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Spada I, Fabbroni V, Chiarello F, Fantoni G. Standardising job descriptions in the humanitarian supply chain: A text mining approach for recruitment process. PLoS One 2024; 19:e0305961. [PMID: 38985717 PMCID: PMC11236101 DOI: 10.1371/journal.pone.0305961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/07/2024] [Indexed: 07/12/2024] Open
Abstract
PURPOSE Uncertainty and complexity have increased in recent decades, posing new challenges to humanitarian organisations. This study investigates whether using standard terminology in Human Resource Management processes can support the Humanitarian supply chain in attracting and maintaining highly skilled operators. METHODOLOGY We exploit text mining to compare job vacancies on ReliefWeb, the reference platform for humanitarian job seekers, and ESCO, the European Classification of Skills, Competencies, and Occupations. We measure the level of alignment in these two resources, providing quantitative evidence about terminology standardisation in job descriptions for supporting HR operators in the Humanitarian field. FINDINGS The most in-demand skills, besides languages, relate to resource management and economics and finance for capital management. Our results show that job vacancies for managerial and financial profiles are relatively more in line with the European database than those for technical profiles. However, the peculiarities of the humanitarian sector and the lack of standardisation are still a barrier to achieving the desired level of coherence with humanitarian policies.
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Affiliation(s)
- Irene Spada
- Department of Energy, Systems, Land and Construction Engineering, School of Engineering, University of Pisa, Pisa, Italy
- Business Engineering for Data Science (B4DS) Research Lab, School of Engineering, University of Pisa, Pisa, Italy
| | - Valeria Fabbroni
- Department of Civilisations and Forms of Knowledge, University of Pisa, Pisa, Italy
- SDCC Department, Asian Development Bank, Fragile Countries, Manila, Philippines
| | - Filippo Chiarello
- Department of Energy, Systems, Land and Construction Engineering, School of Engineering, University of Pisa, Pisa, Italy
- Business Engineering for Data Science (B4DS) Research Lab, School of Engineering, University of Pisa, Pisa, Italy
| | - Gualtiero Fantoni
- Business Engineering for Data Science (B4DS) Research Lab, School of Engineering, University of Pisa, Pisa, Italy
- Department of Industrial and Civil Engineering, School of Engineering, Università di Pisa, Pisa, Italy
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Ruiz AS. Looking to the future of Advanced Practice Nursing in Spain. ENFERMERIA CLINICA (ENGLISH EDITION) 2024; 34:77-81. [PMID: 38710541 DOI: 10.1016/j.enfcle.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Affiliation(s)
- Alfredo Serrano Ruiz
- Profesor de la Escuela Universitaria de Enfermería y Fisioterapia San Juan de Dios, Universidad Pontificia de Comillas, Madrid, Spain; Associate Lecturer of Advanced Practice, Nursing and Midwifery School of Oxford, Oxford Brookes University, Advanced Critical Care Practitioner (ACCP), Plymouth University Oxford, United Kingdom.
