Involvement of Advanced Practice Nurse in the Management of Geriatric Conditions: Examples from Different Countries

A narrative review of the role of geriatric advanced practice nurses in the care of frail older adults in Singapore

In Singapore's rapidly ageing population where the demand for tailored healthcare services is increasing, but is confronted with a shortage of geriatric medicine trained physicians, innovative and sustainable ways to provide quality healthcare care for frail older adults need to be explored. Recognising, developing, growing and establishing the role of geriatric Advanced Practice Nurses (APNs) in Singapore, not just in clinical practice but in education and research as well, potentially offers one such solution to this problem. This narrative review, therefore, examines the available literature on how geriatric APNs can meet the healthcare needs of frail older adults in various local healthcare settings. Using a combination of keywords, a comprehensive search for relevant literature (original articles, theses, and abstracts published in English between 1999 till present) was conducted across databases including PubMed and Cochrane Library. Additional articles referenced in chosen articles were also reviewed when deemed relevant to the topic. Based on more established overseas models of care, it is evident that geriatric APNs can positively and significantly contribute to the healthcare of frail older adults locally. However, there is ambiguity surrounding the definition and description of the APN's role in Singapore, resulting in challenges that limit APNs from functioning to the full extent of their capabilities. A clear definition of the roles, responsibilities and expectations of geriatric APNs will facilitate their effective and significant contribution to caring for frail older adults in Singapore.

Clinical practice and standard discrepancies in aspiration prevention among advanced practice nurses in geriatrics: A cross-sectional survey

AIM

To investigate the discrepancies between clinical practices and aspiration prevention standards among advanced practice nurses (APNs) in geriatrics and provide a basis for risk evaluation and prevention strategies for older adults.

METHODS

Using convenience sampling from November 20 to December 30, 2023, we surveyed 227 APNs in geriatrics from Guangdong Province, China. Data were collected using demographic forms and questionnaires focused on aspiration prevention strategies for older adults. Univariate and multivariate linear stepwise regression analyses were conducted to identify factors that influenced the effectiveness of aspiration prevention by APNs.

RESULTS

The mean score of APNs in geriatrics for older adult aspiration prevention was 94.9 ± 17.4. The multivariate regression analysis identified hospital level, evidence-based practice, and job satisfaction as significant factors.

CONCLUSION

This study highlights the essential contribution of APNs to geriatric care and emphasizes the need for sustained professional development and adherence to evidence-based protocols to optimize aspiration prevention strategies.

Pressure ulcer prevention and treatment interventions in Sub-Saharan Africa: A systematic review

BACKGROUND

The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific treatment strategies.

PURPOSE

Therefore, the purpose of this systematic review was to establish and elucidate PU prevention and treatment interventions tested in SSA.

METHODS

This systematic review of the literature used, PRISMA to guide the search.

FINDINGS

The review identified nine studies on PU prevention (three) and treatment (six). Low-cost interventions assembled from locally available materials and multifaceted policies significantly prevented and treated PUs. The interventions included wound dressing agents, simple negative pressure suction devices that significantly treated PUs, and water-based bed surfaces.

DISCUSSION

There were gaps in the interventions that have been proven successful in other global settings.

CONCLUSION

In SSA, there is a need for nurses to tailor, test, and disseminate findings from evidence-based projects for PU prevention that have been successful in similar settings.

Status and associated factors of gerontological nurse specialists' core competency: a national cross-sectional study

BACKGROUND

Nurses' core competency directly affects patients' safety and health outcomes. Gerontological nurse specialists play an essential role in improving older adults' health status. However, little is known about their core competency level and the factors influencing core competency. Therefore, this study aimed to investigate the status of core competency and factors influencing the core competency of gerontological nurse specialists in China.

METHODS

A multicenter cross-sectional study was conducted on gerontological nurse specialists certified by province-level or above organizations across China between March 2019 and January 2020. The Revised Core Competency Evaluation Instrument for Gerontological Nurse Specialists was used to measure participants' core competency. The median, frequencies, and percentages were used to describe participants' characteristics and level of core competency. Multivariate stepwise regression analysis was applied to analyze the factors influencing core competency.

RESULTS

The median score of gerontological nurse specialists' core competency was 3.84, and professional development skills and research and analysis decision-making skills had the lowest scores among the dimensions. The multivariate stepwise regression analysis showed that individual-level factors (i.e., working experience length of geriatric nursing and attitudes toward caring for older adults), employer-level factors (i.e., departments, job responsibilities, the degree of satisfaction toward the attention and support and the promotion rules provided by the hospital or department), and training-associated factors (i.e., economic zone where training organizations are located and the degree to which the training content met clinical needs) are independently associated with gerontological nurse specialists' core competency level (P < 0.05).

CONCLUSIONS

This study showed that gerontological nurse specialists' core competency needs further improvements, especially regarding professional development skills and research and analysis decision-making skills. Additionally, individual-, training-, and employer-level factors could influence their core competency level, indicating that interventions targeting these factors could be applied to improve the core competency of gerontological nurse specialists.

Pressure ulcer prevention knowledge, practices, and their associated factors among nurses in Gurage Zone Hospitals, South Ethiopia, 2021

A pressure ulcer is a localized skin injury and underlying tissue, usually as a result of friction or pressure against the surface of the skin. The global mortality rate of pressure ulcers was above 60% for hospitalized patients who wait 1 year of hospital stay. Nurses are the primary responsible body and forefront line care providers for the prevention of pressure ulcers, so nurses’ knowledge and practices are the major rollers to handling this preventable problem.