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Guerrero-Menéndez R, Fontán-Vinagre G, Cobos-Serrano JL, Ayuso-Murillo D. The advancement of critical care nursing as a response to the current demands. ENFERMERIA INTENSIVA 2024; 35:e23-e29. [PMID: 38806311 DOI: 10.1016/j.enfie.2024.01.002] [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: 09/21/2023] [Accepted: 01/22/2024] [Indexed: 05/30/2024]
Abstract
The current demand on health services requires that nurses play a key role, by adapting their competencies to different fields and complexity levels. The approach of situations presented by critically ill patients underpins the need for development of specialised competencies in specific areas such as patient safety, prevention and control of healthcare-associated infections, performance of specific techniques and interventions, autonomous medication management or the use of technology, among others. Spain relies on a specialist training programme that is unique worldwide. Training admission is managed through a contract as a "Resident Nurse Intern" (EIR, Enfermera Interna Residente), provided by regional healthcare services. Only 6 specialities have been established and developed, in an uneven manner and with a short provision of places, annually. Given that the specialization in critical care nursing does not exist, nurses usually self-fund their postgraduate training to enhance their opportunities career development. The development of a speciality for critical care nursing is a priority. The models proposed advocate for creating nursing roles that could cover the systemic gaps through the expansion of their competencies and the introduction of procedures that fit nursing into advanced practice, which could be achieved through Advanced Accreditation Diplomas. Simultaneously, it would be convenient to analyse how and why such a dynamic discipline in some countries became stuck in anachronistic models of the Spanish healthcare system. This analysis might contribute to move forward on the development of areas of improvement in terms of service access and quality of care.
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Affiliation(s)
- R Guerrero-Menéndez
- Instituto Español de Investigación Enfermera, Consejo General de Colegios Oficiales de Enfermería de España, Madrid, Spain.
| | - G Fontán-Vinagre
- Instituto Español de Investigación Enfermera, Consejo General de Colegios Oficiales de Enfermería de España, Madrid, Spain
| | - J L Cobos-Serrano
- Consejo General de Colegios Oficiales de Enfermería de España, Madrid, Spain
| | - D Ayuso-Murillo
- Consejo General de Colegios Oficiales de Enfermería de España, Madrid, Spain
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Ljungbeck B, Carlson E, Forss KS. Swedish stakeholders' views of the preparatory work needed before introducing the nurse practitioner role in municipal healthcare-A focus group study. Scand J Caring Sci 2024; 38:284-293. [PMID: 37984433 DOI: 10.1111/scs.13224] [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: 02/03/2023] [Revised: 09/30/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The nurse practitioner role has become important globally in handling the growing healthcare needs of older adults with chronic diseases. Nevertheless, research shows that introducing the role is a complex process, and more studies are needed to prepare for its introduction into different healthcare contexts, such as municipal healthcare. AIM The aim is to investigate what Swedish stakeholders identify as the preparatory work needed before introducing the nurse practitioner role into municipal healthcare. METHODS Data were collected through four focus group interviews conducted virtually on the TEAMS digital platform, with three to six participants in each group and 18 participants total. The transcribed interviews were analysed using a six-step thematic approach: familiarisation with the data, coding the data, generating initial themes, reviewing themes, defining and naming the themes and producing the report. FINDINGS The findings are divided into two main themes, each with two sub-themes. In the first, clarifying why the nurse practitioner role is needed, participants stressed the importance of having a clear intention for introducing the role. The second, ensure a national framework to bolster the introduction at the local level, demonstrates the need for collaboration among national actors to clarify the role's mandate and authority before its introduction. CONCLUSIONS Adding the nurse practitioner role to municipal healthcare can help increase the supply of nursing competence and the quality of patient care, but preparation for introducing the role requires extensive work. The development of the nurse practitioner role requires decision-makers and leaders to take primary responsibility for its introduction. This study can support countries in the early phase of developing the nurse practitioner role by identifying both best practices and pitfalls.
