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Goes M, Oliveira H, Lopes M, Fonseca C, Pinho L, Marques M. A nursing care-sensitive patient satisfaction measure in older patients. Sci Rep 2023; 13:7607. [PMID: 37165074 PMCID: PMC10172317 DOI: 10.1038/s41598-023-33805-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/19/2023] [Indexed: 05/12/2023] Open
Abstract
As a novelty, this article proposes the empirical operationalization of an indicator sensitive to nursing care called patient satisfaction based on functional capacity and quality of life assessments. This was a descriptive cross-sectional study with a sample of 351 individuals aged 65 and older residing in the community. Data acquisition was performed using the structured interview method, employing a core set of 25 codes taken from the International Classification of Functioning, Disability, and Health and the WHOQOL-BREF instrument of the World Health Organization. Confirmatory factor analysis was used to infer the reliability and construct validity of the proposed model, involving three latent factors: functional capacity, quality of life, and patient satisfaction with nursing care received. The proposed model showed good reliability and construct validity, although it failed regarding discriminant validity between latent factors. The greatest statistically significant predictor of the patient satisfaction latent factor was the quality of life latent factor ([Formula: see text]), followed by the functional capacity latent factor ([Formula: see text]). The findings seem to suggest that patient satisfaction is an indicator that may be quantitatively measurable, with functional capacity and quality of life considered very significant predictors of patient satisfaction with the nursing care experience.
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Affiliation(s)
- Margarida Goes
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
| | - Henrique Oliveira
- Instituto de Telecomunicações, Aveiro, Portugal.
- Instituto Politécnico de Beja, Beja, Portugal.
| | - Manuel Lopes
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
| | - César Fonseca
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
| | - Lara Pinho
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
| | - Maria Marques
- Comprehensive Health Research Center, Universidade de Évora, Évora, Portugal
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
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Silva MBD, Engelman B, Figueiredo MS, Almeida MDA. Standardized nursing languages in orthopedics from the perspective of the nursing role effectiveness model. Rev Gaucha Enferm 2022; 43:e20210321. [PMID: 36478008 DOI: 10.1590/1983-1447.2022.20210321.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/20/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To analyze the standardized nursing languages in orthopedics from the perspective of the Nursing Role Effectiveness Model. METHOD Mixed method research carried out in a hospital in southern Brazil between April 2016 and February 2017. Quantitative data were collected from 85 orthopedic patients using the NANDA-International, Nursing Interventions and Outcomes, and submitted to statistical analysis. Qualitative data were collected through interviews with 10 nurses and were analyzed using content analysis. RESULTS Acute pain (96%) was a prevalent nursing diagnosis. Fall Prevention (33.3%) was the most prescribed intervention. Pain Level, Body Positioning: self-initiated and Mobility showed an increase in outcome scores (p<0.001). In the interviews, nurses indicated that priority diagnoses and nursing interventions contributed to improving mobility outcomes. CONCLUSION The findings revealed that the focus of Standardized Nursing Languages in orthopedics from the perspective of the Nursing Role Effectiveness Model lies in the context of mobility, but it needs improvements in diagnostic accuracy and electronic health record.
