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Biesmans JMA, Bolt SR, Janssen DJA, Wintjens T, Khemai C, Schols JMGA, Van Der Steen JT, Zwakhalen SMG, Meijers JMM. Desired dementia care towards end of life: Development and experiences of implementing a new approach to improve person-centred dementia care. J Adv Nurs 2024. [PMID: 38923055 DOI: 10.1111/jan.16285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 04/08/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
AIMS To describe the co-creation of the 'Desired Dementia Care Towards End of Life' (DEDICATED) approach to improve person-centred palliative care for individuals with dementia and to describe the experiences of healthcare professionals during the approach's implementation. METHODS A needs assessment, comprising both qualitative and quantitative studies, informed palliative care needs of healthcare professionals, family caregivers and individuals with dementia. The approach was co-created with healthcare and education professionals, guided by the findings. Then, healthcare professionals were trained to implement the approach in their organizations. From April to June 2022, semi-structured interviews with actively engaged professionals were analysed using Conventional Content Analysis. RESULTS The needs assessment yielded six key themes: (1) raising palliative care awareness, (2) familiarization with a person with dementia, (3) communication about future care preferences, (4) managing pain and responsive behaviour, (5) enhancing interprofessional collaboration in advance care planning and (6) improving interprofessional collaboration during transitions to nursing homes. Interviews with 17 healthcare professionals revealed that active involvement in co-creating or providing feedback facilitated implementation. Overall, the DEDICATED approach was perceived as a valuable toolkit for optimizing palliative care for people with dementia and their loved ones. CONCLUSION Co-creating the DEDICATED approach with healthcare professionals facilitated implementation in daily practice. The approach was considered helpful in enhancing person-centred palliative dementia care. IMPACT STATEMENT This study underscores the importance of active involvement of healthcare professionals in the research and development of new interventions or tools for palliative care, which can influence the successful implementation, dissemination and sustained usage of the developed tools. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE The developed approach can improve person-centred palliative care for individuals with dementia, ultimately improving their quality of life and that of their loved ones. REPORTING METHOD This study used the Consolidated Criteria for Reporting Qualitative Research. PATIENT OF PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jesper M A Biesmans
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Sascha R Bolt
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Daisy J A Janssen
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Toon Wintjens
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Chandni Khemai
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Jos M G A Schols
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Jenny T Van Der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Judith M M Meijers
- Department of Health Services Research, Maastricht University, Care and Public Health Research Institute, Maastricht, The Netherlands
- Living Lab for Aging and Long-Term Care Limburg, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Zuyderland Medical Center, Sittard-Geleen, The Netherlands
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Tower M, Hyun A, Denton M, Cottle-Quinn A. Implementation of a nurse practitioner service in a rural setting: a qualitative analysis of healthcare practitioners' experiences. Contemp Nurse 2024:1-11. [PMID: 38377070 DOI: 10.1080/10376178.2024.2316597] [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: 03/09/2023] [Accepted: 02/04/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Nurse Practitioners work independently and collaboratively within multidisciplinary teams to fill unmet service delivery needs. Despite strong evidence of the benefits of the nurse practitioner service model, organisational support for nurse practitioners varies in terms of resources and support from leadership and other healthcare professionals. AIMS The study aimed to explore healthcare practitioners' experiences of implementation of a NP service in a rural setting. METHODS Semi-structured interviews were conducted with ten healthcare practitioners to investigate their perspectives of a recently implemented NP service. Data were analysed inductively using thematic analysis. FINDINGS Themes emerged related to facilitating collaborative practice, person-centred continuity of care and positive health outcomes for the community. Challenges and limitations related to operational role clarity, scopes of practice and leadership. CONCLUSION Healthcare practitioners were mostly satisfied with the service however challenges caused tension. Change management principles provide a framework to strengthen the effective clinical alignment of the service.