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Horvath S, Visekruna S, Kilpatrick K, McCallum M, Carter N. Models of care with advanced practice nurses in the emergency department: A scoping review. Int J Nurs Stud 2023; 148:104608. [PMID: 37801938 DOI: 10.1016/j.ijnurstu.2023.104608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/31/2023] [Accepted: 09/12/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Emergency departments play a critical role in healthcare systems internationally. Visits for emergency care continue to increase, related to poor access to primary care, the COVID-19 pandemic, and health human resource issues. International literature shows similar stressors in the emergency department. Extended wait times to see health providers lead to poor outcomes, and innovative models of care are needed to address emergency department overcrowding and to meet the needs of patients. Advanced practice nurses have the expertise and scope of practice to optimize and address primary and acute care needs and could be further integrated into the emergency healthcare systems. It is unclear what and how advanced practice nurses are functioning in emergency departments to improve patient and organization outcomes. METHODS This scoping review was a comprehensive search of MEDLINE, EMCARE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and gray literature. Authors developed inclusion and exclusion criteria, performed title and abstract screening, and full text screening using review software. Data about models of care with advanced practice nurses were extracted and organized to understand patient, provider, and organizational outcomes. We also extracted information about the development and implementation of roles. RESULTS Of the 6780 records identified, 76 met inclusion criteria. Emergency department models of care, mainly using nurse practitioners, include fast-track, generalized emergency, minor injury, orthopedics, pediatrics, geriatrics, specific populations, and triage. Reported patient outcomes include improvement in key metrics specific to emergency departments, such as total length of stay, wait times to be seen by a provider, left without being seen rates, treatment for pain, costs, and resource use. When comparing nurse practitioners to other providers, outcomes were similar or better for patient and organizational outcomes. DISCUSSION Various models of care utilizing advanced practice nurses in emergency departments are present internationally and information about how they are developed, integrated, and utilized provides practical information to support and sustain new roles. There is an opportunity to expand the use of these roles into emergency departments as the nurse practitioner scope of practice grows. Given the current crisis across healthcare systems, there is need for innovation, and improving delivery of emergency services with these advanced practice nursing models of care can help to address important health policy priorities in Canada and other countries. TWEETABLE ABSTRACT Advanced Practice Nurse models of care in emergency - Improved outcomes for patients and organizations - A review of the literature. @SamanthaH_RN.
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Affiliation(s)
- Samantha Horvath
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.
| | - Sanja Visekruna
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | | | - Nancy Carter
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.
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Putri AF, Tocher J, Chandler C. Emergency department nurses' role transition towards emergency nurse practitioner: A realist-informed review. Int Emerg Nurs 2021; 60:101081. [PMID: 34864322 DOI: 10.1016/j.ienj.2021.101081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND The integration of emergency nurse practitioner (ENP) services in emergency departments (EDs) has been well established, especially in high-income countries such as the United Kingdom, the United States and Australia. Different types of reviews, including integrative, literature and systematic, have been carried out to examine evidence regarding the impact of ENPs on the quality of ED services. Unfortunately, there is still limited explanation of the influencing factors that may result in a successful transition process from Registered Nurse to Emergency Nurse Practitioner. This review aims to understand these factors. METHODS A realist approach (RAMESES) guided this review. CINAHL Plus, MEDLINE, PsycINFO, EMBASE and Web of Science databases were searched to capture studies from 1990 to 2020, combined with policy documents from professional bodies and government websites and relevant references from identified sources. Realist data analysis was carried out on the included articles to understand how context, mechanism and outcomes related to the ED nurses' role transition. RESULTS Forty-eight articles were included. There were differences in preparatory education and scope of practice of the role. The review configured various contexts, mechanisms and outcomes of the role transition along with their interactions. CONCLUSION The findings provide a comprehensive understanding regarding the emergency nurses' role transition, with a view to providing better insights and explanations to interested parties who would like to integrate the ENP service in their ED.
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Affiliation(s)
- Arcellia Farosyah Putri
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9AG, United Kingdom; Indonesian Emergency and Disaster Nurses Association, Indonesia.