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Affiliation(s)
| | - Bruna Engelman
- Secretaria de Saúde de Eldorado do Sul. Eldorado do Sul, Rio Grande do Sul, Brasil
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Mathews M, Spencer S, Hedden L, Lukewich J, Poitras ME, Marshall EG, Brown JB, Sibbald S, Norful AA. The impact of funding models on the integration of registered nurses in primary health care teams: protocol for a multi-phase mixed-methods study in Canada. BMC PRIMARY CARE 2022; 23:290. [PMID: 36402965 PMCID: PMC9675973 DOI: 10.1186/s12875-022-01900-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Family practice registered nurses co-managing patient care as healthcare professionals in interdisciplinary primary care teams have been shown to improve access, continuity of care, patient satisfaction, and clinical outcomes for patients with chronic diseases while being cost-effective. Currently, however, it is unclear how different funding models support or hinder the integration of family practice nurses into existing primary health care systems and interdisciplinary practices. This has resulted in the underutilisation of family practice nurses in contributing to high-quality patient care. METHODS This mixed-methods project is comprised of three studies: (1) a funding model analysis; (2) case studies; and (3) an online survey with family practice nurses. The funding model analysis will employ policy scans to identify, describe, and compare the various funding models used in Canada to integrate family practice nurses in primary care. Case studies involving qualitative interviews with clinic teams (family practice nurses, physicians, and administrators) and family practice nurse activity logs will explore the variation of nursing professional practice, training, skill set, and team functioning in British Columbia, Nova Scotia, Ontario, and Quebec. Interview transcripts will be analysed thematically and comparisons will be made across funding models. Activity log responses will be analysed to represent nurses' time spent on independent, dependent, interdependent, or non-nursing work in each funding model. Finally, a cross-sectional online survey of family practice nurses in Canada will examine the relationships between funding models, nursing professional practice, training, skill set, team functioning, and patient care co-management in primary care. We will employ bivariate tests and multivariable regression to examine these relationships in the survey results. DISCUSSION This project aims to address a gap in the literature on funding models for family practice nurses. In particular, findings will support provincial and territorial governments in structuring funding models that optimise the roles of family practice nurses while establishing evidence about the benefits of interdisciplinary team-based care. Overall, the findings may contribute to the integration and optimisation of family practice nursing within primary health care, to the benefit of patients, primary healthcare providers, and health care systems nationally.
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Affiliation(s)
- Maria Mathews
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, 1465 Richmond Street, Second Floor, Rm 2140, London, ON, Canada, N6G 2M1.
| | - Sarah Spencer
- Faculty of Health Sciences, Simon Fraser University, BC, Burnaby, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, BC, Burnaby, Canada
| | - Julia Lukewich
- Faculty of Nursing, Memorial University, St John's, NL, Canada
| | - Marie-Eve Poitras
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Judith Belle Brown
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, 1465 Richmond Street, Second Floor, Rm 2140, London, ON, Canada, N6G 2M1
| | - Shannon Sibbald
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, 1465 Richmond Street, Second Floor, Rm 2140, London, ON, Canada, N6G 2M1
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Vaughan C, Lukewich J, Mathews M, Hedden L, Poitras ME, Asghari S, Swab M, Ryan D. Nursing contributions to virtual models of care in primary care: a scoping review protocol. BMJ Open 2022; 12:e065779. [PMID: 36127080 PMCID: PMC9490598 DOI: 10.1136/bmjopen-2022-065779] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Since the onset of the COVID-19 pandemic, virtual care has gained increased attention, particularly in primary care for the ongoing delivery of routine services. Nurses have had an increased presence in virtual care and have contributed meaningfully to the delivery of team-based care in primary care; however, their exact contributions in virtual models of primary care remain unclear. The Nursing Role Effectiveness Model, applied in a virtual care and primary care context, outlines the association between structural variables, nursing roles and patient outcomes. The aim of this scoping review is to identify and synthesise the international literature surrounding nurse contributions to virtual models of primary care. METHODS AND ANALYSIS The Joanna Briggs Institute scoping review methodology will guide this review. We performed preliminary searches in April 2022 and will use CINAHL, MEDLINE, Embase and APA PsycInfo for the collection of sources for this review. We will also consider grey literature, such as dissertations/theses and organisational reports, for inclusion. Studies will include nurses across all designations (ie, nurse practitioners, registered nurses, practical nurses). To ensure studies capture roles, nurses should be actively involved in healthcare delivery. Sources require a virtual care and primary care context; studies involving the use of digital technology without patient-provider interaction will be excluded. Following a pilot test, trained reviewers will independently screen titles/abstracts for inclusion and extract relevant data. Data will be organised using the Nursing Role Effectiveness Model, outlining the virtual care and primary care context (structure component) and the nursing role concept (process component). ETHICS AND DISSEMINATION This review will involve the collection and analysis of secondary sources that have been published and/or are publicly available. Therefore, ethics approval is not required. Scoping review findings will be published in a peer-reviewed journal and presented at relevant conferences, targeting international primary care stakeholders.
