vital role in this care, but their limited exposure and training may hinder their ability, impacting patient care. Given the dearth of literature, we aimed to assess junior doctors' stoma care knowledge and the efficacy of a specialized teaching course in boosting their confidence and skills. Methods The research, conducted at the West Suffolk Hospital NHS Trust in the UK, engaged 60 junior doctors, predominantly from Foundation Year 1 and Year 2, from August 2021 to December 2022. To ensure effective management and assessment, participants were divided into four groups, each comprising 15 doctors. A pivotal aspect of the study was implementing a structured stoma teaching series delivered by a panel of seasoned surgical experts. This series, conducted every Friday for three weeks, comprehensively covered all facets of stoma care. Both before and after the teaching series, assessments were administered to measure the impact of this educational intervention on the participants' understanding of stomas. The study meticulously adhered to ethical guidelines, with all participants providing informed consent, and measures were implemented to guarantee anonymity, thus safeguarding the privacy and confidentiality of all individuals involved. The primary objective of this investigation was to evaluate the efficacy of the stoma teaching series in augmenting the knowledge and comprehension of stomas among junior doctors. The findings of this study hold significant potential in guiding healthcare professionals toward developing more efficacious stoma education programs, ultimately leading to improved patient care outcomes. Results The study involved 60 junior doctors categorized into four groups from August 2021 to December 2022. It aimed to assess their understanding of colorectal stomas, focusing on complications and their knowledge about stoma appliances and care nurses. A questionnaire was used to evaluate their knowledge in these areas at the start of their surgical rotation, which showed significant knowledge gaps among participants. Of the 60 participants, 48 (80%) expressed slight or no confidence in basic stoma care, while 54 (90%) admitted unfamiliar with managing stoma complications. Astonishingly, all 60 (100%) participants lacked awareness of fundamental stoma care concepts. Significant improvements were observed following a comprehensive stoma teaching series covering basic stoma knowledge, its complications and management, and practical stoma care. Feedback from the course revealed positive outcomes, with 54 (87%) doctors feeling confident or very confident in basic stoma knowledge and 48 (80%) reporting increased familiarity with managing stoma complications. Remarkably, all 60 (100%) doctors indicated comfort with stoma care concepts after the sessions. Participants emphasized the course's value in medical education and professional development, citing enhanced practical skills such as communication and teamwork. Conclusion Our study revealed junior doctors' limited stoma knowledge, emphasizing the need for a dedicated teaching program that significantly improves their understanding. Focused stoma education is vital for junior doctors to deliver optimal patient care, necessitating hospitals to promote awareness for improved patient outcomes.
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Affiliation(s)
- Akshay Bavikatte
- General and Colorectal Surgery, West Suffolk Hospital NHS Trust, Bury St Edmunds, GBR
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Gilsenan M, Van Der Linde S, Hill G, Lambros B. Review of advanced practice nurse role in infection throughout the hematopoietic stem cell transplant journey. Transpl Infect Dis 2024; 26:e14268. [PMID: 38477039 DOI: 10.1111/tid.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/30/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Prolonged periods of immunosuppression during hematopoietic stem cell transplant (HSCT) can result in serious infectious complications and contribute to transplant-related morbidity and mortality. Adherence to standardized pre and postinfection screening guidelines, prescribed medications, and early identification of infectious symptoms through comprehensive patient and family education are crucial to minimizing infectious complications. Advanced practice nurses (APNs) are key members of the multidisciplinary care team in the HSCT specialty, maintaining a specialized skillset and scope of practice which includes a holistic based, preventative medicine and risk mitigation approach. METHODS This review sought to describe the role of the APN in HSCT care and to further examine existing APN led models of care which focus on infection prevention and education throughout the HSCT treatment journey. RESULTS No studies specifically examined the APN role in infectious diseases risk assessment, screening, and management throughout the HSCT journey were identified throughout our review, however, there was considerable evidence to demonstrate the benefits of APN led care in the oncology and solid organ transplantation specialty which led to improvements in continuity of care, overall patient outcomes, and multidisciplinary team collaboration. The key themes identified in our review, were the role of the APN in the delivery of comprehensive patient and family education, the role of the APN in supporting, mentoring, and educating junior medical and nursing teams, the collaboration between the APN and the multidisciplinary care team, and the role of the APN in prompt recognition, triage, and management of treatment related complications, such as infection.
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Affiliation(s)
- Maddie Gilsenan
- Children's Cancer Centre, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Sam Van Der Linde
- Department of Clinical Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Geoff Hill
- Health Sciences Library, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Belinda Lambros
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- NHMRC National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
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Thezenas J. [Territorial gradation, multi-professionality and IPA: new levers for monitoring Parkinson's patients]. Soins 2024; 69:22-25. [PMID: 38453394 DOI: 10.1016/j.soin.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
The rapid increase in the number of Parkinson's patients in the population is raising questions about the organization of expert resources. The creation of advanced practice nurses is likely to have an impact on this public health issue, as is the implementation of multi-level care gradation and the prospects for paramedical development.
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Affiliation(s)
- Jérémie Thezenas
- Hôpital Simone-Veil, Groupement hospitalier Eaubonne-Montmorency, 14 rue de Saint-Prix, 95600 Eaubonne, France; Centre hospitalier d'Argenteuil, hôpital Victor-Dupouy, 69 rue du Lieutenant-Colonel-Prudhon, 95100 Argenteuil, France; Université Paris Cité, site Villemin, 10 avenue de Villemin, 75010 Paris, France.
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Gakou S. [Addictions in the elderly: the viewpoint of an IPA working in EMPSA]. Soins Psychiatr 2024; 45:26-28. [PMID: 38527869 DOI: 10.1016/j.spsy.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Many elderly people live well and at home, but some require somatic and psychiatric care. Mobile psychiatric teams for the elderly are called upon to intervene with people aged 65-70 and over who are experiencing psychological distress. Among senior citizens, addictive disorders are very common, and are associated with psychiatric and geriatric co-morbidities. Alcohol, tobacco and benzodiazepine use disorders require holistic, individualized care, based on identification, prevention and referral, as well as training and coordination of professionals and caregivers.
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Affiliation(s)
- Sita Gakou
- Équipe mobile de psychiatrie du sujet âgé, GHU Paris psychiatrie et neurosciences, 24-26 rue d'Hauteville, 75010 Paris, France.
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Gitzhoffen L. [Working in a CSAPA, care through relationships]. Soins Psychiatr 2024; 45:45-47. [PMID: 38527873 DOI: 10.1016/j.spsy.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
In a medical-social setting, the work of addiction care providers is somewhat unusual. Drawing on the teachings of Carl Rogers and his person-centred approach, and Hildegard Peplau and her theory of care based on the interpersonal relationship, this article explores the possibilities of welcoming a user to an addictology care, support and prevention center that is trying to rethink its operations at a time when advanced practice nurses are being deployed.
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Affiliation(s)
- Laure Gitzhoffen
- CSAPA/PAEJ Oppelia Essonne, 110 grand-place de l'Agora, 91034 Évry, France.
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Damien C, Marion DH, Deborah S, Margot M. Professional identity and representations of advanced practice nurses specialising in psychiatry and mental health: A national study. Int J Ment Health Nurs 2024. [PMID: 38240063 DOI: 10.1111/inm.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 03/06/2024]
Abstract
Advanced practice nurses constitute a new professional group within the French health care system. Advanced practice nurses specialise in one of five disciplines including Psychiatry/Mental-Health. This specific discipline is strongly marked by stigmatising representations by healthcare users and other health professionals (including other advanced practice nurses), whose consequences have a deleterious effect. The aim was to highlight all advanced practice nurses representation of Psychiatry/Mental-Health advanced practice nurses. An observational descriptive survey, based on an anonymous online questionnaire was conducted in April 2022 among qualified and student advanced practice nurses from the five specialist disciplines. Overall, 356 advanced practice nurses completed the survey questionnaire. No significant difference in stigmatising representations of Psychiatry/Mental-Health advanced practice nurses versus other advanced practice nurses was observed. Only 3.3% of other advanced practice nurses thought that Psychiatry/Mental-Health advanced practice nurses are often 'strange'. Psychiatry/Mental-Health advanced practice nurses and other advanced practice nurses appeared to have similar representations of the professional roles of advanced practice nurses in general and of advanced practice nurses APN specifically. Unlike other professionals in the psychiatric field (e.g. medical interns, nurses), very little stigmatisation of Psychiatry/Mental-Health advanced practice nurses by their colleagues (i.e. other advanced practice nurses) was observed. This could be partly due to the fact that advanced practice nurses professional identity appeared to be built collectively around the concept of advanced practice. Advanced practice nurses constitute a professional group that is fully involved in contemporary transformations in care and organisational innovation. The very low level of stigmatisation of Psychiatry/Mental-Health advanced practice nurses by other advanced practice nurses in our study suggests that these new healthcare actors could play a crucial role in the improvement of professional health practices, particularly in terms of improved coordination between psychiatric-care and physical-care.
