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Mohebi Z, Bijani M, Dehghan A. Investigating safe nursing care and medication safety competence in nursing students: a multicenter cross-sectional study in Iran. BMC Nurs 2024; 23:13. [PMID: 38166919 PMCID: PMC10759490 DOI: 10.1186/s12912-023-01684-0] [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: 07/30/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Medication safety competence is very important as one of the clinical skills among nursing students to provide safe nursing care. The lack of medication safety competence in nursing students leads to occurrence of medication errors subsequently jeopardizing patient safety. Thus, the present study was conducted to investigate safe nursing care and medication safety competence among nursing students in the south of Iran. METHODS A descriptive cross-sectional multicenter study was conducted from September to December 2022. The research population included nursing students of three universities of medical sciences in Fars Province, Southern Iran. A total of 310 nursing students who were selected through convenience sampling participated in the study. The data collection instruments consisted of a demographics survey, Medication Safety Competence Scale (MSCS), and a Safe Nursing Care Scale (SNCS). The collected data were analyzed using descriptive statistics (absolute and relative frequency, mean and standard deviation) and inferential statistics (Independent t-test, Analysis of variance and Pearson correlation coefficient). The data were analyzed in SPSS 23 and the level of significance was considered 0.05. RESULTS The mean age of the participants was 22.53 ± 1.69 years. The total mean scores for medication safety competence and safe nursing care were found to be 111.97 ± 11.85 and 105.12 ± 11.64, respectively. There was a statistically significant positive correlation between safe nursing care and medication safety competence (r = 0.084, P < 0.001). CONCLUSION The mean scores of nursing students' medication safety competence and safe nursing care were at an average level. To maintain patient safety, nursing instructors and managers are recommended to employ appropriate strategies to improve medication safety competence and safe nursing care in nursing students.
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Affiliation(s)
- Zahra Mohebi
- Student Research Committee, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, 81936-13119, Fasa, Iran.
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
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Kapra O, Asna N, Amoyal M, Bashkin O, Dopelt K. The Oncology Clinical Nurse Specialist: A Rapid Review of Implementation Models and Barriers around the World. Curr Oncol 2023; 30:7425-7438. [PMID: 37623019 PMCID: PMC10453893 DOI: 10.3390/curroncol30080538] [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: 06/18/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
The role of a clinical nurse specialist in oncology varies greatly between healthcare systems, and implementing this healthcare role with its multifaceted and co-existing responsibilities may prove challenging. While already integrated into healthcare systems and services in several European countries, Asia, Canada, and the United States, other countries are just beginning to develop clinical nursing specialties. The current study aims to provide healthcare policymakers with up-to-date evidence that focuses on the diverse modes of oncology clinical nurse specialist role implementation across several healthcare systems and pertinent implementation challenges as described in the literature. A rapid evidence assessment was carried out in order to provide policymakers with a rigorous review in a condensed timescale. Initially, only items in the English language were included, and "grey literature" was excluded. We searched PubMed between 1 January 2022 and 28 February 2022 and two independent scholars reviewed items. Based on 64 papers, both non-scientific and papers that met the initial criteria of the rapid review, we describe the modes of implementation of the oncology clinical nurse specialist in the United States, Canada, United Kingdom, Japan, Brazil and Australia. Barriers to implementation include conflicts around role boundaries, skepticism and lack of organizational support, as well as fears that oncology clinical nurse specialists will "encroach" on doctors' powers. In contrast, an oncology clinical nurse specialist is found to be universally more accessible to patients and their families and can help physicians deal with difficult workloads, among other advantages. Conclusions: This role offers a myriad of gains for cancer patients, oncology physicians, and the healthcare system. The literature demonstrates that it is a necessary role, albeit one that brings specific implementation challenges.