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Affiliation(s)
- Birgitta Ljungbeck
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
- Municipal Healthcare in Hässleholm, Management of Care and Welfare, Malmo, Sweden
| | - Elisabeth Carlson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
| | - Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmo, Sweden
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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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Rivera D, Prades J, Sevilla Guerra S, Borras JM. Contextual factors influencing the implementation of advanced practice nursing in Catalonia, Spain. Int Nurs Rev 2024; 71:309-317. [PMID: 37535808 DOI: 10.1111/inr.12866] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 07/23/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Advanced practice nurse (APN) roles bring great added value to health systems. However, their integration into the health workforce and the sustainability of the role depend on contextual factors surrounding their implementation. AIM To explore the contextual factors that influence the organization, implementation, and performance of clinical practice among oncology APNs in Catalonia (Spain). METHODS This is a descriptive qualitative study. A framework of contextual factors was applied to explore the perspectives of 14 oncology APNs in public hospitals in Catalonia by means of semistructured interviews. Data were analyzed according to the thematic analysis approach. The COREQ checklist was used to report the study. RESULTS APNs in cancer care strongly depend on the hospital environment where they are introduced. Recognition by the multidisciplinary team, the existence of mentoring experiences, and networking between APNs are critical factors that can help or hinder the development and autonomy of the APNs. Likewise, support from nursing managers and directors is decisive in defining the professional profile, establishing accountability mechanisms, and securing financial resources, including economic recognition. Factors related to the external environment can also contribute, including a standardized national APN model and scientific societies. CONCLUSIONS Contextual factors around clinical practice, institutional structures, and professional networks are crucial determinants for adequately integrating APNs at the health system level. IMPLICATIONS FOR NURSING POLICY Professional bodies and national nursing organizations should lay the groundwork for defining standards of practice and advocate for specific regulations. In addition, financial recognition and accountability mechanisms to assess the impact of their contribution should be a priority to ensure sustainability and APN satisfaction.
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Affiliation(s)
- Darinka Rivera
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Joan Prades
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Department of Health, Catalonian Cancer Strategy, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Sonia Sevilla Guerra
- Catalan Health System, Barcelona, Spain
- Global Health, Gender and Society (GHenderS) Research Group, Ramón Llull University, Barcelona, Spain
| | - Josep M Borras
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Department of Health, Catalonian Cancer Strategy, Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
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Serra-Barril MA, Ferro-Garcia T, Falco-Pegueroles A, Delgado-Hito P, Romero-Garcia M, Benito-Aracil L. Patients' and professionals' experiences with advanced practice nursing in cancer care: A qualitative study. Eur J Oncol Nurs 2023; 66:102407. [PMID: 37769540 DOI: 10.1016/j.ejon.2023.102407] [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: 01/12/2023] [Revised: 07/03/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE The growing complexity of cancer treatments requires changes in how care is organized and who provides it. The incorporation of advanced practice nursing roles within multidisciplinary teams can improve care in cancer patients. This study aims to understand the lived experience of cancer patients and multidisciplinary professionals in relation to the care provided by advanced practice nurses (APN). METHODS Phenomenological qualitative study. Data were collected through in-depth interviews and a field diary. Participants were recruited through convenience sampling; until theoretical data saturation was achieved. An interpretative phenomenological analysis was performed, following Guba and Lincoln's criteria for trustworthiness. RESULTS Interviews were performed with 18 professionals and 11 patients, from high-complexity public hospitals between March-December 2021. The main themes that emerged were: Advanced practice nurse role and competencies, Benefits provided by the APN, and Relevant aspects of nursing care. CONCLUSION Advanced practice nurses play a fundamental role in cancer care, making positive contributions to the patient experience and to the multidisciplinary team's work. Elucidating the contribution of advanced practice nurses in oncology will facilitate the definition of their specific competencies and, in turn, the implementation of training and management strategies to consolidate this figure in specialized centers.