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Affiliation(s)
- Croguennec Damien
- Pôle 94g16, Hôpitaux de St. Maurice, St. Maurice, France
- Université Paris Cité, Paris, France
| | - Darras-Hostens Marion
- WHO Collaborating Centre for Research and Training in Mental Health, EPSM Lille-Métropole, Hellemmes-Lille, France
| | - Sebbane Deborah
- WHO Collaborating Centre for Research and Training in Mental Health, EPSM Lille-Métropole, Hellemmes-Lille, France
- ECEVE, UMR 1123, Inserm, Université Paris Cité, Paris, France
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Gakou S, Vlasie M. [A survey of psychiatry and mental health IPAs]. Soins Psychiatr 2024; 45:44-47. [PMID: 38218623 DOI: 10.1016/j.spsy.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
A survey was conducted in June 2022 among the graduate RPNs in the field of psychiatry and mental health. 48 people responded and gave their views on their implementation and job satisfaction. The results were generally positive.
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Affiliation(s)
- Sita Gakou
- 19 rue Picasso, 93370 Montfermeil, France.
| | - Mirela Vlasie
- 90 rue Anatole-France, 92290 Chatenay-Malabry, France
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Buray S, Roca F. [Minimal geriatric assessment by an advanced practice nurse]. Soins 2024; 69:57-59. [PMID: 38296423 DOI: 10.1016/j.soin.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The prevalence of haematological malignancies increases in elderly patients. The complexity of therapeutic management makes it necessary to evaluate them using a global approach, namely bio-psycho-environmental. Identifying and assessing their weaknesses are part of the roles of advanced practice nurse (APN). Various tools are used to do this, including the G8 questionnaire, which directs patients towards a comprehensive geriatric assessment, or the Geriatric core dataset, designed to be used during clinical trials and which is more detailed and faster. Could an APN use the latter?
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Affiliation(s)
- Sandrine Buray
- Hôpital de jour hématologique, centre Henri-Becquerel, 1 rue d'Amiens, 76038 Rouen cedex 1, France.
| | - Frédéric Roca
- Service de médecine gériatrique, CHU de Rouen, 1 rue de Germont, 76000 Rouen, France
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Bourgninaud M. [Transition, a complex and holistic process]. Soins Pediatr Pueric 2023; 44:27-30. [PMID: 37980158 DOI: 10.1016/j.spp.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2023]
Abstract
Transition is a complex process that enables a young person living with a chronic illness to become an adult. It begins early in adolescence and ends once the transfer to the adult service is complete. The high risk of disruption during this transition calls for coordinated care focused on the patient and his or her life course. Many programs are dedicated to this delicate stage, including Jump, developed within the neurology department of a Paris hospital.
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Affiliation(s)
- Marine Bourgninaud
- Département de neurologie, Hôpital de la Pitié-Salpêtrière, AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France.
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Melnyk BM, Holod AF, Hsieh AP, Feist JC. An audit of mental health questions on U.S. nursing licensure applications: Evidence to guide urgent action for change. Worldviews Evid Based Nurs 2023; 20:422-430. [PMID: 37843825 DOI: 10.1111/wvn.12680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Nurses often forgo needed mental healthcare due to stigma and fear of losing their license. The decision to access care or disclose mental health struggles is intensified when registered nurses (RNs) or advanced practice registered nurses (APRNs) discover that licensure applications ask invasive mental health questions that could impact their ability to work. AIMS This study highlights findings from an audit of mental health and substance use questions included in RN and APRN licensure applications across the United States. METHODS A sequential 4-step approach was used to retrieve RN and APRN licensure applications: (1) review of Board of Nursing (BON) websites, (2) communication with BON staff, (3) communication with Deans of Nursing to ask for retrieval assistance, and (4) creation of mock applicants. An embedded checklist within the Dr. Lorna Breen Heroes Foundation's Remove Intrusive Mental Health Questions from Licensure and Credentialing Applications Toolkit guided the audit. Two study team members reviewed the applications independently for intrusive mental health questions, which were designated as non-compliant with the Toolkit's recommendations and arbitrated for consensus. States were designated as non-compliant if ≥1 item on the checklist was violated. RESULTS At least one RN and APRN application was obtained from 42 states. Only RN applications were obtained from five states, while only APRN applications were obtained from three states. Only 13 states (26%) fully adhered to the Took-Kit checklist. LINKING EVIDENCE TO ACTION The majority of BONs did not fully adhere to the Took-Kit checklist. Guidance from national organizations and legislation from state governments concerning the removal or revision of probing mental health and substance use questions is urgently needed to cultivate a stigma-reducing environment where nurses are supported in seeking needed mental health treatment.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- Office of the Chief Wellness Officer, The Ohio State University, Columbus, Ohio, USA
- Helene Fuld Health Trust National Institute for Evidence-based Practice, The Ohio State University, Columbus, Ohio, USA
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Alicia F Holod
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | | | - J Corey Feist
- Dr. Lorna Breen Heroes' Foundation, Charlottesville, Virginia, USA
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Pedreira‐Robles G, Garcimartín P, Bach‐Pascual A, Giró‐Formatger D, Redondo‐Pachón D, Morín‐Fraile V. Creating the nursing care map in the evaluation of kidney transplant candidates: A scoping review and narrative synthesis. Nurs Open 2023; 10:6668-6689. [PMID: 37480193 PMCID: PMC10495730 DOI: 10.1002/nop2.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/21/2023] [Accepted: 07/07/2023] [Indexed: 07/23/2023] Open
Abstract
AIMS To analyse the aspects involved in the care of individuals assessed as kidney transplant candidates and to identify the role of nurses in providing specialised care for this population. DESIGN Scoping review. The results were summarised using a narrative synthesis technique. DATA SOURCES A review of the literature published between 2001 and 2021 was conducted between October and November 2021 using PubMed, CINAHL and SciELO. REVIEW METHODS The research team agreed on a search strategy based on clinical practice guidelines for assessing kidney transplantation candidates. Quantitative, qualitative and mixed methods studies published in peer-reviewed journals in English, Spanish, French and Portuguese were included. RESULTS A total of 377 studies were identified, and 49 articles were included after the inclusion and exclusion criteria were applied. The narrative synthesis was structured into four themes: Physical needs; Psychological and quality of life needs; Education and adherence needs; and Nurses' role. CONCLUSION Nursing assessment of kidney transplantation candidates should encompass physical, psychosocial and adherence aspects. A variety of methodologies and resources are available for this assessment. Nurses contribute to coordinating access to kidney transplantation, aiming to improve adherence to an appropriate lifestyle to prevent patients from being excluded from kidney transplantation or suffering from kidney transplantation-related complications. IMPACT Based on our findings, we managed to design a nursing care map for kidney transplantation candidates combining the main elements of nursing care that should be incorporated into this process. Advanced practice nursing professionals play a crucial role in accessing renal transplant care.
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Affiliation(s)
- Guillermo Pedreira‐Robles
- Nephrology DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
- ESIMar (Mar Nursing School)Parc de Salut Mar, Universitat Pompeu Fabra affiliatedBarcelonaSpain
- SDHEd (Social Determinants and Health Education Research Group)IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Nursing and Health PhD ProgramUniversity of BarcelonaBarcelonaSpain
| | - Paloma Garcimartín
- Nursing DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
- Research Group in Nursing CareIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Biomedical Network Research Center for Cardiovascular DiseasesCIBERCV, Carlos III Health InstituteMadridSpain
| | - Anna Bach‐Pascual
- Nephrology DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
| | - Dolors Giró‐Formatger
- Nursing Care Methodology and Quality departmentHospital del Mar, Parc de Salut MarBarcelonaSpain
| | - Dolores Redondo‐Pachón
- Nephrology DepartmentHospital del Mar, Parc de Salut MarBarcelonaSpain
- Kidney Research Group (GREN)Hospital del Mar Institute for Medical Research (IMIM), RD16/0009/0013 (ISCIII FEDER REDinREN)BarcelonaSpain
| | - Victoria Morín‐Fraile
- Department of Public Health, Mental and Maternal and Child Health, Nursing schoolUniversity of BarcelonaBarcelonaSpain
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Sa W, Shuihong C, Jingfen J, Mao Z, Zhiting G, Danping Y, Chang H, Yuwei W. The effect of trauma advanced practice nurse programme at a Level I regional trauma centre in mainland China. Nurs Open 2023; 10:6559-6565. [PMID: 37332249 PMCID: PMC10416056 DOI: 10.1002/nop2.1911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023] Open
Abstract
AIMS Trauma is the fifth-leading cause of death in China. Despite the establishment of the Chinese Regional Trauma Care System (CRTCS) in 2016, advanced trauma nurse practice has not been incorporated. This study aimed to identify the roles and responsibilities of trauma advanced practice nurse (APN), and to investigate the impact on patient outcomes in a Level I regional trauma centre in mainland China. DESIGN A single-centre pre- and post-control design was used. METHODS The trauma APN programme was established based on multidisciplinary experts' consultation. A retrospective study was conducted on all Level I trauma patients over a period of 5 years, spanning from January 2017 to December 2021, with a sample size of 2420. The data were divided into two comparison groups: a pre-APN programme (January 2017-December 2018; n = 1112) and post-APN programme (January 2020-December 2021; n = 1308). A comparison analysis was conducted to evaluate the effectiveness of trauma APN who were integrated into the trauma care team, with a focus on patient outcomes and time-efficiency indicators. RESULTS The certification of the regional Level I trauma centre resulted in a 17.63% increase in the number of trauma patients. The integration of advanced practice nurses (APN) into the trauma care system led to significant improvements in time-efficiency indicators, with the exception of advanced airway establishment time (p < 0.05). The average emergency department length of stay (LOS) decreased 21%, from 168 to 132 min (p < 0.001); additionally, the mean intensive care unit LOS decreased by nearly 1 day (p = 0.028). Trauma patients who were treated by trauma APN had a higher likelihood of survival, with an odds ratio of 1.816 (95%CI: 1.041, 3.167; p = 0.033), compared to patients who received care prior to the implementation of the trauma APN program. CONCLUSION A trauma APN programme has the potential to enhance the quality of trauma care in the CRTCS. IMPACT This study elucidates the roles and responsibilities of trauma advanced practice nurses (APN) in a Level I regional trauma centre in mainland China. Trauma care quality was significantly improved after the application of a trauma APN programme. In regions with inadequate medical resources, the utilization of advanced practice trauma nurses can enhance the quality of trauma care. In addition, trauma APN can provide a trauma nursing education programme within the regional centres as a strategy to augment the proficiency of regional trauma nursing. No patient or public contribution, the research data all from trauma data bank.
