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Mulders G, Uitslager N, Kavanagh M, Birkedal MF, Nicolo G, Fenton R, Westesson LM. The role of the specialist nurse in comprehensive care for bleeding disorders in Europe: An integrative review. Haemophilia 2024; 30:598-608. [PMID: 38439128 DOI: 10.1111/hae.14974] [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: 12/01/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Managing bleeding disorders (BDs) is complex, requiring a comprehensive approach coordinated by a multidisciplinary team (MDT). Haemophilia nurses (HNs) play a central role in the MDT, frequently coordinating care. As novel treatments bring change to the treatment landscape, ongoing education and development is key. However, understanding of the roles and tasks of HNs is lacking. AIM The EAHAD Nurses Committee sought to identify and describe the roles and tasks of the European HN. METHODS A five-step integrative review was undertaken, including problem identification, literature search, data evaluation, data synthesis and presentation. Relevant literature published from 2000 to 2022 was identified through database, hand and ancestry searching. Data were captured using extraction forms and thematically analysed. RESULTS Seven hundred and seventy-seven articles were identified; 43 were included. Five main roles were identified, with varied and overlapping associated tasks: Educator, Coordinator, Supporter, Treater and Researcher. Tasks related to education, coordination and support were most frequently described. Patient education was often 'nurse-led', though education and coordination roles concerned both patients and health care practitioners (HCPs), within and beyond the MDT. The HN coordinates care and facilitates communication. Long-term patient care relationships place HNs in a unique position to provide support. Guidelines for HN core competencies have been developed in some countries, but autonomy and practice vary. CONCLUSION As the treatment landscape changes, all five main HN roles will be impacted. Despite national variations, this review provides a baseline to anticipate educational needs to enable HNs to continue to fulfil their role.
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Affiliation(s)
- Greta Mulders
- Department of Hematology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Nanda Uitslager
- Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mary Kavanagh
- Children's Coagulation Centre, Children's Health Ireland, Dublin, Ireland
| | | | - Gabriella Nicolo
- Angelo Bianchi Bonomi Haemophilia and Trombosis Center, Milan, Italy
| | | | - Linda Myrin Westesson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy, Institution for Nursing Science and Health at Gothenburg University, Gothenburg, Sweden
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Banerjee DB, Appasawmy N, Caldwell S, Wade RL, Owen A, Patwardhan N, Eradi B. Impact of Colorectal Nurse Specialist supervised parental administration of rectal washouts on Hirschsprung's disease outcomes: a retrospective review. Pediatr Surg Int 2024; 40:107. [PMID: 38615130 DOI: 10.1007/s00383-024-05687-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE To highlight the utility of Colorectal Nurse Specialist (CNS) supervised parental administration of rectal washouts in the management of Hirschsprung's disease (HD). METHODS Retrospective case note review of HD patients treated at a tertiary children's hospital in United Kingdom from January 2011 to December 2022. Data collected included demographics, complications, enterocolitis, obstructive symptoms and stomas. Primary pull-through (PT) is done 8-12 weeks after birth. Parental expertise in performing rectal washouts at home is ensured by our CNS team before and after PT. RESULTS PT was completed in 69 of 74 HD patients. Rectal washouts were attempted on 63 patients before PT. Failure of rectal washout efficacy necessitated a stoma in four patients (6.4%). Of the 65 patients who had PT and stoma closed, three (4.5%) required a further stoma over a mean follow-up period of 57 months (Range 7-144 months). Two of these had intractable diarrhoea due to Total Colonic Aganglionosis (TCA). One patient (1.5%) had unmanageable obstructive symptoms requiring re-diversion. Hirschsprung-associated enterocolitis (HAEC) requiring hospital admission occurred in 14 patients (21%). CONCLUSION Our stoma rates are lower compared to recent UK data. This could potentially be due to emphasis on parental ability to perform effective rectal washouts at home under CNS supervision.
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Affiliation(s)
- Debasish B Banerjee
- Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK
| | - Nalini Appasawmy
- Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK
| | - Stephen Caldwell
- Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK
| | - Rachel L Wade
- Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK
| | - Anthony Owen
- Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK
| | - Nitin Patwardhan
- Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK
| | - Bala Eradi
- Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK.
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Inumerables F, Freedman K, Leary M, Short K. Oncology Clinical Nurse Specialists Practice in the Outpatient Setting. CLIN NURSE SPEC 2024; 38:98-102. [PMID: 38364070 DOI: 10.1097/nur.0000000000000808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
PURPOSE/OBJECTIVES With rapidly evolving oncology care, the role of the outpatient clinical nurse specialist is most valuable and essential. The purpose of this article is to describe the role of the clinical nurse specialist in the ambulatory oncology settings and highlight the clinical nurse specialists' unique influence across the spheres of impact. DESCRIPTION OF THE PROJECT/PROGRAM This article shares several contributions of an outpatient clinical nurse specialist, which include ways this role impacts nursing practice, patient care, and standardizing organizational guidelines. A method of recording the clinical nurse specialists' encounters or indirect consults was also utilized to provide a process to log consultation received in the day-to-day practice. Work exemplars were included to further demonstrate the impact of this role in this setting. CONCLUSION Outpatient clinical nurse specialist need is rising especially in the oncology setting where the majority of cancer care and treatment is delivered. It is important to continue to disseminate and highlight the value it brings to the organization.
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Affiliation(s)
- Faye Inumerables
- Author Affiliations: Nurse Leader, Evidence-based Practice and Clinical Nurse Specialists (Inumerables), Clinical Nurse Specialist (Freedman, Leary, and Short), Memorial Sloan Kettering Cancer Center, New York
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Kurup C, Betihavas V, Burston A, Jacob E. Strategies employed by developed countries to facilitate the transition of internationally qualified nurses specialty skills into clinical practice: An integrative review. Nurs Open 2023; 10:7528-7543. [PMID: 37794722 PMCID: PMC10643820 DOI: 10.1002/nop2.2023] [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: 12/01/2022] [Revised: 08/23/2023] [Accepted: 09/17/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Recruitment of internationally qualified nurses as a labour source is a long-standing human resource strategy being implemented to address the current and increasing global nursing shortage. Internationally qualified nurses transitioning into the health workforce of developed countries following immigration often possess specialty skills. A lack of a clear pathway of specialty skill utilisation makes recognising and using these specialty skills complex for many nurses. The ability for nurses to transition between countries and maintain specialty practice demands immediate attention in the current atmosphere of the global pandemic and the predictions to recruit more specialist nurses from overseas. AIM To identify and synthesise strategies taken by various developed countries in transitioning specialist internationally qualified nurses into practice. METHODS An integrative review was conducted to identify common themes, patterns, and best practices in order to inform policy development and improve the successful integration of internationally qualified nurses into the healthcare systems of developed countries. The study employed the Whittemore and Knafl five-stage integrative review approach. To conduct a comprehensive search, four electronic databases, namely Medline, CINAHL Complete, ProQuest Health, and EMBASE, were systematically searched in October 2021. The search was updated in March 2022 to ensure the inclusion of the most recent literature. Additionally, Google Scholar was utilised to avoid overlooking any important articles. Prior to the full-text review, three reviewers independently evaluated titles and abstracts. The included papers' quality was determined using the JBI critical appraisal tools. RESULTS This study included 10 papers, comprising three studies and seven reports. However, none of these documents provided information on how internationally qualified nurses could transfer their specialty skills acquired overseas to developed countries after immigrating. The guidelines and policies reviewed only offered generic advice on becoming a specialist nurse. Although some countries mentioned that post-graduate qualifications were not mandatory for nurse specialists, the majority of documents in this review emphasised the need for a national framework of education at level eight or higher (equivalent to a post-graduate level) to attain the status of a nurse specialist. Moreover, the included documents did not provide clear information on whether an international specialisation degree would be recognised during the registration process. As a result, confusion persists regarding the requirement of post-graduate qualifications for nurses aiming to specialise and the recognition of international specialisation degrees during the registration process. DISCUSSION The lack of consistency in defining nurse specialty and the skill transferability among institutions and state borders were evident in this review. According to all the 10 documents analysed, developed countries appear to have minimum policies on the transfer of internationally qualified nurse's specialty skills. Recommendations for policymakers, employers, and aspirant migrants have been proposed. Limited research has been done on how developed countries used their internationally qualified nurses' overseas-acquired specialist skills after immigration, indicating a lack of a distinct specialist skill transition pathway. CONCLUSIONS This review presents data to support the need for greater research in this area to better utilise the abilities that internationally qualified nurses bring from their home country and put them to constructive use in the host country, especially in the context of a global pandemic.
