National Association of Clinical Nurse Specialists Affiliate Support for Professional Growth of Clinical Nurse Specialist Students

PURPOSE/OBJECTIVES

The purpose of this article was to describe how a National Association of Clinical Nurse Specialists affiliate partnered with a local university to engage clinical nurse specialist (CNS) students, enhance its mission and activities, and create succession planning opportunities, while providing mentorship and professional growth opportunities.

DESCRIPTION OF THE PROJECT

Academic preparation of CNS students endeavors to instill professionalism. A 3-pronged partnership incorporating the inclusion of a student liaison on the board, presentation of student clinical work at the affiliate's annual conference, and development of a student scholarship was implemented.

OUTCOMES

Membership in professional nursing organizations for a CNS student provides exposure and access to professional development resources, socialization to the role, rewarding networking opportunities with peers and colleagues, and leadership development. Anecdotal feedback demonstrated a better understanding of the CNS role, increased confidence, and enhanced knowledge on topics such as legislative advocacy as well as experiences of sharing clinical challenges with CNS colleagues.

CONCLUSION

Partnership with the local university allowed the affiliate to maintain the influx of new CNSs, which sustains membership, nurtures the growth of new CNSs, and ensures the influx of new ideas. Furthermore, membership in professional nursing organizations is imperative to address the opportunities that exist in healthcare.

Credentialed and Privileged Clinical Nurse Specialists

PURPOSE/OBJECTIVES

The purpose of this article is to illustrate, using exemplars, the practice of clinical nurse specialists (CNSs) in Michigan who are credentialed and privileged as providers by hospital/healthcare agencies to practice in acute inpatient and ambulatory settings.

DESCRIPTION

The CNS provides expert specialty direct patient care to improve patient outcomes. They hold a graduate degree as a CNS, are professionally certified as a CNS in a specialty practice population, and are licensed or otherwise recognized to practice as an advanced practice nurse by the state nursing practice regulatory agency.

OUTCOME

The exemplars illustrate CNS practice as an independent provider within a health system.

CONCLUSION

Hospital-based credentialing and privileging facilitates CNS practice within the full scope of practice authority that consists of education, certification, and licensure and is a valuable contribution to cost-effective, high-quality clinical care for specialty populations.

Differentiating Specialized and Advanced Nursing Roles: The Pathway to Role Optimization

Aim

We aimed to differentiate the practice patterns of nurses in specialized and advanced roles in a cross-sectional study.

Method

Canadian nurses completed a self-report questionnaire (June 2017-September 2017). Demographic data and time spent in five domains of advanced practice were compared across three nurse groups. Regression analysis examined factors associated with domain involvement.

Results

Respondents (n = 1,107) represented all provinces/territories, including 396 specialized nurses (SNs), 211 clinical nurse specialists (CNSs) and 490 nurse practitioners (NPs). Nurses across all groups were the most involved in direct comprehensive care and the least involved in research. NPs were more involved in direct comprehensive care compared to CNSs (p < 0.001) and SNs (p < 0.001). CNSs were more involved than SNs and NPs in support of systems, education, research and professional leadership (p < 0.001). Role type, years as an advanced practice nurse and specialist certification were modest predictors of domain involvement.

Conclusion

Distinguishing how specialized and advanced nursing roles contribute to healthcare can inform policies to support their optimal utilization in healthcare systems.

Market competition and demand for skills in a credence goods market: Evidence from face-to-face and web-based non-physician clinician training in rural China

Background

Non-physician clinicians (NPCs) providing services in functionally private markets account for a large share of the workforce in the primary care system in many low-income and middle-income countries. Although regular in-service training is believed to be crucial to updating NPCs’ professional knowledge, skills, and practices, participation rates are often low. Low participation may result from the “credence good” nature of the market for primary care: if patients are unable to observe quality improvements from training, NPCs have weaker incentives to participate. Empirical evidence is limited on the relationship between market competition and NPC participation in-service training as well as how participation varies with the type of training available.

Methods

The study uses a dataset of 301 NPCs from three prefectures in Yunnan, a province in southwest China, collected in July 2017. Logistic regression is used to estimate the relationship between competition and NPC’s participation in in-service training. We assess the relationship between participation and both the quantity of competition (number of competitors in the same village and surrounding villages) and the quality of competition (proxied using characteristics of competing clinicians).

Results

In 2016, nearly two thirds of NPCs participated in face-to-face or web-based in-service trainings at least once. Specifically, 58 percent of NPCs participated in face-to-face in-service trainings, and 24 percent of NPCs participated in web-based in-service trainings. The quantity of competitors is unrelated to participation in in-service training. The quality of competition is not related to face-to-face training but has a significant positive relationship with participation in web-based training.