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Affiliation(s)
- Ori Kapra
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
| | - Noam Asna
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem 91031, Israel;
| | - Mazal Amoyal
- Palliative Care Unit, Barzilai Medical Center, Ashkelon 78306, Israel;
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel
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Dopelt K, Asna N, Amoyal M, Bashkin O. Nurses and Physicians' Perceptions Regarding the Role of Oncology Clinical Nurse Specialists in an Exploratory Qualitative Study. Healthcare (Basel) 2023; 11:1831. [PMID: 37444665 DOI: 10.3390/healthcare11131831] [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: 05/03/2023] [Revised: 06/05/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
The purpose of the study was to examine the attitudes of nursing and medical teams about the role of oncology clinical nurse specialists in the healthcare system in Israel, where, unlike many countries in the world, such a role has not yet been developed or professionally defined. We conducted 24 interviews with physicians and nurses between August and October 2021. The interviews were transcribed and analyzed using a thematic analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study. Five main themes emerged from the interviews: (1) contribution to the healthcare system, (2) contribution to the patient, (3) drawing professional boundaries, (4) additional responsibilities and authority for oncology clinical nurse specialists, and (5) the field's readiness for a new position of oncology clinical nurse specialists. The findings provide evidence about the need to develop the role of clinical nurse specialists in the oncology field due to its potential benefits for nurses, physicians, patients, family members, and the healthcare system. At the same time, an in-depth exploration of the boundaries of the role and its implementation, in full cooperation with the oncologists and relevant professional unions, is needed to prevent unnecessary conflicts in the oncology field. Professional development training programs in nursing must create a platform for open dialogue between key stakeholders, nurses, and physicians, in order to help all involved parties, place the benefits to the patients above any personal or status considerations.
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Affiliation(s)
- Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel
| | - Noam Asna
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem 91031, Israel
| | - Mazal Amoyal
- Palliative Care Unit, Barzilai Medical Center, Ashkelon 78306, Israel
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel
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Liao PH, Chu W, Ho CS. An Analysis of Waiting Time for Emergency Treatment and Optimal Allocation of Nursing Manpower. Healthcare (Basel) 2022; 10:healthcare10050820. [PMID: 35627957 PMCID: PMC9140927 DOI: 10.3390/healthcare10050820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: Emergency care is the frontline of the healthcare system. Taiwanese typically seek emergency care when suffering from an acute or unknown illness, which leads to a large number of emergency patients and the related misallocation of nursing manpower, and the excessive workloads of emergency service providers have become serious issues for Taiwan’s medical institutions. Participants: This study conducted purposive sampling and recruited patients and nursing staffs from the emergency room of a medical center in New Taipei City as the research participants. Methods: This study applied the queueing theory and the derived optimal model to solve the problems of excessive workloads for emergency service providers and misallocation of nursing manpower, in an attempt to provide decision makers with more flexible resource allocation and process improvement suggestions. Results: This study analyzed the causes of emergency service overload and identified solutions for improving nursing manpower utilization. Conclusions: A wait-time model and the queueing theory were used to determine resource parameters for the optimal allocation of patient waiting times and to develop the best model for estimating nursing manpower.
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Affiliation(s)
- Pei-Hung Liao
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan; (P.-H.L.); (W.C.)
| | - William Chu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan; (P.-H.L.); (W.C.)
- Department of Orthopedics, Cheng Hsin General Hospital, Taipei 112, Taiwan
| | - Chen-Shie Ho
- Department of Healthcare Administration, Asia Eastern University of Science and Technology, Taipei 112, Taiwan
- Correspondence: ; Tel.: +886-2-2822-7101 (ext. 3185)
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Unruh L, Rutherford A, Schirle L, Brunell ML. Benefits of Less Restrictive Regulation of Advance Practice Registered Nurses in Florida. Nurs Outlook 2018; 66:539-550. [DOI: 10.1016/j.outlook.2018.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/27/2018] [Accepted: 09/02/2018] [Indexed: 10/28/2022]
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Jarrar M, Rahman HA, Minai MS, AbuMadini MS, Larbi M. The function of patient-centered care in mitigating the effect of nursing shortage on the outcomes of care. Int J Health Plann Manage 2018; 33:e464-e473. [PMID: 29380909 DOI: 10.1002/hpm.2491] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/14/2017] [Accepted: 01/03/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The shortage of nursing staff is a national and international issue. Inadequate number of hospital nurse staff leads to poor health care services. Yet the effects of patient-centeredness between the relationships of nursing shortage on the quality of care (QC) and patient safety (PS) have not been explored. The aim of this study was to examine the mediating effects of patient-centeredness on the relationship of nursing shortage on the QC and PS in the Medical and Surgical Wards, in Malaysian private hospitals. METHOD A descriptive, cross-sectional study was carried out on 12 private hospitals. Data was gathered, through a self- administered questionnaire, from 652 nurses, with a 61.8% response rate. Stratified simple random sampling was used to allow all nurses to participate in the study. Hayes PROCESS macro-regression analyses were conducted to explore the mediating effects of patient-centeredness on the relationships of hospital nurse staffing on the QC and PS. RESULTS Patient-centeredness mediated the relationships of hospital nurse staffing on both the QC (F = 52.73 and P = 0.000) and PS (F = 31.56 and P = 0.000). CONCLUSION Patient-centeredness helps to mitigate the negative associations of nursing shortage on the outcomes of care. The study provides a guide for hospital managers, leaders, decision-makers, risk managers, and policymakers to maintain adequate staffing level and instill the culture of patient-centeredness in order to deliver high quality and safer care.