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Affiliation(s)
- Chanchal Kurup
- Faculty of Health Sciences, School of Nursing, Midwifery and ParamedicineAustralian Catholic UniversityVirginiaQueenslandAustralia
- Central Queensland University AustraliaNorth RockhamptonQueenslandAustralia
| | - Vasiliki Betihavas
- Faculty of Health Sciences, School of Nursing, Midwifery and ParamedicineAustralian Catholic UniversityVirginiaQueenslandAustralia
| | - Adam Burston
- Faculty of Health Sciences, School of Nursing, Midwifery and ParamedicineAustralian Catholic UniversityVirginiaQueenslandAustralia
- Nursing Research and Practice Development CentreThe Prince Charles HospitalChermsideQueenslandAustralia
| | - Elisabeth Jacob
- Faculty of Health Sciences, School of Nursing, Midwifery and ParamedicineAustralian Catholic UniversityVirginiaQueenslandAustralia
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Wu J, Wang F, Wang J, Yuan R, Lv Y, Tao D, Hu L. Construction of an index system of core competence assessment for otolaryngology nurse specialists in China: A Delphi study. Nurse Educ Today 2023; 131:105956. [PMID: 37769600 DOI: 10.1016/j.nedt.2023.105956] [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] [Received: 08/25/2022] [Revised: 06/10/2023] [Accepted: 09/03/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Clinical nurse specialists play a vital role in the work quality, patient safety and team development of nurses. However, there is currently no prior study constructing the index of core competence assessment for otolaryngology Nurse Specialists. OBJECTIVES To establish an index system for the evaluation of Chinese otolaryngology Nurse Specialists' core competence. DESIGN A Delphi study. SETTINGS The study was mainly conducted in a university-affiliated hospital in China. PARTICIPANTS Twenty-two experts with otolaryngology knowledge and practical experience from different regions and organizations in China. METHODS We used literature reviews and expert meetings to establish a draft index system . Subsequently, a two-round Delphi survey was utilized to consult opinions from 22 experts about the index for the evaluation of otolaryngology nurse specialists' core competence and provide qualitative comments on their ratings. Consensus was predefined as a mean important score of 4.0 or above and a coefficient of variation is not above 0.25 among the participants. RESULTS The final evaluation indexes of the core competencies for otolaryngology Nurse Specialists included 5 first-level indexes (clinical competence, critical thinking competence, leadership, professional development competence, professionalism), 19 second-level indexes, and 85 third-level indexes. The effective response rates of the two expert consultation rounds were 100 %. The expert authority coefficients were 0.864 and 0.859 in the first and second rounds of consultation, respectively. In the second round of consultation, the first, second and third indexes of Kendall's coefficient of concordance were 0.357, 0.330, and 0.232, respectively (P < 0.001). CONCLUSIONS The constructed evaluation indexes of the core competencies of otolaryngology Nurse Specialists are scientific, reasonable, comprehensive, and specific and may provide references for the training and evaluation of otolaryngology Nurse Specialists.
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Affiliation(s)
- Jieli Wu
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fengli Wang
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiamin Wang
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ruya Yuan
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yunxia Lv
- Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China
| | - Duo Tao
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lijing Hu
- Department of Nursing, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
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Panattoni N, Mariani R, Spano A, Leo AD, Iacorossi L, Petrone F, Simone ED. Nurse specialist and ostomy patient: Competence and skills in the care pathway. A scoping review. J Clin Nurs 2023; 32:5959-5973. [PMID: 37073684 DOI: 10.1111/jocn.16722] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 04/20/2023]
Abstract
AIMS AND OBJECTIVES To summarise the evidence published to date regarding nursing core competence in stoma care of any type of ostomy throughout the patient's ostomy surgery candidate care pathway from preoperative to follow-up. BACKGROUND Nurses should play a key role in all ostomy patient care pathways to help them to adapt to the new physics and psychological conditions from the preoperative phases to the prevention of tardive stomal complications. DESIGN Scoping review. METHODS This scoping review was conducted following the methodological framework proposed by Arskey and O'Malley, following the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review. PRISMA-ScR Checklist is included in the manuscript. The following databases were queried: PubMed, EMBASE and CINAHL, from August to October 2022. RESULTS The search strategy in the consulted databases identified 3144 studies. Different types of ostomies were found and investigated: tracheostomy, gastrostomy, jejunostomy, ileostomy, colostomy and urostomy. The results of the included studies helped address the objective that allowed the ostomatherapy skills to be broken down into the different periods of the care pathway. CONCLUSION Caring for an ostomy patient requires advanced skills and a trusting relationship. The skills outlined in this research suggest how essential the stoma care nurse specialist is in these patients' care.
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Affiliation(s)
- Nicolò Panattoni
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Mariani
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Alessandro Spano
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Aurora De Leo
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Laura Iacorossi
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
| | - Fabrizio Petrone
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
| | - Emanuele Di Simone
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Yang D, Zhang R, Kirkland-Kyhn H. Training and practice of wound ostomy continence nurse specialists in China. Wound Manag Prev 2023; 69:28-31. [PMID: 38052013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
BACKGROUND In China, with chronic wound patients increasing by 10% per year and more than 1 million stoma patients, there is an increasing demand for wound ostomy continence care. Accordingly, specialized wound care in China is developing rapidly and the gap with developed countries is narrowing. PURPOSE This paper aims to describe the status of training, practice, and management of wound nurses in China. METHODS Data on the training and practice of wound specialist nurses in the Chinese Mainland were collected through literature review and hospital surveys. RESULTS The training system of Chinese Wound, Ostomy and Continence (WOC) specialist nurses is developing rapidly, but lacks a unified access standard, curriculum, teaching materials, and assessment system. Specialist nurses play an important role in education, clinical practice, and scientific research, but home care and independent nursing practices are still in their infancy. CONCLUSION The developing momentum of wound care in China is encouraging, but it is necessary to unify and standardize WOC nurses' qualification certification, scope of practice, level-to-level administration, and other aspects to cultivate higher-quality specialized wound nurses.
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Affiliation(s)
- Dandan Yang
- The Fourth Central Hospital of Baoding City, Baoding, China
| | - Ruihong Zhang
- The Fourth Central Hospital of Baoding City, Baoding, China
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Gu J, Luo L, Li C, Ma S, Gong F. Effects of a Modified Six-Sigma-Methodology-Based Training Program on Core Competencies in Rehabilitation Nurse Specialists. J Korean Acad Nurs 2023; 53:412-425. [PMID: 37673816 DOI: 10.4040/jkan.22122] [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: 10/06/2022] [Revised: 06/26/2023] [Accepted: 08/04/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform-a modified Six-Sigma-based training program-against a conventional educational program on rehabilitation specialist nurses' core competencies, post-training performance, and satisfaction. METHODS A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base's 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented. RESULTS Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05). CONCLUSION The modified training program strengthens rehabilitation nurses' base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.
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Affiliation(s)
- Jiayi Gu
- Department of Rehabilitation, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Lan Luo
- Department of Rehabilitation, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Chengjuan Li
- School of Nursing, University of South China, Hengyang, China
| | - Sumin Ma
- School of Nursing, University of South China, Hengyang, China
| | - Fanghua Gong
- Department of Nursing, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China.
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Xu H, Dong C, Yang Y, Sun H. Developing a professional competence framework for the master of nursing specialist degree program in China: A modified Delphi study. Nurse Educ Today 2022; 118:105524. [PMID: 36084450 DOI: 10.1016/j.nedt.2022.105524] [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] [Received: 03/24/2022] [Revised: 07/26/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The urgency of ensuring adequate professional competence in clinical nursing practice is evident. However, there is little formal professional competence framework for the education of master's degree students in nursing specialist programs in China. OBJECTIVE To develop a professional competence framework for the Master of Nursing Specialist (MNS) degree program in China. DESIGN A modified Delphi study. PARTICIPANTS An expert panel discussion was held with 12 experts, and Delphi rounds were conducted with 24 experts. METHODS A literature review and an expert panel discussion were conducted to develop an initial competence framework. A two-round Delphi survey was employed to obtain a consensus on the framework through either an online or paper questionnaire. Descriptive statistics were used to analyze the data. The consensus threshold was set according to the mean (≥ 4.0), coefficient of variation (< 0.25), and consensus level of agreement (≥70 %). RESULTS A consensus on seven domains and 54 items of the professional framework for the MNS degree program was achieved. The framework domains included clinical practice (12 items), professional attitude (8 items), collaboration and communication (5 items), professional development (8 items), research (7 items), education (7 items), and administration (7 items). CONCLUSION The professional competence framework offers guidelines for MNS degree programs in China. Future research should focus on imbedding these competences in MNS degree programs to prepare qualified advanced practice nurses.