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Affiliation(s)
- Crystal Vaughan
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Julia Lukewich
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Maria Mathews
- Department of Family Medicine, University of Western Ontario, London, Ontario, Canada
| | - Lindsay Hedden
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Marie-Eve Poitras
- Department of Family Medicine and Emergency Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Shabnam Asghari
- Center for Rural Health Studies, Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Michelle Swab
- Health Sciences Library, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Dana Ryan
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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Lukewich J, Asghari S, Marshall EG, Mathews M, Swab M, Tranmer J, Bryant-Lukosius D, Martin-Misener R, Norful AA, Ryan D, Poitras ME. Effectiveness of registered nurses on system outcomes in primary care: a systematic review. BMC Health Serv Res 2022; 22:440. [PMID: 35379241 PMCID: PMC8981870 DOI: 10.1186/s12913-022-07662-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Internationally, policy-makers and health administrators are seeking evidence to inform further integration and optimal utilization of registered nurses (RNs) within primary care teams. Although existing literature provides some information regarding RN contributions, further evidence on the impact of RNs towards quality and cost of care is necessary to demonstrate the contribution of this role on health system outcomes. In this study we synthesize international evidence on the effectiveness of RNs on care delivery and system-level outcomes in primary care. METHODS A systematic review was conducted in accordance with Joanna Briggs Institute methodology. Searches were conducted in CINAHL, MEDLINE Complete, PsycINFO, and Embase for published literature and ProQuest Dissertations and Theses and MedNar for unpublished literature between 2019 and 2022 using relevant subject headings and keywords. Additional literature was identified through Google Scholar, websites, and reference lists of included articles. Studies were included if they measured effectiveness of a RN-led intervention (i.e., any care/activity performed by a primary care RN within the context of an independent or interdependent role) and reported outcomes of these interventions. Included studies were published in English; no date or location restrictions were applied. Risk of bias was assessed using the Integrated Quality Criteria for Review of Multiple Study Designs tool. Due to the heterogeneity of included studies, a narrative synthesis was undertaken. RESULTS Seventeen articles were eligible for inclusion, with 11 examining system outcomes (e.g., cost, workload) and 15 reporting on outcomes related to care delivery (e.g., illness management, quality of smoking cessation support). The studies suggest that RN-led care may have an impact on outcomes, specifically in relation to the provision of medication management, patient triage, chronic disease management, sexual health, routine preventative care, health promotion/education, and self-management interventions (e.g. smoking cessation support). CONCLUSIONS The findings suggest that primary care RNs impact the delivery of quality primary care, and that RN-led care may complement and potentially enhance primary care delivered by other primary care providers. Ongoing evaluation in this area is important to further refine nursing scope of practice policy, determine the impact of RN-led care on outcomes, and inform improvements to primary care infrastructure and systems management to meet care needs. PROTOCOL REGISTRATION ID PROSPERO: International prospective register of systematic reviews. 2018. ID= CRD42018090767 .
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Affiliation(s)
- Julia Lukewich
- Faculty of Nursing, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada.