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Affiliation(s)
- Mu'taman Jarrar
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Mahdi S AbuMadini
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mercy Larbi
- College of Applied Studies and Cummunity Services, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Jaeger CB, Acree-Hamann C, Zurmehly J, Buck J, Patrick T. Assessment of Neonatal Nurse Practitioner Workload in a Level IV Neonatal Intensive Care Unit: Satisfaction. ACTA ACUST UNITED AC 2016. [DOI: 10.1053/j.nainr.2016.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Liao PH, Hsu PT, Chu W, Chu WC. Applying artificial intelligence technology to support decision-making in nursing: A case study in Taiwan. Health Informatics J 2015; 21:137-48. [PMID: 26021669 DOI: 10.1177/1460458213509806] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study applied artificial intelligence to help nurses address problems and receive instructions through information technology. Nurses make diagnoses according to professional knowledge, clinical experience, and even instinct. Without comprehensive knowledge and thinking, diagnostic accuracy can be compromised and decisions may be delayed. We used a back-propagation neural network and other tools for data mining and statistical analysis. We further compared the prediction accuracy of the previous methods with an adaptive-network-based fuzzy inference system and the back-propagation neural network, identifying differences in the questions and in nurse satisfaction levels before and after using the nursing information system. This study investigated the use of artificial intelligence to generate nursing diagnoses. The percentage of agreement between diagnoses suggested by the information system and those made by nurses was as much as 87 percent. When patients are hospitalized, we can calculate the probability of various nursing diagnoses based on certain characteristics.
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Affiliation(s)
- Pei-Hung Liao
- National Yang Ming University, Taiwan (ROC); MacKay Medicine Nursing and Management College, Taiwan (ROC)
| | - Pei-Ti Hsu
- Ching Kuo Institute of Management and Health, Taiwan (ROC)
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Abstract
OBJECTIVES To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. DATA SOURCE Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." CONCLUSION Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. IMPLICATIONS FOR NURSING PRACTICE APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care.
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Jarrar M, Abdul Rahman H, Don MS. Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions. Glob J Health Sci 2015; 8:44132. [PMID: 26755459 PMCID: PMC4954916 DOI: 10.5539/gjhs.v8n6p75] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND & OBJECTIVE Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. DESIGN Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. RESULTS The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme "1 Care for 1 Malaysia" in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. CONCLUSIONS There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia.
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Affiliation(s)
- Mu'taman Jarrar
- College of Business, Universiti Utara Malaysia, Kedah, Malaysia.
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Vali L, Tabatabaee SS, Kalhor R, Amini S, Kiaei MZ. Analysis of Productivity Improvement Act for Clinical Staff Working in the Health System: A Qualitative Study. Glob J Health Sci 2015; 8:106-16. [PMID: 26383203 PMCID: PMC4803926 DOI: 10.5539/gjhs.v8n2p106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 03/26/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The productivity of healthcare staff is one of the main issues for health managers. This study explores the concept of executive regulation of Productivity Improvement Act of clinical staff in health. METHODS In this study phenomenological methodology has been employed. The data were collected through semi-structured interviews and focus group composed of 10 hospital experts and experts in human resources department working in headquarter of Mashhad University of Medical Sciences and 16 nursing managers working in public and private hospitals of Mashhad using purposive sampling. Findings were analyzed using Colaizzi's seven step method. RESULTS The strengths of this Act included increasing spirit of hope in nurses, paying attention to quality of nursing care and decreasing problems related to the work plan development. Some of the weaknesses of Productivity Improvement Act included lack of required executive mechanisms, lack of considering nursing productivity indicator, increasing non-public hospitals problems, discrimination between employees, and removal of resting on night shifts. Suggestions were introduced to strengthen the Act such as increased organizational posts, use of a coefficient for wage in unusual work shifts and consideration of a performance indicator. CONCLUSION The results may be used as a proper tool for long term management planning at organization level. Finally, if high quality care by health system staff is expected, in the first step, we should take care of them through proper policy making and focusing on occupational characteristics of the target group so that it does not result in discrimination among the staff.