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Affiliation(s)
- Wang Sa
- Nursing DepartmentZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
- Emergency MedicineZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
| | - Chen Shuihong
- Quality Management DepartmentZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
| | - Jin Jingfen
- Nursing DepartmentZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
- Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang ProvinceHangzhouChina
| | - Zhang Mao
- Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang ProvinceHangzhouChina
- Emergency MedicineZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
| | - Guo Zhiting
- Nursing DepartmentZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
| | - Yan Danping
- Nursing DepartmentZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
- Emergency MedicineZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
| | - Huang Chang
- Nursing DepartmentZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
- Emergency MedicineZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
| | - Wang Yuwei
- Nursing DepartmentZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
- Emergency MedicineZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
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14
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Bednarek A, Klepacz R, Bodys-Cupak IE. The Role of the Nurse in the Care and Management of Patients with Rheumatic Diseases Arising from the Current EULAR Recommendations: A Literature Review. Healthcare (Basel) 2023; 11:2434. [PMID: 37685467 PMCID: PMC10486762 DOI: 10.3390/healthcare11172434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/24/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
In some countries, restructuring of the healthcare system has contributed to the introduction of a new domain in professional nursing-the Advanced Practice Nurse (APN). In order to provide the highest quality of care to patients, nurses working at the advanced level are expected to develop knowledge and to initiate services and practices carried out in collaboration with other professionals. In 2018, the European League Against Rheumatism (EULAR) updated its recommendations for the role of the nurse in the management and care of patients with rheumatic conditions. The objective of the study was a presentation of the scope of medical services provided by nurses for patients with rheumatic diseases based on current EULAR recommendations. A review of the literature on the participation of nurses, as members of a multidisciplinary team, in the education, management, psychosocial support, and promotion of self-care in patients with rheumatic diseases was presented. The expert group formulated three overarching principles and eight recommendations. The literature review and expert recommendations indicated that nurses' tasks in relation to patients with rheumatic diseases should include an initial assessment of health needs, routine follow-up care, and counseling for patients on self-care and lifestyle changes. In the EULAR recommendations, nursing care is also defined as a practice model in which nurses, in collaboration with physicians, provide support, education, and disease monitoring to patients with rheumatic conditions. The requirement for extended nursing education at the advanced practice level, aimed at acquiring diagnostic, therapeutic, caring, and educational knowledge and skills was highlighted, particularly with regard to the EULAR recommendations.
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Affiliation(s)
- Anna Bednarek
- Department of Health Promotion, Faculty of Health Sciences, Medical University of Lublin, 20-093 Lublin, Poland
| | - Robert Klepacz
- Department of Clinical Pathomorphology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Iwona Elżbieta Bodys-Cupak
- Department of Nursing Fundamentals, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland;
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15
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Cheng CW, Gau BS. [Advanced Practice Nursing Experience of a Female Adolescent With Leigh Syndrome and Her Family: A Family Strengths-Oriented Therapeutic Conversations Approach]. Hu Li Za Zhi 2023; 70:103-111. [PMID: 37469325 DOI: 10.6224/jn.202308_70(4).13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
This article applied a family strengths-oriented therapeutic conversations approach to explore the advanced practice nursing experience of a female adolescent with Leigh Syndrome and her family. During the nursing care period from September 20 to November 19, 2022, the author collected data through direct care, observation, interview, telecare, home visits, and medical record reviews and confirmed the nursing problems to be the inadequate coping capability of the family. The author leveraged her advanced nurse practitioner role and used family strength-oriented therapeutic conversations to enable the parents of the patient to reflect on their experiences with this disease and to improve their quality of life and satisfaction with healthcare services. Three modes of care, including accessibility, coordination, and comprehensiveness, were offered to the female adolescent patient and her family to achieve the goal of family-centered, community-based, and medical-system-centered care. It is suggested that before making healthcare decisions, patients and their families should be given the opportunity to participate in the healthcare process and reach consensus on healthcare decisions based on existing evidence and their values and preferences. The medical decisions made by patients and their families after carefully considering their current situation and needs should be supported and assisted.
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Affiliation(s)
- Ching-Wen Cheng
- BSN, RN, Master Student, School of Nursing, College of Medicine, National Taiwan University, Taiwan, ROC
| | - Bih-Shya Gau
- PhD, RN, Associate Professor, School of Nursing, College of Medicine, National Taiwan University, Taiwan, ROC.
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16
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Simon P. [Telehealth, what place for the advanced practice nurse?]. Soins 2023; 68:33-35. [PMID: 37419599 DOI: 10.1016/j.soin.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
Remote professional practices or telehealth have been adopted by most healthcare professions around the world. Telehealth is now part of the means available to health professionals to strengthen the quality of pathways. Telehealth is not a substitute for face-to-face exercise but complements it. The relevance of a use of telehealth is the responsibility of the health professional. In this article, we specify the place of telehealth in the professional practice of an advanced practice nurse, whether in private practice or salaried by a care institution.
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Affiliation(s)
- Pierre Simon
- Société française de télémédecine, 2 rue de Cherbourg, 22000 Saint-Brieuc, France.
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17
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Charpigny M, Patry C, Bourgogne I, Gonzalez J, Courtois-Amiot P, Laurent L. [Implementation of an EMG IPA in the emergency department]. Soins Gerontol 2023; 28:16-19. [PMID: 37328201 DOI: 10.1016/j.sger.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
An advanced practice nurse from the Bretonneau-Bichat (AP-HP) hospitals' mobile geriatric outpatient team works in the emergency department (SAU). Its mission is to facilitate the identification, evaluation and referral of frail elderly patients discharged home after a visit to the emergency department. Description of the implementation of this project, its progress, and one-year assessment.
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Affiliation(s)
- Mathilde Charpigny
- Département de gériatrie Bichat-Beaujon-Bretonneau, Groupe hospitalier universitaire AP-HP Nord-Université de Paris, 46 rue Henri-Huchard, 75018 Paris, France; Service d'accueil des urgences, Hôpital Bichat, Groupe hospitalier universitaire AP-HP Nord-Université de Paris, 46 rue Henri-Huchard, 75018 Paris, France.
| | - Claire Patry
- Département de gériatrie Bichat-Beaujon-Bretonneau, Groupe hospitalier universitaire AP-HP Nord-Université de Paris, 46 rue Henri-Huchard, 75018 Paris, France
| | - Ingrid Bourgogne
- Département de gériatrie Bichat-Beaujon-Bretonneau, Groupe hospitalier universitaire AP-HP Nord-Université de Paris, 46 rue Henri-Huchard, 75018 Paris, France
| | - Julie Gonzalez
- Département de gériatrie Bichat-Beaujon-Bretonneau, Groupe hospitalier universitaire AP-HP Nord-Université de Paris, 46 rue Henri-Huchard, 75018 Paris, France
| | - Pauline Courtois-Amiot
- Département de gériatrie Bichat-Beaujon-Bretonneau, Groupe hospitalier universitaire AP-HP Nord-Université de Paris, 46 rue Henri-Huchard, 75018 Paris, France
| | - Louise Laurent
- Département de gériatrie Bichat-Beaujon-Bretonneau, Groupe hospitalier universitaire AP-HP Nord-Université de Paris, 46 rue Henri-Huchard, 75018 Paris, France
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18
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Mancinelli J. [Role of a stabilized chronic pathology RPN in mental health]. Soins Psychiatr 2023; 44:31-33. [PMID: 37328228 DOI: 10.1016/j.spsy.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
While our health care system is compartmentalized by specialty, the implementation of an advanced practice nurse mentioning stabilized chronic pathologies in a public mental health institution may seem ambitious. However, it is interesting, for patients suffering from a mental pathology, for caregivers practicing in psychiatry and for the institution, to integrate it into the care pathway.
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Affiliation(s)
- Jenny Mancinelli
- Unité "Soins pour tous", Centre psychothérapique de Nancy, 1, rue du Docteur-Archambault, 54520 Laxou, France.
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19
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Gakou S, Vlasie M. [IPA exercise at extreme ages of life, differences or similarities?]. Soins Psychiatr 2023; 44:34-38. [PMID: 37328229 DOI: 10.1016/j.spsy.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Advanced practice nursing is intended for children, adolescents, adults and the elderly. In the field of mental health, this population-based approach allows advanced practice nurses to apply all of their skills for individualized and adapted care. Whether these professionals work in child and adolescent psychiatry or in psychiatry for the elderly, their practices have many similarities.
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Affiliation(s)
- Sita Gakou
- GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Mirela Vlasie
- GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France.
