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Reato F, Bresil A, D'Angelo C, Gorli M, Ivziku D, Lommi M, Carcano G. Toward the Definition of a Repertoire of Technical Professional Specialist Competencies for Operating Room Nurses: An Ethnographic Study. Healthcare (Basel) 2024; 12:1774. [PMID: 39273798 PMCID: PMC11394865 DOI: 10.3390/healthcare12171774] [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: 07/21/2024] [Revised: 08/29/2024] [Accepted: 09/01/2024] [Indexed: 09/15/2024] Open
Abstract
Registered nurses in the operating room require specialized competencies that surpass basic educational training. Existing national and international documents attempt to outline these competencies but often lack comprehensive details. To address this, a repertoire of technical and professional competencies for operating room nurses, aligned with European and National Qualifications Frameworks, is proposed. Aim: Develop a repertoire of technical and professional competencies for perioperative and perianesthesiological specialist nursing roles. Methods: An at-home ethnography design was employed, utilizing participant observation, interviews to the double, and focus groups. Convenience sampling included 46 participants from a university and a public hospital in northern Italy. Data were collected from September 2021 to June 2023 and analyzed using inductive content analysis and data triangulation. Results: Identified 17 specialized technical professional competencies for perioperative and perianesthesiological nursing, divided into 6 areas of activity. These competencies encompass 19 learning outcomes, 152 tasks, 222 knowledge elements, and 218 skills. Conclusions: This competency repertoire aids in the public recognition of qualifications and serves as a valuable tool for identifying, validating, and certifying competencies. Future research should focus on exploring the competencies of central sterilization nurses and transversal competencies.
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Affiliation(s)
- Francesca Reato
- Department of Health and Social Professions, ASST dei Sette Laghi, 21100 Varese, Italy
- Educational Coordinator Master in Operating Room Nurses, University of Insubria, 21100 Varese, Italy
| | - Alessia Bresil
- Operating Room Department, ASST dei Sette Laghi, 21100 Varese, Italy
| | - Chiara D'Angelo
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Brescia, Italy
| | - Mara Gorli
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Brescia, Italy
| | - Dhurata Ivziku
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Marzia Lommi
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University La Sapienza, 00157 Rome, Italy
| | - Giulio Carcano
- Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy
- Department of General, Emergency and Transplantation Surgery, ASST dei Sette Laghi, 21100 Varese, Italy
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Stievano A, Caruso R, Friganović A. The Specialist Nurse in European Healthcare 2030: ESNO Congress 2024 Highlights. Healthcare (Basel) 2024; 12:1623. [PMID: 39201181 PMCID: PMC11353440 DOI: 10.3390/healthcare12161623] [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: 06/28/2024] [Accepted: 07/24/2024] [Indexed: 09/02/2024] Open
Abstract
The European Specialist Nurses Organization (ESNO), after a series of congresses in Brussels, organised its 6th International Congress in Milan, Italy. The ESNO Congress 2024 focused on "The Specialist Nurse in European Healthcare 2030", addressing the evolving roles and increasing importance of specialist nurses. The event featured keynote presentations and discussions on enhancing clinical practice through advanced education, bridging policy-practice gaps, and improving working conditions. The ESNO Declaration emphasised lifelong learning, harmonised qualification recognition, and interdisciplinary collaboration. A dynamic hackathon preceded the congress, generating innovative solutions to pressing nursing challenges. New inductees of the ESNO Fellowship Program were celebrated. The congress highlighted critical advancements and set a strategic roadmap for the future of specialist nursing in Europe.
