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Gorjian Z, Asadizaker M, Zarea K, Irajpour A, Ahmadi F, Rokhafroz D. Experiences and attitudes of clinical and academic nurses about infection prevention and control nursing curriculum and duties - a qualitative study. BMC MEDICAL EDUCATION 2024; 24:672. [PMID: 38886696 PMCID: PMC11184893 DOI: 10.1186/s12909-024-05633-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Infectious diseases are becoming more widespread and re-emerging, causing psychological, social, economic, and health effects at both national and international levels. Specialist nurses can help prevent and control these infections. However, in Iran, there are currently no specialist infection prevention and control (IPC) nurses to manage and control infections. This study aims to explore clinical and academic nurses' attitudes toward IPC nursing curriculum and duties. METHODS The study used a qualitative content analysis approach. Thirty-six participants, including clinical and academic nurses, were selected using a purposeful sampling method. Data was collected through seven focused group discussions. The accuracy and validity of the research tools were measured using the Four-Dimension Criteria developed by Lincoln and Guba. Data analysis was conducted using directed content analysis. RESULTS The data analysis of the discussions held in the seven focus groups extracted 628 codes. Three themes were developed from the qualitative analysis: "Core characteristics of the curriculum", "Expected competencies and skills", and "Evaluation." These themes were derived from nine main categories and 25 subcategories. CONCLUSIONS Specialist IPC nurses can play important roles in various positions and environments. Therefore, educational policymakers in Iran should consider establishing IPC nursing courses. It is also recommended that policymakers and decision-makers in the nursing field of other less developed countries should prioritize this issue.
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Affiliation(s)
- Zahra Gorjian
- Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Abadan University of Medical Sciences, Abadan, Iran
| | - Marziyeh Asadizaker
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Irajpour
- Nursing & Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Ahmadi
- Infection and Tropical Disease Research Center, Health research institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dariush Rokhafroz
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Deschodt M, Heeren P, Cerulus M, Duerinckx N, Pape E, van Achterberg T, Vanclooster A, Dauvrin M, Detollenaere J, Van den Heede K, Dobbels F. The effect of consultations performed by specialised nurses or advanced nurse practitioners on patient and organisational outcomes in patients with complex health conditions: An umbrella review. Int J Nurs Stud 2024; 158:104840. [PMID: 38945063 DOI: 10.1016/j.ijnurstu.2024.104840] [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: 10/26/2023] [Revised: 04/22/2024] [Accepted: 06/04/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Policymakers and researchers often suggest that nurses may play a crucial role in addressing the evolving needs of patients with complex conditions, by taking on advanced roles and providing nursing consultations. Nursing consultations vary widely across settings and countries, and their activities range from complementing to substituting traditional physician-led consultations or usual care. OBJECTIVE This study was aimed at describing the effects of nursing consultations with patients with complex conditions in any setting on patient outcomes (quality of life, physical status, psychosocial health, health behaviour, medication adherence, mortality, anthropometric and physiological outcomes, and patient satisfaction) and organisational outcomes (health resource use and costs). DESIGN Umbrella review. METHODS We followed the Joanna Briggs Institute method for umbrella reviews. We searched PubMed, Embase, Cochrane Database of Systematic Reviews and CINAHL to identify relevant articles published in English, Dutch, French, Spanish or German between January 2013 and February 2023. We included systematic literature reviews, with or without meta-analyses, that included randomised controlled trials conducted in high-income countries. Reviews were eligible if they pertained to consultations led by specialised nurses or advanced nurse practitioners. Article selection, data extraction and quality appraisal were performed independently by at least two reviewers. RESULTS We included 50 systematic reviews based on 473 unique trials. For all patient outcomes, nursing consultations achieved effects at least equivalent to those of physician-led consultations or usual care (i.e., non-inferiority). For quality of life, health behaviour, medication adherence, mortality and patient satisfaction, more than half the meta-analyses found statistically significant effects in favour of nursing consultations (i.e., superiority). Cost results must be interpreted with caution, because very few and heterogeneous cost-related data were extracted, and the methodological quality of the cost analyses was questionable. Narrative syntheses confirmed the overall conclusions of the meta-analyses. CONCLUSIONS The effects of nursing consultations on patients with complex health conditions across healthcare settings appear to be at least similar to physician-led consultations or usual care. Nursing consultations appear to be more effective than physician-led consultations or usual care in terms of quality of life, health behaviour, mortality, patient satisfaction and medication adherence. Further analysis of the primary data is necessary to determine the patient populations and settings in which nursing consultations are most effective. Moderate study quality, diversity amongst and within systematic reviews, and quality of reporting hamper the strength of the findings.
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Affiliation(s)
- Mieke Deschodt
- Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven, Belgium; Competence Center of Nursing, University Hospitals Leuven, Belgium.
| | - Pieter Heeren
- Competence Center of Nursing, University Hospitals Leuven, Belgium; Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Belgium
| | - Marie Cerulus
- Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven, Belgium; Competence Center of Nursing, University Hospitals Leuven, Belgium
| | - Nathalie Duerinckx
- Competence Center of Nursing, University Hospitals Leuven, Belgium; Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Belgium; Heart Transplant Program, Department of Cardiovascular Diseases, KU Leuven, Belgium
| | - Eva Pape
- Cancer Centre, Ghent University Hospital, Belgium
| | - Theo van Achterberg
- Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Belgium
| | | | | | | | | | - Fabienne Dobbels
- Academic Center for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Belgium
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Serra-Barril MA, Ferro-Garcia T, Fernandez-Ortega P, Sanchez-Lopez C, Martinez-Momblan MA, Benito-Aracil L, Romero-Garcia M. The role experience of advanced practice nurses in oncology: An interpretative phenomenological study. J Adv Nurs 2024; 80:2512-2524. [PMID: 38054402 DOI: 10.1111/jan.15997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/06/2023] [Accepted: 11/19/2023] [Indexed: 12/07/2023]
Abstract
AIM(S) To understand the experiences of advanced practice nurses working in cancer care. DESIGN Phenomenological qualitative study. METHODS Three focus groups were held to collect qualitative data. Participants were recruited through theoretical non-probabilistic sampling of maximum variation, based on 12 profiles. Data saturation was achieved with a final sample of 21 oncology advanced practice nurses who were performing advanced clinical practice roles in the four centers from December 2021 to March 2022. An interpretative phenomenological analysis was performed following Guba and Lincoln's criteria of trustworthiness. The centers' ethics committee approved the study, and all participants gave written informed consent. Data analysis was undertaken with NVivo 12 software. RESULTS Three broad themes emerged from the data analysis: the role performed, facilitators and barriers in the development of the role and nurses' lived experience of the role. CONCLUSION Advanced practice nurses are aware that they do not perform their role to its full potential, and they describe different facilitators and barriers. Despite the difficulties, they present a positive attitude as well as a capacity for leadership, which has allowed them to consolidate the advanced practice nursing role in unfavourable environments. IMPLICATIONS FOR THE PROFESSION These results will enable institutions to establish strategies at different levels in the implementation and development of advanced practice nursing roles. REPORTING METHOD Reporting complied with COREQ criteria for qualitative research. PATIENT OR PUBLIC CONTRIBUTIONS No patient or public contribution.