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20
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Lippler N. [Advanced nursing practice in a medical-psychological center]. Soins Psychiatr 2023; 44:39-42. [PMID: 37328230 DOI: 10.1016/j.spsy.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The introduction of an advanced practice nurse in psychiatry and mental health (APN) at the University Hospital of Nîmes has made it possible to improve the quality and safety of care while controlling costs and ensuring the satisfaction of patients, partners and care teams. A favorable institutional policy, the involvement of the management, psychiatrists and the IPA PSM facilitated the acceptance of this new profession by the care teams and other professionals, despite the existence of statutory and logistical obstacles.
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Affiliation(s)
- Nadia Lippler
- Centre hospitalier universitaire de Nîmes, 4, rue du Professeur-Robert-Debré, 30900 Nîmes, France.
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21
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Abstract
Since September 2021, at the Paris Psychiatry and Neurosciences University Hospital Group, an advanced practice nurse has been providing post-emergency consultations for people who were initially seen in the emergency department, for whom an indication for outpatient care was given and who had problems accessing care. Collaboration with the nursing team is an important element not to be neglected in the implementation of this new profession.
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Affiliation(s)
- Romain Pérot
- Centre psychiatrique d'orientation et d'accueil, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France.
| | - Karine Fauchereau
- Centre psychiatrique d'orientation et d'accueil, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
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Abstract
The Paul-Guiraud Hospital Group has three advanced practice nurses (APNs) specializing in psychiatry and mental health who work in different medical-psychological centers. Supported by the institution, each APN project has been thought out by a multi-professional team within the structures, according to their specific needs.
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Affiliation(s)
- Gurvan Queffelec
- CMP de Vitry-sur-Seine, 20 allée du petit tonneau 94400 Vitry-sur-Seine, France; Groupe hospitalier Paul-Guiraud, 54 avenue de la République, BP 20065, 94806 Villejuif cedex, France.
| | - Rayan Bchini
- CMP du Kremlin-Bicêtre, 5, place Victor Hugo 94270 le Kremlin-Bicêtre, France; Groupe hospitalier Paul-Guiraud, 54 avenue de la République, BP 20065, 94806 Villejuif cedex, France
| | - Malasi Sonethavy
- CMP de Choisy-le-Roi, 41 avenue Louis Luc, 2 zac du PortChoisy-l, 94600 e-Roi, France; Groupe hospitalier Paul-Guiraud, 54 avenue de la République, BP 20065, 94806 Villejuif cedex, France
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23
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Poret A, Dupuy Goodrich L. [Supporting the frail elderly: from resilience to reducing hospitalizations]. Soins 2023; 68:60-62. [PMID: 37127393 DOI: 10.1016/j.soin.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The frail elderly population will most certainly continue to grow in the coming years. Consequently, the number of hospitalizations and the iatrogenic dependence linked to them will increase. In this context, it seems interesting to question frailty. Indeed, accompanying, in ambulatory care, these patients towards a resilient behavior is one of the roles of advanced practice nurses, which it would be judicious to deepen in order to decrease the recourse to hospitalization.
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Affiliation(s)
- Arnaud Poret
- c/o Soins, 65 rue Camille-Desmoulins, 92442 Issy-les-Moulineaux, France.
| | - Laura Dupuy Goodrich
- Fondation hospitalière de la Miséricorde, 15 rue des Fossés-Saint-Julien, BP 100, 14008 Caen cedex 1, France
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24
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Solberg MT, Sørensen AL, Clarke S, Nes AAG. Virtual Reflection Group Meetings as a Structured Active Learning Method to Enhance Perceived Competence in Critical Care: Focus Group Interviews With Advanced Practice Nursing Students. JMIR Med Educ 2023; 9:e42512. [PMID: 36951919 PMCID: PMC10131641 DOI: 10.2196/42512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/27/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Advanced practice nurses (APNs) are in high demand in critical care units. In Norway, APNs are educated at the master's degree level and acquire the competence to ensure the independent, safe, and effective treatment of patients in constantly and rapidly changing health situations. APNs' competence embraces expert knowledge and skills to perform complex decision-making in the clinical context; therefore, it is essential that educational institutions in nursing facilitate learning activities that ensure and improve students' achievement of the required competence. In clinical practice studies of APN education, face-to-face reflection group (FFRG) meetings, held on campus with the participation of a nurse educator and advanced practice nursing students (APNSs), are a common learning activity to improve the competence of APNSs. Although FFRG meetings stimulate APNSs' development of required competencies, they may also result in unproductive academic discussions, reduce the time that APNSs spend in clinical practice, and make it impossible for nurse preceptors (NPs) to attend the meetings, which are all challenges that need to be addressed. OBJECTIVE This study aimed to address the challenges experienced in FFRG meetings by implementing virtual reflection group (VRG) meetings and to explore the experiences of APNSs, NPs, and nurse educators in VRG meetings as an active learning method supported by technology to stimulate students' development of the required competence to become APNs in critical care. METHODS This study adopted a qualitative explorative design with 2 focus group interviews and used inductive content analysis to explore the collected data. RESULTS The main finding is that reflection group meetings supported by technology resulted in a better-structured active learning method. The VRG meeting design allowed APNSs to spend more time in clinical practice placements. The APNSs and NPs experienced that they participated actively and effectively in the meetings, which led to a perceived increase in competence. The APNSs also perceived an improved learning experience compared with their prior expectations. CONCLUSIONS Users perceived that the implemented novel teaching design supported by technology, the VRG meeting, was a more effective method than FFRG meetings on campus to develop APNSs' required competence in critical care. The VRG was also perceived as an improved method to solve the challenges encountered in FFRG meetings. Specifically, the APNSs felt that they were prepared to undertake complex decision-making with a higher level of analytic cognition in a clinical context and to lead professional discussions in the ward. This developed teaching design can easily be adapted to diverse educational programs at various levels of professional education.
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Affiliation(s)
| | | | - Sara Clarke
- Lovisenberg Diaconal University College, Oslo, Norway
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25
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Peters CJ. Dr. Loretta C. Ford: A pioneer in healthcare. Public Health Nurs 2023; 40:466-467. [PMID: 36943180 DOI: 10.1111/phn.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
Dr Loretta C. Ford is a true pioneer. Her work in public health launched the nurse practitioner movement. Together with Dr Henry Silver in 1965, Dr Ford co-founded the first expanded or advanced role to educate nurses to: assess, diagnose and treat common pediatric problems in primary care. Since then, there has been an increase in the number of specialty programs and an acknowledged global need for advanced practice nurses. She transformed our understanding of health and illness, the education of nurses, and the practice of humane patient care.
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26
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Hourmant M, Gatault P, Anglicheau D, Moulin B, Canet S, Chatelet V, Dubart C, Hertig A, Schvartz B, Mariat C. [The 2022-2026 Transplantation Plan: objectives and priorities for a new development of kidney transplantation]. Nephrol Ther 2023; 19:7-11. [PMID: 36919591 DOI: 10.1684/ndt.2023.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The 2022-2026 Transplantation Plan has been launched by the French government to stimulate the activities of organ harvesting and transplantation, after the failure of the previous one. It has been designed by the Biomedicine Agency in collaboration with learning societies, including the SFNDT, and patient associations. The plan is original in its objectives, its regional organization with its driving by the Regional Health Agencies, the involvement of advanced practice nurses and its funding. The ambition is to transplant every transplantable patient. The increase in the number of kidney transplantations, more of all from a living donor, requires the active participation of all the nephrologists, who are the first in delivering information to the patients and their family on advanced chronic kidney disease treatment and living donation.
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27
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Pedreira-Robles G, Garcimartín P, Sevilla-Guerra S, Bach-Pascual A, García-Martínez M, Morín-Fraile V. Nurse-led clinical activity in kidney transplantation care in Spain: A cross-sectional observational study. J Ren Care 2023. [PMID: 36906846 DOI: 10.1111/jorc.12463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/11/2023] [Accepted: 02/25/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES To explore the presence of specialist outpatient nursing activity in care for kidney transplant recipients in Spain and to determine the level of competence development of this activity according to the Advanced Practice Nurse model. DESIGN Descriptive, cross-sectional study. PARTICIPANTS AND MEASUREMENTS All outpatient nurses specialising in renal transplantation in the 39 transplant hospitals in Spain were included. To fulfil the study objectives, an ad hoc questionnaire and the 'Advanced Practice Nurse Role Definition Instrument (IDREPA)' were administered to assess the nurses' level of competence development. RESULTS Of the facilities included in the study, 25 (64.1%) had posttransplant nursing activity, 13 (33.3%) had pretransplant nursing activity and 11 (28.2%) had nursing activity involving kidney donor candidates. Twenty-seven specialist nurse's offices were identified. The results of the IDREPA reflect the presence of advanced practice in the domains of 'expert care planning' and 'comprehensive care'. Three (11.1%) nurses met all criteria for advanced nursing practice. CONCLUSION The results on specialised outpatient nursing activity at the 39 transplantation facilities in Spain indicate a low presence of this type of activity, with an even lower presence of advanced practice nurses. IMPLICATIONS FOR CLINICAL PRACTICE Management teams should consider investing in the quality of care provided by advanced nurse practice to ensure that suitable treatment is provided and better clinical outcomes are obtained.