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Affiliation(s)
- Huan Xu
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China.
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China.
| | - Yeqin Yang
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China.
| | - Hongyu Sun
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China; 38 Xueyuan Road, School of Nursing, Peking University, Haidian District, Beijing 100191, China.
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Hunnisett A, Victor D. Non-metastatic castration-resistant prostate cancer: the evolving treatment landscape and role of nurse specialists. Br J Nurs 2022; 31:S4-S13. [PMID: 35648671 DOI: 10.12968/bjon.2022.31.10.s4] [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
Prostate cancer is the most common type of cancer in men in the UK. Within 2 years of diagnosis, one-third of patients with non-metastatic castration-resistant prostate cancer (nmCRPC) will develop metastatic disease, which is associated with significantly greater morbidity and mortality compared to disease without metastases. The approval of second-generation androgen receptor inhibitors such as darolutamide has transformed the nmCRPC treatment landscape because they lead to prolonged metastasis-free survival and better maintenance of quality of life compared with placebo. Early identification of patients with nmCRPC who are suitable for treatment is imperative because most of these patients are asymptomatic. Clinical nurse specialists (CNSs) play a critical, supportive role in the management of disease and treatment follow-up. This product-focused article discusses the use of darolutamide in nmCRPC and the vital role that CNSs play in the management and care of patients with prostate cancer.
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Affiliation(s)
- Andrew Hunnisett
- Macmillan Clinical Nurse Specialist, Lancashire Teaching Hospitals NHS Foundation Trust
| | - Debbie Victor
- Uro-Oncology Cancer Nurse Specialist, Royal Cornwall Hospitals NHS Trust
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Kemp K, Duncan J, Mason I, Younge L, Dibley L. Scoping review with textual narrative synthesis of the literature reporting stress and burn-out in specialist nurses: making the case for inflammatory bowel disease nurse specialists. BMJ Open Gastroenterol 2022; 9:bmjgast-2021-000852. [PMID: 35428670 PMCID: PMC9013983 DOI: 10.1136/bmjgast-2021-000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/31/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Inflammatory bowel disease clinical nurse specialists (IBD-CNSs) face increasing pressures due to rising clinical and patient demands, advanced complexity of work role, and minimal specialist management training and support. Stress and burn-out could undermine the stability of this workforce, disrupting clinical provision. We reviewed the literature on stress and burn-out to demonstrate the lack of evidence pertinent to IBD-CNSs and make the case for further research. Design Following Levac et al’s scoping review framework, relevant databases were searched for publications reporting work-related stress and burn-out among specialist nurses. Following screening and consensus on selection of the final articles for review, all authors contributed to data charting. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension guided reporting of the review. Results Of 194 retrieved articles, eight were eligible for review. None focused on IBD-CNSs, were qualitative, or UK-based. Three core themes were identified: Rates of Burn-out, Mitigating and Alleviating Factors, and Preventing and Resolving Burn-out. Risk of burn-out is greatest in novice and mid-career CNSs. Age and duration in role appear protective. Personal achievement is also protective and can mitigate earlier episodes of burn-out; opportunities for career progression are limited. Promoting personal well-being is beneficial. Senior managers have poor understanding of the role and provide inadequate support. Commitment to patients remains high. Conclusion Burn-out arises in CNSs across clinical specialisms in the international literature and has a significant negative effect on the workforce. Further research is needed to address the dearth of evidence on burn-out in IBD-CNSs in the UK.
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Affiliation(s)
- Karen Kemp
- Department of Gastroenterology, Manchester Royal Infirmary, Manchester, UK
| | - Julie Duncan
- Clinical Nurse Education, Takeda UK Limited, London, UK
| | - Isobel Mason
- Centre for Gastroenterology, Royal Free Hospital, London, UK
| | - Lisa Younge
- IBD Unit, St Mark's Hospital and Academic Institute, Harrow, UK
| | - Lesley Dibley
- Institute for Lifecourse Development, University of Greenwich, London, UK
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Abstract
The role of the nutrition nurse specialist (NNS) is diverse and is usually integral to a wider, multidisciplinary nutrition support team (NST). Practice frameworks have been developed to identify competencies within the NNS role. A mind-mapping technique was used with the NNS team and the wider NST to explore the role of the NNS in the authors' intestinal failure tertiary referral centre. The results of this were further compared with the published competency frameworks. The mind maps from the NNS team and NST demonstrated commonality. It was encouraging to see that colleagues seem to have a similar understanding of the NNS role and contribution to the wider service. Published competency frameworks did not entirely reflect the expanded scope of practice that is undertaken within this particular team. It is important for clinical nurse specialist teams to evaluate their role and service provision and to compare this against published competency frameworks.
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Affiliation(s)
- Hardip Malhi
- Nutrition Nurse, Queen Elizabeth Hospital Birmingham
| | | | - Jane Fletcher
- Nutrition Nurse, Queen Elizabeth Hospital Birmingham/School of Nursing, University of Birmingham
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Cairnes V. Providing information, care and support to IBD patients during the pandemic. Br J Nurs 2022; 31:334-335. [PMID: 35333563 DOI: 10.12968/bjon.2022.31.6.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Vida Cairnes, Lead Inflammatory Bowel Disease (IBD) Nurse Specialist, Royal Devon and Exeter Hospital, and the Exeter IBD Specialist Nursing Team were runners-up in the Gastrointestinal/IBD Nurse of the Year category of the BJN Awards 2021 (vida.cairnes@nhs.net).
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Affiliation(s)
- Vida Cairnes
- Lead Inflammatory Bowel Disease (IBD) Nurse Specialist, Royal Devon and Exeter Hospital
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14
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Sawyer M, Kool B, Hamill JK. Tertiary survey by trauma nurse specialist at a paediatric trauma centre. N Z Med J 2021; 134:73-82. [PMID: 34482391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Tertiary surveys aim to detect injuries missed in the initial assessment of trauma. We introduced a process by which the trauma nurse specialist performed a number of the tertiary surveys (NTSs) at our paediatric trauma centre. METHODS Data from the first six months following introduction of the NTS were compared to retrospective data from the six months prior to NTS implementation (pre-NTS), when trauma surveys were completed by medical staff. RESULTS Over the 12-month period, 130 children met the criteria for a tertiary survey. Pre-NTS, 57/62 eligible patients received a tertiary survey, compared to 61/68 during NTS (p=0.77). There were significantly more road traffic crash patients in the NTS group (p=0.008) but no significant differences by demographics, injury pattern, injury severity score or outcomes. New injuries were found in three patients pre-NTS compared to five patients during NTS (odds ratio 1.3 (95%CI 1.3-2.0, p=0.73)). CONCLUSION This study conservatively supports the hypothesis that, with training and support, a trauma nurse specialist can perform tertiary surveys as effectively as doctors. A larger study is required to confirm these findings.
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Affiliation(s)
- Matt Sawyer
- Starship Children's Health, Children's Trauma Service
| | - Bridget Kool
- University of Auckland, Faculty of Medical and Health Sciences
| | - James K Hamill
- Starship Children's Health, Children's Trauma Service; University of Auckland, Faculty of Medical and Health Sciences
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Tschannen D, Alexander C, Taylor S, Tovar EG, Ghosh B, Zellefrow C, Milner KA. Quality improvement engagement and competence: A comparison between frontline nurses and nurse leaders. Nurs Outlook 2021; 69:836-847. [PMID: 33993986 DOI: 10.1016/j.outlook.2021.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/27/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nurses play a pivotal role in improving patient care. To maximize nurses' impact on quality, nurses must have quality improvement (QI) competence and engage fully in QI initiatives. PURPOSE To describe QI competence (knowledge, skills, and attitudes) among frontline nurses and leaders; and compare variations in competence among nursing roles, experience, and specialty areas. METHODS A total of 681 nurses at one heath system fully completed the Nursing Quality Improvement Practice tool electronically. FINDINGS Half of the respondents reported QI engagement (53.6%). Mean knowledge scores were 5.08 (SD 1.16, 7 items). Skill proficiency was low (M = 2.82, SD = 1.03; range 1-6) although QI attitudes were favorable (M = 3.76, SD = 0.63; range 1-5). Significant differences in skills and attitudes were identified by role. QI competence among nurses employed in various specialty areas were similar. DISCUSSION Strategies for increasing QI competence and engagement of nurses must be created and deployed in order to improve quality and safety.