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Affiliation(s)
- Alessandro Stievano
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy;
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
- Department of Biomedical Science for Health, University of Milan, 20133 Milan, Italy
| | - Adriano Friganović
- Department of Quality Improvement and Assurance, University Hospital Centre, 10000 Zagreb, Croatia;
- Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia
- Department of Nursing, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia
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Tiliander A, Olsson C, Kalèn S, Ponzer S, Fagerdahl A. Exploring career choices of specialist nurse students: Their decision-making motives. A qualitative study. Nurs Open 2024; 11:e2241. [PMID: 39032132 PMCID: PMC11259742 DOI: 10.1002/nop2.2241] [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: 01/16/2024] [Accepted: 06/07/2024] [Indexed: 07/22/2024] Open
Abstract
AIMS To explore Registered Nurses' motives to undergo specialist training and to choose a particular speciality. DESIGN A descriptive qualitative interview study. METHODS Semi-structured interviews were conducted during 2021 with 20 Swedish specialist nurse students from different specialisation areas. Qualitative content analysis was used. The COREQ checklist was used to report the study. RESULTS Specialist nurse students' motivations for further training were divided into three main categories with two sub-categories each. The main categories were 'toward new challenges and conditions in work life', 'contributions to the development and higher competencies in health care' and 'personal work and life experiences as ground for choice'. CONCLUSION Our study demonstrates the importance of motivating factors in the career choices of Specialist nurse students, such as personal challenges, desirable working conditions, career growth opportunities and personal experiences in the career choices. Creating a supportive work environment that helps to prioritise work-life balance and offers the development of new skills might help retain nurses. NO PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was used. However, if more nurses would choose to undergo specialist training, especially in areas facing significant shortages, it would most likely lead to improved health-related outcomes for patients or populations.
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Affiliation(s)
- Annika Tiliander
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Caroline Olsson
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Susanne Kalèn
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Sari Ponzer
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Ami Fagerdahl
- Department of Clinical Science and Education, SödersjukhusetKarolinska InstitutetStockholmSweden
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Brown P, Cooper C, Dening KH, Hoe J, Burton A. An exploration of how specialist dementia nurses perceive and maintain the skills and competencies that frame their specialism: A qualitative survey. Heliyon 2024; 10:e27856. [PMID: 38596077 PMCID: PMC11001773 DOI: 10.1016/j.heliyon.2024.e27856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 04/11/2024] Open
Abstract
Background UK policy for complex and long-term health conditions including dementia has recommended that specialist nursing intervention is offered across the trajectory of the condition, but there is a lack of agreement regarding the skills and competencies that specialist nurses are expected to possess. Admiral Nurses are the largest UK group of specialist dementia nurses. Objective To explore how Admiral Nurses met and were supported to meet competencies as defined in the Admiral Nurse Competency Framework, and to develop and maintain skills as dementia specialists. Design Cross-sectional, semi-structured survey. Setting Online national survey. Participants Admiral (specialist dementia) Nurses. Methods We co-designed our survey with Admiral Nurses; then invited Admiral Nurses to complete it in 2022-23 Data were analysed thematically. Results 68 (20% of all Admiral Nurses) completed the survey; most were female (85.2%), from a white ethnic group (88.2%); they reported on average 24 years of nursing experience. We identified three themes in responses: 1.Having time and skills for meaningful support, explored how participants were resourced with time and skills to understand and address family carer client needs by active listening, tailoring person-centred support, and "walking alongside" families. 2.Partnering family carers, concerned how they co-designed interventions with family carers, learning from these collaborative partnerships where expertise was shared. 3.Practice and peer-based learning, explored how participants took responsibility for using available training, peer learning and self-reflection to develop their practice. Conclusions Admiral Nurse roles enabled respondents to develop as autonomous practitioners and to access resources that supported them to build and sustain their dementia specialist practice. Learning was practice based, through partnerships with family carer clients, peer support and self-directed learning. Specialist nursing models may help address the global health workforce emergency, through enabling creative practice development and valued roles that support retention of experienced nurses.