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Affiliation(s)
- M Antònia Serra-Barril
- Innovation and Quality Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, L'Hospitalet, Spain
| | - Tàrsila Ferro-Garcia
- Innovation and Quality Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, L'Hospitalet, Spain
| | - Paz Fernandez-Ortega
- Department of Public Health, Mental Health and Maternal Care, Faculty of Medicine and Health Sciences, University of Barcelona, Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Sanchez-Lopez
- Catalan Institute of Oncology, Oncology Hospitalization/Inpatient Unit, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Antonia Martinez-Momblan
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, L'Hospitalet, Spain
| | - Llúcia Benito-Aracil
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, L'Hospitalet, Spain
- IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marta Romero-Garcia
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, L'Hospitalet, Spain
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Willder S, Kelsey E, O'Connor E, Grills R. Expanding urological services into regional Australia and reducing interhospital transfers: how the nurse practitioner can help. ANZ J Surg 2024; 94:1076-1082. [PMID: 38619216 DOI: 10.1111/ans.18993] [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: 05/21/2023] [Revised: 09/25/2023] [Accepted: 03/07/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND A visiting urology service has been in existence at Hamilton Base Hospital, Western Victoria, over the past 25 years, serving an unmet need. A Urology Nurse Practitioner (UNP) provides the care and management of urology patients working in close association with visiting urologists. We aim to assess the impact of the UNP's role in the delivery of regional urological care. METHODS A retrospective analysis of medical records identified all clinical interventions by the UNP between January 2016 and December 2019. Each encounter was graded according to a clinical severity scale from grade 1 to 5 and assessed for UNP management of patients and the prevention of interhospital transfers. RESULTS One hundred eighty-four patients with 654 individual assessments were identified for inclusion and classified according to the adapted clinical severity scale. Most interventions for category 3 and 4 patients related to major bleeding, catheter difficulties, and haemodynamic instability. A total of 19 patients whose urological issues would typically require interhospital transfer were able to be managed locally. CONCLUSIONS Transferring an acute patient from a regional to a tertiary hospital for specialist care is often necessary but not ideal for the patient and their family. The presence of a dedicated UNP in a regional centre is important for patient care and has an important role in preventing unnecessary transfers. This is a vital component of a visiting urological service to a rural community.
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Affiliation(s)
- S Willder
- Depatment of Surgery, Western District Health Service, Hamilton, Victoria, Australia
| | - E Kelsey
- Department of Urological Surgery, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia
| | - E O'Connor
- Department of Urological Surgery, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia
| | - R Grills
- Depatment of Surgery, Western District Health Service, Hamilton, Victoria, Australia
- Department of Urological Surgery, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia
- Department of Surgery, School of Medicine, Deakin University, Geelong, Victoria, Australia
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Pedreira-Robles G, Garcimartín P, Sevilla-Guerra S, Bach-Pascual A, García-Martínez M, Morín-Fraile V. Nurse-led clinical activity in kidney transplantation care in Spain: A cross-sectional observational study. J Ren Care 2024; 50:168-175. [PMID: 36906846 DOI: 10.1111/jorc.12463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/11/2023] [Accepted: 02/25/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES To explore the presence of specialist outpatient nursing activity in care for kidney transplant recipients in Spain and to determine the level of competence development of this activity according to the Advanced Practice Nurse model. DESIGN Descriptive, cross-sectional study. PARTICIPANTS AND MEASUREMENTS All outpatient nurses specialising in renal transplantation in the 39 transplant hospitals in Spain were included. To fulfil the study objectives, an ad hoc questionnaire and the 'Advanced Practice Nurse Role Definition Instrument (IDREPA)' were administered to assess the nurses' level of competence development. RESULTS Of the facilities included in the study, 25 (64.1%) had posttransplant nursing activity, 13 (33.3%) had pretransplant nursing activity and 11 (28.2%) had nursing activity involving kidney donor candidates. Twenty-seven specialist nurse's offices were identified. The results of the IDREPA reflect the presence of advanced practice in the domains of 'expert care planning' and 'comprehensive care'. Three (11.1%) nurses met all criteria for advanced nursing practice. CONCLUSION The results on specialised outpatient nursing activity at the 39 transplantation facilities in Spain indicate a low presence of this type of activity, with an even lower presence of advanced practice nurses. IMPLICATIONS FOR CLINICAL PRACTICE Management teams should consider investing in the quality of care provided by advanced nurse practice to ensure that suitable treatment is provided and better clinical outcomes are obtained.