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Affiliation(s)
- Dana Tschannen
- University of Michigan, School of Nursing, Ann Arbor, MI.
| | | | - Sarah Taylor
- University of Michigan Health System, Trauma Burn ICU, Ann Arbor MI
| | - Elizabeth G Tovar
- DNP Primary Care Track Coordinator University of Kentucky, Lexington, KY
| | | | - Cindy Zellefrow
- Academic Core at The Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, The Ohio State University College of Nursing, Columbus, OH
| | - Kerry A Milner
- Sacred Heart University, Davis & Henley College of Nursing, Fairfield, CT
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Hansen DG, Trabjerg TB, Sisler JJ, Søndergaard J, Jensen LH. Cross-sectoral communication by bringing together patient with cancer, general practitioner and oncologist in a video-based consultation: a qualitative study of oncologists' and nurse specialists' perspectives. BMJ Open 2021; 11:e043038. [PMID: 33952540 PMCID: PMC8103367 DOI: 10.1136/bmjopen-2020-043038] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED Shared care models in the field of cancer aim to improve care coordination, role clarification and patient satisfaction. Cross-sectoral communication is pivotal. Involvement of patients may add to intended mechanisms.A randomised controlled trial 'The Partnership Study' tested the effect of bringing together patient, general practitioner (GP) and oncologist for a consultation conducted by video. PURPOSE As part of the process evaluation, this study aimed to explore experiences, attitudes and perspectives of the oncological department on sharing patient consultations with GPs using video. METHODS Four semistructured interviews with five oncologists and four nurse specialists were conducted in February 2020. We focused on the informants' experiences and reflections on the potential of future implementation of the concept 'inviting the GP for a shared consultation by video'. The analyses were based on an inductive, open-minded, hermeneutic phenomenological approach. RESULTS A total of six overall themes were identified: structuring consultation and communication, perceptions of GP involvement in cancer care, stressors, making a difference, alternative ways of cross-sector communication and needs for redesigning the model. The concept made sense and was deemed useful, but solving the many technical and organisational problems is pivotal. Case-specific tasks and relational issues were targeted by pragmatically rethinking protocol expectations and the usual way of communication and structuring patient encounters. Case selection was discussed as one way of maturing the concept. CONCLUSION This Danish study adds new insight into understanding different aspects of the process, causal mechanisms as well as the potential of future implementation of video-based tripartite encounters. Beyond solving the technical problems, case selection and organisational issues are important. Acknowledging the disruption of the usual workflow, the introduction of new phases of the usual encounter and the variety of patient-GP relationships to be embraced may help to better understand and comply with barriers and facilitators of communication and sharing. TRIAL REGISTRATION NUMBER NCT02716168.
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Affiliation(s)
- Dorte Gilså Hansen
- Research Unit for General Practice, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Center for Shared Decision Making, Lillebælt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Theis Bitz Trabjerg
- Research Unit for General Practice, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jeffrey James Sisler
- Department of Family Medicine, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| | - Jens Søndergaard
- Research Unit for General Practice, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Lars Henrik Jensen
- Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
- Department of Oncology, Lillebælt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Danish Colorectal Cancer Center South, Center of Clinical Excellence, Lillebaelt Hospital, University Hospital of Southern Denmark, University of Southern Denmark, Vejle, Denmark
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Forde R, Arente L, Ausili D, De Backer K, Due‐Christensen M, Epps A, Fitzpatrick A, Grixti M, Groen S, Halkoaho A, Huber C, Iversen MM, Johansson U, Leippert C, Ozcan S, Parker J, Paiva AC, Sanpetreanu A, Savet M, Rosana S, Szewczyk A, Valverde M, Vlachou E, Forbes A. The impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium. Diabet Med 2021; 38:e14498. [PMID: 33314244 PMCID: PMC7883040 DOI: 10.1111/dme.14498] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 01/10/2023]
Abstract
AIM To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe. METHODS An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks. RESULTS Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n = 504) and 48% (n = 873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n = 1486); diabetes distress 65% (n = 1189); depression 49% (n = 893); acute hyperglycaemia 39% (n = 710) and foot complications 18% (n = 323). Forty-seven percent (n = 771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n = 499), 63% (n = 1,027) and 34% (n = 551), respectively. CONCLUSION The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues, we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Arja Halkoaho
- Tampere University of Applied SciencesTampereFinland
| | - Claudia Huber
- HES‐SO Haute école de santé Fribourg SwitzerlandFribourgSwitzerland
| | | | - Unn‐Britt Johansson
- Sophiahemmet University College StockholmStockholmSweden
- Karolinska InstituteStockholmSweden
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18
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Page E, Allen R, Wensley F, Rayman G. Improving the peri-operative pathway of people with diabetes undergoing elective surgery: the IP3D project. Diabet Med 2020; 37:2019-2026. [PMID: 32297351 DOI: 10.1111/dme.14307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2020] [Indexed: 11/27/2022]
Abstract
AIM To determine whether outcomes for people with diabetes undergoing elective surgery improve following the introduction of innovations in the peri-operative care pathway. METHODS Following a baseline audit of 185 people with diabetes listed for elective surgery (July to December 2017) with a length of stay > 24 hours, a number of changes in practice were implemented. These included dissemination of a 'diabetes peri-operative passport' to participants preoperatively, formation of a diabetes surgery working group, recruitment of surgical diabetes champions and the roll-out of surgical diabetes study days. Crucial was recruitment of a diabetes peri-operative nurse, whose role included engaging and educating others and supporting individuals throughout their peri-operative diabetes care. Records of 166 individuals listed for surgery during the implementation period (July to December 2018) were then audited using the same methodology. RESULTS The availability of a recent HbA1c measurement significantly increased (63% vs 92%; P ≤ 0.001). The mean HbA1c of those seen for optimizations by the diabetes peri-operative nurse significantly decreased [84 mmol/mol (9.8%) vs 62 mmol/mol (7.8%); P ≤ 0.001]. Recurrent hypoglycaemia significantly decreased (7.0% vs 0.6%; P = 0.002) and the mean number of hyperglycaemic events in people experiencing hyperglycaemia almost halved (3.0 vs 1.7; P=0.007). The mean length of hospital stay significantly decreased (4.8 vs 3.3 days; P=0.001) and, crucially, 30-day readmissions did not increase (12% vs 9%; P=0.307). Postoperative complications significantly decreased (28% vs 16%; P=0.008), including a composite of dysglycaemic complications, poor wound healing, wound infection and other infections (12% vs 5.4%; P=0.023). CONCLUSION The new pathway improved important peri-operative outcomes for people with diabetes undergoing elective surgery with the potential for cost savings. These findings could have important implications for peri-operative care on a wider scale.
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Affiliation(s)
- E Page
- East Suffolk and North Essex NHS Foundation Trust, Ipswich Hospital, Ipswich, UK
| | - R Allen
- East Suffolk and North Essex NHS Foundation Trust, Ipswich Hospital, Ipswich, UK
| | - F Wensley
- University Hospitals Southampton NHS Trust, Southampton, UK
| | - G Rayman
- East Suffolk and North Essex NHS Foundation Trust, Ipswich Hospital, Ipswich, UK
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Abstract
We tested whether responses to trolley problems by nurse specialist students correlated with their responses to hypothetical vaccine problems, as a follow-up to a similar study on ethics committees. No statistically significant correlation was found between the trolley and vaccination scores. These results confirmed and strengthened the finding of a very weak correlation (possibly zero), and the point estimate was even lower than for the ethics committees. Hence, the nurse specialists' responses to the trolley problems cannot be used to indicate any direction for their responses to the vaccine problems, although there is a common core issue of sacrificing some for many. The respondents reported a relatively high willingness to push one man in front of a trolley to save five. They also reported a high willingness to act in trolley dilemmas compared with vaccination dilemmas, although the dimensions of risk-reward ratios and consent heavily favored the latter.