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Affiliation(s)
- Pat Brown
- Division of Psychiatry, University College London, London, UK & Dementia UK, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK, And East London NHS Foundation Trust
| | - Karen Harrison Dening
- School of Health & Life Sciences, De Montfort University, Leicester, Leicestershire & Dementia UK, London, UK
| | - Juanita Hoe
- Geller Institute of Ageing and Memory (GIAM), University of West London, London, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, London, UK
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Vaismoradi M, Rae J, Turunen H, Logan PA. Specialized nurses' role in ensuring patient safety within the context of telehealth in home care: A scoping review. Digit Health 2024; 10:20552076241287272. [PMID: 39381815 PMCID: PMC11459674 DOI: 10.1177/20552076241287272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 09/10/2024] [Indexed: 10/10/2024] Open
Abstract
Objectives Specialized nurses are uniquely positioned to implement innovative telehealth solutions to improve the quality and safety of home care, and this has become a focal point of contemporary healthcare research. This review aimed to identify the nature and scope of specialized nurses' roles in ensuring patient safety within the context of telehealth in home care. Methods A scoping review of the international literature was carried out from January 1, 2013, to August 29, 2024. The review employed Levac et al.'s framework to delineate the research phenomenon and consolidate existing empirical research findings. Through a comparative analysis, the review integrated findings from selected studies, highlighting both similarities and differences related to this phenomenon, which led to the development of distinct categories. Results The search yielded 1127 articles, from which 23 studies met the inclusion criteria for research synthesis and subsequent reporting of results. These studies spanned specialized nurses' roles in telehealth and various fields in which specialized nurses utilized telehealth to deliver high-quality and safe home care. The findings highlighted key outcomes linked to the improvement of patient safety in home care encompassing continuity of care, confidence in care, monitoring and early intervention, medication safety, engagement and adherence, and healthcare costs. Conclusions The review revealed the crucial role played by specialized nurses in harnessing telehealth in healthcare to meet the highest care standards, creating an environment that prioritizes the well-being and patient safety in home care.
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Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
| | - John Rae
- Faculty of Science and Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Hannele Turunen
- Department of Nursing Science, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Patricia A. Logan
- Faculty of Science and Health, Charles Sturt University, Bathurst, NSW, Australia
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Bruyneel A, Larcin L, Martins D, Van Den Bulcke J, Leclercq P, Pirson M. Cost comparisons and factors related to cost per stay in intensive care units in Belgium. BMC Health Serv Res 2023; 23:986. [PMID: 37705056 PMCID: PMC10500739 DOI: 10.1186/s12913-023-09926-2] [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: 04/27/2023] [Accepted: 08/16/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Given the variability of intensive care unit (ICU) costs in different countries and the importance of this information for guiding clinicians to effective treatment and to the organisation of ICUs at the national level, it is of value to gather data on this topic for analysis at the national level in Belgium. The objectives of the study were to assess the total cost of ICUs and the factors that influence the cost of ICUs in hospitals in Belgium. METHODS This was a retrospective cohort study using data collected from the ICUs of 17 Belgian hospitals from January 01 to December 31, 2018. A total of 18,235 adult ICU stays were included in the study. The data set was a compilation of inpatient information from analytical cost accounting of hospitals, medical discharge summaries, and length of stay data. The costs were evaluated as the expenses related to the management of hospital stays from the hospital's point of view. The cost from the hospital perspective was calculated using a cost accounting analytical methodology in full costing. We used multivariate linear regression to evaluate factors associated with total ICU cost per stay. The ICU cost was log-transformed before regression and geometric mean ratios (GMRs) were estimated for each factor. RESULTS The proportion of ICU beds to ward beds was a median [p25-p75] of 4.7% [4.4-5.9]. The proportion of indirect costs to total costs in the ICU was 12.1% [11.4-13.3]. The cost of nurses represented 57.2% [55.4-62.2] of direct costs and this was 15.9% [12.0-18.2] of the cost of nurses in the whole hospital. The median cost per stay was €4,267 [2,050-9,658] and was €2,160 [1,545-3,221] per ICU day. The main factors associated with higher cost per stay in ICU were Charlson score, mechanical ventilation, ECMO, continuous hemofiltration, length of stay, readmission, ICU mortality, hospitalisation in an academic hospital, and diagnosis of coma/convulsions or intoxication. CONCLUSIONS This study demonstrated that, despite the small proportion of ICU beds in relation to all services, the ICU represented a significant cost to the hospital. In addition, this study confirms that nursing staff represent a significant proportion of the direct costs of the ICU. Finally, the total cost per stay was also important but highly variable depending on the medical factors identified in our results.