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Fathabad HS, Yazdanpanah A, Hessam S, Chimeh EE, Aghlmand S. Organizational Justice and the Shortage of Nurses in Medical & Educational Hospitals, in Urmia-2014. Glob J Health Sci 2015; 8:99-105. [PMID: 26383199 PMCID: PMC4804033 DOI: 10.5539/gjhs.v8n2p99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/02/2015] [Indexed: 11/16/2022] Open
Abstract
Objective: One of the most important reasons of turnover is perceptions of organizational justice. The purpose of this study was to investigate the effect of perceived organizational justice and its components on turnover intentions of nurses in hospitals of Urmia University of Medical Sciences. Methods: This cross-sectional study was among nurses. 310 samples were estimated according to Morgan Table. Two valid and reliable questionnaires of turnover and organizational justice were used. Data analysis was performed using the software SPSS20. Using the Kolmogorov-Smirnov test, the normality and relationship between variables with Pearson and Spearman correlation test were analyzed. Results: Most people were married and aged between 26 and 35 years, BA and were hired with contraction. The mean score of organizational justice variable was 2.59. The highest average was the interactional justice variable (2.81) and then Procedural fairness variable (2.75) and distributive justices (2.03) were, respectively. The mean range of turnover variable was 3.10. The results showed weak and negative relationship between various dimensions of organizational justice and turnover in nurses. Conclusion: Organizational justice and turnover had inverse relationship with each other. Therefore how much organizational justice in the organization is more; employees tend to stay more. Finally, suggestions for improvement of justice proposed.
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Rispel LC, Moorman J. The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals. Glob Health Action 2015; 8:26494. [PMID: 25971399 PMCID: PMC4430684 DOI: 10.3402/gha.v8.26494] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Globally, flexible work arrangements - through the use of temporary nursing staff - are an important strategy for dealing with nursing shortages in hospitals. OBJECTIVE The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. METHODS Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices). RESULTS In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million) on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million). The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467) and at Hospital 2 the value was R300,121 (US$42,874), thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. CONCLUSION Hospital managers and policy-makers need to address the effective utilisation of agency nurses and quality of patient care in tandem.
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Affiliation(s)
- Laetitia C Rispel
- Centre for Health Policy & Medical Research Council Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
| | - Julia Moorman
- Department of Community Health, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Good H, Riley-Doucet CK, Dunn KS. The prevalence of uncontrolled pain in long-term care: a pilot study examining outcomes of pain management processes. J Gerontol Nurs 2014; 41:33-41; quiz 42-3. [PMID: 25369582 DOI: 10.3928/00989134-20141028-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 09/09/2014] [Indexed: 11/20/2022]
Abstract
Pain in long-term care (LTC) is common among older residents despite the vast options available for optimal pain management. Inadequate pain management affects individual health care outcomes. Researcher evidence has shown that nurse practitioners (NPs) improve the quality of care in LTC but are challenged by multiple barriers that inhibit optimal pain control. The purpose of the current pilot study was to explore both the pain management processes used by nurses in LTC and the documented patient outcomes that come from these processes. In addition, factors were identified that may impact the NP role in providing adequate pain control in LTC. This descriptive study used a retrospective, case-controlled research design that incorporated reviewing 55 LTC resident medical records. Results show how the process of pain management in LTC can be improved by expanding the professional role of the NP.
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Kwak CY, Park JA. Current Roles and Administrative Facts of the Korean Physician Assistant. ACTA ACUST UNITED AC 2014. [DOI: 10.5392/jkca.2014.14.10.583] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bakerjian D, Harrington C. Factors associated with the use of advanced practice nurses/physician assistants in a fee-for-service nursing home practice: a comparison with primary care physicians. Res Gerontol Nurs 2012; 5:163-73. [PMID: 22716651 DOI: 10.3928/19404921-20120605-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 08/01/2011] [Indexed: 11/20/2022]
Abstract
The purpose of this research was to examine factors associated with the use of advanced practice nurse and physician assistant (APN/PA) visits to nursing home (NH) patients compared with those by primary care physicians (PCPs). This was a secondary analysis using Medicare claims data. General estimation equations were used to determine the odds of NH residents receiving APN/PA visits. Ordinary least squares analyses were used to examine factors associated with these visits. A total of 5,436 APN/PAs provided care to 27% of 129,812 residents and were responsible for 16% of the 1.1 million Medicare NH fee-for-service visits in 2004. APN/PAs made an average of 33 visits annually compared with PCPs (21 visits). Neuropsychiatric and acute diagnoses and patients with a long-stay status were associated with more APN/PA visits. APN/PAs provide a substantial amount of care, but regional variations occur, and Medicare regulations constrain the ability of APN/PAs to substitute for physician visits.