Conclusions

Web-based trainings may be a better approach to increase NPC skills in developing country primary care markets.

An Academic and Clinical Practice Partnership Model: Collaboration Toward Baccalaureate Preparation of RNs

BACKGROUND

In response to the call for a baccalaureate-prepared nursing workforce versed in enhanced critical thinking, clinical judgment, and complex decision making, an innovative and highly accessible model for developing academic and clinical practice partnerships among stake-holders in nursing education was developed and implemented.

METHOD

Participatory action research informed the qualitative research methodology for implementing the model. The model allows for a number of data collection points to ensure the needs and concerns of stakeholders were considered.

RESULTS

Implementation of the model resulted in six new academic partnership agreements and two new clinical practice partnerships.

CONCLUSION

Academic and clinical practice partnerships are integral to fostering mutual respect among stakeholder institutions, enhancing collaboration toward evidence-based practice and joint research efforts, and creating seamless pathways to academic progression in the nursing profession. Such collaborative efforts are paramount to easing the barriers to baccalaureate and advanced-degree preparation in nursing. [J Nurs Educ. 2020;59(4):203-209.].

Clinical nurses' beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture

BACKGROUND

This study aimed to identify clinical nurses' evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt's Advancing Research & Clinical Practice through Close Collaboration model as the first step.

METHODS

A descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP.

RESULTS

Our findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation.

CONCLUSIONS

Based on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization.

Impact of Socio-Emotional Skills On The Performance of Clinical Nursing Practices

Aim To analyze the Socio-emotional (SE) skills of the students in the Nursing Degree, and their relationship with their clinical practice in hospital centers. Methods Cross-sectional descriptive study of a sample of 91 nursing students. SE skills were analyzed through self-administered questionnaires, and the clinical practices through the instrument "Clinical Practices Evaluation Notebook". Findings The students obtained medium and high scores in the SE skills and in the clinical practices. Most of the SE skills had a positive and statistically significant relationship (p < 0.05) between them. A relationship was observed between SE skills with performance in clinical practices, through a multiple linear regression. Discussion It is suggested that the development of the SE skills of the nursing students within the Nursing degree curriculum has an influence on their performance during their clinical practices. Conclusion The SE skills are a potential predictor of the performance of the nursing students in clinical practices.

The framework for developing nursing specialist roles in the health care system of Iran

BACKGROUND

A key step to the development of a roadmap for developing nursing specialist roles is to create its framework based on the immediate context.

PURPOSE

This study aimed to create the framework for developing nursing specialist roles in the health care system of Iran.

METHODS

This was a descriptive qualitative study. A purposeful sample of 81 nursing and nonnursing experts was recruited. The directed content analysis approach was used for data analysis.

FINDINGS

The framework for developing nursing specialist roles in the health care system include eight main categories. These categories are role titles, prioritization of the necessary specialties, the necessary competencies of nurses at specialist level, the scope of nursing specialist practice, expected authorizations, requirements for role development, and its barriers and facilitators.

DISCUSSION

Creating a context-based framework for nursing specialist role development based on the characteristics of each country is recommended.

The Admiral Nurse Competency Framework: Encouraging Engagement and Putting It Into Practice

BACKGROUND

Admiral Nurses undertake complex work with families living with dementia. Dementia UK commissioned The Association for Dementia Studies to refresh the Admiral Nurse Competency Framework and enable Admiral Nurses to articulate and critically reflect on their own practice progression. The Admiral Nurses were involved throughout the process to refresh the framework to ensure it was evidence based.

METHOD

To encourage engagement with the framework, The Association for Dementia Studies worked with the Admiral Nurses during a roll-out phase. An exercise was developed to initiate critical reflective discussion. Critiquing a colleague's practice is a skill, provoking defensiveness if not facilitated thoughtfully.

RESULTS

An exercise combining art cards with case study analysis worked well, promoting critical reflective dialogue between Admiral Nurses as peers. Engagement and feedback were positive, and the neutrality of the exercise provided a safe environment with the flexibility to allow in-depth and meaningful discussions.

CONCLUSION

This technique could benefit work-based learning, facilitating creative critical reflection within practice. [J Contin Educ Nurs. 2019;50(5):205-210.].