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Affiliation(s)
- Gry Oftedal
- Department of Philosophy, Classics, History of Art and Ideas, University of Oslo, Norway
| | - Ingrid H. Ravn
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway
| | - Fredrik A. Dahl
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway
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Antunes B, Bowers B, Winterburn I, Kelly MP, Brodrick R, Pollock K, Majumder M, Spathis A, Lawrie I, George R, Ryan R, Barclay S. Anticipatory prescribing in community end-of-life care in the UK and Ireland during the COVID-19 pandemic: online survey. BMJ Support Palliat Care 2020; 10:343-349. [PMID: 32546559 PMCID: PMC7335692 DOI: 10.1136/bmjspcare-2020-002394] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/01/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Anticipatory prescribing (AP) of injectable medications in advance of clinical need is established practice in community end-of-life care. Changes to prescribing guidelines and practice have been reported during the COVID-19 pandemic. AIMS AND OBJECTIVES To investigate UK and Ireland clinicians' experiences concerning changes in AP during the COVID-19 pandemic and their recommendations for change. METHODS Online survey of participants at previous AP national workshops, members of the Association for Palliative Medicine of Great Britain and Ireland and other professional organisations, with snowball sampling. RESULTS Two hundred and sixty-one replies were received between 9 and 19 April 2020 from clinicians in community, hospice and hospital settings across all areas of the UK and Ireland. Changes to AP local guidance and practice were reported: route of administration (47%), drugs prescribed (38%), total quantities prescribed (35%), doses and ranges (29%). Concerns over shortages of nurses and doctors to administer subcutaneous injections led 37% to consider drug administration by family or social caregivers, often by buccal, sublingual and transdermal routes. Clinical contact and patient assessment were more often remote via telephone or video (63%). Recommendations for regulatory changes to permit drug repurposing and easier community access were made. CONCLUSIONS The challenges of the COVID-19 pandemic for UK community palliative care has stimulated rapid innovation in AP. The extent to which these are implemented and their clinical efficacy need further examination.
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Affiliation(s)
- Bárbara Antunes
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
| | - Ben Bowers
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
| | - Isaac Winterburn
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
| | - Michael P Kelly
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
| | - Robert Brodrick
- Community Specialist Palliative Care Team, Arthur Rank Hospice Charity, Cambridge, UK
- Palliative Medicine, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Kristian Pollock
- School of Nursing, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Megha Majumder
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
| | - Anna Spathis
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
| | - Iain Lawrie
- Palliative Medicine, North Manchester General Hospital, Manchester, UK
- Manchester Medical School, The University of Manchester, Manchester, UK
| | - Rob George
- Medicine, St Christopher's Hospice, London, UK
- Cicely Saunders Institute, King's College London School of Medical Education, London, UK
| | - Richella Ryan
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
- Community Specialist Palliative Care Team, Arthur Rank Hospice Charity, Cambridge, UK
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge Primary Care Unit, Cambridge, Cambridgeshire, UK
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Lacroix C, Georges G, Thézenas S, Flori N, Francioni L, Janiszewski C, Courraud J, Lecornu H, de Forges H, Senesse P. [The role of the specialist nurse in parenteral nutrition : An observational study of complications with home parenteral nutrition in adult cancer patients]. Rech Soins Infirm 2020; 140:107-116. [PMID: 32524798 DOI: 10.3917/rsi.140.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background : In France, home parenteral nutrition (HPN) is managed by two parallel healthcare systems : in approved specialist centers (HPN > 12 weeks), and outside of these approved specialist centers (HPN<12 weeks).
Objective : To prospectively evaluate infectious and vascular complications in adult cancer patients undergoing HPN administered via a central venous line, outside of approved specialist HPN centers.
Methods : Our observational prospective study included adult patients with cancer, hospitalized for 48 hours or more, and under HPN. They had a WHO performance status of ≤ 2 and had had a nutritional consultation before discharge.
Results : 25 patients were included in the study, with a median age of 63 years [19–74]. Weight loss of ≥ 5% was reported in 79% of patients. The Ingesta score was < 7 in 96% of cases. 87% of patients presented chill or body temperature variation episodes, with a median of 2 episodes [1–6] per patient. The median delay between end of hospitalization and the first chill episode was 11 days [1–85]. A vascular complication (obstruction without thrombosis) was reported in one patient.
Discussion : This high number of infectious episodes requires improvement of patient care when it comes to strictly adhering to the recommendations. Getting the approved specialist HPN centers to work together and share care protocols could be the first important step.
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Abstract
OBJECTIVE Inflammatory bowel diseases (IBDs) are chronic relapsing remitting diseases which potentially result in hospitalisation, requiring long-term outpatient follow-up, ideally by a dedicated, multidisciplinary team. In this team, the IBD nurse is the key point of access for education, advice and support.The aim of this study was to assess the impact of introduction of an IBD nurse position on healthcare use and costs in a tertiary IBD centre. METHODS An IBD nurse was instituted in September 2017 in our multidisciplinary IBD team. We compared differences in healthcare use 1 year before and 1 year after the introduction of an IBD nurse position for all the patients with a confirmed diagnosis of IBD attending the Robert Debre Hospital via two information sources: Programme de Médicalisation des Systèmes d'Information and Centre des Maladies Rares. RESULTS 252 patients (78.5% of patients with IBD followed up in our centre) were included in the patient education programme. After the introduction of an IBD nurse position, fewer patients were hospitalised for a flare, with less hospital stays: 56 before vs 28 after (p=0.002). An estimated saving of €35 070 was achieved through the decrease of hospitalisations for flare.More patients were also hospitalised for diagnosis: 32 hospitalisations before vs 54 hospitalisations after (p=0.001). All other hospitalisation categories were comparable, and the same reasons for hospitalisation were found before and after. CONCLUSION This study demonstrates that the IBD nurse position reduces hospital admissions. Instead of the traditional model, the IBD nurse provides accessible advice and allows patients to be outpatients.
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Affiliation(s)
- Christine Martinez-Vinson
- Service de Gastroentérologie et Nutrition pédiatriques, Hopital Universitaire Robert-Debre, Paris, Paris, France
| | - Sebastien Le
- Service de Gastroentérologie et Nutrition pédiatriques, Hopital Universitaire Robert-Debre, Paris, Paris, France
| | - Audrey Blachier
- Service de Gastroentérologie et Nutrition pédiatriques, Hopital Universitaire Robert-Debre, Paris, Paris, France
| | - Maud Lipari
- Service de Gastroentérologie et Nutrition pédiatriques, Hopital Universitaire Robert-Debre, Paris, Paris, France
| | - Jean-Pierre Hugot
- Service de Gastroentérologie et Nutrition pédiatriques, Hopital Universitaire Robert-Debre, Paris, Paris, France
| | - Jerome Viala
- Service de Gastroentérologie et Nutrition pédiatriques, Hopital Universitaire Robert-Debre, Paris, Paris, France
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von Vogelsang A, Swenne CL, Gustafsson BÅ, Falk Brynhildsen K. Operating theatre nurse specialist competence to ensure patient safety in the operating theatre: A discursive paper. Nurs Open 2020; 7:495-502. [PMID: 32089845 PMCID: PMC7024629 DOI: 10.1002/nop2.424] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 11/05/2019] [Indexed: 12/15/2022] Open
Abstract
Aim To discuss specialist operating theatre nurses' competence in relation to the general six core competencies and patient safety. Design A discursive analysis of legal statutes and scientific articles. Methods Swedish legal statutes and an overview of scientific articles on operating theatre nursing were deductively analysed and classified into healthcare providers' general six core competencies. Results All healthcare professionals should possess the general core competencies, regardless of their discipline. The specific content within these competencies differs between disciplines. The specialized operating theatre nurse is the only healthcare professional having the competence to be responsible for asepsis, instrumentation, infection and complication, control and management of biological specimens during the surgical procedure. Besides operating theatre nurses, no other healthcare profession has the formal education, competence or skills to perform operating theatre nursing care in the theatre during the surgical procedure. Operating theatre nurse competence is therefore indispensable to ensure patient safety during surgery.