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Affiliation(s)
- Guillermo Pedreira-Robles
- Nephrology Department, Hospital del Mar, Barcelona, Spain
- ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra affiliated, Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Nursing and Health PhD Programme, University of Barcelona, Barcelona, Spain
| | - Paloma Garcimartín
- Nursing direction, Hospital del Mar, Barcelona, Spain
- Department of Biomedical Research in Heart Diseases, Hospital del Mar Institute for Medical Research (IMIM), Barcelona, Spain
| | - Sonia Sevilla-Guerra
- Gerència de Processos Integrats de Salut, Àrea Assistencial, Catalan Health System, Barcelona, Spain
| | | | | | - Victoria Morín-Fraile
- Department of Public Health, Mental and Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
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Li Y, Wang C, Tan W, Jiang Y. The transition to advanced practice nursing: A systematic review of qualitative studies. Int J Nurs Stud 2023; 144:104525. [PMID: 37263057 DOI: 10.1016/j.ijnurstu.2023.104525] [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: 12/18/2022] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Advanced practice nurses have made important contributions to the tasks of stabilising the operation of the health system and improving the quality of care. However, taking on the role of an advanced practice nurse is always challenging and can even result in the intention to leave the profession. Insights into advanced practice nursing role transitions are important to implement effective interventions to help nurses cope with the corresponding turbulence and changes. AIM To explore the experiences of advanced practice nurses during their role transition from registered nurses to their current role. DESIGN A systematic review of qualitative studies. DATA SOURCES Five databases were searched from inception to August 2022: PubMed, Web of Science, Cochrane, Embase and CINAHL. REVIEW METHODS This review was reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Two reviewers independently conducted study selection and data extraction, and quality appraisal was performed using the Joanna Briggs Institute critical appraisal instrument for qualitative research. Data synthesis was conducted using thematic analysis. FINDINGS A total of 14 studies were included in this review. Three analytical themes emerged: (1) trudging along a narrow road, (2) driving and restraining forces in the transition, and (3) embracing the new identity. Four subthemes were graded as high confidence and the other four were moderate confidence. Establishing a new role was a priority and a significant challenge for advanced practice nurses. Beliefs regarding advanced practice, the attitudes of colleagues, and the support of mentors impacted the transition process. Advanced practice nurses expressed appreciation for their new role and developed new ambitions at the end of the transition. CONCLUSIONS Advanced practice nurses face a series of challenges during the process of role development, especially struggles with vague feelings and a lack of confidence in practice. These difficulties could be exacerbated without the support of team and organisational managers. The implementation of mentorship and the mediation of interprofessional conflicts are necessary to facilitate successful role transitions.
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Affiliation(s)
- Yijing Li
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Cong Wang
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Wei Tan
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yan Jiang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
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Nightingale J, Ali N, Lewis R, Ibbotson R, Monks H, Urquhart-Kelly T, Saunders L. Transforming nursing care for children with serious long-term conditions: A mixed methods exploration of the impact of Roald Dahl Specialist Nurses in the United Kingdom. J Pediatr Nurs 2023; 70:90-102. [PMID: 36848741 DOI: 10.1016/j.pedn.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/15/2023] [Accepted: 02/09/2023] [Indexed: 02/27/2023]
Abstract
PURPOSE A new model of paediatric nursing, funded initially by a charitable organisation working in partnership with UK healthcare providers, was implemented to support children living with serious long-term conditions. This study explored, from the perspective of multiple stakeholders, the impact of services provided by 21 'Roald Dahl Specialist Nurses' (RDSN) within 14 NHS Trust hospitals. DESIGN AND METHODS A Mixed Methods Exploratory design commenced with interviews with RDSNs (n = 21) and their managers (n = 15), alongside a medical clinician questionnaire (n = 17). Initial themes (constructivist grounded theory) were validated through four RDSN focus groups, and informed development of an online survey of parents (n = 159) and children (n = 32). Findings related to impact were integrated using a six-step triangulation protocol. RESULTS Zones of significant impact included: Improving quality and experience of care; Improved efficiencies and cost-effectiveness; Provision of holistic family-centred care; and Impactful leadership and innovation. The RDSNs forged networks across inter-agency boundaries to safeguard the child and enhance the family experience of care. RDSNs delivered improvements across a range of metrics, and were valued for their emotional support, care navigation and advocacy. CONCLUSIONS Children living with serious long-term conditions have complex needs. Regardless of the specialty, location, organisation or service focus, this new model of care crosses organisational and inter-agency boundaries to ensure that the healthcare delivered has maximum impact. It has a profoundly positive impact on families. PRACTICE IMPLICATIONS This integrated and family-centred model of care is strongly recommended for children with complex needs crossing organisational divides.
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Affiliation(s)
- Julie Nightingale
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, United Kingdom.
| | - Nancy Ali
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, United Kingdom
| | - Robin Lewis
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, United Kingdom
| | - Rachel Ibbotson
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, United Kingdom
| | - Helen Monks
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, United Kingdom
| | - Tanya Urquhart-Kelly
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, United Kingdom
| | - Lesley Saunders
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, United Kingdom
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Woodman H, Spencer S. Advanced clinical practice in paediatric haematology and oncology: developing a capability document. Nurs Child Young People 2023; 35:27-33. [PMID: 35875922 DOI: 10.7748/ncyp.2022.e1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 01/06/2023]
Abstract
Specialist roles have been developed to provide holistic care to children and young people with cancer, one of which is the advanced clinical practitioner (ACP) in paediatric oncology and haematology. A survey showed that paediatric oncology and haematology ACPs in the UK work in a wide variety of roles and that their numbers vary greatly between treatment centres. The survey also confirmed the need for a national standardised framework delineating the knowledge, skills and expertise required of ACPs working in paediatric oncology and haematology. This article describes the development of a capability document to support and standardise advanced practice in paediatric oncology and haematology. The document reflects the advanced level of critical thinking, autonomy and decision-making required of ACPs and has been endorsed by the Children's Cancer and Leukaemia Group and by the Royal College of Nursing. It is hoped that it will support ACPs to consistently deliver high-quality, safe care for the benefit of children and young people with cancer and their families.
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Affiliation(s)
- Helen Woodman
- oncology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, England
| | - Sally Spencer
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, England
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Mokhtari-Nouri J, Hashemi S, Karimi L, Moradian S, Ebadi A, Vahedian-Azimi A. Identifying structure, process and outcome factors of the clinical specialist nurse: A scoping review study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:1-9. [DOI: 10.4103/ijnmr.ijnmr_297_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/27/2021] [Accepted: 04/17/2022] [Indexed: 01/26/2023]
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Optimizing the productivity and placement of nurse practitioners and physician assistants in outpatient primary care sites. J Am Assoc Nurse Pract 2022; 34:1022-1032. [PMID: 36330553 DOI: 10.1097/jxx.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND It is increasingly imperative that organizational leaders continually assess nurse practitioners' (NPs) and physician assistants' (PAs) productivity, turnover, and vacancies. Optimizing the feasibility, impact, strategic placement, and monitoring increases patient access, improves wait times and affordability, and increases revenue. LOCAL PROBLEM A healthcare system needed a systematic, data-driven approach aimed at optimizing productivity and placement of NPs and PAs in outpatient primary care sites. METHOD Results from this project are reported using the Revised Standards for Quality Improvement Reporting Excellence framework. After formation of a QI team, a gap analysis, and action plans were developed and implemented. INTERVENTION/RESULTS Priority areas requiring action included the development of an integrated position justification algorithm and tracking form addressing NPs' and PAs' placement, establishing consistent patient contact hours, setting workload expectations, and consistently communicating these via an organization-specific situation background, assessment, and recommendation communication tool. CONCLUSION Health care leaders should leverage the talents of NPs and PAs meeting organizational benchmarks and goals as well as the needs of patients. Nurse practitioner and PA leaders should focus on benchmarking performance and analyzing barriers to optimization. These efforts are most beneficial when multidisciplinary in nature.