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Affiliation(s)
- Debra Bakerjian
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA.
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Gorski MS, Schaffner M, Tieman L. Aligning Nursing Leadership and Regulatory Action. JOURNAL OF NURSING REGULATION 2012. [DOI: 10.1016/s2155-8256(15)30236-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Coddington J, Sands L, Edwards N, Kirkpatrick J, Chen S. Quality of health care provided at a pediatric nurse-managed clinic. ACTA ACUST UNITED AC 2011; 23:674-80. [DOI: 10.1111/j.1745-7599.2011.00657.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Nieminen AL, Mannevaara B, Fagerström L. Advanced practice nurses' scope of practice: a qualitative study of advanced clinical competencies. Scand J Caring Sci 2011; 25:661-70. [PMID: 21371072 DOI: 10.1111/j.1471-6712.2011.00876.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To describe and explore Advanced Practice Nurses' clinical competencies and how these are expressed in clinical practice. BACKGROUND Discussion concerning advanced clinical practice has been ongoing in the USA since the 1960s and in the UK since the late 1980s. Approximately 24 countries, excluding the USA, have implemented the role of Advance Practice Nurse (APN). In the Nordic countries, especially Sweden and Finland, APNs have been introduced in some organizations but their competency domains have not yet been clearly defined. THEORETICAL FRAMEWORK The study's theoretical framework emanates from Aristotle's three-dimensional view of knowledge that is epistêmê, technê, and phronesis. METHODS Between October 2005 and January 2006, focus group interviews of Clinical Nurse Specialists who provide expert functions in pediatric, internal medicine, and surgical units (n = 26) and APN students (n = 8) were conducted. The data material was analyzed using inductive content analysis. FINDINGS Grouped into five main themes, the study results indicate that APNs possess advanced level clinical competencies in: (A) assessment of patients' caring needs and nursing care activities, (B) the caring relationship, (C) multi-professional teamwork, (D) development of competence and nursing care, and (E) leadership in a learning and caring culture. CONCLUSION Clinical competencies consist of advanced skills, which typify an expanding role that offers new possibilities for holistic patient care practice. APNs' scope of practice is characterized by responsibility and competence in making autonomous judgments based on expanded clinical competence. On an advanced level, clinical competence consists not merely of advanced skills for assessing and meeting the needs of patients but also the creation of safe and trustful relationships with patients and collaboration with colleagues. APNs can realize advanced skills in their actions through their manner of knowing, doing, and being.
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Affiliation(s)
- Anna-Lena Nieminen
- Health Care and Social Welfare, Novia University of Applied Sciences, Vasa, Finland.
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Abstract
The people of the United States sent a clear message in November 2008 that they wanted a change in the nation's priorities, including healthcare. The question is whether healthcare reform will extend to the care of older adults, especially in the face of complex needs in the last years of their lives. This article addresses this question by examining the demographics of the older adult population, the eldercare workforce, and the current inadequate patchwork of financing. Some aging issues, such as chronic care, are being addressed in the broad context of healthcare reform, whereas health information technology and others remain marginal. The window of opportunity for a clear and coherent voice in a reformed/reshaped healthcare system is narrow. Now is the time for the "trusted" profession to advocate for meaningful change that will meet the current and future needs of older adults. The article concludes with strategies and Web-based resources for nurses to bring aging issues to the healthcare reform debate at both the national and local levels.
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Pierce DN. Primary care in the ED - Why? Nurs Manag (Harrow) 2009; 40:23-51. [PMID: 19738548 DOI: 10.1097/01.numa.0000360769.74976.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Certain patient populations regularly access the ED for primary healthcare. How can you help decrease these nonemergent visits in a way that benefits patients and your hospital?