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Affiliation(s)
- Guillermo Pedreira-Robles
- Nephrology Department, Hospital del Mar, Barcelona, Spain.,ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra affiliated, Barcelona, Spain.,SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Nursing and Health PhD Programme, University of Barcelona, Barcelona, Spain
| | - Paloma Garcimartín
- Nursing direction, Hospital del Mar, Barcelona, Spain.,Department of Biomedical Research in Heart Diseases, Hospital del Mar Institute for Medical Research (IMIM), Barcelona, Spain
| | - Sonia Sevilla-Guerra
- Gerència de Processos Integrats de Salut, Àrea Assistencial, Catalan Health System, Barcelona, Spain
| | | | | | - Victoria Morín-Fraile
- Department of Public Health, Mental and Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
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Wan J, Xia H. How Advanced Practice Nurses Can Be Better Managed in Hospitals: A Multi-Case Study. Healthcare (Basel) 2023; 11:healthcare11060780. [PMID: 36981438 PMCID: PMC10048132 DOI: 10.3390/healthcare11060780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
The labor markets for care professionals are a perennial topic of discussion. Advanced practice nurses (APN), as an advanced role in nursing, arose to solve the shortage of primary health care professionals. Prior research has advanced several areas of exploration for APNs' training or employing methods in Chinese hospitals. However, this leaves a key imperative unexplored: the management strategy of APNs in hospitals. The present study seeks to explore the management strategy of APNs in Chinese hospitals. The resource orchestration theory served as the guide as the multi-case study method investigated 18 case hospitals, gathered information from a variety of case data sources, and summarized the management strategies for hospitals' advanced practice nurses. Four types of APN management strategies-expert customized type, hierarchical linkage type, multidisciplinary benefit type, and professional penetration type-have been identified through resource orchestration. Hospitals can utilize the APN management strategy model as a guide to manage APNs in accordance with the unique characteristics of APN resources.
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Affiliation(s)
- Jia Wan
- School of Nursing, Fudan University, Shanghai 200437, China
| | - Haiou Xia
- School of Nursing, Fudan University, Shanghai 200437, China
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29
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Jackson HJ, Kennedy K, Hande K. Implementing an Oncology Nurse Practitioner Fellowship: Reflections and Lessons Learned. Clin J Oncol Nurs 2023; 27:13-16. [PMID: 37677823 DOI: 10.1188/23.cjon.13-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
As oncology nurse practitioner (NP) fellowships expand across the United States, institutions note improved transitions to specialty practice and better patient outcomes. These fellowships may further serve as a strategy to a.
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30
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Wong AKC, Bayuo J, Wong FKY, Kwok VWY, Yuen BMK, Fong CS, Chan ST, Pung HL, Kwek OL. The feasibility and effectiveness of telecare consultations in nurse-led post-acute stroke clinics: A study protocol. Digit Health 2023; 9:20552076231180759. [PMID: 37334318 PMCID: PMC10272633 DOI: 10.1177/20552076231180759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 05/22/2023] [Indexed: 06/20/2023] Open
Abstract
Background Globally, nurse-led post-acute stroke clinics have been developed to provide secondary care services to stroke survivors. Although synthesized evidence supports the idea that the secondary prevention services delivered by nurses in these clinics can improve the functional ability of stroke survivors and reduce their readmission rates, long travel and waiting times, high costs, and the pandemic have limited the utilization of such clinics. Telecare consultations are a new modality for expanding public access to healthcare services, although how it can be applied in nurse-led clinics has not been reported. Objective The aim of this study is to determine the feasibility and effects of telecare consultations in nurse-led post-acute stroke clinics. Methods The study adopts a quasi-experimental design. The participants will receive three secondary stroke care consultations in 3 months provided via telecare by experienced advanced practice nurses. The outcome measures include feasibility (reasons for refusing to participate and for dropping-out, the attitudes and satisfaction of both the advanced practice nurses and their patients towards the programme), and preliminary effectiveness (degree of disability after stroke, activities of daily living, instrumental activities of daily living, health-related quality of life, depression) outcomes. Data will be collected at pre-(T1) and post-(T2) intervention. Conclusions The findings of this study may help facilitate the implementation of telecare consultations in a nurse-led post-acute stroke clinic, which may benefit the stroke survivors who are having mobility restrictions from accessing customary healthcare services and may protect them from being exposed to the infectious risk.
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Affiliation(s)
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | | | | | | | - Ching Sing Fong
- Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Shun Tim Chan
- Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Hoi Lam Pung
- Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Oi Lam Kwek
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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31
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Chang YC, Hsieh LW, Chen TC, Yen M. [Developing and Evaluating the Effectiveness of a Leadership Integrated Educational Program for Master's Nursing Students in Taiwan]. Hu Li Za Zhi 2022; 69:56-67. [PMID: 36127759 DOI: 10.6224/jn.202210_69(5).08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Nursing students with master degrees have the strong potential to serve as future leaders in medical teams. Implementing a well-developed and integrated educational program for nursing leadership at the master's level can strengthen the leadership of advanced practice nurses and promote a positive nursing practice environment. PURPOSE To develop a leadership integrated educational program for master's nursing students and conduct a preliminary evaluation of the effectiveness of this program in cultivating leadership competencies in these students. METHODS Phase 1: A modified Delphi survey conducted on 14 experts with clinical or academic backgrounds was used to identify the teaching objectives and strategies of the leadership integrated educational program. Phase 2: These teaching objectives and strategies were embedded into nine compulsory courses within a current training program for master's nursing students at a national university. The core elements of the leadership integrated educational program were incorporated into each compulsory course. The objectives of each compulsory course directly reflected the objectives of the integrated program. The leadership integrated educational program was implemented for one academic year, and its effectiveness was evaluated using a quasi-experimental test with a single group pre- and post-test design. A self-developed, 10-item "Master Nursing Student's Leadership Competence Scale" covering four core elements was applied to measure the self-reported leadership competencies of the participants. A paired sample t-test was applied to analyze the differences in leadership competencies between pre- and post-intervention. RESULTS A consensus on the teaching objectives and strategies of the leadership integrated educational program was achieved in the first round of the Delphi survey. The overarching teaching objective of the leadership integrated educational program was to "lead the healthcare team with the leadership and competencies, and demonstrate the advanced nursing practice skills for improving quality of care." In addition, the four core elements under the overarching goal, i.e., personal characteristics, leading people, business management, and vision building, were proposed. Forty-eight master's nursing students participated in this study. The results showed the average total score of leadership competency was 42.33 ± 12.16 (potential range: 10 - 70), indicating that the participants had a middle level of leadership competency prior to program participation. After participating in the Leadership Integrated Educational Program for one academic year, the average total score for leadership competency increased to 51.27 ± 9.74, indicating that the participants still had a middle level of leadership competency. Nevertheless, the 8.94 increase in the post-intervention score was statistically significant (p < .01). Moreover, the scores for each subscale (personal characteristics, leading people, business management, and vision building) had all increased significantly increased from 13.52 to 15.71, 12.65 to 15.35, 8.15 to 10.31, and 8.02 to 9.90, respectively (p < .01). CONCLUSIONS / IMPLICATIONS FOR PRACTICE This study offers proactive recommendations for reforming master's degree programs in nursing. The proposed multidisciplinary-expert-informed leadership integrated educational program may be used to strengthen leadership competencies in this student population. Furthermore, the findings provide a benchmark for developing an effective nursing leadership integrated educational program that may be incorporated into domestic master's degree programs.
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Affiliation(s)
- Yu-Chun Chang
- MSN, RN, Doctoral Student, School of Nursing, College of Medicine, National Taiwan University, Taiwan, ROC
| | - Li-Wei Hsieh
- PhD, RN, Deputy Secretary, Interdisciplinary Center, Taichung Hospital, Ministry of Health and Welfare, Taiwan, ROC
| | - Tzu-Chun Chen
- MSN, RN, Supervisor, Cancer Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan, ROC
| | - Miaofen Yen
- PhD, RN, FAAN, Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan, ROC.
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Longuechaud C, Haute JC. [Thinking about care to enhance its meaning]. Soins 2022; 67:48-52. [PMID: 36509500 DOI: 10.1016/j.soin.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Advanced nursing practice is one of the avenues proposed by politicians to meet the new needs of people being cared for in a rapidly changing healthcare system. It is therefore interesting to conceptualize the theoretical foundations of these new practices, in order to reveal their meaning. To do this, we will discuss some of the missions of the advanced practice nurse, whose primary objective is to provide high-quality care. We will then demonstrate that the evolution of nursing care, which allows professionals to deploy their skills and gain in responsibility, is indeed at the service of the cared-for person.
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Affiliation(s)
- Cathy Longuechaud
- Établissement public de santé mentale de Vendée, Centre hospitalier Georges-Mazurelle, rue Georges-Mazurelle, 85026 La Roche-sur-Yon cedex, France.
| | - Jean-Charles Haute
- Département des instituts de formation du centre hospitalier universitaire de Nantes, 5 allée de l'Île-Gloriette, 44093 Nantes cedex 1, France; UFR Médecine et techniques médicales, Université de Nantes, 1 rue Gaston-Veil, BP 53508, 44035 Nantes cedex 1, France
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Meury-Abraham P, Fourneau C. [Advanced practice nursing as a complement to primary care physician practice]. Soins 2022; 67:12-20. [PMID: 36442917 DOI: 10.1016/j.soin.2022.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Two advanced practice nurses (APNs) who graduated in France propose a feasibility perspective on their future multiprofessional practice in primary care. A retrospective exploratory study of 9 physicians was carried out on 396 consultations according to reasons and patient profiles. Slightly more than 22% of the consultations could be oriented strictly towards IPA. Approximately 60% of IPA consultations would fall under the heading of parallel therapeutic education.