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Affiliation(s)
- Ann‐Christin von Vogelsang
- Neuro ThemeKarolinska University HospitalStockholmSweden
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
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24
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Lawton S. The specialist dermatology nurse: providing expert care to patients. Br J Nurs 2020; 29:136-138. [PMID: 32053450 DOI: 10.12968/bjon.2020.29.3.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sandra Lawton, Nurse Consultant, Dermatology, Rotherham NHS Foundation Trust, describes the wide variety of work undertaken by nurses specialising in dermatology.
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Affiliation(s)
- Sandra Lawton
- Nurse Consultant, Dermatology, Rotherham NHS Foundation Trust
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25
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Akiboye F, Adderley NJ, Martin J, Gokhale K, Rudge GM, Marshall TP, Rajendran R, Nirantharakumar K, Rayman G. Impact of the Diabetes Inpatient Care and Education (DICE) project on length of stay and mortality. Diabet Med 2020; 37:277-285. [PMID: 31265148 DOI: 10.1111/dme.14062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2019] [Indexed: 01/09/2023]
Abstract
AIM To determine whether the Diabetes Inpatient Care and Education (DICE) programme, a whole-systems approach to managing inpatient diabetes, reduces length of stay, in-hospital mortality and readmissions. RESEARCH DESIGN AND METHODS Diabetes Inpatient Care and Education initiatives included identification of all diabetes admissions, a novel DICE care-pathway, an online system for prioritizing referrals, use of web-linked glucose meters, an enhanced diabetes team, and novel diabetes training for doctors. Patient administration system data were extracted for people admitted to Ipswich Hospital from January 2008 to June 2016. Logistic regression was used to compare binary outcomes (mortality, 30-day readmissions) 6 months before and after the intervention; generalized estimating equations were used to compare lengths of stay. Interrupted time series analysis was performed over the full 7.5-year period to account for secular trends. RESULTS Before-and-after analysis revealed a significant reduction in lengths of stay for people with and without diabetes: relative ratios 0.89 (95% CI 0.83, 0.97) and 0.93 (95% CI 0.90, 0.96), respectively; however, in interrupted time series analysis the change in long-term trend for length of stay following the intervention was significant only for people with diabetes (P=0.017 vs P=0.48). Odds ratios for mortality were 0.63 (0.48, 0.82) and 0.81 (0.70, 0.93) in people with and without diabetes, respectively; however, the change in trend was not significant in people with diabetes, while there was an apparent increase in those without diabetes. There was no significant change in 30-day readmissions, but interrupted time series analysis showed a rising trend in both groups. CONCLUSION The DICE programme was associated with a shorter length of stay in inpatients with diabetes beyond that observed in people without diabetes.
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Affiliation(s)
- F Akiboye
- Diabetes Research Unit, Ipswich Hospital NHS Trust, Ipswich, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - N J Adderley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - J Martin
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - K Gokhale
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - G M Rudge
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - T P Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - R Rajendran
- Diabetes Research Unit, Ipswich Hospital NHS Trust, Ipswich, UK
| | - K Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - G Rayman
- Diabetes Research Unit, Ipswich Hospital NHS Trust, Ipswich, UK
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White M. Let the voices of specialist nurses be heard. Br J Nurs 2019; 28:S3. [PMID: 31835950 DOI: 10.12968/bjon.2019.28.22.s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Kohli S, Bawa A, Crooks S, Nagarajakumar A, Brooker J, Doddi S. A hip fracture nurse specialist has a positive outcome on the length of stay for patients with hip fractures. G Chir 2019; 40:551-555. [PMID: 32007119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM To determine if recruitment of a hip fracture nurse specialist has a reduction in length of stay for hip fracture patients. METHOD Primary data was extracted from the National Hip Fracture Database (NHFD). The length of stay of hip fracture patients from 2011-2014 was compared to the period 2014-17, following appointment of a hip fracture nurse specialist in 2014. RESULTS The average length of stay in the first group (2011-2014) was 19.94 days and in the second group (2014-2017) was 16.52 days. There was a reduction of 3.42 days (17.15%) and was statistically significant. There was also a reduction in the time to surgery (1.38 days versus 1.15 days) and the crude 30-day mortality (10% versus 6.06%) both of which were statistically significant. The two groups were well-matched with regards to age, female: male ratio and severity of co-morbidities (based on American Society of Anaesthesiologists physical status classification system). CONCLUSION The introduction of a dedicated hip fracture nurse specialist has a positive outcome on hip fracture patients by reducing length of stay, time to surgery and the crude 30-day mortality.
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Abstract
Specialist nurses who have acquired specific expertise are often expected to demonstrate clinical leadership within their teams. They must therefore be suitably prepared for this during their training.
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Affiliation(s)
- Charles Eury
- Association nationale des puéricultrices(teurs) diplômé(e)s et des étudiants, 132, avenue du Général-Leclerc, 75014 Paris, France
| | - Christophe Paysant
- Syndicat national des infirmiers anesthésiste, 41B, boulevard la Tour-Maubourg, 75007 Paris, France
| | - Ghislaine Rouby
- Comité d'entente des écoles d'infirmiers anesthésistes, 5, avenue Esquirol, 69003 Lyon, France
| | - Brigitte Ludwig
- Union nationale des associations d'infirmiers de bloc opératoire diplômés d'État, 16, rue Daguerre, 75014 Paris, France
| | - Aline Dequidt
- Association des enseignants et des écoles d'infirmiers de bloc opératoire, École d'infirmiers de bloc opératoire Lille, 351, rue Ambroise-Paré, 59120 Loos, France
| | - Laurence Meteyer
- Association des enseignants et des écoles d'infirmiers de bloc opératoire, École d'infirmiers de bloc opératoire Lille, 351, rue Ambroise-Paré, 59120 Loos, France
| | - Christophe Debout
- c/o Soins, Elsevier Masson SAS, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux, France.
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Chamberlain D, Hegney D, Harvey C, Knight B, Garrahy A, Tsai LPS. The factors influencing the effective early career and rapid transition to a nursing specialty in differing contexts of practice: a modified Delphi consensus study. BMJ Open 2019; 9:e028541. [PMID: 31462470 PMCID: PMC6720241 DOI: 10.1136/bmjopen-2018-028541] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study aimed to test and further develop the 'Early Career and Rapid Transition to a Nursing Specialty' (TRANSPEC) model to a nursing specialty developed from a systematic review. Semi-structured interviews of specialist clinically based nurses and a consensus Delphi study with an expert panel were used to expand and achieve consensus, agreement, reliability and stability of the model. DESIGN A modified Delphi, two rounds (64 and 52 Likert items) of reiterative online questionnaires and one round as a nominal group technique, was informed by qualitative thematic analysis of semi-structured interviews. SETTING AND PARTICIPANTS Interviews with 14 specialists clinical practicing registered nurses and a panel of 25 national experts participated in the Delphi study. RESULTS The interview participants experienced 14 rapid transitions and three were early career transition. The overarching themes from the preliminary model were confirmed and further expanded. These were the self (personal and professional); the transition processes (final and informal); a sense of belonging; and the overarching context of practice over a time continuum. In the Delphi, the highest rating item was 'Specialty work colleagues respect, include, support, and accept specialist nurse on completion of transition processes'. Pre-entry was highlighted as an important time point prior to transition. All items reaching consensus were included in the final model. Cronbach α increased from 0.725 to 0.875 for the final model. CONCLUSIONS The TRANSPEC model is a valid and reliable evidence-based tool for use in the career pathway and development of nursing specialists. Using the Benner model 'Novice to Expert' after the novice incomer phase is achieved, further lifelong learning development will transform the novice specialist over time continuum.