Nurses' objective knowledge regarding venous thromboembolism prophylaxis: A national survey study

Venous thromboembolism (VTE) is a common vascular disorder with high mortality and morbidity. Clinical nurses are a pivotal group that can serve as first-line health care providers. Lack of knowledge about VTE is an important barrier to effective nursing performance. This study aimed to determine nurses' knowledge of VTE prophylaxis through a nationwide survey across China, to understand gaps between current knowledge, and guidelines, and to help improve clinical nursing.The survey included 5 topics with 68 items on VTE, including basic knowledge, risk assessment, basic prophylaxis, physical prophylaxis, and pharmacological prophylaxis.The survey was distributed to 106 AAA-grade hospitals throughout China; 5218 valid questionnaires were submitted for analysis. There were 5097 women and 121 men respondents, with average age 30.29 ± 8.60 years. The average rate of correct responses regarding VTE knowledge was 59.90 ± 15.63%; 77.81% of subjects answered more than half of the survey items correctly. Better knowledge about thromboprophylaxis was observed among nurses who were more highly educated, more experienced, had received continuing education, intensive care unit (ICU), and lead nurses. Correct response rates were 68.39 ± 17.03%, 60.35 ± 21.01%, 75.51 ± 22.85%, 41.72 ± 17.47%, and 46.01 ± 21.22% for basic knowledge, risk assessment, basic prophylaxis, physical prophylaxis, and pharmacological prophylaxis, respectively.Respondents showed satisfactory results regarding basic prophylaxis, basic knowledge, and risk assessment for VTE; respondents had poorer knowledge regarding physical and pharmacological prophylaxis. Better mastery of knowledge about thromboprophylaxis was observed among nurses who were more highly educated, more experienced, had received continuous education, ICU, and lead nurses.This study suggested that nurse trainers should develop comprehensive educational programs that focus on low correct rate aspects. Higher-level continuous education could improve nurses' knowledge of thromboprophylaxis.

Postgraduate nurses' self-assessment of clinical competence and need for further training. A European cross-sectional survey

BACKGROUND

Nursing practice requires application of knowledge, skills and values in various combinations and has undergone substantial changes the last decades. An increased focus on inter-professional collaboration and possible new and more independent roles for nurses are described. A variety of programs have been developed in order to educate registered nurses (RN) to meet the changes and demands in health and nursing care throughout the world.

AIM

The aims were to 1) describe nurses' self-assessment of clinical competence and need for further training, and 2) explore possible differences between nurses in specialist vs master's programs.

METHODS

A cross-sectional survey design was applied. 97 nurses in postgraduate programs from five countries responded (response rate 45%). A revised version of the Professional Nurse Self-Assessment Scale of clinical core competencies (PROFFNurseSASII) was used for data collection. Independent student t-test and regression analyses were carried out.

RESULTS

The respondents rated their competence highest in taking full responsibility, cooperation with other health professionals and in acting ethically. Items where they considered themselves needing further training most were competence on medications, interaction and side effects and differential diagnoses. For all items, nurses in master's programs rated their competence higher than nurses in the specialist programs. Nurses in specialist programs rated their need for more training for all items higher than nurses in master's degree programs, and for 47 out of the 50 items these differences were statistically significant.

CONCLUSION

Even though the nurses rated their competence high for important competence aspects such as taking responsibility and cooperation with other health professionals, it is worrying that their need for further training was highest for effects and interaction of various types of medications. Further studies are needed to conclude if and how master's education improves patient outcome.

Knowledge Level and Educational Needs of Turkish Oncology Nurses Regarding the Genetics of Hereditary Breast and Ovarian Cancer

BACKGROUND

This study evaluated Turkish oncology nurses' knowledge and educational needs regarding genetics of hereditary breast and ovarian cancers.

METHOD

An online survey was used to collect data from 104 Turkish oncology nurses.

RESULTS

The mean level of knowledge in oncology genetics was 6.74 ± 3.85. The majority of nurses (78.7%) were aware of the fact that family history of ovarian or breast cancer is an important risk factor for ovarian or breast cancer; however, a much smaller percentage (25.5%) understood that BRCA1 mutations in women can be transferred by the father. The majority of the nurses (59.6%) were willing to take continuing education in cancer genetics.

CONCLUSION

Turkish oncology nurses have a moderate level of knowledge in cancer genetics. Therefore, educators should develop targeted educational activities in genetics as a part of continuing education programs to enhance nursing practice in cancer care. J Contin Educ Nurs. 2017;48(12):570-576.

Innovative Intraprofessional Clinical Training for Clinical Nurse Specialists and Nurse Practitioner Students

BACKGROUND

Most graduate nursing education curricula naturally segregate students by role as they move into their role-specific coursework and clinical experiences. Segregation diminishes the opportunity for students to form important intraprofessional relationships. Intraprofessional collaboration can potentiate the influence of advanced practice nurses on individual patients, patient populations, and larger health care systems.