| | - Shabnam Asghari
- Department of Family Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Emily Gard Marshall
- Department of Family Medicine Primary Care Research Unit, Dalhousie University, 1465 Brenton Street, Suite 402, Halifax, NS, B3J 3T4, Canada
| | - Maria Mathews
- Department of Family Medicine, Schulich School of Medicine & Dentistry, University of Western, Ontario 1151 Richmond Street, London, ON, N6A 5C1, Canada
| | - Michelle Swab
- Health Sciences Library, Faculty of Medicine, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Joan Tranmer
- School of Nursing, Queen's University, 92 Barrie Street, Kingston, ON, K7L 3N6, Canada
| | | | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, 5869 University Ave. St, Halifax, NS, B3H 4R2, Canada
| | - Allison A Norful
- School of Nursing, Columbia University, 630 West 168th Street, New York, NY, 10032, USA
| | - Dana Ryan
- Faculty of Nursing, Memorial University, 300 Prince Phillip Drive, St. John's, NL, A1B 3V6, Canada
| | - Marie-Eve Poitras
- Département de médecine de famille et médecine d'urgence, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
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Silva MBD, Engelman B, Figueiredo MS, Almeida MDA. Linguagens padronizadas de enfermagem em ortopedia na perspectiva do nursing role effectiveness model. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20210321.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
RESUMO Objetivo Analisar as Linguagens padronizadas de enfermagem em ortopedia na perspectiva do Nursing Role Effectiveness Model. Método Pesquisa com método misto realizado em um hospital do Sul do Brasil entre abril de 2016 a fevereiro de 2017. Os dados quantitativos foram coletados de 85 pacientes ortopédicos usando a NANDA-International, Classificação de Intervenções e Resultados de enfermagem, submetidos à análise estatística. Os dados qualitativos foram coletados por meio de entrevistas com 10 enfermeiros e foram analisadas mediante análise de conteúdo. Resultados Dor aguda (96%) foi diagnóstico de enfermagem prevalente. Prevenção de quedas (33,3%) foi a intervenção mais prescrita. Nível de Dor, Posicionamento do Corpo: autoiniciado e Mobilidade apresentaram aumento nos escores de resultado (p<0,001). Nas entrevistas os enfermeiros apontaram que os diagnósticos prioritários e as intervenções de enfermagem contribuíram para a melhoria dos resultados de mobilidade. Conclusão Os resultados revelaram que o foco das Linguagens padronizadas de enfermagem em ortopedia na perspectiva do Nursing Role Effectiveness Model reside no contexto da mobilidade, porém precisa de melhorias na acurácia diagnóstica e registro no prontuário do paciente.
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Nanda L, Anilkumar A. Role of nurse practitioners within health system in India: A case of untapped potential. J Family Med Prim Care 2021; 10:2751-2756. [PMID: 34660400 PMCID: PMC8483105 DOI: 10.4103/jfmpc.jfmpc_2283_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/02/2021] [Accepted: 03/16/2021] [Indexed: 12/02/2022] Open
Abstract
Nurses form the pillar of India's healthcare system representing 30.5% of the entire health workforce in India. Amidst a significant shortage in the provision of effective primary care, jeopardizing millions of Indians’ access to basic healthcare services, especially the poorest, it is very evident that nurse practitioners are the need of the hour in India. The current scenario of nursing in India warrants policy reforms to facilitate nurses as valuable primary care providers. It also shows the path towards making the Health and Wellness Centre operational by creating a pivotal role for the cadre in such centres, and it will also be important for the nurse practitioner to have a public health leadership role in a country like India. With additional training and qualification and also recognition of nurse practitioners as essential healthcare providers, a complete quality healthcare could be provided. In this research paper we assess the need for nurse practitioners as primary contact providers; reflect on the global evidence on nurse practitioners linking to health outcomes, effective coverage and access to services. We also try to contemplate on the training needs, their role in home-based care and as enablers of the referral mechanism, their untapped potential, and a plan for evaluating their effectiveness. This policy research paper focuses to build an argument for a policy towards making nurse practitioners the first contact providers.