| | - Jennifer Tocher
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9AG, United Kingdom
| | - Colin Chandler
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9AG, United Kingdom
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Ruiz LM. Multidisciplinary team attitudes to an advanced nurse practitioner service in an emergency department. Emerg Nurse 2020; 28:33-42. [PMID: 30277346 DOI: 10.7748/en.2018.e1793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 06/08/2023]
Abstract
AIM The aim of this study was to examine an emergency department's (ED) multidisciplinary teams' (MDTs) attitudes towards an advanced nurse practitioner (ANP) service. The ED in question is not the author's place of work. METHOD A Likert-type questionnaire was used to gain a total attitude score (TAS), which was analysed in relation to participants' gender, age, professional background, level of education and years of experience in the ED, as well as previous and current contact with emergency nurse practitioners and/or ANPs. A total of 115 questionnaires were distributed, and respondents included doctors, nurses, managers, pharmacists, radiographers and a physiotherapist. Participants provided qualitative data to explain their choices, and were asked to describe positive and negative aspects of an ANP service. The data were analysed using a mixed-methods approach. FINDINGS The TASs were generally positive and there were no statistical differences between the professional groups, although there was some resistance from participants. CONCLUSION Overall, the MDT believes the ANP service will improve patient care, waiting times, team divisions and patients' experiences in the ED if the roles and responsibilities are clearly defined and communicated. In addition, the service should receive enough funding to ensure its sustainability and appropriate supervision by a senior doctor should be made available.
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Affiliation(s)
- Lorena Medina Ruiz
- Emergency department, Dartford and Gravesham NHS Trust, Dartford, England
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Middleton S, Gardner G, Gardner A, Considine J, Fitzgerald G, Christofis L, Doubrovsky A, Della P, Fasugba O, D'Este C. Are service and patient indicators different in the presence or absence of nurse practitioners? The EDPRAC cohort study of Australian emergency departments. BMJ Open 2019; 9:e024529. [PMID: 31366634 PMCID: PMC6678028 DOI: 10.1136/bmjopen-2018-024529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 04/02/2019] [Accepted: 07/04/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the impact of nurse practitioner (NP) service in Australian public hospital emergency departments (EDs) on service and patient safety and quality indicators. DESIGN AND SETTING Cohort study comprising ED presentations (July 2013-June 2014) for a random sample of hospitals, stratified by state/territory and metropolitan versus non-metropolitan location; and a retrospective medical record audit of ED re-presentations. METHODS Service indicator data (patient waiting times for Australasian Triage Scale categories 2, 3, 4 and 5; number of patients who did not-wait; length of ED stay for non-admitted patients) were compared between EDs with and without NPs using logistic regression and Cox proportional hazards regression, adjusting for hospital and patient characteristics and correlation of outcomes within hospitals. Safety and quality indicator data (rates of ED unplanned re-presentations) for a random subset of re-presentations were compared using Poisson regression. RESULTS Of 66 EDs, 55 (83%) provided service indicator data on 2 463 543 ED patient episodes while 58 (88%) provided safety and quality indicator data on 2853 ED re-presentations. EDs with NPs had significantly (p<0.001) higher rates of waiting times compared with EDs without NPs. Patients presenting to EDs with NPs spent 13 min (8%) longer in ED compared with EDs without NPs (median, (first quartile-third quartile): 156 (93-233) and 143 (84-217) for EDs with and without NPs, respectively). EDs with NPs had 1.8% more patients who did not wait, but similar re-presentations rates as EDs with NPs. CONCLUSIONS EDs with NPs had statistically significantly lower performance for service indicators. However, these findings should be treated with caution. NPs are relatively new in the ED workforce and low NP numbers, staffing patterns and still-evolving roles may limit their impact on service indicators. Further research is needed to explain the dichotomy between the benefits of NPs demonstrated in individual clinical outcomes research and these macro system-wide observations.