METHOD

This pilot program paired clinical nurse specialists and nurse practitioner students in immersion clinical practicum experiences aimed to increase their understanding of each other's role and potential avenues for collaboration in future practice.

RESULTS

Students report increased levels of understanding of each other's roles and scope of practice. Pairing students in immersion experiences broadens their clinical reach and potentiates their influence on vulnerable patient populations.

CONCLUSION

Findings indicate that this pilot program can be sustained. Benefits to early and focused intraprofessional educational experiences include increased awareness of advanced practice roles, scope of practice, and potential avenues for future collaboration. [J Nurs Educ. 2017;56(12):748-751.].

Translating Knowledge From a Family Systems Approach to Clinical Practice: Insights From Knowledge Translation Research Experiences

While there has been continued growth in family nursing knowledge, the complex process of implementing and sustaining family nursing in health care settings continues to be a challenge for family nursing researchers and clinicians alike. Developing knowledge and skills about how to translate family nursing theory to practice settings is a global priority to make family nursing more visible. There is a critical need for more research methods and research evidence about how to best move family nursing knowledge into action. Enhancing health care practice is a multifactorial process that calls for a systemic perspective to ensure its efficacy and sustainability. This article presents insights derived from lessons learned through recent research experiences of using a knowledge translation model to promote practice changes in health care settings. These insights aim to optimize (a) knowledge translation of a Family Systems Approach (FSA) in practice settings; (b) knowledge translation research processes; and

Overview of the uptake and implementation of non-medical prescribing in Wales: a national survey

OBJECTIVES

To identify (1) the non-medical healthcare professionals in Wales qualified to prescribe medicines (including job title, employer, where the prescribing qualification is used, care setting and service provided); (2) the mode of prescribing used by these healthcare professionals, the frequency with which medicines are prescribed and the different ways in which the prescribing qualification is used; and (3) the safety and clinical governance systems within which these healthcare professionals practise.

DESIGN

National questionnaire survey.

SETTING

All three National Health Service (NHS) Trusts and seven Health Boards (HB) in Wales.

PARTICIPANTS

Non-medical prescribers.

RESULTS

379 (63%) participants responded to the survey. Most of these prescribers (41.1%) were specialist nurses who work in a variety of healthcare settings (primarily in secondary care) within each HB/NHS Trust, and regularly use independent prescribing to prescribe for a broad range of conditions. Nearly a quarter of the sample (22%) reported that prior to undertaking the prescribing programme, they had completed master's level specialist training and 65.5% had 5 years qualified experience. Over half (55.8%) reported that there were plans to increase non-medical prescriber numbers within the team in which they worked. Only 7.1% reported they did not prescribe and the median number of items prescribed per week was between 21 and 30. Nearly all (87.8%) of the sample reported that they perceived prescribing to have ensured better use of their skills and 91.5% indicated that they believed it had improved the quality of care they were able to provide.

CONCLUSION

Non-medical prescribing has been implemented across the whole of Wales; however, its uptake within HBs and NHS Trusts has been inconsistent, and it has not been considered across all services, particularly those in primary care. Opportunities therefore exist to share learning across organisations.

Disseminating START: training clinical psychologists and admiral nurses as trainers in a psychosocial intervention for carers of people with dementia's depressive and anxiety symptoms

OBJECTIVES

To put into practice and to evaluate an initial dissemination programme for the Strategies for Relatives (START), a clinically and cost-effective manualised intervention for family carers of people with dementia.

SETTING

We offered 3-hour 'train-the-trainer' sessions through the British Psychological Society and Dementia UK.

PARTICIPANTS

Clinical psychologists and admiral nurses across the UK.

PRIMARY AND SECONDARY OUTCOME MEASURES

After the training session, attendees completed an evaluation. Attendees were asked how they had implemented START 6 and 12 months later, and to participate in telephone interviews about their experiences of what helps or hinders implementation 1 year after training.

RESULTS

We trained 134 clinical psychologists and 39 admiral nurses through 14 training sessions between October 2014 and September 2015 in nine UK locations and made materials available online. The 40 survey respondents had trained 75 other staff. By this time, 136 carers had received START across 11 service areas. Findings from 13 qualitative interviews indicated that some clinical psychologists had begun to implement START, facilitated by buy-in from colleagues, existing skills in delivering this type of intervention, availability of other staff to deliver the intervention and support from the research team. Admiral nurses did not supervise other staff and were unable to cascade the intervention. Where START has not been used, common barriers included lack of staff to deliver the intervention and family carer support not being a service priority. Participants wanted the training to be longer.

