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López-Panza ER, Pacheco-Roys VC, Fernández-Ahumada KJ, Díaz-Mass DC, Expósito-Concepción MY, Villarreal-Cantillo E, Aviles Gonzalez CI. Competencies of the nurses in the limitation of therapeutic effort in the intensive care unit: An integrative review. Int J Nurs Sci 2024; 11:143-154. [PMID: 38352294 PMCID: PMC10859575 DOI: 10.1016/j.ijnss.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 02/16/2024] Open
Abstract
Objective Nurses inevitably encounter patients who require care aimed at limiting therapeutic effort (LTE), even though many of them are not prepared to provide support to individuals with terminal illnesses and their families. One of the contexts in which the LTE is considered is the intensive care unit (ICU). This review is to describe the competencies for the execution of a nursing professional role in the LTE in the ICU. Method An integrative review of the literature published between the years 2010 and 2023. The search was carried out in five databases: Medline, Wiley Online Library, SciELO, ScienceDirect, and Web of Science. The Critical Appraisal Skills Programme in Spanish was used as the template for study evaluation. The methodology of the Oxford Center for Evidence-Based Medicine (CEBM) was used to assess the level of evidence and the degree of recommendation. Result A total of 25 articles in a wide range of studies were included. The findings suggest that the competencies for LTE in the ICU are direct patient care, family-centered care, and the role of the nurse within the team. However, more high-quality studies are needed to confirm these conclusions. Three categories were identified: (a) competencies as defender agent between the patient, his family, and the interdisciplinary team; (b) competencies for decision-making in limiting the therapeutic effort; and (c) competencies for nursing therapeutic interventions at the end of life. Conclusion The competencies of the nursing professionals who work in the adult ICU in the LTE are essential to the patient's quality of life, dignity of their death, and comprehensive family support for coping with grief.
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Affiliation(s)
- Elvia R. López-Panza
- Nursing Department, Universidad del Norte, Barranquilla, Colombia
- Nursing Program, Faculty of Health Sciences, Universidad Popular del César, Valledupar, Colombia
| | - Vanessa C. Pacheco-Roys
- Nursing Department, Universidad del Norte, Barranquilla, Colombia
- Clínica Valledupar, Valledupar, Colombia
| | - Kelly J. Fernández-Ahumada
- Nursing Department, Universidad del Norte, Barranquilla, Colombia
- Hospital Universidad del Norte, Soledad, Colombia
| | | | | | | | - Cesar I. Aviles Gonzalez
- Nursing Program, Faculty of Health Sciences, Universidad Popular del César, Valledupar, Colombia
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria di Monserrato, Cagliari, Italy
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Püschel VADA, Paz EPA, Ribeiro RM, Alvarez AM, Cunha CLF. Advanced Practice Nursing in Brazil: how are we and what is missing? Rev Esc Enferm USP 2022; 56:e20210455. [PMID: 35848610 DOI: 10.1590/1980-220x-reeusp-2021-0455en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/01/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To reflect on the role and initiatives of the Brazilian Nursing Association (ABEn) and the Federal Nursing Council (Cofen) in the development, recognition, and regulation necessary to implement advanced practice nursing (APN) in Brazil. METHOD This is a theoretical-reflective essay resulting from the roundtable discussion entitled "Regulation and recognition of advanced nursing practices in Brazil: how are we and what is missing" held in May 2021, at the III International Symposium on Adult Health. RESULTS ABEn and Cofen are strategic partners to define the areas of activity of this specialization in Brazil. Nursing organizations are responsible for defining professional profiles and curricula, advanced practice nursing conditions, and adequacy of existing graduate courses aiming at technical support, political leadership, regulation, and construction of an APN foundation in Brazil. CONCLUSION Brazil must broaden the national debate on APN, define a training model for it, and articulate efforts with all its strategic partners to build a theoretical, political, and labor framework for advanced practice nurses' full professional practice.