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Affiliation(s)
- Diane Chamberlain
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Desley Hegney
- Research Division, Central Queensland University, Brisbane, Queensland, Australia
- School of Nursing, University of Adelaide, Adelaide, South Australia, Australia
| | - Clare Harvey
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Mackay, Queensland, Australia
| | - Bruce Knight
- School of Education and the Arts, Central Queensland University, Townsville, Queensland, Australia
| | - Anne Garrahy
- Department of Health, Queensland Government, Brisbane, Queensland, Australia
| | - Lily Pei-San Tsai
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
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Lawler J, Trevatt P, Elliot C, Leary A. Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence. Hum Resour Health 2019; 17:65. [PMID: 31391081 PMCID: PMC6686398 DOI: 10.1186/s12960-019-0401-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/19/2019] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The aim of the hermeneutic review was to identify and clarify the mechanisms by which the Diabetes Specialist Nursing workforce affect the outcomes of diabetes patients, with a focus on those in the United Kingdom. A clarification of diabetes specialist nurses' work is necessary in understanding and improving diabetes inpatient care. DESIGN The design is a hermeneutic evidence review and was part of a wider evaluation of Diabetes Inpatient Specialist Nurses for which the evidence was sourced. The literature search was limited to specialist nursing workforce caring for adults with diabetes. In order to gain global understanding of the impact of specialist nursing in diabetes, worldwide literature was included. METHODS A hermeneutic literature review of 45 publications was carried out, which included citation analysis. Relevant literature was identified from 1990 to 2018. RESULTS Evidence suggests that Diabetes Specialist Nurses educate patients and other healthcare professionals as well as delivering direct care. The outcomes of these actions include a reduced patient length of stay in hospital, reduced inpatient harms and complications, and improved patient satisfaction. Additionally, they are cost-effective. CONCLUSIONS The Diabetes Specialist Nursing workforce is essential in diabetes care, particularly in hospital settings. They improve patient experience and outcomes.
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Affiliation(s)
- Jessica Lawler
- London South Bank University, School of Health and Social Care, 103 Borough Rd, London, SE1 0AA, United Kingdom.
| | - Paul Trevatt
- Cardiovascular Disease/End of Life Care, Clinical Networks, NHS England (London region), London, United Kingdom
| | - Clare Elliot
- South West London Health & Care Partnership, London, United Kingdom
| | - Alison Leary
- London South Bank University, School of Health and Social Care, 103 Borough Rd, London, SE1 0AA, United Kingdom
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Horseman Z, Milton L, Finucane A. Barriers and facilitators to implementing the Carer Support Needs Assessment Tool in a community palliative care setting. Br J Community Nurs 2019; 24:284-290. [PMID: 31166774 DOI: 10.12968/bjcn.2019.24.6.284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 06/09/2023]
Abstract
Family carers play a central role in community-based palliative care. However, caring for a terminally ill person puts the carer at increased risk of physical and mental morbidity. The Carer Support Needs Assessment Tool (CSNAT) enables comprehensive assessment of carer support needs. The present study aimed to identify barriers and facilitators to implementing the CSNAT in a community specialist palliative care service. Semi-structured interviews with 12 palliative care nurse specialists from two community nursing teams in Lothian, Scotland, June 2017. Data was audio-recorded, transcribed and analysed. Palliative care nurse specialists acknowledge the importance of carers in palliative care and encourage carer support practices. Nurses perceived the CSNAT as useful, but used it as an 'add-on' to current practice, rather than as a new approach to carer-led assessment. Further training is recommended to ensure community palliative care nurses are familiar with the broader CSNAT approach.
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Affiliation(s)
- Zoe Horseman
- Research Assistant, Usher Institute of Population Health Sciences and Informatics College of Medicine and Veterinary Medicine, University of Edinburgh
| | | | - Anne Finucane
- Honorary Fellow, University of Edinburgh; Research Lead, Marie Curie Hospice
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Abstract
Over the past 25 years, the roles of school nurses have been both expanding and specializing in public and non-public school settings. To help meet the ever-changing and demanding challenges that specialized school nurses encounter in their unique settings, NASN embraced the idea that school nurses need a way to connect with colleagues working in similar practices. Thus, special interest groups (SIGs) were established, and the SIGs have become an integral part of NASN.
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Affiliation(s)
- Cheryl Blake
- Chair, Private, Independent, and Parochial School Nurses (PIPSN), Durham, NC
| | - Shirley C Gordon
- Co-Chair, Consortium of School Nurse Educators, and Professor and the Founder/Director, Head Lice Treatment and Prevention Project, Florida Atlantic University Christine E. Lynn College of Nursing, Boca Raton, FL
| | - Linda Kimel
- Co-Chair, Special Needs School Nurses Special Interest Group, and Certified School Nurse, Rockford Public Schools, Rockford, IL
| | - Lindsey Minchella
- Co-Chair, NASN Special Needs School Nurses Special Interest Group, West Lafayette, IN
| | - Robin Adair Shannon
- Co-Chair, Consortium of School Nurse Educators, and Clinical Assistant Professor, University of Illinois College of Nursing, Chicago, IL
| | - Rhoda Shepherd
- Co-Chair, School Nurse Administrator Special Interest Group, Cedar Rapids, IA
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Abstract
PURPOSE The purpose of this study was to investigate developments in antidepressant prescriptions by Dutch general practitioners, alongside the national introduction of mental health nurses. Antidepressant prescriptions are very common in general practice, but are often not in line with recommendations. The recent introduction of mental health nurses may have decreased antidepressant prescriptions, as general practitioners (GPs) have greater potential to offer psychological treatment as a first choice option instead of medication. MATERIAL AND METHODS Anonymised data from the medical records of general practices participating in the NIVEL Primary Care Database in 2011-2015 were analysed in an observational study. We used multilevel logistic regression analyses to determine whether total antidepressant prescriptions and antidepressants prescribed within one week of diagnosing anxiety or depression decreased in the period 2011-2015. We analysed whether changes in antidepressant prescriptions were associated with the employment or consultation of mental health nurses. RESULTS Antidepressants were prescribed in 30.3% of all anxiety or depression episodes; about half were prescribed within the first week. Antidepressants prescriptions for anxiety or depression increased slightly in the period 2011-2015. The employment of mental health nurses was not associated with a decreased number of prescriptions of antidepressants. Patients who had at least one mental health nurse consultation had fewer immediate prescriptions of antidepressants, but not fewer antidepressants in general. CONCLUSIONS Antidepressant prescriptions are still common in general practice. So far, the introduction of mental health nurses has not decreased antidepressant prescriptions, but it may have a postponing effect.
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Affiliation(s)
- Tessa Magnée
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- CONTACT T. Magnée Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands
| | - Derek P. de Beurs
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Francois G. Schellevis
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Peter F. Verhaak
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Department of General Practice, Groningen University, Groningen, The Netherlands
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Riordan F, McHugh SM, Murphy K, Barrett J, Kearney PM. The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services. BMJ Open 2017; 7:e015049. [PMID: 28801394 PMCID: PMC5724109 DOI: 10.1136/bmjopen-2016-015049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. DESIGN A cross-sectional survey of hospital and community-based DNS in Ireland. METHODS Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. RESULTS The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. CONCLUSIONS Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed.
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Affiliation(s)
- Fiona Riordan
- Department of Epidemiology and Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Sheena M McHugh
- Department of Epidemiology and Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Katie Murphy
- Department of General Practice, University College Cork, Cork, Ireland
| | - Julie Barrett
- Department of Epidemiology and Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Patricia M Kearney
- Department of Epidemiology and Public Health, University College Cork National University of Ireland, Cork, Ireland
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Affiliation(s)
- Liz Anderson
- Nutrition Nurse Specialist, Nutrition and Dietetics Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust
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36
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Abstract
As life expectancy increases so people often develop a range of conditions and disabilities in the years before death. Multimorbidity represents the most common 'disease pattern' found among the elderly and is characterised by complex interactions of co-existing diseases where a medical approach focused on a single disease does not suffice. People with dementia who also have other comorbidities do not always have their comorbid conditions managed as those without dementia which often lead to a high number of hospital admissions with longer lengths of stay and greater treatment costs. This case study presents the case management approach taken by Admiral Nursing in managing the complexities where there is comorbidity of a long-term condition and a diagnosis of dementia. By empowering the person and their carer with information and choices and through good case management and communication, people can be supported to live well and avoid inappropriate hospital admissions.