CONCLUSIONS

We trained clinical psychologists and admiral nurses to deliver and implement START locally. Results from survey respondents show that it was cascaded further and used in practice in some areas, but we do not know whether START was implemented by non-respondents. Future dissemination requires management buy-in, availability of practitioners and supervisors and consideration of other ways of delivery.

A Survey of Coronary Risk Factors and B-Type Natriuretic Peptide Concentrations in Cardiac Nurses from Europe: Do Nurses Still Practice what they Preach?

BACKGROUND

From a previous survey of cardiac nurses attending a scientific conference, we learned that these nurses adopted a healthier lifestyle than the general population.

AIMS

The aim of this study was to determine the overall profile of cardiac risk factors in a similar cohort and determine whether cardiac nurses continue to 'practice what they preach' in this regard. Secondly, we examined the practical value of screening a large cohort of individuals within a short time frame (total of 8 hours screening time) and determined the range of BNP concentrations within a 'healthy' cohort.

METHODS

Data on CHD risk factors were collected with a short self-report questionnaire. The sample consisted of 122 cardiac nurses from 19 countries attending a European cardiac nursing conference held in Stockholm. A venous blood sample was collected into a tube containing potassium ETDA. B-type natriuretic peptide was measured on-site with the use of a portable fluorescence immunoassay kit.

RESULTS

Most participants were female (89%). Participants ranged in age from 23 to 60 years with a mean age of 41 (S.D. 9.4). Eleven percent - all female - reported they were current smokers, 27% (34) had a BMI >25 and 27% of the sample stated they did not exercise regularly. Almost half (48%) of the sample reported a family history of CHD. As expected, all BNP-values were within the normal range. There were significant differences in BNP on the basis of sex (P<0.05) and age (P<0.05) and a trend towards increasing BNP concentrations with progressively higher BMI scores (P=0.06).

CONCLUSION

This study reconfirms the likelihood that many cardiac nurses heed their own advice on lifestyle modification to reduce cardiovascular risk and therefore provide a good role model for the promotion of primary and secondary prevention initiatives.

Diabetes Educators

A survey evaluating the professional characteristics and practice patterns of diabetes educators was distributed across the United States. The specific survey aims were to assess whether (1) there continues to be a growing trend among US health professionals who consider themselves diabetes educators to obtain certification as certified diabetes educators (CDEs), (2) duties/services associated with diabetes self-management training (DSMT) and medical/medication management differ between diabetes educators who are CDEs versus those who are non-CDEs, and (3) educator practice patterns differ across the major geographic regions of the United States. Of the 507 diabetes educators completing the survey, 83% identified themselves as CDEs. Diabetes educators responding to similar surveys done in 1992 and 1999, 51% and 63%, respectively, identified themselves as CDEs. In this survey, a similar percentage of CDEs and non-CDEs employed DSMT practices of relatively low complexity (eg, general diabetes education) whereas a significantly higher percentage (P< .001) of CDEs employed DSMT practices of relatively high complexity (eg, insulin pump training). Significantly (P < .001) more CDEs provided medical/medication management services compared to non-CDEs. Finally, the practice patterns among CDEs were minimally influenced by region of the country. These results suggest that (1) the trend toward increased certification among diabetes educators has continued, (2) certification is associated with a greater likelihood of delivering complex DSMT services and medical/medication management, and (3) this pattern is consistent across the nation as a whole.

Comprehensive Care for Adults with Congenital Heart Disease: Expanding Roles for Nurses

Adults with congenital heart disease constitute a growing patient population. Although life expectancy of these patients is increasing, they may be confronted with specific medical, psychosocial and behavioural problems throughout their life span. Special attention needs to be given to patients' illness experiences; knowledge and health behaviour; employability and insurability. Hence, comprehensive care by specialised health care professionals, addressing the multidimensional problems experienced by the patients is required. Interdisciplinary teams in which nurses guarantee the management beyond typical medical issues are promising. Key elements of nurses' involvement are facilitation of the transition process from paediatric to adult cardiology, identification of patient needs, screening and referral for psychosocial problems, and education and counselling of patients and families. In particular, an advanced practice nurse seems to be pre-eminent to optimise illness management of adult patients with congenital heart disease.