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Sichieri K, Regina Secoli S. Cost-effectiveness analysis of the implementation of advanced practice nursing: how to move forward? Rev Esc Enferm USP 2022; 56:e20210463. [PMID: 35723249 DOI: 10.1590/1980-220x-reeusp-2021-0463en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/05/2021] [Indexed: 11/22/2022] Open
Abstract
This essay explores possibilities of advances in cost-effectiveness analysis (CEA) in advanced practice nursing (APN). The arguments were structured according to the current health landscape, the need to evaluate APN practices as health technology and evidence and recommendations for conducting CEA. Benefits of APN were evidenced in the improvement of indicators such as mortality, hospital readmission, among others. However, the absence of a standard of care, combined with the existence of different models and short time horizon interfered with the estimation of direct costs. The studies on CEA were inconclusive, mainly due to the lack of cost per unit of success and calculation of the CEA ratio. In the context of the APN, to conduct CEA that really contributes to robust results, thus subsidizing decision-making requires a joint effort of training institutions, delimitation and standardization of practice by regulatory agencies of the profession and health services, based especially on accreditation policies.
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Affiliation(s)
- Karina Sichieri
- Universidade de São Paulo, Hospital Universitário, Departamento de Enfermagem, São Paulo, SP, Brazil
| | - Sílvia Regina Secoli
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil
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Lukewich J, Martin-Misener R, Norful AA, Poitras ME, Bryant-Lukosius D, Asghari S, Marshall EG, Mathews M, Swab M, Ryan D, Tranmer J. Effectiveness of registered nurses on patient outcomes in primary care: a systematic review. BMC Health Serv Res 2022; 22:740. [PMID: 35659215 PMCID: PMC9166606 DOI: 10.1186/s12913-022-07866-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/03/2022] [Indexed: 12/22/2022] Open
Abstract
Background Globally, registered nurses (RNs) are increasingly working in primary care interdisciplinary teams. Although existing literature provides some information about the contributions of RNs towards outcomes of care, further evidence on RN workforce contributions, specifically towards patient-level outcomes, is needed. This study synthesized evidence regarding the effectiveness of RNs on patient outcomes in primary care. Methods A systematic review was conducted in accordance with Joanna Briggs Institute methodology. A comprehensive search of databases (CINAHL, MEDLINE Complete, PsycINFO, Embase) was performed using applicable subject headings and keywords. Additional literature was identified through grey literature searches (ProQuest Dissertations and Theses, MedNar, Google Scholar, websites, reference lists of included articles). Quantitative studies measuring the effectiveness of a RN-led intervention (i.e., any care/activity performed by a primary care RN) that reported related outcomes were included. Articles were screened independently by two researchers and assessed for bias using the Integrated Quality Criteria for Review of Multiple Study Designs tool. A narrative synthesis was undertaken due to the heterogeneity in study designs, RN-led interventions, and outcome measures across included studies. Results Forty-six patient outcomes were identified across 23 studies. Outcomes were categorized in accordance with the PaRIS Conceptual Framework (patient-reported experience measures, patient-reported outcome measures, health behaviours) and an additional category added by the research team (biomarkers). Primary care RN-led interventions resulted in improvements within each outcome category, specifically with respect to weight loss, pelvic floor muscle strength and endurance, blood pressure and glycemic control, exercise self-efficacy, social activity, improved diet and physical activity levels, and reduced tobacco use. Patients reported high levels of satisfaction with RN-led care. Conclusions This review provides evidence regarding the effectiveness of RNs on patient outcomes in primary care, specifically with respect to satisfaction, enablement, quality of life, self-efficacy, and improvements in health behaviours. Ongoing evaluation that accounts for primary care RNs’ unique scope of practice and emphasizes the patient experience is necessary to optimize the delivery of patient-centered primary care. Protocol registration ID PROSPERO: International Prospective Register of Systematic Reviews. 2018. ID=CRD42 018090767. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07866-x.
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Spadoni G. Clinician’s Commentary on Crawford et al. Physiother Can 2022. [DOI: 10.3138/ptc-2020-0119-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Greg Spadoni
- Clinical Specialist, Musculoskeletal Associate Professor, School of Rehabilitation Sciences (Physiotherapy), McMaster University, Hamilton, Ontario, 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] [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. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07662-7.
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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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15
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United Nations’ Sustainable Development Goal 3 Target Indicators: Examples of Advanced Practice Nurses’ Actions. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Zhang M, Chen H, Wang N, Li Y, Li X, Liu Y. The mediating role of job satisfaction between psychological capital and work engagement among Chinese nurses during COVID-19 outbreak: A comparative study between nurse specialists and general nurses. Front Psychiatry 2022; 13:990216. [PMID: 36713893 PMCID: PMC9878697 DOI: 10.3389/fpsyt.2022.990216] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 12/15/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The outbreak of COVID-19 has become a global public health emergency, causing great psychological distress to nurses. It is unknown whether the pandemic will affect the work engagement of nurses, the relationship between psychological capital, job satisfaction, and work engagement among nurses, and whether there are differences between nurse specialists and general nurses during the pandemic. OBJECTIVES The purpose of this study was to compare psychological capital, job satisfaction, and work engagement among nurse specialists and general nurses during the pandemic, as well as to test the role of job satisfaction as a mediator in the association between psychological capital and work engagement among nurses, and to examine whether the underlying mechanism of the relationship between psychological capital and job satisfaction differs between nurse specialists and general nurses. MATERIALS AND METHODS A convenience sampling was used to assess a sample of 372 nurse specialists and 318 general nurses from nine provincial general hospitals in China to participate in the online survey. Data were collected using self-report questionnaires, including the following tools: self-designed socio-demographic questionnaire, psychological capital scale, job satisfaction scale, and work engagement scale. RESULTS Compared with general nurses, the nurse specialists had higher psychological capital, job satisfaction, and work engagement. Job satisfaction partially mediated the positive association between psychological capital and work engagement and the indirect effect was stronger in nurse specialists in comparison to general nurses during the COVID-19 pandemic. CONCLUSION The findings provide important practical implications for future intervention programs aimed at enhancing nurses' work engagement, which may be realized through strengthening psychological capital and job satisfaction during the pandemic. Moreover, considering the cost-effectiveness of limited health care spending, nursing managers should pay more attention to the continuing professional development of young general nurses.