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Affiliation(s)
- Marion Tower
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Australia
| | - Areum Hyun
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Australia
| | - Michelle Denton
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Australia
| | - Amanda Cottle-Quinn
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Australia
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Ahsan A, Rahmawati IN, Noviyanti LW, Harwiati Ningrum E, Nasir A, Harianto S. The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:817-826. [PMID: 37534334 PMCID: PMC10392907 DOI: 10.2147/amep.s416847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023]
Abstract
Objective Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency. Methods A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups. Results There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000). Conclusion The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.
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Affiliation(s)
- Ahsan Ahsan
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Ike Nesdia Rahmawati
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Linda Wieke Noviyanti
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Evi Harwiati Ningrum
- Department of Nursing, Faculty of Health Sciences, Brawijaya University, Malang, Indonesia
| | - Abd Nasir
- Faculty of Vocational Studies, Airlangga University, Surabaya, Indonesia
| | - Susilo Harianto
- Faculty of Vocational Studies, Airlangga University, Surabaya, Indonesia
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Poveda VDB, Nogueira LDS. Advanced Nursing Practice: the next achievement of Brazilian nursing. Rev Esc Enferm USP 2022; 56:e20220211. [PMID: 35848611 DOI: 10.1590/1980-220x-reeusp-2022-0211en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/22/2022] Open
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A Preliminary Study on the Cultural Competence of Nurse Practitioners and Its Affecting Factors. Healthcare (Basel) 2022; 10:healthcare10040678. [PMID: 35455855 PMCID: PMC9026283 DOI: 10.3390/healthcare10040678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 02/01/2023] Open
Abstract
Cultural competence refers to a healthcare provider’s ability to consider cultural factors that affect an individual’s health and attitudes toward disease and disability. Nurse practitioners (NPs) are increasingly important in healthcare, practicing culturally competent care strategies to improve the quality of patient care. The aim of this study was to explore cultural competence and its related factors among NPs. A cross sectional study design with a structured questionnaire survey was used. Purposive sampling was employed, for which 86 NPs were recruited from a medical center in northern Taiwan. A T-test, one-way ANOVA, and Pearson’s product-moment correlation coefficient were used for data analysis. The results were as follows: (1) overall, the total score for cultural competence was above-average, with a score of 3.75; (2) years of experience as a NP was found to have a statistically significant correlation with overall clinical competence, with r = 0.23, p < 0.05; (3) there were significant differences in clinical awareness and cultural sensitivity related to the clinical ladder system (t = −2.42, p = 0.01; t = −2.04, p = 0.04). The findings of this study can provide information for directors of medical institutions to design an in-service educational program for NPs to enhance their cultural competence and nursing quality.
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Ryder M, Gallagher P. A survey of nurse practitioner perceptions of integration into acute care organisations across one region in Ireland. J Nurs Manag 2022; 30:1053-1060. [PMID: 35307900 PMCID: PMC9314621 DOI: 10.1111/jonm.13602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/02/2022]
Abstract
Aim The purpose of the study was to explore nurse practitioner perceptions of integration practices in acute hospitals across one health care region in Ireland. Background A recent Department of Health National policy towards developing a critical mass of nurse practitioners was implemented across Ireland. Successful integration of nurse practitioner roles is integral to the success of the service and sustainability of the roles for the long term. Method An electronic survey was circulated to a convenience sample of 85 nurse practitioners across a single, acute health care region in Ireland. Results Sixty‐six (78%) of nurse practitioners participated. A standardized governance structure was reported by 24 (36%) participants. Thirty‐two (48%) participants expressed their job description clearly defined their role. Consultant physicians were identified as the most supportive stakeholder by participants. Conclusions This research identifies that nurse practitioner integration is not currently structured. A framework to support nurse practitioner integration is required to ensure ongoing support for the role. This research identifies that integration is not currently optimized. Implications for Nursing Management Failure to successfully integrate the nurse practitioner role risks the long‐term sustainability of the role and is a missed opportunity to demonstrate the success of advanced clinical leadership to health care.
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Affiliation(s)
- Mary Ryder
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin
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