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Affiliation(s)
- Pierrette Meury-Abraham
- Association Asalée, 70 rue du Commerce, 79170 Brioux-sur-Boutonne, France; Université des Antilles, campus de Fouillole, 97157 Pointe-à-Pitre, France.
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Gerber KS, Alvarez G, Alamian A, Behar-Zusman V, Downs CA. Biomarkers of Neuroinflammation in Traumatic Brain Injury. Clin Nurs Res 2022; 31:1203-1218. [PMID: 35770330 DOI: 10.1177/10547738221107081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Traumatic brain injury (TBI) is characterized by neuroinflammation and structural damage leading to symptoms and altered brain function. Biomarkers are useful in understanding neuroinflammation and correlations with TBI sequalae. The purpose of this paper is to identify and discuss biomarkers of neuroinflammation used to study TBI and its sequalae. A systematic review was conducted using PubMed, CINAHL, Embase, and Web of Science. A total of 350 articles met criteria; 70 used biomarkers. PRISMA criteria were used for Quality Assessment. Articles included reviews (n = 17), case-control (n = 25), cross-sectional (n = 25) studies, and randomized controlled trials (n = 3). Twenty-seven biomarkers were identified, including inflammasomes, cytokines, neuropeptides, complement complexes, miRNA and exosomes, and glial cell-specific proteins. Biomarkers aid in predicting morbidity and mortality and advance our understanding of neuroinflammation in TBI. This systematic review advances our understanding of the neuroinflammatory response to better enable nurses and clinicians to provide informed care of TBI patients.
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Affiliation(s)
- Kathryn S Gerber
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Gema Alvarez
- University of Miami Miller School of Medicine, FL, USA
| | - Arsham Alamian
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | | | - Charles A Downs
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
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Wheeler KJ, Miller M, Pulcini J, Gray D, Ladd E, Rayens MK. Advanced Practice Nursing Roles, Regulation, Education, and Practice: A Global Study. Ann Glob Health 2022; 88:42. [PMID: 35755314 DOI: 10.5334/aogh.3698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background and Objectives Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives. Methods An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The study was launched in August 2018 at the 10th Annual ICN NP/APNN Conference in Rotterdam, Netherlands. Links to the survey were provided there and via multiple platforms over the next year. Results Survey results from 325 respondents, representing 26 countries, were analyzed through descriptive techniques. Although progress was reported, particularly in education, results indicated the APN profession around the world continues to struggle over titling, title protection, regulation development, credentialing, and barriers to practice. Conclusions and Practice/Policy Relevance APNs have the potential to help the world reach the Sustainable Development Goal of universal health coverage. Several recommendations are provided to help ensure APNs achieve these goals.
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Payongayong JV, Thomas-Hawkins C, Jarrín OF, Barberio J, Hain DJ. Effects of End-of-Life Communication Knowledge, Attitudes, and Perceived Behavioral Control on End-of-Life Communication Behaviors Among Nephrology Nurse Practitioners. Nephrol Nurs J 2022; 49:213-225. [PMID: 35802360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The scope of end-of-life communication is not well known among nephrology advanced practice nurses (APNs). Guided by the Theory of Planned Behavior, the study aimed to examine the independent effects of knowledge, attitude, and perceived behavioral control on the engagement of APNs in end-of-life communication and the mediating and moderating effects of attitude and perceived behavioral control on the relationships between knowledge and end-of-life communication. A theoretically derived 17-item survey measuring the concepts was administered to a convenience sample of 127 APNs. Descriptive statistics, Pearson's correlation, and multiple linear regression were employed. Attitudes and perceived behavioral control on end-of-life communication mediated and moderated the relationship between knowledge of end-of-life communication and engagement in end-of-life communication among nephrology APNs.
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Affiliation(s)
- Joanne V Payongayong
- Critical Care Advanced Practice Nurse, Valley Hospital, Ridgewood, NJ
- member of ANNA
| | - Charlotte Thomas-Hawkins
- Associate Professor, Associate Dean, Nursing Science Division and Director, Center for Health Services Research and Policy at Rutgers, The State University of New Jersey, Newark, NJ
- member of ANNA's New Jersey Chapter
| | - Olga F Jarrín
- Assistant Professor, Rutgers, The State University of New Jersey School of Nursing, Division of Nursing Science, and Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ
| | - Judith Barberio
- Clinical Associate Professor, Division of Nursing Science at Rutgers, The State University of New Jersey School of Nursing, Newark, NJ
- Advanced Practice Nurse in Pain Management and Palliative Care at St.Michael's Medical Center, Newark, NJ
- Board Member of the NJ Palliative Care Advance Practice Nurse Consortium
| | - Debra J Hain
- Professor, DNP Program Director, Graduate Co-Coordinator, AGNP Concentration, Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, FL
- President-Elect of ANNA's South Florida Flamingo Chapter
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Woo BFY, Tam WWS, Rangpa T, Liau WF, Nathania J, Lim TW. A Nurse-Led Integrated Chronic Care E-Enhanced Atrial Fibrillation (NICE-AF) Clinic in the Community: A Preliminary Evaluation. Int J Environ Res Public Health 2022; 19:ijerph19084467. [PMID: 35457336 PMCID: PMC9026946 DOI: 10.3390/ijerph19084467] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023]
Abstract
The current physician-centric model of care is not sustainable for the rising tide of atrial fibrillation. The integrated model of care has been recommended for managing atrial fibrillation. This study aims to provide a preliminary evaluation of the effectiveness of a Nurse-led Integrated Chronic care E-enhanced Atrial Fibrillation (NICE-AF) clinic in the community. The NICE-AF clinic was led by an advanced practice nurse (APN) who collaborated with a family physician. The clinic embodied integrated care and shifted from hospital-based, physician-centric care. Regular patient education, supplemented by a specially curated webpage, fast-tracked appointments for hospital-based specialised investigations, and teleconsultation with a hospital-based cardiologist were the highlights of the clinic. Forty-three participants were included in the six-month preliminary evaluation. No significant differences were observed in cardiovascular hospitalisations (p-value = 0.102) and stroke incidence (p-value = 1.00) after attending the NICE-AF clinic. However, significant improvements were noted for AF-specific QoL (p = 0.001), AF knowledge (p < 0.001), medication adherence (p = 0.008), patient satisfaction (p = 0.020), and depression (p = 0004). The preliminary evaluation of the NICE-AF clinic demonstrated the clinical utility of this new model of integrated care in providing safe and effective community-based AF care. Although a full evaluation is pending, the preliminary results highlighted its promising potential to be expanded into a permanent, larger-scale service.
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Affiliation(s)
- Brigitte Fong Yeong Woo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore;
- Correspondence: ; Tel.: +65-6601-6812
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore;
| | - Taiju Rangpa
- Bukit Batok—Medical, National University Polyclinics, National University Health System, Singapore 659164, Singapore;
| | - Wei Fong Liau
- Bukit Batok—Nursing, National University Polyclinics, National University Health System, Singapore 659164, Singapore;
| | - Jennifer Nathania
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore;
| | - Toon Wei Lim
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore 119228, Singapore;
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Mahon SM, Yackzan S. Oncology Nurse Practitioners in Genetics: Examining Scope of Practice and Competence. Clin J Oncol Nurs 2022; 26:141-145. [PMID: 35302542 DOI: 10.1188/22.cjon.141-145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Genomic science is rapidly evolving, and ordering germline testing requires appropriate and comprehensive assessment of a patient's personal and family history, as well as the knowledge base to facilitate selection of the best test or panel of tests, provision of pretest counseling for informed consent, interpretation of test results, post-test recommendations, and coordination of care for other at-risk family members. Prior to ordering germline genetic testing, an advanced practice RN's scope of practice accountability includes consideration of competence in the provision of genomic care. This article provides a case study to illustrate the complexities of issues related to competence when ordering germline genetic testing.
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Zhao Q, Wu X, Li Z. [Situation of nurses in China]. Soins 2022; 67:50-51. [PMID: 35551788 DOI: 10.1016/j.soin.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nurses play an essential role in the People's Republic of China. In particular, they are essential to meet the challenges of an aging population. While there has been little change in their situation for many years, change is now underway. The National Health Commission of the People's Republic of China has announced the upcoming implementation of strategies essential to the development of the profession.
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Affiliation(s)
- Qinqin Zhao
- Chinese Nursing Association, 28/F Tower C Chengming Building, No.2 Xizhimen South Street, Beijing 100035, China.
| | - Xinjuan Wu
- Chinese Nursing Association, 28/F Tower C Chengming Building, No.2 Xizhimen South Street, Beijing 100035, China
| | - Zheng Li
- Chinese Nursing Association, 28/F Tower C Chengming Building, No.2 Xizhimen South Street, Beijing 100035, China; Peking Union Medical College (Dongdan campus), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China
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Tzeng HM, Raji MA, Chou LN, Kuo YF. Impact of State Nurse Practitioner Regulations on Potentially Inappropriate Medication Prescribing Between Physicians and Nurse Practitioners: A National Study in the United States. J Nurs Care Qual 2022; 37:6-13. [PMID: 34483310 PMCID: PMC8608008 DOI: 10.1097/ncq.0000000000000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The American Geriatrics Society regularly updates the Beers Criteria for Potentially Inappropriate Medication (PIM) to improve prescribing safety. PURPOSE This study assessed the impact of nurse practitioner (NP) practices on PIM prescribing across states in the United States and compared the change in PIM prescribing rates between 2016 and 2018. METHODS We used data from a random selection of 20% of Medicare beneficiaries (66 years or older) from 2015 to 2018 to perform multilevel logistic regression. A PIM prescription was classified as initial or refill on the basis of medication history 1 year before a visit. PIM use after an outpatient visit was the primary study outcome. RESULTS We included 9 000 224 visits in 2016 and 9 310 261 in 2018. The PIM prescription rate was lower in states with full NP practice and lower among NPs than among physicians; these rates for both physicians and NPs decreased from 2016 to 2018. CONCLUSIONS Changes could be due to individual state practices.