Educating Nurses and Patients to Manage Heart Failure

Patient education is an important component in the management of patients with heart failure and nurses are increasingly involved in this area. This paper reviews the literature on education to patients with heart failure and the education and training for heart failure nurses. Patients with heart failure need education in order to adapt to their chronic syndrome and perform self-care. The education process often starts during the hospital admission, but must continue in the outpatient setting. Nurses need to be skilled in assessing the requirements and level of the education given to the individual. Computer-based education has been found to be a preferred and effective compliment to the education provided by health care professionals. The effect of new materials and methods needs to be evaluated in order to improve the overall effectiveness of the education provided. The patient with heart failure should have an active role in this development and evaluation. The heart failure nurse needs to be experienced in cardiac care, have an ability to work independently in order to be delegated responsibilities such as drug titration and patient assessment. This requires optimal experience, training and education for advanced practice. In order to develop and evaluate the education of patients with heart failure and the overall effectiveness of heart failure nurses in this regard, national and international collaborations are needed.

Undertaking Nursing Interventions Throughout Europe (UNITE) Study Group. A Survey of Coronary Risk Factors in a Cohort of Cardiac Nurses from Europe: Do Nurses Practise What They Preach?

BACKGROUND

Cardiac nurses play a key role in coronary heart disease (CHD) prevention, health promotion and education. Thus, one would expect that nurses would have a heightened awareness of the need to modify lifestyle in order to prevent or reduce the risk of CHD.

AIMS

The aim of this study was to determine the prevalence of the major CHD risk factors in a cohort of cardiac nurses from a range of European countries.

METHODS

Data on CHD risk factors were collected at a health-screening interview. The sample consisted of 130 cardiac nurses from 11 countries attending a European cardiac nursing conference held in the UK. Demographic data, lipid profile, blood pressure and exercise, alcohol and smoking habits were recorded.

RESULTS

Of the 130 nurses who took part in this survey, 81% were from the UK. The mean (S.D.) age of the sample was 40 (7.5) years and 91% were female. The means (S.D.) of the risk factors were: systolic blood pressure 132 (16) mmHg; diastolic blood pressure 83 (11) mmHg; body mass index (BMI) 24.6 (3.8) kg/m(2); total cholesterol 5.1 (0.9) mmol/l; and blood glucose 5.5 (1.2) mmol/l. Ten nurses admitted to smoking and the mean weekly alcohol consumption was 10 units. Over half (53%) of the sample reported a family history of CHD and 49% reported exercising regularly.

CONCLUSIONS

Results indicate that in general, cardiac nurses have adopted a healthier lifestyle than the general population. Self-reported exercise was higher than the UK national norms and BMI was lower than UK national norms.

The Role of the Nurse in Cardiac Rehabilitation Programmes

Cardiac rehabilitation programmes are intended to enhance the effect of acute treatment actions and to prevent risk factors, thus leading to an improvement in the patient's well being and recovery. Accordingly, all cardiac rehabilitation activities do not take place at the same time, which is the reason why the nurse's role changes in character over time. The aim of this paper is, therefore, to highlight the role of the nurse in cardiac rehabilitation programmes. The nurse's multiple roles in cardiac rehabilitation have a 'spider in the web-like' character and, depending on the phase of the patient's recovery, he/she acts as a container, a counsellor, a coach and an educator. To implement a successful cardiac rehabilitation, the nurse needs to have improved evaluation tools in clinical practice as well as to be self-critical and serve as a good role model. Finally, the cardiac rehabilitation nurse has to have a four-fold comprehensive perspective of the cardiac rehabilitation concept; an impact perspective, a timing perspective, a lifespan perspective, and a personal perspective.

The Critical Role of the Continuing Education Specialist

Continuing education departments are charged with the responsibility of developing, implementing, and evaluating education that improves the practice of nursing and enhances the professional development of the nurse. This article addresses the importance of the continuing education (CE) Specialist in supporting this work. J Contin Educ Nurs. 2016;47(11):482-483.

A Leadership Development Program Through Mentorship for Clinical Nurses in Turkey

Mentoring programs can enhance nursing satisfaction, improve retention, ensure optimal patient outcomes, and may have a positive organizational effect in developing leadership skills in nursing. In this study, the effects of a formal mentoring program were explored on a sample of 18 professional nurse leaders (nine mentors and nine proteges) at a university hospital in Turkey. After receiving a formal mentoring training program, mentors and proteges were paired with each other for a 6-month monitoring period. An overall assessment revealed both mentors and proteges perceived benefits from the mentoring program. The formal mentoring program created positive change in leadership behaviors for both mentors and proteges and contributed toward relational job learning for mentors and personal skill development for proteges. Suggestions are provided for the integration of formal mentoring programs into the organizational culture.