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Affiliation(s)
- M Antònia Serra-Barril
- Innovation and Quality Department, Catalan Institute of Oncology, Granvia de L'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, Campus Bellvitge, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Tarsila Ferro-Garcia
- Innovation and Quality Department, Catalan Institute of Oncology, Granvia de L'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, Campus Bellvitge, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Anna Falco-Pegueroles
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, Campus Bellvitge, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Pilar Delgado-Hito
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, Campus Bellvitge, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain; IDIBELL, Institute of Biomedical Research, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Marta Romero-Garcia
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, Campus Bellvitge, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Llúcia Benito-Aracil
- Department of Fundamental and Clinical Nursing, Faculty of Nursing, University of Barcelona, Campus Bellvitge, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain; IDIBELL, Institute of Biomedical Research, Feixa Llarga s/n., 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
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Muñoz-Villaverde S, Martínez-García M, Serrano-Oviedo L, Sobrado-Sobrado AM, Cidoncha-Moreno MÁ, Garcimartin P. Professional competencies of oncology nurses: Recognizing advanced practice in nursing. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:338-345. [PMID: 37543360 DOI: 10.1016/j.enfcle.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/30/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE To identify the competency profile of advanced practice nurses involved in the care process of cancer patients. METHODS Cross-sectional and descriptive study. The study included all nurses involved in the cancer patient care process in a tertiary hospital in Barcelona. Competence profile data were collected using the instrument for defining the role of the advanced practice nurse (APRD), as well as sociodemographic and occupational variables. Sociodemographic and occupational data were compared against the performance of advanced practice activities. RESULTS A total of 29 (82.9%) nurses participated with a mean age of 42.6±12.54 years. 9 (31%) nurses were identified as meeting the standard in all 6 domains on the APRD scale to be considered advanced practice nurses. Of these 9 (31%) nurses, 7 (24.1%) met the training standards required by the International Council of Nurses (ICN) with an official master's degree and 2 (6.9%) with a PhD. CONCLUSIONS There are nurses who carry out their activity in the oncology field of the hospital analyzed with the EPA profile. The identification of advanced practice nurses (APNs) in our health system is essential to be able to recognize the competencies of these professionals and create specific positions that help to address chronicity, patients' quality of life, their survival, and the optimization of health resources. Our study highlights the importance of chronicity and cancer as areas for the development of the APNs.
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Affiliation(s)
- Sergio Muñoz-Villaverde
- Unidad de ensayos clínicos de oncología, Hospital del Mar, Barcelona, Spain; Programa de investigación en cáncer, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Centro de Atención Primaria Casc Antic, Instituto Catalán de Salud, Gerencia territorial de Barcelona, Barcelona, Spain.
| | - María Martínez-García
- Unidad de ensayos clínicos de oncología, Hospital del Mar, Barcelona, Spain; Programa de investigación en cáncer, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain; Departamento de oncología médica, Hospital del Mar, Barcelona, Spain
| | - Leticia Serrano-Oviedo
- Unidad de Investigación Traslacional, Hospital General Universitario de Ciudad Real, Servicio de Salud de Castilla-La Mancha (SESCAM), Ciudad Real, Spain
| | | | | | - Paloma Garcimartin
- Dirección Enfermera, Hospital del Mar, Barcelona, Spain; Grupo de Investigación en Cuidados de Enfermería, IMIM (Instituto Hospital del Mar de Investigaciones Médicas), Barcelona, Spain
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Sevilla Guerra S, Jean E, Kilpatrick K, Zabalegui A, Martínez Gaitero C. Contextual factors of advanced practice nursing development: A network analysis. Int J Nurs Pract 2022:e13114. [PMID: 36329680 DOI: 10.1111/ijn.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 02/22/2021] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
AIMS This study aimed to delineate the relationships between actors and contextual factors associated with the development of the advanced practice role in Catalonia. METHODS A complementary data analysis was conducted based on the social network analysis (SNA) method. The primary study design was qualitative, descriptive and explanatory. Participants from diverse perspectives of practice, organization and external environment were engaged to participate in semi-structured focus groups. Data collection was conducted between March and May 2016 in Catalonia, Spain. Participants were asked to report on various dimensions of the role development context: understanding of the role, felt needs, perceived outcomes, barriers and facilitators. RESULTS Primary data analysis performed for 44 participants identified 71 related contextual factors associated with role development. Complementary network analysis revealed multiple relationships and agreements among participants and context-related themes. Professional roles and disciplines clustered around topics show consensus and the significance of topics. CONCLUSION Understanding the level of interactions and consensus among participants and contextual factors will ultimately allow better insight into how complex contexts influence the development of advanced practice nursing in healthcare organizations. Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes.