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Affiliation(s)
- Huey-Ming Tzeng
- School of Nursing (Dr Tzeng), Department of Internal Medicine (Drs Raji and Kuo), Sealy Center on Aging (Drs Tzeng, Raji, and Kuo), Department of Preventive Medicine and Population Health (Dr Kuo), and Office of Biostatistics (Ms Chou and Dr Kuo), University of Texas Medical Branch, Galveston
| | - Mukaila A. Raji
- School of Nursing (Dr Tzeng), Department of Internal Medicine (Drs Raji and Kuo), Sealy Center on Aging (Drs Tzeng, Raji, and Kuo), Department of Preventive Medicine and Population Health (Dr Kuo), and Office of Biostatistics (Ms Chou and Dr Kuo), University of Texas Medical Branch, Galveston
| | - Lin-Na Chou
- School of Nursing (Dr Tzeng), Department of Internal Medicine (Drs Raji and Kuo), Sealy Center on Aging (Drs Tzeng, Raji, and Kuo), Department of Preventive Medicine and Population Health (Dr Kuo), and Office of Biostatistics (Ms Chou and Dr Kuo), University of Texas Medical Branch, Galveston
| | - Yong-Fang Kuo
- School of Nursing (Dr Tzeng), Department of Internal Medicine (Drs Raji and Kuo), Sealy Center on Aging (Drs Tzeng, Raji, and Kuo), Department of Preventive Medicine and Population Health (Dr Kuo), and Office of Biostatistics (Ms Chou and Dr Kuo), University of Texas Medical Branch, Galveston
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Abstract
AIMS To systematically explore the structures, functions, outcomes, roles and nursing credentials of memory clinics where nurses autonomously lead diagnosis and postdiagnostic care. DESIGN A systematic rapid review was conducted. DATA SOURCES MEDLINE (Ovid), CINAHL Full-Text (EBSCO) and EMBASE were systematically searched in December 2019 with no timeframe limitations imposed. REVIEW METHODS The modified PRISMA checklist was used as a guide to facilitate the review. Articles identified were screened and assessed for inclusion criteria, and screening of reference lists of included studies was also completed. RESULTS Six articles, published between 2011-2019, including two case studies, two descriptive reports, one qualitative study and one programme evaluation were included in the review. Nurse-led memory clinics were situated in community centres, on university campuses, hospitals and in general practitioners' offices. The services offered included assessment, diagnosis and treatment/postdiagnostic care. Nurse credentials included advanced practice nurses and a community psychiatric nurse who was a non-medical prescriber. Overall, there was low quantity and quality of evidence to evaluate outcomes.
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Affiliation(s)
| | - Shelley Doucet
- University of New BrunswickSaint JohnNBCanada
- Dalhousie Medicine New BrunswickSaint JohnNBCanada
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Lefebvre-Durel C, Bailly I, Hunault J, Jovic L, Novic M, Vorspan F, Bellivier F, Drunat O, Kerever S. Benzodiazepine and Z drug cessation in elderly patients: A qualitative study on the perception of healthcare providers and the place of advanced practice nurses. Int J Ment Health Nurs 2021; 30:653-666. [PMID: 33314689 DOI: 10.1111/inm.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/09/2020] [Accepted: 11/19/2020] [Indexed: 11/30/2022]
Abstract
Sedative-use disorder can occur in elderly individuals, but remains a taboo subject. France is the second top-consuming country of benzodiazepines (BZDs) and Z drugs in Europe, with 38% of women >80 years old using these drugs. Despite the recommendations of the French National Authority for Health (HAS) to general practitioners, deprescription remains rare. The aim of this study was to understand the perception of healthcare providers towards BZD or Z drug withdrawal within a psychogeriatric unit and to provide insights from advanced practice nurses (APRNs) on this topic. Eight healthcare providers from different professions in a psychogeriatric unit were interviewed. The interviews were recorded and transcribed verbatim, and the data were analysed following the interpretive phenomenological approach. The COREQ statement was used as a guide in the reporting of the study. Four themes were identified in the interview transcripts: (i) problems specific to the elderly; (ii) problems specific to BZD or Z drug consumption; (iii) present care; and (iv) envisioned practice. While the healthcare providers interviewed appeared to have knowledge on the adverse effects of BZDs, it appears difficult to taper the use of BZDs outside crisis periods of behaviour disorders in elderly patients. Caregivers recommend an evolution of practices, such as introducing BDZ and Z drug withdrawal programs that could involve the emerging profession of APRNs in general practice in France. APRNs could be a valuable resource to screen for BZD-related disorders and to manage withdrawal strategies in complex cases.
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Affiliation(s)
- Camille Lefebvre-Durel
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Isabelle Bailly
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Johanna Hunault
- Public Health Student, Université de Paris - EHESP, Paris, France
| | - Ljiljana Jovic
- ECEVE UMR 1123, Inserm, Directrice des soins-Conseillère technique régionale, ARS Ile-de-France, Université de Paris, Paris, France
| | - Martine Novic
- Directrice des soins, Université de Paris, Paris, France.,Directrice adjointe du Département Universitaire des Sciences Infirmières et Rééducation, Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique - Hôpitaux de Paris, Paris, France.,Faculté de Médecine, Université de Paris et INSERM UMRS 1144, Paris, France
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Centres Experts Bipolaire et, Paris, France.,Dépression Résistante Hôpital Fernand WIDAL, INSERM UMR-S1144, Paris, France
| | - Olivier Drunat
- Department of Psycho-Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sébastien Kerever
- Departments of Anesthesiology and Critical Care, Lariboisière University Hospital, AP-HP, Université de Paris, Paris, France
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McGuire M, Olivo A, Yackzan S. Productivity Measures: Empowering Oncology Nurse Practitioners to Understand and Demonstrate Value in Practice. Clin J Oncol Nurs 2021; 25:247-250. [PMID: 34019016 DOI: 10.1188/21.cjon.247-250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Oncology nurse practitioners (ONPs) are essential providers of oncology care who work in a variety of practice settings. ONPs add to productivity in practice, but the way in which productivity is measured may not capture their full contributions and value. A greater understanding of productivity measures can empower ONPs to communicate and demonstrate their full value in practice.
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Jokiniemi K, Pietilä AM, Mikkonen S. Construct validity of clinical nurse specialist core competency scale: An exploratory factor analysis. J Clin Nurs 2021; 30:1863-1873. [PMID: 33259668 DOI: 10.1111/jocn.15587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/29/2020] [Accepted: 11/13/2020] [Indexed: 01/10/2023]
Abstract
AIM To conduct a construct validity test on a clinical nurse specialist core competency scale. BACKGROUND Clinical nurse specialists' competency development dates back to the late 20th century; however, there is scarcity of competency descriptions from outside of North America. Furthermore, little knowledge is available on the previous research-driven efforts to develop and validate clinical nurse specialist core competencies. DESIGN A descriptive study, using an online self-report questionnaire, was conducted from May to September 2019 in three Nordic countries. METHODS An exploratory factor analysis using principal axis factoring and rotation method oblimin with Kaiser normalisation was undertaken to examine factors in the 50-item scale. Parallel analysis with eigenvalue Monte Carlo simulation and scree plot was used to determine the number of factors to extract. Psychometric properties of the scale were evaluated, and subjective interpretation was used to modify the tool in line with the statistical analysis. The STROBE checklist was used as the reporting guideline for this study. RESULTS One hundred and eighty-four responses were obtained (Finland n = 52, Denmark n = 95, Iceland n = 37) with an overall response rate of 45%. The results provided construct validity evidence of the underlying theoretical structures of the four competency spheres of patient, nursing, organisation and scholarship. Cronbach's alpha coefficient for the original overall scale was 0.94, thus indicating adequate reliability of the scale. CONCLUSIONS Based on the analysis and subjective interpretation, we suggest a 47-item clinical nurse specialist core competency scale. Further study should be conducted to validate the core competency content and construct in other contexts beyond the present study. RELEVANCE TO CLINICAL PRACTICE The scale may be used to guide clinical nurse specialist practice and identify areas for professional development, develop graduate-level programme curricula and inform future competency research.