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Synthesis of Research Articles to Examine Reporting of the Educational Preparation and Practice Parameters of Emergency Nurse Practitioners. Adv Emerg Nurs J 2018; 40:226-237. [DOI: 10.1097/tme.0000000000000202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Developing the role of Swedish advanced practice nurse (APN) through a blended learning master's program: Consequences of knowledge organisation. Nurse Educ Pract 2018; 28:196-201. [DOI: 10.1016/j.nepr.2017.10.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 10/17/2017] [Accepted: 10/26/2017] [Indexed: 11/23/2022]
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Halcomb E, Stephens M, Bryce J, Foley E, Ashley C. Nursing competency standards in primary health care: an integrative review. J Clin Nurs 2016; 25:1193-205. [DOI: 10.1111/jocn.13224] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth Halcomb
- School of Nursing; Faculty of Science, Medicine & Health; University of Wollongong; Wollongong NSW
| | - Moira Stephens
- School of Nursing; Faculty of Science, Medicine & Health; University of Wollongong; Wollongong NSW
| | - Julianne Bryce
- Australian Nursing & Midwifery Federation; Federal Office; Melbourne Vic
| | - Elizabeth Foley
- Australian Nursing & Midwifery Federation; Federal Office; Melbourne Vic
| | - Christine Ashley
- School of Nursing; Faculty of Science, Medicine & Health; University of Wollongong; Wollongong NSW
- Australian Nursing & Midwifery Federation; Federal Office; Melbourne Vic
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Identifying advanced practice: A national survey of a nursing workforce. Int J Nurs Stud 2016; 55:60-70. [DOI: 10.1016/j.ijnurstu.2015.12.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 12/03/2015] [Accepted: 12/04/2015] [Indexed: 11/22/2022]
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MacLellan L, Higgins I, Levett-Jones T. Medical acceptance of the nurse practitioner role in Australia: A decade on. J Am Assoc Nurse Pract 2015; 27:152-9. [DOI: 10.1002/2327-6924.12141] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/25/2013] [Indexed: 11/07/2022]
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Jennings N, Clifford S, Fox AR, O’Connell J, Gardner G. The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. Int J Nurs Stud 2015; 52:421-35. [DOI: 10.1016/j.ijnurstu.2014.07.006] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 07/10/2014] [Accepted: 07/13/2014] [Indexed: 12/19/2022]
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Azuri P, Haron Y, Riba S. Israeli emergency department nurses' attitudes to an extension of their role and powers. J Clin Nurs 2013; 23:261-7. [DOI: 10.1111/jocn.12405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 04/10/2013] [Accepted: 04/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Pazit Azuri
- Nursing Division; Ministry of Health; Jerusalem Israel
| | - Yafa Haron
- Research Unit; Nursing Division; Ministry of Health; Jerusalem Israel
| | - Shoshana Riba
- Nursing Division; Ministry of Health; Jerusalem Israel
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Li J, Westbrook J, Callen J, Georgiou A, Braithwaite J. The impact of nurse practitioners on care delivery in the emergency department: a multiple perspectives qualitative study. BMC Health Serv Res 2013; 13:356. [PMID: 24053508 PMCID: PMC3848906 DOI: 10.1186/1472-6963-13-356] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/17/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Despite well-articulated benefits, the introduction of Nurse Practitioners (NPs) in Australia has been slow. Poorly defined nomenclature relating to advanced practice roles in nursing and variations in such roles both across Australia and worldwide have resulted in confusion and uncertainty regarding the functions and roles of NPs. Qualitative studies focussing on the perceived impact on the care settings into which NPs are introduced are scarce, but are valuable in providing a complete contextual account of NPs in care delivery settings. This study aimed to investigate the perceived impact of the NP on the delivery of care in the ED by senior doctors, nurses, and NPs. Results will facilitate adoption and best use of this human resource innovation. METHODS A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior doctors (staff specialists and ED directors) and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the impact of the NP role on the ED. Member checking of results was conducted by revisiting the sites to clarify findings with participants and further explore emergent themes. RESULTS The impact of the NP role was perceived differently by different groups of participants. Whilst NPs were observed to deliver few quantitative improvements to ED functioning from the perspective of ED directors, NPs believed that they assisted doctors in managing the increasing subacute presentations to the contemporary ED. NPs also believed they embraced a preventative paradigm of care which addressed the long term priorities of chronic disease prevention and cost containment in the broader healthcare environment. The ambiguous position of the NP role, which crosses the gap between nursing and medicine, emerged and resulted in a duality of NP governance. CONCLUSIONS Interpretation of the NPs' role occurred through different frames of reference. This has implications for the development of the NP role in the ED. Collaboration and dialogue between various stakeholders, such as ED doctors and senior nursing management is required.