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Affiliation(s)
- Minyi Zhang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Hongyu Chen
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Ning Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Yao Li
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Xiaofei Li
- Department of Transplantation/Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Yan Liu
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
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17
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Montgomery KE, Ward J, Raybin JL, Balian C, Gilger EA, Smith C. Building capacity through integration of advanced practice nurses in research. Nurs Outlook 2021; 69:1030-1038. [PMID: 34625275 DOI: 10.1016/j.outlook.2021.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/03/2021] [Accepted: 06/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Advanced practice nurses (APNs) are well-positioned to function in research settings, however barriers to their engagement persist. Capacity-building through multisite research opportunities is an important strategy to overcome these barriers. PURPOSE To describe the benefits and challenges of incorporating APNs in research and discuss opportunities for building capacity for nursing research. METHOD Grounded in the experience of a nurse-led multisite longitudinal observational descriptive symptom study, field notes representing the research continuum were reviewed and categorized into themes reflecting benefits and challenges. FINDINGS Uniform benefits of acquiring research knowledge and skills, participating in research activities, and engaging in professional development were experienced among APNs. Limited support for regulatory and research activities, inadequate financial infrastructure, and a perceived lack of value for APNs' professional growth were commonly encountered challenges. DISCUSSION Establishment of an infrastructure that elevates benefits and mitigates challenges is necessary to effectively incorporate APNs in a research environment, build capacity, and advance nursing science.
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Affiliation(s)
| | - Jessica Ward
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, CA
| | - Jennifer L Raybin
- Center for Cancer and Blood Disorders and Palliative Care, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Chelsea Balian
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA
| | - Elizabeth A Gilger
- Cancer and Blood Disease Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Corey Smith
- School of Nursing, University of Wisconsin-Madison, Madison, WI
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18
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Lopatina E, Marshall DA, Le Clercq SA, Noseworthy TW, Suter E, De la Rossa Jaimes C, Lauf AM, Mosher DP, Barber CEH. Nurse-Led Care for Stable Patients with Rheumatoid Arthritis: Quality of Care in Routine Practice Compared to the Traditional Rheumatologist-Led Model. Rheumatol Ther 2021; 8:1263-1285. [PMID: 34236650 PMCID: PMC8380599 DOI: 10.1007/s40744-021-00339-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/16/2021] [Indexed: 02/04/2023] Open
Abstract
Introduction This pragmatic non-inferiority study assessed quality of care within a nurse-led care (NLC) model for stable patients with rheumatoid arthritis (RA) compared to the traditional rheumatologist-led care (RLC) model. Methods Data were collected through a chart review. Baseline demographic and clinical characteristics were compared using Chi-square test and t test. The primary outcome measure was the percentage of patients being in remission or low disease activity (R/LDA) with the Disease Activity Score (DAS-28) ≤ 3.2 at 1-year follow-up. Process measures included the percentages of patients with chart documentation of (1) comorbidity screening; (2) education on flare management, and (3) vaccinations screening. Outcomes were summarized using descriptive statistics. Results Each group included 124 patients. At baseline, demographic and clinical characteristics were comparable between the groups for most variables. Exceptions were the median (Q1, Q3) Health Assessment Questionnaire Disability Index scores [0 (0, 0.25) in NLC and 0.38 (0, 0.88) in RLC, p = 0.01], and treatment patterns with 3% of NLC and 38% of RLC patients receiving a biologic agent, p = 0.01. NLC was non-inferior to RLC with 97% of NLC and 92% of RLC patients being in R/LDA at 1-year follow-up. Patients in the NLC group had better documentation across all process measures. Conclusions This study provided real-world evidence that the evaluated NLC model providing protocolized follow-up care for stable patients with RA is effective to address patients’ needs for ongoing disease monitoring, chronic disease management, education, and support. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-021-00339-3.
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Affiliation(s)
- Elena Lopatina
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre (HRIC), 3C60, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre (HRIC), 3C56, 3280 Hospital Drive NW , Calgary, AB, T2N 4Z6, Canada.
| | - Sharon A Le Clercq
- Department of Medicine, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre (HRIC), 3C60, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Tom W Noseworthy
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Teaching, Research, and Wellness Building (TRW), 3D14-B, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Esther Suter
- Faculty of Social Work, University of Calgary, Health Research Innovation Centre (HRIC), 3C60, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Carolina De la Rossa Jaimes
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre (HRIC), 3C60, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Anne Marie Lauf
- Cumming School of Medicine, University of Calgary, Health Research Innovation Centre (HRIC), 3C60, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Dianne P Mosher
- Department of Medicine, Cumming School of Medicine, University of Calgary, Health Sciences Centre (HSC), G-802A, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Claire E H Barber
- Department of Medicine, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre (HRIC), 3AA20, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre (HRIC), 3AA20, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
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19
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McGuire M, Olivo A, Yackzan S. Productivity Measures: Empowering Oncology Nurse Practitioners to Understand and Demonstrate Value in Practice. Clin J Oncol Nurs 2021; 25:247-250. [PMID: 34019016 DOI: 10.1188/21.cjon.247-250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Oncology nurse practitioners (ONPs) are essential providers of oncology care who work in a variety of practice settings. ONPs add to productivity in practice, but the way in which productivity is measured may not capture their full contributions and value. A greater understanding of productivity measures can empower ONPs to communicate and demonstrate their full value in practice.