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Affiliation(s)
- Lipika Nanda
- Regional Resource Hub, HTA, Indian Institute of Public Health, Hyderabad, Public Health Foundation of India
| | - Aiswarya Anilkumar
- Regional Resource Hub, HTA, Indian Institute of Public Health, Hyderabad, Public Health Foundation of India
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Marcinowicz L, Wojnar D, Terlikowski SJ. Work activities of primary health care nurses in Poland: National Survey Results. BMC Nurs 2021; 20:22. [PMID: 33446176 PMCID: PMC7809755 DOI: 10.1186/s12912-021-00541-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In some countries, including Poland, nurses have acquired autonomy from being a designated "ancillary staff" to "professional staff" only in recent decades. No prior published studies have examined, however, whether the actual nursing practice in primary health care (PHC) has evolved with the advancement of education and professional autonomy. The aim of this study is to assess the scope of practice of a PHC nurses and their actual work activities. METHODS A cross-sectional study design using an investigator-developed survey was conducted in Poland, in 2018. The survey was sent to professionally active PHC nurses in Poland. Of the 225 questionnaires distributed, 202 (89.8%) were returned. RESULTS Out of 44 work activities examined, the most often performed activity was administering medications. Less frequent activities included recognizing patients' nursing needs and health problems and monitoring, assessing, and interpreting basic vital signs. A correlation was found between the length of work experience and the following three activities: performing nursing care, issuing referrals for specific diagnostic tests, and ordering of specific treatments, medications, and nutritional supplements. The longer was the work experience, the more often the nurses performed nursing care (r = 0.15; p = 0.035) but less often issued referrals for diagnostic tests (r = - 0.24; p = 0.001) or orders within their scope of practice (r = - 0.23; p = 0.002). CONCLUSION While nurses in general are most likely to carry out physician orders, junior nurses tend to be more likely to work toward professional autonomy and pursuing new challenges. PHC nurses in Poland perform work associated more with carrying out physicians' orders and less with what they were prepared to do. Engaging nursing students in interprofessional education, dissemination of nursing research, and advocacy of nursing professional organizations on behalf of the profession may be an effective strategy to overcome the current barriers for PHC nurses to work the top of their license.
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Affiliation(s)
- Ludmila Marcinowicz
- Department of Obstetrics, Gynaecology and Maternity Care, Medical University of Bialystok, Szpitalna 37, 15-295 Bialystok, Poland
| | - Danuta Wojnar
- College of Nursing, Robert Wood Johnson Foundation Executive Nurse Fellow 2012-2015, J. Bushman Endowed Chair in Nursing, Seattle University, 901 12th Avenue, Seattle, WA 98122-1090 USA
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Fonseca-Teixeira SA, Parreira P, Mónico L, Salgueiro-Oliveira A, Amado JC. Referral to the national network of integrated care: the nurses' perception. Rev Lat Am Enfermagem 2020; 28:e3372. [PMID: 33084775 PMCID: PMC7575240 DOI: 10.1590/1518-8345.3800.3372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/06/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to understand the referral to the National Network of Integrated Continuous Care, from the perspective of nurses who work in this care context. METHOD an exploratory and descriptive study with a qualitative approach, with data collection between July and September 2019 through interviews with 12 nurses who work in Integrated Continuous Care Teams, in Northern Portugal. The content analysis technique was used to analyze the statements. RESULTS the professionals revealed that there are difficulties and constraints in the process of referring users to the National Network of Integrated Continuous Care. The process is bureaucratic, complex, and time-consuming, conditioning user accessibility to timely care. CONCLUSION the referral process is a very bureaucratic and time-consuming procedure, which not only conditions and delays users' access to the National Network of Integrated Continuous Care network, contributing to the worsening of the clinical status of some patients. The number of professionals is insufficient, inducing the demand for services through urgency. The focus on primary care should seek to improve inequalities in access, compete for more equitable and accessible care, generating more quality in health care.
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Affiliation(s)
| | - Pedro Parreira
- Escola Superior de Enfermagem de Coimbra, Unidade de Pesquisa em
Ciências da Saúde: Enfermagem, Coimbra, Portugal
| | - Lisete Mónico
- Universidade de Coimbra, Faculdade de Psicologia e Ciências da
Educação, Coimbra, Portugal
| | - Anabela Salgueiro-Oliveira
- Escola Superior de Enfermagem de Coimbra, Unidade de Pesquisa em
Ciências da Saúde: Enfermagem, Coimbra, Portugal
| | - João Costa Amado
- Universidade Católica Portuguesa, Centro de Investigação
Interdisciplinar em Saúde, Instituto de Ciências da Saúde, Porto, Portugal
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