Theory-Guided Evidence-Based Reflective Practice: An Orientation to Education for Quality Care

This column weaves a discussion of the authors' experiences, nursing theory, evidence, and a call for a sea change in nursing education informed by knowledge from the discipline of nursing.

Re-Defining Nursing Expertise in the United Kingdom

There is now international recognition of the importance of practice expertise in modern and effective health services. The Expertise in Practice Project in the United Kingdom began in May 1998 and continued to 2004. It included nurses working in all four countries of the United Kingdom, and it covered clinical specialists from pediatrics to palliative care. The project added to the current understanding of what nursing practice expertise is, through the identification and verification of attributes and factors which enable expert practice. The proposed framework offers a language for sharing what constitutes practice expertise and offers insight into what occurs between the expert practitioner and the people that experience their care. The Expertise in Practice Project demonstrates that nurses affect change and facilitate performance and organizational development.

Cardiac nursing: Achieving Competent Practitioners

This paper describes how competency statements were integrated into an academic framework to provide a transparent yet flexible career pathway for the nurse working in acute cardiac care. Nurses are expanding and developing their roles and use wide ranging skills and knowledge to care for patients. Additionally, models of care delivery are changing and patients are cared for in a variety of settings. Where evidence exists, these models demonstrate improvement in the provision and quality of services and contribute to improved quality of life, maximise medication and therapy and reduce waiting times for investigations. However, whilst many studies have demonstrated benefit, translating these results into routine practice requires skilled nurses who are “fit for purpose”, and to support this, professional competencies can be used to measure competence in practice whilst informing educational initiatives. This paper outlines the development of competency statements that identify the knowledge and skills required for safe, effective and competent care and direct the cardiac nurse acquire skills and knowledge in a focused and coherent way.

Nurse Educational Activity on Non-Prescription Therapies in Patients with Chronic Heart Failure

BACKGROUND

Notwithstanding the polypharmacy required for heart failure therapy, many patients use non-prescription therapies, including alternative medicines, herbal remedies, integrators and over-the-counter (OTC) drugs.

AIMS

Non-prescription therapies could interfere with heart failure therapy, both promoting non-compliance and through pharmacological interferences. Heart failure nurses, in order to plan their educational activity, need to known about the use of therapies other than prescription.

METHODS

The use of non-prescription therapies was assessed by a structured interview in 153 chronic patients with heart failure.

RESULTS

Only 15.7% patients exclusively used medicines prescribed by their physicians. Alternative medicine use was not frequent (5.8%), herbal remedies (21.3%) and integrators (20.9%) were more used; OTC drugs were most common, with 75.8% use. Patients were often unaware of possible interaction with heart failure therapies, and seldom informed physician of use.

CONCLUSIONS

Advice about drugs avoidance is emphasized by heart failure guidelines, and is part of the nurse educational activity. More attention should be paid to OTC drug assessment and education since their use is common.

Is Heart Failure Nursing Practice at the Level of a Clinical Nurse Specialist or Advanced Nurse Practitioner? The Irish Experience

Since 2000 there has been a significant increase of Heart Failure Nursing positions in the Irish health service. The background to these positions has been based on the model established at St. Vincent's University Hospital, Dublin since 1998. Recognition of nursing practice in Ireland has also transformed with the introduction of Clinical Nurse Specialist and Advance Nurse Practitioner positions. To date Clinical Nurse Specialists coordinate and manage heart failure programmes, however it remains to be seen whether current practices are within the scope of practice of these nurses. Advanced Nurse Practitioner is a new position in Irish Nursing from examining guidelines and education this may be the way forward for Heart Failure Nursing in Ireland.

Comparing Interventions in Older Unpartnered Adults after Myocardial Infarction

BACKGROUND

Older adults after myocardial infarction (MI) are a vulnerable group who may benefit from interventions to improve health outcomes. The use of a peer advisor or an advanced practice nurse (APN) to provide a self-efficacy intervention is a promising method of improving health outcomes after MI.

AIMS

The purpose of this paper was to compare the effect of two self-efficacy interventions, a peer advisor and an APN, to a group who received standard care after MI.

METHODS

The study was a three-group randomized clinical trial with a peer advisor intervention group, an APN intervention group, and a standard care group. Outcome data were collected in the hospital after MI and by telephone at 12 weeks after hospital discharge, after the interventions were completed.

RESULTS

At 12 weeks after MI, there were no significant differences between the 3 groups in health outcomes. There were similar changes in self-efficacy for performing recovery behaviors, the actual performance of recovery behavior, physical and mental health across both intervention groups and the standard care group.