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20
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Murphy EJ, Tuot DS. Assuring safety and efficacy of nurse triage for electronic consultation to improve access to specialty care. BMJ Qual Saf 2021; 30:533-535. [PMID: 33542064 DOI: 10.1136/bmjqs-2020-012619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Elizabeth J Murphy
- Division of Endocrinology at Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA.,Center for Innovation in Access and Quality at Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - Delphine S Tuot
- Center for Innovation in Access and Quality at Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA .,Division of Nephrology at Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
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21
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Kowalski C, Albert US, Baumann W, Carl EG, Ernstmann N, Hermes-Moll K, Fallenberg EM, Feick G, Feiten S, Härter M, Heidt V, Heuser C, Hübner J, Joos S, Katalinic A, Kempkens Ö, Kerek-Bodden H, Klinkhammer-Schalke M, Koller M, Langer T, Lehner B, Lux MP, Maatouk I, Pfaff H, Ratsch B, Schach S, Scholl I, Skoetz N, Voltz R, Wiskemann J, Inwald E. [DNVF Memorandum Health Services Research in Oncology]. DAS GESUNDHEITSWESEN 2020; 82:e108-e121. [PMID: 32858754 DOI: 10.1055/a-1191-3759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Health services research in oncology deals with all situations which cancer patients face. It looks at the different phases of care, i. e. prevention / early detection, prehabilitation, diagnostics, therapy, rehabilitation and palliative care as well as the various actors, including those affected, the carers and self-help. It deals with healthy people (e. g. in the context of prevention / early detection), patients and cancer survivors. Due to the nature of cancer and the existing care structures, there are a number of specific contents for health services research in oncology compared to general health services research while the methods remain essentially identical. This memorandum describes the subject, illustrates the care structures and identifies areas of health services research in oncology. This memorandum has been prepared by the Oncology Section of the German Network for Health Services Research and is the result of intensive discussions.
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Affiliation(s)
| | | | - Walter Baumann
- Wissenschaftliches Institut der Niedergelassenen Hämatologen und Onkologen (WINHO GmbH), Köln
| | - Ernst-Günther Carl
- Haus der Krebsselbsthilfe, Bonn.,Bundesverband Prostatakrebs Selbsthilfe, Bonn
| | - Nicole Ernstmann
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung, Universitätsklinikum Bonn, Bonn.,Zentrum für Integrierte Onkologie, Universitätsklinikum Bonn, Bonn.,Institut für Patientensicherheit, Universitätsklinikum Bonn, Bonn
| | - Kerstin Hermes-Moll
- Wissenschaftliches Institut der Niedergelassenen Hämatologen und Onkologen (WINHO GmbH), Köln
| | - Eva Maria Fallenberg
- Klinik und Poliklinik für Radiologie, Ludwig-Maximilians-Universität München, München
| | | | - Stefan Feiten
- Institut für Versorgungsforschung in der Onkologie GbR, Koblenz
| | - Martin Härter
- Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Vitali Heidt
- Wissenschaftliches Institut der Niedergelassenen Hämatologen und Onkologen (WINHO GmbH), Köln
| | - Christian Heuser
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung, Universitätsklinikum Bonn, Bonn.,Zentrum für Integrierte Onkologie, Universitätsklinikum Bonn, Bonn
| | - Joachim Hübner
- Zentrum für Bevölkerungsmedizin und Versorgungsforschung, Universität zu Lübeck, Lübeck
| | - Stefanie Joos
- Institute of General Practice and Interprofessional Care, University of Tübingen Faculty of Science, Tübingen
| | - Alexander Katalinic
- Institut für Sozialmedizin und Epidemiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck.,Institut für Krebsepidemiologie e.V., Universität zu Lübeck, Lübeck
| | | | | | - Monika Klinkhammer-Schalke
- Institut für Qualitätssicherung und Versorgungsforschung, Tumorzentrum Regensburg, Universität Regensburg, Regensburg.,Institut for Quality Assurance and Health Services Research, Tumorcenter Regensburg, University of Regensburg, Regensburg
| | - Michael Koller
- Zentrum für Klinische Studien, Universitätsklinikum Regensburg, Regensburg
| | | | - Burkhard Lehner
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinik Heidelberg, Heidelberg
| | - Michael P Lux
- Frauen- und Kinderklinik St. Louise, St. Vincenz-Krankenhaus, Paderborn
| | - Imad Maatouk
- Klinik für Allgemeine Innere Medizin und Psychosomatik, UniversitätsKlinikum Heidelberg, Heidelberg
| | | | - Boris Ratsch
- Market Access & Public Affairs, Takeda Pharma Vertrieb GmbH & Co KG, Berlin
| | | | - Isabelle Scholl
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Nicole Skoetz
- Zentrum für integrierte Onkologie, Universitätsklinik Köln
| | | | - Joachim Wiskemann
- Nationales Zentrum für Tumorerkrankungen Heidelberg, Heidelberg.,UniversitätsKlinikum Heidelberg, Heidelberg
| | - Elisabeth Inwald
- Klinik für Frauenheilkunde und Geburtshilfe, Universität Regensburg, Regensburg
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22
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Cannaby AM, Carter V, Rolland P, Finn A, Owen J. The scope and variance of clinical nurse specialist job descriptions. ACTA ACUST UNITED AC 2020; 29:606-611. [DOI: 10.12968/bjon.2020.29.11.606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Specialist nurses have been part of the nursing workforce for decades but articulating the scope of such roles, educational requirements, professional expertise and levels of pay is still widely debated within the workplace. This article reports on a study that examined a sample of clinical nurse specialist (CNS) job descriptions from across the UK. One hundred job descriptions were sourced, originating from various healthcare settings, and audited to explore their scope and content. In conclusion, the job descriptions showed a high level of agreement of the scope domains of a CNS role but were less consistent when considering the experience and educational requirements of CNSs.