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Affiliation(s)
- Julie Li
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Johanna Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Joanne Callen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Jeffrey Braithwaite
- Centre for Clinical Governance Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
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Aftyka A, Rudnicka-Drożak E, Rybojad B. A comparison of ambulance responses to incidents of Medical Emergency Teams led by nurses and paramedics--A retrospective single-center study. Int J Nurs Stud 2013; 51:555-61. [PMID: 23932264 DOI: 10.1016/j.ijnurstu.2013.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 07/12/2013] [Accepted: 07/16/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND In Poland there are currently two main types of Medical Emergency Team: basic, run by nurses or paramedics, and specialist, led by physicians. They differ not only in professional qualifications but also in their terms of reference. OBJECTIVES We compared the responses to incidents of Medical Emergency Teams led by nurses and paramedics, in terms of the frequency of pharmacotherapy use and medical rescue activities. STUDY DESIGN Ambulance call reports. SETTINGS Medical Emergency Teams in Eastern Poland. PARTICIPANTS Medical Emergency Teams led by nurses or paramedics. Exclusion criteria were cancelation of calls by the dispatcher, calls with no patient on the scene, and neonatal and interhospital transportation. METHODS A retrospective analysis of ambulance call reports. A comparison of actions of nurses and paramedics taken in the field, and decisions concerning transportation of the patient to a hospital or leaving the home were collected. RESULTS Of 1115 Medical Emergency Teams calls, those led by paramedics (60.5%) were more common. Paramedics, more often than nurses, provided aid solely in the field-27.5% and 16.0%, respectively-and less frequently transported patients to the hospital-38.5% and 50.7%, respectively. Significant differences in administration of oxygen therapy and analgesics were identified; paramedics used them more often than nurses. Paramedics used cervical collars, 3.6% and 1.1% (p=0.01), respectively, and performed 12-lead electrocardiograms, 4.7% and 1.4% (p=0.002), respectively, significantly more frequently than did nurses. CONCLUSIONS Despite the comparable competency of paramedics and emergency nurses in Poland, Medical Emergency Teams' activities varied depending on whether a nurse or a paramedic was the team leader. It is recommended that further in-depth research is conducted in this area.
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Affiliation(s)
- Anna Aftyka
- Department of Nursing Anesthesia and Intensive Care, Medical University of Lublin, Poland
| | - Ewa Rudnicka-Drożak
- Department of Expert Medical Assistance, Medical University of Lublin, Poland
| | - Beata Rybojad
- Department of Anesthesiology and Intensive Care, Children's University Hospital of Lublin, Poland.
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Gardner G, Gardner A, O'Connell J. Using the Donabedian framework to examine the quality and safety of nursing service innovation. J Clin Nurs 2013; 23:145-55. [PMID: 23834585 DOI: 10.1111/jocn.12146] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the safety and quality of nurse practitioner service using the audit framework of Structure, Process and Outcome. BACKGROUND Health service and workforce reform are on the agenda of governments and other service providers seeking to contain healthcare costs whilst providing safe and effective health care to communities. The nurse practitioner service is one health workforce innovation that has been adopted globally to improve timely access to clinical care, but there is scant literature reporting evaluation of the quality of this service innovation. DESIGN A mixed-methods design within the Donabedian evaluation framework was used. METHODS The Donabedian framework was used to evaluate the Structure, Process and Outcome of nurse practitioner service. A range of data collection approaches was used, including stakeholder survey (n = 36), in-depth interviews (11 patients and 13 nurse practitioners) and health records data on service processes. RESULTS The study identified that adequate and detailed preparation of Structure and Process is essential for the successful implementation of a service innovation. The multidisciplinary team was accepting of the addition of nurse practitioner service, and nurse practitioner clinical care was shown to be effective, satisfactory and safe from the perspective of the clinician stakeholders and patients. CONCLUSIONS This study demonstrated that the Donabedian framework of Structure, Process and Outcome evaluation is a valuable and validated approach to examine the safety and quality of a service innovation. Furthermore, in this study, specific Structure elements were shown to influence the quality of service processes further validating the framework and the interdependence of the Structure, Process and Outcome components. RELEVANCE TO CLINICAL PRACTICE Understanding the Structure and Process requirements for establishing nursing service innovation lays the foundation for safe, effective and patient-centred clinical care.