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Affiliation(s)
| | | | | | | | - Carlos Martínez Gaitero
- Tecnocampus. Research Group in Attention to Chronicity and Innovation in Health (GRACIS) Universitat Pompeu Fabra Mataró Spain
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Serra-Barril MA, Benito-Aracil L, Pla-Consuegra M, Ferro-García T. Delphi survey on the application of advanced practice nursing competencies: Strong points and unfinished business in cancer care. J Nurs Manag 2022; 30:4339-4353. [PMID: 36194472 PMCID: PMC10092559 DOI: 10.1111/jonm.13843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 12/30/2022]
Abstract
AIM This study assessed the application of advanced practice nursing competencies in cancer care to identify obstacles to their full implementation. BACKGROUND Internationally, the implementation of advanced practice nursing roles depends on the context and environment, which shape the definition, scope and competencies associated with these roles. METHODS Nurses participated in two rounds of an online Delphi survey about the competencies of advanced practice oncology nurses. The threshold for expert consensus was set at 75%. RESULTS Eleven competency domains were proposed; all yielded consensus of over 75%. However, for 57.8% of the specific competencies proposed in round 1 and for 62.2% in round 2, there was no consensus on which were applied in practice. There was more agreement on the competencies applied in the domains of direct clinical practice, consultation and collaboration and interprofessional relations than in dimensions such as health care promotion, quality improvement, evidence-based practice and research. Barriers related to unimplemented competencies were identified. CONCLUSIONS The competencies applied in advanced practice nursing reflect incomplete development of these roles. Domains related to direct clinical practice, consultation and collaboration and interprofessional relations are relatively well developed, whereas those related to leadership, research, evidence-based practice and quality improvement are not. The identified barriers hindering implementation of some competencies can inform strategies to develop this role in cancer care. IMPLICATIONS FOR NURSING MANAGEMENT Hospital administrators and nurse managers should reflect and be mindful of the development of advanced practice nurse (APN) competencies along with the challenges associated with implementing advanced practice roles.
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Affiliation(s)
- M Antònia Serra-Barril
- Innovation and Quality Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Fundamental Care and Medical-Surgical Nursing Department, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Llúcia Benito-Aracil
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Margarida Pla-Consuegra
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Tarsila Ferro-García
- Innovation and Quality Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Fundamental Care and Medical-Surgical Nursing Department, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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Evans CK, Sabatier R, Chinot O, Loschi A, Arnaud S, Mellinas M. Développement des infirmiers en pratique avancée en oncologie et hémato-oncologie en France : état des lieux précoce. Bull Cancer 2022; 109:139-150. [DOI: 10.1016/j.bulcan.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/21/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022]
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Busca E, Savatteri A, Calafato TL, Mazzoleni B, Barisone M, Dal Molin A. Barriers and facilitators to the implementation of nurse's role in primary care settings: an integrative review. BMC Nurs 2021; 20:171. [PMID: 34530813 PMCID: PMC8444166 DOI: 10.1186/s12912-021-00696-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background The rapid evolution of the epidemiological picture and the recent SARS-COV-2 pandemic has expressed the vulnerabilities of health systems and focuses attention on the population’s needs. The nurse’s figure in the care teams is universally identified; however, the implementation of the role within some care settings turns out to be complex and challenging. This integrative review aims to identify the barriers and facilitators in implementing the role of the nurse in primary care settings. Methods An integrative review was conducted on the Medline and Cinahl databases until 9 June 2020. Qualitative, quantitative, and Mixed-method research studies were selected to identify studies related to the barriers and facilitators of the nurse’s role in nursing facilities’ primary care. For the extraction of the results, the Consolidating Framework for Research Implementation (CFIR) was used to identify the factors that influence implementation in health care. Results Following the duplicates’ removal, the search identified 18,257 articles, of which 56 were relevant to the inclusion criteria; therefore, they were included in the summary. The selected studies were conducted in thirteen countries, most from Oceania, Europe, North America, Latin America, and the Caribbean. The barriers reported most frequently concern the nursing profession’s regulatory and regulatory aspects within the contexts of care, cultural and organizational aspects, training, and the transfer of specific skills, which were previously designated to doctors. The facilitators are mainly linked to the nurse’s adaptability to the various contexts of care, recognizing the patient’s role, and the desire to develop multidisciplinary and effective working groups to respond to the health needs of the population in primary care contexts. Conclusion This review highlighted the main barriers and facilitators in implementing the nurse’s role in primary care settings. These results offer useful elements for stakeholders to identify effective strategies in preparing programs and activities for implementing the nurse’s role, acting on the elements identified as barriers and favouring the aspects that emerge as facilitators. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00696-y.