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Affiliation(s)
- Ann-Marie Cannaby
- Chief Nursing Officer, Royal Wolverhampton NHS Trust, Professor of Nursing Science, Birmingham City University, Visiting Fellow, La Trobe University, Melbourne, Australia, and Visiting Fellow, Staffordshire University
| | - Vanda Carter
- Practice Education Facilitator for Research, Royal Wolverhampton NHS Trust
| | - Peter Rolland
- Independent Consultant, Re-Think Performance, London
| | - Aimee Finn
- Agency Nurse, Dublin, Ireland, when this article was written
| | - James Owen
- Programme Partner, Monitoring and Measurement, Royal Wolverhampton NHS Trust
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23
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Campbell C, Nowell A, Karagheusian K, Giroux J, Kiteley C, Martelli L, McQuestion M, Quinn M, Rowe Samadhin YP, Touw M, Moody L. Practical innovation: Advanced practice nurses in cancer care. Can Oncol Nurs J 2020; 30:9-15. [PMID: 33119001 DOI: 10.5737/23688076301915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives The objectives of this study were to gather emerging practice evidence, through consultation with Advance Practice Nurses (APN), to fill the evidence gaps in the published guidelines, Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario, and to provide a set of expert panel recommendations to build a research agenda to promote the collection and publication of Level 1 and 2 evidence. Method A three-step RAND/UCLA Appropriateness Methodology (RAM) modified Delphi process was used to solicit expert opinion on the use of APNs in adult cancer care in Ontario. Results Thirty-four (34) case examples of APN use were gathered. The modified Delphi process concluded with the endorsement of 30 APN role statements that were used to develop nine (9) additional recommendations regarding the use of APNs in the delivery of adult cancer care. Conclusion The recommendations from this study provide direction for future research to close the current evidence gap regarding the role of APNs in cancer care delivery in Canada.
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Affiliation(s)
- Colleen Campbell
- Nurse Practitioner, Stronach Regional Cancer Centre, 596 Davis Dr., Newmarket, ON L3Y 2P9,
| | - Allyson Nowell
- Advanced Practice Nurse, Palliative Care Consult Service, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, H337, Toronto, ON, M4N 3M5,
| | - Karen Karagheusian
- Senior Specialist, Cancer Care Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Janet Giroux
- de Souza APN, Nurse Practitioner-Adult, Gynecology Oncology, Oncology Sexual Health Clinic-NP, Kingston Health Sciences Centre, Kingston General Hospital, Cancer Centre of Southeastern Ontario,
| | | | - Lorraine Martelli
- Provincial Head of Cancer-Nursing, Ontario, Cancer Care Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Maurene McQuestion
- Clinical Nurse Specialist/Advanced Practice Nurse, Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network,
| | - Maureen Quinn
- Nurse Practitioner-Adult, London Health Sciences Centre, 800 Commissioners Road East, PO Box 5010, Stn B,
| | - Yvonne P Rowe Samadhin
- Nurse Practitioner-Hospice Palliative Care Team, Waterloo Wellington Local Health Integration Network, 73 Water Street North, Cambridge, ON N1R 7L6,
| | - Melissa Touw
- Clinical Nurse Specialist - Palliative Care, Kingston Health Sciences Centre - KGH site,
| | - Lesley Moody
- Director, Person-Centred Care, 620 University Ave., Toronto, ON M5G 2L7,
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24
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Campbell C, Nowell A, Karagheusian K, Giroux J, Kiteley C, Martelli L, McQuestion M, Quinn M, Rowe Samadhin YP, Touw M, Moody L. Innovation pratique : infirmières en pratique avancée et soins du cancer. Can Oncol Nurs J 2020; 30:16-22. [PMID: 33118993 DOI: 10.5737/236880763011622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectifs La présente étude avait pour but de recueillir, en consultation avec les infirmières en pratique avancée (IPA), des données probantes sur les pratiques émergentes afin de combler les lacunes à cet égard dans les lignes directrices sur le recours judicieux aux infirmières en pratique avancée dans la prestation des services aux adultes atteints de cancer en Ontario (Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario), ainsi que de proposer un ensemble de recommandations, formulées par un groupe d'experts, pour créer un programme de recherche qui permettra de recueillir et de publier des données probantes de niveau 1 et de niveau 2. Méthodologie Une enquête Delphi modifiée à trois tours faisant appel à la méthodologie mise au point par RAND et UCLA (aussi appelée ≪ Appropriateness Methodology ≫) a été utilisée pour solliciter l'avis des spécialistes sur le recours aux IPA pour le soin des adultes atteints de cancer en Ontario. Résultats Trente-quatre (34) cas de recours aux IPA ont été recensés. L'enquête Delphi modifiée a permis de définir 30 énoncés de rôle à partir desquels ont été formulées neuf (9) recommandations supplémentaires sur l'intervention des IPA dans la prestation des soins aux adultes atteints de cancer. Conclusion Les recommandations de la présente étude orienteront les recherches à venir pour combler les lacunes au chapitre des données probantes quant au rôle des IPA dans la prestation des soins du cancer au Canada.
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Affiliation(s)
- Colleen Campbell
- Infirmière praticienne, Centre régional de cancérologie Stronach, 596 Davis Dr, Newmarket, ON L3Y 2P9,
| | - Allyson Nowell
- Infirmière en pratique avancée, consultation en soins palliatifs, Centre des sciences de la santé Sunnybrook, 2075 Bayview Avenue, H337, Toronto, ON M4N 3M5,
| | - Karen Karagheusian
- Spécialiste principale, Action Cancer Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Janet Giroux
- IPA de Souza, Infirmière praticienne-Adulte, oncologie gynécologique, infirmière praticienne en clinique de santé sexuelle et d'oncologie, Centre des sciences de la santé de Kingston, Hôpital général de Kingston, Centre de cancérologie du Sud-Est de l'Ontario,
| | | | - Lorraine Martelli
- Directrice du programme provincial de soins infirmiers oncologiques de l'Ontario, Action Cancer Ontario, 620 University Ave., Toronto, ON M5G 2L7,
| | - Maurene McQuestion
- Infirmière clinicienne spécialisée / Infirmière en pratique avancée, programme de médecine des rayonnements, Centre de cancérologie Princess Margaret, Réseau universitaire de santé,
| | - Maureen Quinn
- Infirmière praticienne-Adulte, Centre des sciences de la santé de London, 800 Commissioners Road East, C.P. 5010, Stn B,
| | - Yvonne P Rowe Samadhin
- Infirmière praticienne - équipe de soins palliatifs, Réseau local d'intégration des services de santé de Waterloo Wellington, 73 Water Street North, Cambridge, ON N1R 7L6,
| | - Melissa Touw
- Infirmière clinicienne spécialisée - Soins palliatifs, Centre des sciences de la santé de Kingston - Hôpital général de Kingston,
| | - Lesley Moody
- Directrice, Soins centrés sur la personne, 620 University Ave., Toronto, ON M5G 2L7,
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Research status and hotspots of economic evaluation in nursing by co-word clustering analysis. FRONTIERS OF NURSING 2019. [DOI: 10.2478/fon-2019-0031] [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
Abstract
Objective
The aim of this study is to discover research status and hotspots of economic evaluation (EE) in nursing area using co-word cluster analysis.