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Affiliation(s)
- Cathy Knight
- Consultant Admiral Nurse & Lecturer in Dementia Care, Coventry University
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37
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Lin JX, Chen XW, Chen ZH, Huang XY, Yang JJ, Xing YF, Yin LH, Li X, Wu XY. A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy: A clinical trial. Medicine (Baltimore) 2017; 96:e7373. [PMID: 28658162 PMCID: PMC5500084 DOI: 10.1097/md.0000000000007373] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND & AIMS Nutritional interventions for malnutrition in cancer patients can be helpful. However, concise intervention recommendations remain controversial. Thus, the aim of this study was to report on a nutrition intervention conducted by a multidisciplinary team of specialist nurses and to explore the effect of nutritional intervention on cancer patients. METHODS This prospective clinical trial study enrolled 110 colorectal cancer patients undergoing chemotherapy. The patients were evaluated upon admission using the 2002 Nutritional Risk Screening system (NRS-2002). The patients were randomly divided into intervention and control groups including 55 patients each. Patients in the control group were administered a normal diet, while those in the intervention group received individual recipes developed by a team of professional nurses, clinical doctors, dietitian, family caregivers, and the patients themselves. Patient weight and serum albumin and prealbumin levels were compared between the 2 groups at different time points. RESULTS There was a significant difference in patient weight and serum albumin and prealbumin levels before and after nutrition intervention in the intervention group (P < .05). In the control group, weight did not change during ordinary diet guidance. Serum albumin level was slightly improved after 12 cycles of chemotherapy, similar to the prealbumin results. There were statistically significant differences in serum albumin and prealbumin levels between the intervention and control groups after nutrition intervention (P < .05). However, there was no statistically significant difference in weight between the groups after nutrition intervention (P > .05). CONCLUSION A multidisciplinary team approach for nutrition intervention conducted by specialist nurses improved prealbumin levels in colorectal cancer patients undergoing chemotherapy, with no weight change.
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Affiliation(s)
- Jin-Xiang Lin
- Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University
| | - Xiang-Wei Chen
- Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University
| | - Zhan-Hong Chen
- Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University
| | - Xiu-Yan Huang
- Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University
| | - Jin-Jie Yang
- Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University
| | - Yan-Fang Xing
- Department of Nephrology, the Third Affiliated Hospital of Guangzhou Medical University
| | - Liang-Hong Yin
- Department of Nephrology, First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China
| | - Xing Li
- Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University
| | - Xiang-Yuan Wu
- Department of Medical Oncology and Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University
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38
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Abstract
Inflammatory bowel disease (IBD) nurse specialists provide invaluable support and expertise to patients to help improve their quality of life and give them more control over their treatment.
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39
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Marley J. Let's face the future together. Br J Nurs 2017; 26:S3. [PMID: 28493777 DOI: 10.12968/bjon.2017.26.9.s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Jerome Marley
- Lecturer in Nursing and Faculty Subject Partnership Manager, School of Nursing, Ulster University, and Past President of BAUN
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40
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Morey MP. [The pain resource nurse consultation guidelines]. Soins 2017; 62:44-45. [PMID: 28477761 DOI: 10.1016/j.soin.2017.03.017] [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: 06/07/2023]
Abstract
The cross-disciplinary activities of pain resource nurses were provided with guidelines in 2007. Due to the development of their role in care structures and the ongoing organisation of the nursing activity, guidelines relating to their consultation activities were drawn up in 2016. These describe the circumstances in which a pain resource nurse may intervene and the types of consultation she carries out.
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Affiliation(s)
- Muriel Perriot Morey
- Centre hospitalier de Châteauroux-Le Blanc, 216, avenue de Verdun, 36000 Châteauroux, France.
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Bévis C. [Role of the pain resource child health nurse faced with the chronic pain of a child]. Soins 2017; 62:46-47. [PMID: 28477762 DOI: 10.1016/j.soin.2017.03.012] [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: 06/07/2023]
Abstract
Along their care pathway, children complaining of chronic pain may sometimes be hospitalised. During their stay, health professionals, trained in acute pain management, may find it difficult to deal with this particular syndrome. A specialised unit, comprising notably a pain resource child health nurse, supports the teams to help them understand chronic pain.
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Affiliation(s)
- Charlotte Bévis
- Centre d'étude et de traitement de la douleur chronique de l'enfant et de l'adolescent, Cap Sud Enfant, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
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Cousins G, Lord J. Runner up 2017. Br J Nurs 2017; 26:454-455. [PMID: 28453317 DOI: 10.12968/bjon.2017.26.8.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Gary Cousins
- Resident Experience Care Specialist Nurse for Four Seasons Health Care, Belfast
| | - Jane Lord
- Infection Prevention and Control Nurse Specialist, Lincolnshire Partnerships Foundation Trust, Lincoln
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Nicholl K. The role of the biologics nurse specialist in rheumatology. Br J Nurs 2017; 26:390. [PMID: 28410045 DOI: 10.12968/bjon.2017.26.7.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Karl Nicholl
- Biologics Nurse Specialist, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust
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Lavender V. Finding our voice in the MDT. Br J Nurs 2017; 26:S3. [PMID: 28230424 DOI: 10.12968/bjon.2017.26.4.s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Verna Lavender
- Senior Lecturer in Cancer Care, Oxford Brookes University
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Morgan K. National Lymphoedema Education and Research Specialist in Wales. Br J Nurs 2017; 26:207. [PMID: 28230444 DOI: 10.12968/bjon.2017.26.4.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Karen Morgan, National Lymphoedema Education and Research Specialist, Lymphoedema Network Wales discusses her 25-year nursing career and the broad-ranging responsibilities that form part of her role.
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Churches M, Merkel S, Robbins S, George C. Procedural Pain Reduction and Comfort for Patients Undergoing Ophthalmic Surgery. Insight 2017; 42:28-32. [PMID: 30074691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Lee TY. The Roles and Functions of Informatics Nurse Specialists in Taiwan. Stud Health Technol Inform 2017; 232:97-100. [PMID: 28106587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
During the modernization process in hospitals, information technology is an important indicator. "Informatics nurses" play a critical role in hospitals and clinics. In Taiwan, the certification system of informatics nurses just recently began in 2016. The development of certificated personnel results from students who have graduated with a university degree in nursing and have taken classes in informatics, as well as nurses who have been trained in informatics at clinics and hospitals, and the establishment of a national nursing informatics association. Clinically, the main responsibilities of Informatics Nurse Specialists are system analysis, training, problem solving, data analysis, and communication. In Taiwan, as of September 2016, only 48 informatics nurses have been certified. They are working either in hospitals or at universities.
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Affiliation(s)
- Tso Ying Lee
- Nursing Department, Cheng Hsin General Hospital, Taipei, Taiwan
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48
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Keep the pressure on commissioners to fund children's care. Nurs Child Young People 2016; 28:5. [PMID: 27927109 DOI: 10.7748/ncyp.28.10.5.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The inability of the most vulnerable people to get the care they deserve, whether at the beginning, middle or end of their lives, is a sad reflection on the society's priorities. This is why the news that children's hospices are facing a funding crisis is a cause for huge concern.
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49
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Affiliation(s)
- Julia Williams
- Senior Lecturer, Adult Nursing, Buckinghamshire New University, Uxbridge
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50
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Gultekin G, Kincir Z, Kurt M, Catal Y, Acil A, Aydin A, Özcan M, Delikkaya BN, Kacar S, Emul M. Facial emotion recognition ability: psychiatry nurses versus nurses from other departments. CLIN INVEST MED 2016; 39:27503. [PMID: 27917794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Facial emotion recognition is a basic element in non-verbal communication. Although some researchers have shown that recognizing facial expressions may be important in the interaction between doctors and patients, there are no studies concerning facial emotion recognition in nurses. Here, we aimed to investigate facial emotion recognition ability in nurses and compare the abilities between nurses from psychiatry and other departments. METHODS In this cross-sectional study, sixty seven nurses were divided into two groups according to their departments: psychiatry (n=31); and, other departments (n=36). A Facial Emotion Recognition Test, constructed from a set of photographs from Ekman and Friesen's book "Pictures of Facial Affect", was administered to all participants. RESULTS In whole group, the highest mean accuracy rate of recognizing facial emotion was the happy (99.14%) while the lowest accurately recognized facial expression was fear (47.71%). There were no significant differences between two groups among mean accuracy rates in recognizing happy, sad, fear, angry, surprised facial emotion expressions (for all, p>0.05). The ability of recognizing disgusted and neutral facial emotions tended to be better in other nurses than psychiatry nurses (p=0.052 and p=0.053, respectively) Conclusion: This study was the first that revealed indifference in the ability of FER between psychiatry nurses and non-psychiatry nurses. In medical education curricula throughout the world, no specific training program is scheduled for recognizing emotional cues of patients. We considered that improving the ability of recognizing facial emotion expression in medical stuff might be beneficial in reducing inappropriate patient-medical stuff interaction.
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