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Storesund A, McMurray A. Quality of practice in an intensive care unit (ICU): a mini-ethnographic case study. Intensive Crit Care Nurs 2009; 25:120-7. [PMID: 19307120 DOI: 10.1016/j.iccn.2009.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Revised: 01/25/2009] [Accepted: 02/04/2009] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nurses' perspectives of maintaining quality practice is important in the context of today's safety and quality agenda. This study provides a snapshot of registered nurses' perspectives on practice quality in one Australian ICU. METHODS A mini-ethnographic case study examined how quality is embedded in the culture of ICU nursing. Semi-structured interviews of 10 informants were analysed using Spradley's (Spradley JP. The ethnographic interview. Sydney: Holt, Rinehart and Winston, Inc.;1979) ethnographic guidelines. FINDINGS Three major themes influenced nursing quality: maintaining cohesiveness in a complex and stressful environment; rapid, effective and respectful communication; and specialist knowledge gained through experience and formal learning. CONCLUSION The nurses reported satisfaction with the quality of their ICU practice, but revealed factors that could diminish quality and contribute to job dissatisfaction. Given current recruitment and retention issues and the link between satisfaction and retention, it is important to consider this these factors in advancing the knowledge base for workforce planning.
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Affiliation(s)
- Anette Storesund
- Haukeland University Hospital, Surgery Department, Postoperative Section, Bergen 5021, Norway.
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Pazargadi M, Tafreshi MZ, Abedsaeedi Z, Majd HA, Lankshear AJ. Proposing indicators for the development of nursing care quality in Iran. Int Nurs Rev 2009; 55:399-406. [PMID: 19146550 DOI: 10.1111/j.1466-7657.2008.00642.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nursing has come a long way in developing frameworks for the delivery of high-quality care; however, it is still grappling with identifying key performance indicators and defining the patient outcomes that are directly or indirectly affected by nurses. OBJECTIVE The study aimed to determine performance quality indicators in nursing care based on the healthcare system in Iran. METHODS A descriptive exploratory study was conducted and 220 nurses from seven provinces in Iran were selected by quota sampling. A questionnaire including 97 indicators in seven categories was developed to collect data and respondents were asked to rate each indicator for importance, scientific acceptability and feasibility of implementation. RESULTS Of the initial 220 distributed questionnaires, 74% (n = 119) nurse managers and 26% (n = 42) expert nurses (total: n = 161) returned questionnaires (73% response rate). The mean scores for all categories showed that the most of the indicators were important and scientifically acceptable (mean > 2.40), but difficult to implement in hospitals (mean < 2.15). An analysis using ANOVA showed that there were no significant differences between seven categories for the 'importance' aspect, but there were significant differences between 'time and quality of care' and 'job satisfaction', for 'scientific acceptability' (P = 0.004) and significant differences between most of categories for 'feasibility of implication'(P = 0.000). CONCLUSION The researchers have proposed the most significant nursing quality indicators for the clinical setting in Iran. These indicators would be useful for nurse managers as a first step to assess the quality of nursing care in hospitals.
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Affiliation(s)
- M Pazargadi
- Shaheed Beheshti Medical Sciences University, Tehran, Iran
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Advanced practice nurses core competencies: a framework for developing and testing an advanced practice nurse discharge intervention. CLIN NURSE SPEC 2008; 22:218-25. [PMID: 18753879 DOI: 10.1097/01.nur.0000325366.15927.2d] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this paper was to describe evidenced-based interventions as implemented by advanced practice nurses (APNs) conducting intervention research with a vulnerable population of blood and marrow transplant patients. In addition, each of the 6 core competencies of the APN role identified by Hamric are outlined and applied using a patient case study. These competencies are the following: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision making. This article chronicles a typical patient's journey through a post-hospital discharge nursing research study involving APNs as "intervention nurses" and discusses the various aspects of the APN core competencies throughout the process.