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Affiliation(s)
- Glenn Gardner
- School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Qld, Australia
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Gardner G, Chang AM, Duffield C, Doubrovsky A. Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice. J Adv Nurs 2012. [DOI: 10.1111/jan.12054] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Glenn Gardner
- Institute for Health & Biomedical Innovation; Queensland University of Technology; Brisbane Queensland Australia
- Centre for Clinical Nursing; Royal Brisbane and Women's Hospital; Queensland Australia
| | - Anne M. Chang
- Institute for Health & Biomedical Innovation; Queensland University of Technology; Brisbane Queensland Australia
- Mater Health Services; Brisbane Queensland Australia
| | - Christine Duffield
- Centre for Health Services Management; University of Technology Sydney; New South Wales Australia
| | - Anna Doubrovsky
- Queensland University of Technology; Brisbane Queensland Australia
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McConnell D, Slevin OD, McIlfatrick SJ. Emergency nurse practitioners' perceptions of their role and scope of practice: is it advanced practice? Int Emerg Nurs 2012; 21:76-83. [PMID: 23615513 DOI: 10.1016/j.ienj.2012.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 03/13/2012] [Accepted: 03/22/2012] [Indexed: 11/30/2022]
Abstract
There are multiple interpretations of the nurse practitioner role which appear to be shaped by discourses within and outside the profession and its regulatory body. This study aimed to explore and clarify the role and scope of practice of emergency nurse practitioners in a region in the United Kingdom and determine if they fulfil the proposed criteria for Advanced Nurse Practitioners. A survey approach using questionnaires (n=42) was adopted. The sample included all emergency nurse practitioners working in Accident and Emergency Departments and Minor Injury Units in the region. Statistical data was analysed using SPSS for Windows and qualitative data was content analysed for themes. Results revealed a variation in education. Investigation of role typology and scope of practice revealed a relatively homogenous group where the clinical aspect of the role dominated. The scope of practice was perceived to be influenced by internal factors such as competence; however protocol use, referral rights and prescribing authority could be considered ways that nursing management and medical staff indirectly control the role. Findings suggested that emergency nurse practitioners were working at a level significantly beyond registration, yet do not fulfil the Nursing and Midwifery Council proposed criteria for Advanced Nurse Practitioner.
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Lutze M, Ratchford A, Fry M. A review of the Transitional Emergency Nurse Practitioner. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.aenj.2011.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Lowe G, Plummer V, O’Brien AP, Boyd L. Time to clarify - the value of advanced practice nursing roles in health care. J Adv Nurs 2011; 68:677-85. [DOI: 10.1111/j.1365-2648.2011.05790.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Melby V, Gillespie M, Martin S. Emergency nurse practitioners: the views of patients and hospital staff at a major acute trust in the UK. J Clin Nurs 2010; 20:236-46. [DOI: 10.1111/j.1365-2702.2010.03333.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Duffield CM, Conlon L, Kelly M, Catling-Paull C, Stasa H. The emergency department nursing workforce: local solutions for local issues. Int Emerg Nurs 2009; 18:181-7. [PMID: 20869658 DOI: 10.1016/j.ienj.2009.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 10/08/2009] [Accepted: 10/08/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Christine M Duffield
- Centre for Health Services Management, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia.
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