Methods
Medical Subject Heading (MeSH) term “cost–benefit analysis” was searched in PubMed and nursing journals were limited by the function of filter. The information of author, country, year, journal, and keywords of collected paper was extracted and exported to Bicomb 2.0 system, where high-frequency terms and other data could be further mined. SPSS 19.0 was used for cluster analysis to generate dendrogram.
Results
In all, 3,020 articles were found and 10,573 MeSH terms were detected; among them, 1,909 were MeSH major topics and generated 42 high-frequency terms. The consequence of dendrogram showed seven clusters, representing seven research hotspots: skin administration, infection prevention, education program, nurse education and management, EE research, neoplasm patient, and extension of nurse function.
Conclusions
Nursing EE research involved multiple aspects in nursing area, which is an important indicator for decision-making. Although the number of papers is increasing, the quality of study is not promising. Therefore, further study may be required to detect nurses’ knowledge of economic analysis method and their attitude to apply it into nursing research. More nursing economics course could carry out in nursing school or hospitals.
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Davidson PM, Rahman A. Time for a Renaissance of the Clinical Nurse Specialist Role in Critical Care? AACN Adv Crit Care 2019; 30:61-64. [PMID: 30842075 DOI: 10.4037/aacnacc2019779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Patricia M Davidson
- Patricia M. Davidson is Dean and Professor, Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205 . Alphonsa Rahman is Clinical Nurse Specialist, Department of Medicine, Interprofessional Practice & Patient Safety, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
| | - Alphonsa Rahman
- Patricia M. Davidson is Dean and Professor, Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205 . Alphonsa Rahman is Clinical Nurse Specialist, Department of Medicine, Interprofessional Practice & Patient Safety, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
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Lawton K, Royals K, Carson‐Chahhoud KV, Campbell F, Smith BJ. Nurse-led versus doctor-led care for bronchiectasis. Cochrane Database Syst Rev 2018; 6:CD004359. [PMID: 29926473 PMCID: PMC6513279 DOI: 10.1002/14651858.cd004359.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Specialist nursing roles to manage stable disease populations are being used to meet the needs of both patients and health services. With increasing cost pressures on health departments, alternative models such as nurse-led care are gaining momentum as a substitute for traditional doctor-led care. This review evaluates the safety, effectiveness, and health outcomes of nurses practising in autonomous roles while using advanced practice skills, within the context of bronchiectasis management in subacute, ambulatory, and/or community care. OBJECTIVES To compare the effectiveness of nurse-led care versus doctor-led care in the management of stable bronchiectasis. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register and bibliographies of selected papers in addition to grey literature such as electronic clinical trials registries. Searches were current as of March 2018. SELECTION CRITERIA Randomised controlled trials were eligible for inclusion in the review. DATA COLLECTION AND ANALYSIS Two reviewers extracted and entered data from included studies. Primary outcomes were numbers of exacerbations requiring treatment with antibiotics, hospital admissions, and emergency department attendances. MAIN RESULTS We included one United Kingdom (UK) study in the review. In this randomised controlled trial, a total of 80 participants, with a mean age of 58 years, were treated for 12 months by a specialist nurse or doctor, then were crossed over to the other clinician for the next 12 months. Two participants died during the study period. Six participants failed to cross over to nurse-led care because of unstable bronchiectasis. Overall, the level of study completion was high.Data show no difference in the numbers of exacerbations requiring treatment with antibiotics (rate ratio 1.09, 95% confidence interval (CI) 0.91 to 1.30, 80 participants, moderate-certainty evidence). Investigators reported more hospital admissions in the nurse-led care group (rate ratio 1.52, 95% CI 1.04 to 2.23, 80 participants, moderate-certainty evidence) and did not report emergency department attendance.For secondary outcomes, participants in the nurse-led care group used more healthcare resources during the first year of the trial. Increased admissions and greater use of resources made treatment costs for nurse-led groups' higher. Total costs for both years of the study were £8,464 and £5,228 for nurse-led care compared with doctor-led care. However, by the second year, treatment costs were almost equitable between the two groups, which may reflect the nurses' learning of how to better treat people with bronchiectasis. No statistically significant changes were observed in quality of life, exercise capacity, mortality, or lung function. Wide confidence intervals led to uncertainty regarding these results. Adverse events were not an outcome for this review. AUTHORS' CONCLUSIONS This update of the review shows that only one trial met review criteria. Review authors were unable to demonstrate effectiveness of nurse-led care compared with doctor-led care on the basis of findings of a single study. The included study reported no significant differences, but limited evidence means that differences in clinical outcomes between nurse-led care and usual care within the setting of a specialist clinic remain unclear. Further research is required to determine whether nurse-led care is cost-effective, if guidelines and protocols for bronchiectasis management are followed does this increases costs and how effective nurse-led management of bronchiectasis is in other clinical settings such as inpatient and outreach.
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Affiliation(s)
- Kathryn Lawton
- The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkRespiratory Medicine UnitAdelaideAustralia
- The University of AdelaideSchool of MedicineAdelaideAustralia
| | - Karen Royals
- The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkRespiratory Medicine UnitAdelaideAustralia
- The University of AdelaideSchool of MedicineAdelaideAustralia
| | - Kristin V Carson‐Chahhoud
- The University of AdelaideSchool of MedicineAdelaideAustralia
- The University of South AustraliaSchool of Health SciencesCity East Campus, Frome RoadAdelaideAustralia5001
- School of Health Sciences, University of South AustraliaAdelaideAustralia
| | - Fiona Campbell
- The University of SheffieldSchool of Health and Related ResearchRegent StreetSheffieldUKS1 4DA
| | - Brian J Smith
- The Queen Elizabeth Hospital, Central Adelaide Local Health NetworkRespiratory Medicine UnitAdelaideAustralia
- The University of AdelaideSchool of MedicineAdelaideAustralia
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