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Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
| | - Lionel Larcin
- Research Centre for Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Dimitri Martins
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Van Den Bulcke
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Pol Leclercq
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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Brown P, Burton A, Ayden J, Harrison Dening K, Hoe J, Cooper C. Specialist dementia nursing models and impacts: a systematic review. Curr Opin Psychiatry 2023; 36:376-390. [PMID: 37191653 DOI: 10.1097/yco.0000000000000874] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW Dementia policy priorities recommend that people who are living with dementia and their family should have access to support and interventions delivered by dementia specialists, including specialist nurses. However, specialist dementia nursing models and role-related competencies are not clearly defined. We systematically review the current evidence regarding specialist dementia nursing models and their impacts. RECENT FINDINGS Thirty-one studies from across three databases, and grey literature were included in the review. One framework defining specific specialist dementia nursing competencies was found. We did not find convincing evidence of the effectiveness of specialist nursing dementia services, relative to standard models of care from the current, limited evidence base, although families living with dementia valued it. No Randomised Controlled Trial (RCT) has compared the impact of specialist nursing on client and carer outcomes relative to less specialist care, although one nonrandomised study reported that specialist dementia nursing reduces emergency and inpatient service use compared with a usual care group. SUMMARY Current models of specialist dementia nursing are numerous and heterogeneous. Further exploration of the specialist nursing skills and the impact of specialist nursing interventions is needed to usefully inform workforce development strategies and clinical practice.
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Affiliation(s)
- Pat Brown
- Division of Psychiatry, University college London, and Dementia UK
| | | | - Jordan Ayden
- Division of Psychiatry, University College London
| | - Karen Harrison Dening
- Faculty of Health and Life Sciences, De Montfort University, Leicester, and Dementia UK
| | - Juanita Hoe
- Geller Institute of Ageing and Memory (GIAM), University of West London
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Sulosaari V, Blaževičienė A, Bragadóttir H, Bäckström J, Heikkilä J, Hellesø R, Hopia H, Lenk-Adusoo M, Norlyk A, Urban R. A comparative review of advanced practice nurse programmes in the Nordic and Baltic countries. NURSE EDUCATION TODAY 2023; 127:105847. [PMID: 37216703 DOI: 10.1016/j.nedt.2023.105847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/09/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Advanced practice nurses (APNs) programs are career-development opportunities significant for nursing workforce retention as well as for the quality of patient care. Inconsistency regarding policy, education, titles, scope of practice, skills and competencies have been identified as major challenges in developing advanced practice nursing in Europe. APN roles and education are under development in the Nordic and Baltic countries. However, there is a lack of information on the current state in this region. OBJECTIVE The purpose of this paper is to compare APN programs in the Nordic and Baltic countries to identify their commonalities and differences. DESIGN AND METHODS This descriptive comparative study reviewed seven master's level APN programs in six Nordic and Baltic countries. Data was extracted from the programme by the expert teachers or leaders of the programmes (N = 9). Competencies recommended in the European Tuning Project (ETP) and the International Council of Nurses (ICN) guidelines on advanced practice nursing, were used to evaluate the programs. The same informants provided additional information on the current state of APN education in the country. RESULTS The admission requirements were similar in the six countries but in two, clinical work experience is an entry requirement. There are two commonly identified APN roles: clinical nurse specialist (CNS) and nurse practitioner (NP). Most of the programs included all the EPT and ICN competencies. The main differences regarded prescribing competencies. All programmes included clinical training, but the methods on how it is implemented varies. CONCLUSION The findings indicate that APN programs in the Nordic and Baltic countries correspond with the recommendations of the European Tuning Project and ICN guidelines. This is an important message for administrators, policymakers, and politicians, as well as the nursing community, on providing opportunities for APNs to practice to their full potential within each country as well as cross-country. TWEETABLE ABSTRACT "APN programmes in the Nordic and Baltic countries correspond with international guidelines. Special attention is needed in future on the clinical training of APNs".