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Bigbee JL. Relationships between nurse- and physician-to-population ratios and state health rankings. Public Health Nurs 2008; 25:244-52. [PMID: 18477375 DOI: 10.1111/j.1525-1446.2008.00701.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the relationship between nurse-to-population ratios and population health, as indicated by state health ranking, and to compare the findings with physician-to-population ratios. DESIGN Secondary analysis correlational design. SAMPLE The sample consisted of all 50 states in the United States. Data sources included the United Health Foundation's 2006 state health rankings, the 2004 National Sample Survey for Registered Nurses, and the U.S. Health Workforce Profile from the New York Center for Health Workforce Studies. RESULTS Significant relationships between nurse-to-population ratio and overall state health ranking (rho=-.446, p tf?>=.001) and 11 of the 18 components of that ranking were found. Significant components included motor vehicle death rate, high school graduation rate, violent crime rate, infectious disease rate, percentage of children in poverty, percentage of uninsured residents, immunization rate, adequacy of prenatal care, number of poor mental health days, number of poor physical health days, and premature death rate, with higher nurse-to-population ratios associated with higher health rankings. Specialty (public health and school) nurse-to-population ratios were not as strongly related to state health ranking. Physician-to-population ratios were also significantly related to state health ranking, but were associated with different components than nurses. CONCLUSIONS These findings suggest that greater nurses per capita may be uniquely associated with healthier communities; however, further multivariate research is needed.
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Affiliation(s)
- Jeri L Bigbee
- Department of Nursing, Boise State University, Boise, Idaho 93725-1840, USA.
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Tafreshi MZ, Pazargadi M, Abed Saeedi Z. Nurses' perspectives on quality of nursing care: a qualitative study in Iran. Int J Health Care Qual Assur 2007. [DOI: 10.1108/09526860710754389] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
PURPOSE To describe the concept of Nurse Dose. METHODS The concept of nurse dose has been identified from decades of clinical research as a concept essential in the delivery of safe and high quality health care. The components of nurse dose were conceptualized through review of the literature from nursing, medicine, and health services research. FINDINGS Nurse dose is conceptualized as having three equally essential components: dose, nurse, and host and host response. Dose in the macro view includes the number of nurses per patient or per population in cities, states, regions, or countries. Dose in a micro view includes the amount of nurse time and the number of contacts. The nurse component consists of the education, expertise, and experience of the nurse. Host is represented by an organization and its characteristics (culture, autonomy, practice control) in a macro view and by the patient and characteristics (beliefs, values, culture) in a micro view. Host response includes response to the autonomy and acceptability of the nurse. CONCLUSIONS Greater nurse dose has been associated with decreases in patient mortality, morbidity, and healthcare costs.
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Affiliation(s)
- Dorothy Brooten
- School of Nursing, Florida International University, Miami 33181, USA.
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McBride AB. Nursing and the informatics revolution. Nurs Outlook 2005; 53:183-91; discussion 192. [PMID: 16115510 DOI: 10.1016/j.outlook.2005.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2004] [Revised: 02/08/2005] [Accepted: 02/19/2005] [Indexed: 10/23/2022]
Abstract
The Institute of Medicine's quality initiatives have collectively emphasized the importance of information technology to the transformation of health care. Not coincidentally, federal initiatives in 2004 have signaled the start of "the decade of health information technology." Building on those reports, this article describes the informatics revolution in process, and nursing's readiness to move in that direction. The promise of informatics in reshaping practice is sketched out in terms of seven aims for improvement, followed by a listing of some of the issues that must be addressed for nursing to realize those possibilities. In similar fashion, changes in academia are discussed both in terms of the promise of informatics applications and the barriers to achieving that preferred future. The article ends with some policy recommendations and reflections on opportunities at hand, particularly the growing emphasis on patient self-management support.
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Abstract
ISSUES AND PURPOSE To describe the characteristics and role functions of Advanced Practice Nurses (APNs) in a tertiary pediatric setting. DESIGN AND METHODS This descriptive survey design used a convenience sample (N = 39) of APNs at The Children's Hospital in Denver. A 56-item survey asked participants to define their role by rating how often they performed various primary and specialty care functions. RESULTS Findings validated the notion that APNs combine expert knowledge and practice skills into a holistic framework to provide sick children and their families with a full range of comprehensive services across a variety of settings. APNs work collaboratively with physicians and other professionals and are an excellent resource for students. PRACTICE IMPLICATIONS Describing and characterizing how APNs contribute to and enhance the delivery of care help to clarify and authenticate the scope of practice of the pediatric acute care APN.
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Affiliation(s)
- Anne Marie Kotzer
- University of Colorado Health Sciences Center, School of Nursing, Denver, CO, USA.
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NICTF Activities. Comput Inform Nurs 2004. [DOI: 10.1097/00024665-200409000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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