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.

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.