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Affiliation(s)
- Erica Busca
- Department of Translational Medicine, University of Piemonte Orientale, Via P. Solaroli, 17, 28100, Novara, Italy
| | - Alessia Savatteri
- Functional Oncology Department - Gastroenterology, Hospital "San Vincenzo" of Taormina, Contrada Sirina, 98039, Taormina, Italy
| | - Tania Lorenza Calafato
- Emergency-Urgency Department, Hospital "Sant'Elia" of Caltanissetta, Via Cusmano,1, 93100, Caltanissetta, Italy
| | - Beatrice Mazzoleni
- Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
| | - Michela Barisone
- Department of Translational Medicine, University of Piemonte Orientale, Via P. Solaroli, 17, 28100, Novara, Italy.
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Direzione delle Professioni Sanitarie - A.O.U. Maggiore della Carità di Novara, Via P. Solaroli, 17, 28100, Novara, Italy
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Manzanares I, Sevilla Guerra S, Peña-Ceballos J, Carreño M, Palanca M, Lombraña M, Conde-Blanco E, Centeno M, Donaire A, Gil-Lopez F, Khawaja M, López Poyato M, Zabalegui A. The emerging role of the advanced practice epilepsy nurse: A comparative study between two countries. J Clin Nurs 2021; 30:1263-1272. [PMID: 33471366 DOI: 10.1111/jocn.15669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/11/2020] [Accepted: 01/07/2021] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES The aim of the study was to compare advanced practice in epilepsy nurses in Spain and United Kingdom, identifying differences in the domains of standard advanced practice. BACKGROUND Europe has recently faced the challenge of providing high-quality care for patients with epilepsy, a disease that generates many health demands. In some countries, such as the United Kingdom, advanced practice nursing is well established and could serve as a guide for implantation in countries where it is still in development, as is the case of Spain. DESIGN A multicentre cross-sectional descriptive cohort study compared differences in the roles of advanced practice nurses in Spain and the United Kingdom. METHODS The Advanced Practice Role Delineation Tool and its validated Spanish version were administered using an online questionnaire in a cohort of advanced practice epilepsy nurses in both countries. A convenience sample was recruited between January to December 2019. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. RESULTS Most United Kingdom nurses in our sample came from community environments, in contrast to Spanish nurses who worked in hospital. All domains analysed in the survey had significantly higher scores in the United Kingdom than in the Spanish cohort, especially in the research and leadership domains. CONCLUSIONS The advanced practice role in Spain is underdeveloped compared with the United Kingdom. Differences in the settings of advanced roles in epilepsy nurses may be explained by greater community practice in the United Kingdom and differences in organisational and health systems. RELEVANCE TO CLINICAL PRACTICE Our study showed the need to implement specific policies to develop advance practice nurse roles in Spain to improve the quality of care of patients with epilepsy.
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Affiliation(s)
- Isabel Manzanares
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Sonia Sevilla Guerra
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hospital Clínic de Barcelona, Barcelona, Spain
| | - Javier Peña-Ceballos
- Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mar Carreño
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María Palanca
- Refractory Epilepsy Unit, Department of Neurology, Hospital Universitari i Politècnic La Fe de Valencia, Valencia, Spain
| | - María Lombraña
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hospital Clínic de Barcelona, Barcelona, Spain
| | - Estefanía Conde-Blanco
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María Centeno
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Antonio Donaire
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Francisco Gil-Lopez
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mariam Khawaja
- Epilepsy Unit, Department of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mireia López Poyato
- Department of Nursing, Facultad de Medicina i Ciencias de la Salud, Universidad de Barcelona, Barcelona, Spain.,Primary Care Centre Les Corts, Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain
| | - Adelaida Zabalegui
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hospital Clínic de Barcelona, Barcelona, Spain
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