Gerontological nurse practitioners (GNPs) for the first time in Israel

Understanding factors affecting the integration of geriatric nurse practitioners into health systems

BACKGROUND

Geriatric nurse practitioners (NPs) are introduced into health systems to alleviate provider shortages and improve care for older adults. To achieve these goals, geriatric NPs must be integrated into the health system such that they can efficaciously practice. Internationally, little is known about factors affecting the integration of NPs. Such evidence would improve policymaking and the impact of geriatric NPs on care. In Israel, geriatric NPs were recently introduced. Their ongoing integration is an exemplar for other countries.

PURPOSE

To identify factors affecting the integration of geriatric NPs in Israel and discuss application of these factors in international policy and research.

METHODOLOGY

The Consolidated Framework for Implementation Research guided this qualitative descriptive study. A semistructured interview guide was used to collect data from four professional groups (geriatric NPs, physicians, administrators, and policymakers), which, together, provide a system-level perspective. Factors were identified using deductive content analysis and designated as facilitators, barriers, neutral, or mixed effects.

RESULTS

There were 58 participants across the four professional groups. Twenty-eight factors were identified, including patient needs and leadership engagement (facilitators), available information (barrier), culture (mixed), and evidence strength (neutral). Perspectives on several factors differed by the professional group's role in integrating NPs (e.g., costs ).

CONCLUSIONS

The barriers highlight lacking interprofessional support from a priori policymaking and communication breakdowns. Policies should reflect priorities of administrators, clinicians, and policymakers.

IMPLICATIONS

These factors may inform policymaking in other countries but would be most effective if based on country-specific research. This implementation science approach may inform future studies.

Expanding nurses' authority - Physicians' and nurses' attitudes

AIM

To examine and compare the attitudes of physicians and registered nurses regarding extending nurses' authority.

DESIGN

This was a comparative quantitative study, which used a questionnaire that examined the attitudes of nurses and physicians regarding expanding nurses' authority.

METHODS

The study comprised a sample of 134 nurses (62.7%) and physicians (37.3%), who filled out the self-report questionnaire that included sociodemographic data and questions designed to examine the participants' attitudes and perceptions on expanding nurses' authority. The general reliability of the questionnaire was Cronbach's α = 0.931. Participants were sampled through the convenience-snowball method.

RESULTS

Differences were found between the attitudes of physicians and nurses to expanding nurses' authority. Nurses tended to be in favor, whereas physicians tended to be against (t(86.29) = 7.713; p < 0.05). Nurses' attitudes are also more positive specifically to procedures related to drug administration (t(132) = 6.894; p < 0.05) and resuscitation (t(132) = 2.974; p < 0.05), compared to physicians.

CONCLUSIONS

Nurses have more positive attitudes toward expanding nurses' authority than physicians do, specifically toward drug administration and resuscitation. Further study is proposed to identify factors which affect the physician-nurse relationship and attitudes on a large scale through a qualitative study.

Perceptions and Expectations of Advanced Geriatric Nursing Role Development in Primary Health Care: A Qualitative Study Exploring Staff's Perspectives

PURPOSE

This qualitative study aimed to explore multidisciplinary members' perceptions and expectations of advanced geriatric nursing role development in primary health care.

PATIENTS AND METHODS

A multi-center, cross-sectional study based on semi-structured individual interviews was conducted with registered nurses, general physicians, and managers involved in the care of older people in primary health care between September 2020 and January 2021. Recruitment was purposive and the framework method was used to inductively analyze the data. The Consolidated Criteria for Reporting Qualitative research (COREQ) served to structure our manuscript.

RESULTS

In total, 29 registered nurses, 6 general physicians, and 10 managers from 8 health centers were interviewed. The relevant themes interpreted from the interview data were as follows: (1) the current roles of registered nurses in the care of older people; (2) the factors affect the advanced geriatric nursing role development; (3) expectations of the advanced geriatric nursing roles.

CONCLUSION

There is a need for appropriate educational programs, well-established laws, and regulations to support the sustainable development of advanced geriatric nursing roles. To build the expected role model, the nursing education program in the future should integrate gerontological nursing, public health nursing, and nursing management to maximize the role of gerontological nurse practitioners in primary health care.

The gerontological nurse specialist's core competencies in China: A cross-sectional study

Aim

To describe the core competencies of gerontological nurse specialists and investigate the factors that contribute to the development of core competencies.

Design

A descriptive cross‐sectional study was conducted from August 2015–March 2016.

Methods

The descriptive study of gerontological nurse specialists’ core competencies used a self‐assessment instrument with three first‐level domains (attitude, skill and knowledge) and 9 s‐level dimensions. A total of 225 gerontological nurse specialists from ten provinces in China were selected by a convenience sampling method.

Results

The average core competency score of the gerontological nurse specialists was 3.78, in the middle level(3.30–4.17/5.00). Core competency was associated with gerontological nurse specialists’ age (p = .005), professional title (p = .017), hospital level (p = .006) and passion for geriatric nursing (p = .000). The average scores of attitude, skill and knowledge were 4.45, 4.02 and 4.18, respectively. All first‐level domains were related to age (p ≤ .021) and passion for geriatric nursing (p ≤ .008); knowledge and skill were associated with professional title (p ≤ .045) and attitude and skill were associated with hospital level (p ≤ .020).