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Affiliation(s)
- Vilanice Alves de Araújo Püschel
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil.,Associação Brasileira de Enfermagem-Seção São Paulo, São Paulo, SP, Brazil
| | - Elisabete Pimenta Araújo Paz
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Rio de Janeiro, RJ, Brazil.,Conselho Federal de Enfermagem, Brasília, DF, Brazil
| | - Rennan Martins Ribeiro
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brazil
| | - Angela Maria Alvarez
- Universidade Federal de Santa Catarina, Departamento de Enfermagem, Florianópolis, SC, Brazil
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Püschel VADA, Paz EPA, Ribeiro RM, Alvarez AM, Cunha CLF. Práticas Avançadas em Enfermagem no Brasil: como estamos e o que falta? Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0455pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: Refletir sobre o papel e as iniciativas da Associação Brasileira de Enfermagem (ABEn) e do Conselho Federal de Enfermagem (Cofen) no desenvolvimento, reconhecimento e regulamentação necessários à implantação da Enfermagem de Prática Avançada (EPA) no Brasil. Método: Ensaio teórico-reflexivo resultante da mesa-redonda intitulada “Regulamentação e reconhecimento das práticas avançadas em enfermagem no Brasil: Como estamos e o que falta?”, realizada em maio de 2021, no III Simpósio Internacional de Saúde do Adulto. Resultados: Fica evidenciado que a ABEn e o Cofen são parceiros estratégicos para definição das áreas de atuação desta especialização no país. As responsabilidades das organizações da Enfermagem consistem em definir o perfil profissional, o currículo, as condições para o exercício dos enfermeiros de prática avançada, adequação dos cursos de pós-graduação existentes, com vistas ao apoio técnico, liderança política, regulação, regulamentação e construção de bases para EPA no país. Conclusão: É preciso ampliar o debate sobre a EPA no Brasil, definir o modelo de formação e articular esforços com todos os parceiros estratégicos, no intuito de construir um arcabouço teórico, político e laboral para o pleno exercício profissional do enfermeiro de prática avançada.
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Achury Saldaña DM, Achury Beltrán LF, Rodríguez Colmenares SM, Alvarado Romero HR, Cavallo E, Ulloa AC, Merino V, da Silva Barreto M, Andrade Fonseca D, Muñoz Acuña D, Betancur Manrique Y, Rodríguez Marín JE, González Gómez AA, Herrera Corpas K, Andrade Méndez B, Vargas Toloza RE, Martínez Rojas SM, De Las Salas Martínez RP. Professional profile and work conditions of nurses working in intensive care units: A multicentre study. J Clin Nurs 2021; 31:1697-1708. [PMID: 34655269 PMCID: PMC9291988 DOI: 10.1111/jocn.16026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/18/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
AIM To determine the professional profile and the work conditions of nurses working in intensive care units (ICU) in Colombia, Argentina, Peru and Brazil. BACKGROUND ICUs require a differentiated professional profile to provide quality care, and appropriate working conditions, leading to a transformation of care and management practices. DESIGN Descriptive multicentre cross-sectional observational study. METHODS An online survey was applied to identify both the characteristics of the professional profile and the working conditions. 1,427 ICU nursing professionals were included. RStudio statistical software was used for the analysis of the information. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study. RESULTS Only 33.6% of the professionals had a specialisation degree in intensive care. The skills that were most frequently put into practice were communication (68.5%) and care management (78.5%). The most predominant nurse-to-patient ratios were 1:2, and greater than 1:6. 59.1% of the nurses had an indefinite term contract, 38.8% worked 48 hours per week and 49.8% had rotating shifts. Only 50.4% of them received incentives. The average salary ranged between 348 and 1,500 USD. 64.5% of the participants were satisfied with their job. CONCLUSION It is necessary to strengthen nurses' professional profile by promoting both postgraduate education and the development of troubleshooting and teamwork skills. It is necessary to standardise the nurse-to-patient ratio, improve wages and increase incentives to achieve greater job satisfaction. RELEVANCE TO PRACTICE The knowledge and the improvement of both the professional profile and the work conditions of nurses working in intensive care units will improve the quality of the care given to critical patients and, therefore, the quality of health outcomes.
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San Martín-Rodríguez L, Soto-Ruiz N, Escalada-Hernández P. Formación de las enfermeras de práctica avanzada: perspectiva internacional. ENFERMERIA CLINICA 2019; 29:125-130. [DOI: 10.1016/j.enfcli.2018.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/09/2018] [Indexed: 11/28/2022]
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Oliveira JLCD, Toso BRGDO, Matsuda LM. Advanced practices for care management: reflections on the Brazilian Nursing. Rev Bras Enferm 2019; 71:2060-2065. [PMID: 30156697 DOI: 10.1590/0034-7167-2017-0115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/26/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to explain about the Advanced Nursing Practice and to discuss the possibilities of the Advanced Practice for the management of nursing care in Brazil. METHOD this is a theoretical-reflexive trial, based on the international literature on advanced practices in nursing and analysis relevant to the profession and to the Brazilian context. RESULTS the object of the study was described in the following driving axes: Advanced Practice Nurse: international examples and Brazilian reality; Reflections on the care management by the Advanced Practice Nurse in Brazil. Autonomy, qualified training, leadership and performance based on scientific evidences as the foundation of the best care management by the Advanced Nursing Practice, stand out. FINAL CONSIDERATIONS while early and challenging, the work of Brazilian nursing towards advanced professional practice seems to be interesting, since the possibilities of managing the care of this modality of nurses' performance are evident.
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Affiliation(s)
- João Lucas Campos de Oliveira
- Universidade Estadual de Maringá. Maringá, Paraná, Brazil.,Universidade Estadual do Oeste do Paraná. Cascavel, Paraná, Brazil
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