CONCLUSIONS

Although the data did not validate the benefits of these self-efficacy interventions, future efforts at identifying changes in health outcomes may need to use more discrete measurements that are more sensitive to changes in the older unpartnered adult after an MI.

Cardiovascular Nursing in RN and Higher Education in Swedish Universities: A National Survey

Cardiovascular nursing (CVN) is rapidly developing and has accumulated a large amount of evidence to support interventions aimed at reducing suffering and hastening recovery. However, knowledge of the extent and content of CVN training in Sweden is lacking. The aim of this study was therefore to identify and describe CVN in the Swedish RN education as well as in higher education, with reference to type of course and credits, content, area and target group. A nationwide survey was carried out in Sweden at all university level nursing schools (N=26) by means of a 25-item questionnaire, which was analysed by descriptive statistics. The findings show that 69% and 23% of the schools awarded 0-1 credits [0-1.5 European Credit Transfer and Accumulation System (ECTS)] and 2-3 credits (3-4.5 ECTS), respectively for cardiology/CVN in the RN education. Target areas outside the hospital setting reported by 23% and 19% of nursing schools were primary health care and community care, respectively. Special target groups in addition to the general public were the elderly (42%) and women (58%). Advanced courses in CVN comprising 10-40 credits (15-60 ECTS) were held by 27% of nursing schools, but no school had a specialist or Master level education. Important educational implications from the study of the RN education are the establishment of a minimum credit figure and to reach out into primary health care.

Developing voluntary standards for district nurse education and practice

This article charts the development of a project, funded by the Queen's Nursing Institute and Queen's Nursing Institute Scotland, to develop voluntary standards that reflect the contemporary and future practice of district nurses. The standards are designed to enhance, but not replace, the Nursing and Midwifery Council standards for district nurse specialist practice. The project encompassed the four UK countries and gathered data from a wide range of sources to inform the new standards that were launched in September 2015.

In the Palm of Your Hand - Normalizing the Use of Mobile Technology for Nurse Practitioner Education and Clinical Practice

The use of mobile devices by nurse practitioners (NPs) to meet an evolving technological landscape is expanding rapidly. A longitudinal study of the ways NP students "normalize" the use of mobile devices in clinical education was completed. This study used researcher-designed survey tools, including sociodemographic questions, and the numerical picture was augmented and interpreted in light of the textual data in the form of selected interviews. Data indicate that mobile technology is normalized in the social realm but still developing in the clinical realm. Progress is hindered by non-modelling by faculty, inconsistent healthcare policy and lack of understanding of the affordances available through this technology. Overall, mobile technology is utilized and normalized in practice; this in turn has influenced their ability to prepare students for practice. Data presented can assist educators and clinicians alike in developing a more fulsome understanding on how to appropriately incorporate mobile technology into education and practice.

Clinical Boot Camp: An Innovative Simulation Experience to Prepare Nursing Students for Obstetric and Pediatric Clinicals

Obstetric and pediatric patients require unique specialized care not included in traditional adult health education. To prepare nursing students for clinical rotations beginning the second week of class, faculty developed an innovative one-day simulation seminar, the OB/PEDS Boot Camp, in which groups of students rotated through six stations of obstetric and pediatric simulation exercises. This article provides insight on the development and implementation of the OB/PEDS Boot Camp.

Development and implementation of a peer mentoring program for early career gerontological faculty

PURPOSE

The Hartford Gerontological Nursing Leaders (HGNL) formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), in conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), developed and executed a peer mentoring program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of HGNL members. The purpose of this article is to describe key strategies used to develop and execute the peer mentoring program and to present formative program evaluation.

DESIGN

The program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts.

FINDINGS

An additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program.

CONCLUSIONS

Informal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce.

CLINICAL RELEVANCE

Findings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings.

Strengthening new graduate nurse residency programs in critical care: recommendations from nurse residents and organizational stakeholders

BACKGROUND

Thirty-four new graduate nurses participated in a critical care nurse residency program in preparation for opening a new intensive care unit. At the end of the program, multi-constituent focus groups were held to assess program effectiveness.

METHOD

Participants included 34 new graduate nurses, 18 preceptors and staff nurse partners, five clinical nurse specialists, and five nurse directors. Twelve focus groups were held; groups included four to eight nurses from the same role group. Two independent reviewers analyzed recordings and transcripts of focus group content to identify themes.

RESULTS

Five themes were identified: program design, developing nursing expertise, program impact on the unit, future expectations, and communication. Comments were used to guide program improvements and offer new insights for residency programs in acute and critical care.

CONCLUSION

Obtaining structured input from multiple program stakeholders is beneficial in evaluating a program's impact and identifying areas for improvement.