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Affiliation(s)
- Krista Jokiniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Santtu Mikkonen
- Department of Environmental and Biological Sciences and Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Harpula K, Bartosiewicz A, Krukowski J. Polish Nurses' Opinions on the Expansion of Their Competences-Cross-Sectional Study. Nurs Rep 2021; 11:301-310. [PMID: 34968207 PMCID: PMC8608099 DOI: 10.3390/nursrep11020029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 12/03/2022] Open
Abstract
The development of medical science creates new challenges for nurses to acquire new skills. Thanks to legal changes in Poland, nurses have gained the opportunity to independently provide health services in many areas, including consultations for patients. The aim of the survey is to analyze nurses’ opinions on the expansion of competences in their profession. This is a cross-sectional, descriptive study conducted among 798 nurses using the survey technique. The majority (65.48%) of the respondents believed that they were adequately prepared to take up new competences. Most of the respondents believed that the new competence would improve the efficiency of the healthcare system in Poland (71.06%) and facilitate patients’ access to health services (65.29%). According to the nurses, the scope of nursing advice will mainly concern the promotion of health education, wound treatment and prescribing medications. Age, seniority and education level significantly influenced the nurses’ opinions on the scope of nursing advice. The Mann–Whitney test and the Kruskal–Wallis test were used. A correlation between two quantitative variables was assessed with the Spearman’s rho coefficient. The significance level of p < 0.05 was assumed. The extension of the professional competences of nurses will increase the prestige of the profession and is another step toward introducing the role of Advanced Practice Nurse in Poland.
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Affiliation(s)
- Kinga Harpula
- Medical College, University of Information Technology and Management in Rzeszów, 35-225 Rzeszów, Poland;
- Healthcare Complex No. 2, Specialist Outpatient Clinic, Diagnostic Center, 35-005 Rzeszów, Poland
| | - Anna Bartosiewicz
- Institute of Health Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland
- Correspondence: ; Tel.: +48-17-851-68-11
| | - Jerzy Krukowski
- Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Institute of Nursing and Midwifery, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
- Palium Foundation, 89-600 Chojnice, Poland
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Schuetz Haemmerli N, von Gunten G, Khan J, Stoffel L, Humpl T, Cignacco E. Interprofessional Collaboration in a New Model of Transitional Care for Families with Preterm Infants - The Health Care Professional's Perspective. J Multidiscip Healthc 2021; 14:897-908. [PMID: 33935499 PMCID: PMC8079346 DOI: 10.2147/jmdh.s303988] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background Families with preterm infants find life after hospital discharge challenging and need tailored support to thrive. The “Transition to Home (TtH)”-model offers structured, individual support for families with preterm infants before and after hospital discharge. TtH improves parental mental health and competence, promotes child development and fosters interprofessional collaboration (IPC). Aim Evaluate the TtH-models’ structure and implementation process and its associated interprofessional collaboration from the healthcare professional’s (HCP) perspective. Methods This qualitative explorative study thematically analyzed four focus group interviews (n=28 HCP) and an open-ended questionnaire with general pediatricians (n=8). Results The main themes of the thematic analysis were the benefits of the TtH-model, tailored parental support, the challenges of changing interprofessional collaboration, facilitators and barriers to successfully implementing the model, and feasibility and health economic limits. HCP acknowledge that continuous family-centered care led by an advanced practice nurse (APN) supports, strengthens, and relieves families with preterm infants in the transition from hospital to home. Families in complex situations benefit most. The TtH-model incorporates key aspects of integrated care like shared decision-making, considering family preferences, and defining the APN as the family’s main contact. HCP want network collaboration but found communication, cooperation, and reorganization challenging in the new IPC process. IPC challenges and involving many HCP in family care can create parental oversupply, negatively affect treatment outcomes, and raise health care costs. Conclusion These challenges need to be addressed to ensure sustainable implementation of the model. The roles and tasks of HCP should be clearly distinguished from each other, and HCP must have time to learn this new form of IPC. Learning requires time, effective communication strategies, and leadership support. Political action is also required to implement new models of care, including regulating advanced practice roles and developing new financing models.
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Affiliation(s)
- Natascha Schuetz Haemmerli
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.,Inselspital, University Children's Hospital, Neonatology, Bern, Switzerland
| | - Geraldine von Gunten
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.,Inselspital, University Children's Hospital, Neonatology, Bern, Switzerland
| | - Jeannine Khan
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Liliane Stoffel
- Inselspital, University Children's Hospital, Neonatology, Bern, Switzerland
| | - Tilman Humpl
- Inselspital, University Children's Hospital, Neonatology, Bern, Switzerland
| | - Eva Cignacco
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Urbanowicz J. The impact of an intentional APRN student clinical experience on role transition towards becoming a clinically competent practitioner; pilot study. J Adv Nurs 2021; 77:2050-2053. [PMID: 33580722 DOI: 10.1111/jan.14746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/09/2020] [Indexed: 11/27/2022]
Abstract
AIMS This study was to determine if there is a greater difference in Advanced Practice student nurse self-reported transition towards practice and professional identity for an experimental group compared with a control group. The information gathered is expected to: (a) provide a curriculum baseline for focused clinical objectives as well as preceptor training, and (b) to meet these objectives in alignment with the expectations for graduation and subsequent post-graduation transition into practice. DESIGN Pilot exploration using quasi-experimental, mixed methods included a quantitative five-point Likert Scale and a self-reported qualitative phenomenological analysis. METHODS This study evaluated responses from all participants through a series of three self-report periods during a 14-week clinical semester. RESULTS Based on the self-reported data, the experimental group made minor additional progress with respect to their growth and professional identity transition compared with the control group. CONCLUSION This study fostered the need for further studies to support residency programs that aid newly graduated nurse practitioners as they transition into the advanced practice role. IMPACT The cost to replace these practitioners can be as high as twice their annual salary. The adjustment to an advanced practice role is difficult as postgraduate training is currently optional in many States. According to Brown, et al. (Nurse Educator, 2015, 40:148), novice Advanced Practice Nurses report being underprepared for this new role, particularly diagnostic interpretation skills. Supporting the advanced practitioner with a structured curriculum is imperative to achieve successful skills development, transition to practice, and professional identity.
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Affiliation(s)
- Janet Urbanowicz
- Marjorie K. Unterberg School of Nursing and Health Studies, West Long Branch, New Jesey, USA
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic necessitated social distancing mandates, the conservation of personal protective equipment, and the prioritization of health care resources, thus prompting the rapid scale-up of telehealth services. The COVID-19 pandemic illustrates the importance of taking a broader view of health policy that facilitates the optimal conditions in which patient-centered care occurs and health equity is pursued. This article examines the use of telehealth during the pandemic as a case for demonstrating the necessity for advanced practice nurses to engage in broad policy initiatives to address social determinants of health care.
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Abstract
In the course of his life, a patient with chronic kidney disease will have to hear the announcement of a diagnosis, live with a pathology for which there is no hope of cure, undergo a multitude of tests and, finally, choose a mode of substitution (dialysis and/or transplantation). The advanced practice nurse has a role to play in bringing added value to these patients. In this function lies a constant questioning of his practices, a development of his intellectual curiosity in the service of patients.
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Affiliation(s)
- Maxime Mathy
- Association régionale pour la promotion de la dialyse à domicile, 12, rue Fernand-Brunet, 51100 Reims, France
| | - Élodie Touin
- Centre de néphrologie et de dialyse d'Armorique, B. Braun Avitum France, 385, rue Ernestine- de-Trémaudan, 29200 Brest, France
| | - Ludivine Videloup
- Service de néphrologie-dialyse-transplantation, centre universitaire des maladies rénales, avenue de la Côte-de-Nacre, 14033 Caen, France.
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Allsop S, Morphet J, Lee S, Cook O. Exploring the roles of advanced practice nurses in the care of patients following fragility hip fracture: A systematic review. J Adv Nurs 2020; 77:2166-2184. [PMID: 33320350 DOI: 10.1111/jan.14692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/26/2020] [Accepted: 11/05/2020] [Indexed: 12/20/2022]
Abstract
AIM This study aimed to explore the role and impact of advanced practice nurses (APNs) in care of patients following fragility hip fracture by systematically reviewing the available evidence. REVIEW DESIGN Systematic review. DATA SOURCES A search of the databases Ovid Medline, CINAHL, Embase, Emcare, Cochrane Library, and Google Scholar was conducted from January-February 2019. METHOD This systematic review adhered to The PRISMA Statement. Study selection was managed using the Covidence software platform and quality was assessed using JBI Critical appraisal tools. Studies included adults >18 years and described the role and impact of APNs in care of patients following fragility hip fracture on clinical and non-clinical outcomes. RESULTS There were 19 papers identified that met the inclusion/exclusion criteria. Quality was graded as moderate to low risk of bias. Six characteristics of APNs were identified: (1) coordination; (2) collaboration; (3) education; (4) assessment, investigation and treatment recommendations; (5) discharge planning, support and follow up; and (6) documentation. Overall mortality and LOS improved when characteristics of the APN role were present. CONCLUSION Key findings from this systematic review showed: (1) The APN title and role are not clearly defined, but characteristics of the APN role are evident; (2) characteristics of APNs promote the delivery of best practice hip fracture care and have a positive impact on mortality and LOS; and (3) innovative service delivery models involving APNs should be considered to address future projections of hip fracture rates and improve outcomes. IMPACT This systematic review provides evidence of the role characteristics of APNs in fragility hip fracture and the impact of the role on outcomes. Findings from this research could be used to develop service delivery models using APNs to care for patients following fragility hip fracture and to inform practice where APN roles may improve outcomes for other patient cohorts.
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Affiliation(s)
- Sharon Allsop
- Nursing & Midwifery, Monash University, Frankston, Vic, Australia.,Peninsula Health, Frankston, Vic, Australia
| | - Julia Morphet
- Nursing & Midwifery, Monash University, Frankston, Vic, Australia
| | - Susan Lee
- Nursing & Midwifery, Monash University, Frankston, Vic, Australia
| | - Olivia Cook
- Nursing & Midwifery, Monash University, Frankston, Vic, Australia
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