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Affiliation(s)
- Virpi Sulosaari
- Health and Wellbeing, Turku University of Applied Sciences, Joukahaisenkatu 3, 20520 Turku, Finland.
| | | | - Helga Bragadóttir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Landspítali University Hospital, Iceland.
| | - Josefin Bäckström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
| | - Johanna Heikkilä
- School of Health and Social Studies, JAMK University of Applied Sciences, Finland.
| | | | - Hanna Hopia
- School of Health and Social Studies, JAMK University of Applied Sciences, Finland.
| | - Margit Lenk-Adusoo
- Department of Nursing and Midwifery, Tartu Health Care College, Estonia.
| | - Annelise Norlyk
- Department of Public Health, Health, Aarhus University, Denmark.
| | - Reet Urban
- Department of Nursing and Midwifery, Tartu Health Care College, Estonia.
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Wallin K, Bremer A, Fridlund B, Hörberg U, Werkander Harstäde C. The ways specialist nursing students understand the work in the ambulance service - a national Swedish phenomenographic study. Int J Qual Stud Health Well-being 2022; 17:2099023. [PMID: 35799452 PMCID: PMC9272920 DOI: 10.1080/17482631.2022.2099023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objective Design, sample, and measurements Findings Conclusions
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Affiliation(s)
- Kim Wallin
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Vaxjo, Sweden
- Faculty of Health and Life Sciences, Linnaeus University, Vaxjo, Sweden
| | - Anders Bremer
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Vaxjo, Sweden
- Faculty of Health and Life Sciences, Linnaeus University, Vaxjo, Sweden
| | - Bengt Fridlund
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Vaxjo, Sweden
| | - Ulrica Hörberg
- Faculty of Health and Life Sciences, Linnaeus University, Vaxjo, Sweden
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Larsson M, Sundler AJ, Blomberg K, Bisholt B. The clinical learning environment during clinical practice in postgraduate district nursing students' education: A cross-sectional study. Nurs Open 2022; 10:879-888. [PMID: 36062832 PMCID: PMC9834198 DOI: 10.1002/nop2.1356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To describe and compare the clinical learning environment in community-based home care and primary health care in postgraduate district nursing students' education. DESIGN Cross-sectional study design. METHODS A convenience sample of postgraduate district nursing students was derived from five Swedish universities in 2016 and 2017. RESULTS The postgraduate district nursing students were generally satisfied with the clinical learning environment in their clinical placement. In clinical placement, several factors affected the students' opportunities to learn, such as sufficiently meaningful learning situations with multidimensional content. A working environment that imposed psychosocial strain and high levels of stress among the staff negatively affected the students' learning. To further improve their learning from clinical practices, the students need preceptors who have the skills and competence required to support more advanced reflections and critical thinking on caring situations.
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Affiliation(s)
| | - Annelie J. Sundler
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health SciencesÖrebro UniversityÖrebroSweden
| | - Birgitta Bisholt
- Institution of Health SciencesRed Cross UniversityStockholmSweden
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Dong Z, Wei L, Sun X, Xiang J, Hu Y, Lin M, Tan Y. Experiences of nurses working in nurse-led clinics in Traditional Chinese Medicine hospitals: A focused ethnographic study. Nurs Open 2022; 10:603-612. [PMID: 36054474 PMCID: PMC9834534 DOI: 10.1002/nop2.1326] [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: 01/06/2021] [Revised: 12/03/2021] [Accepted: 07/29/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Traditional Chinese Medicine (TCM) nurse-led clinics (NLC) is an innovative working model in China, representing the specialization and extension of nurses' role. However, as a pioneer in TCM nursing, this new model of working is facing both opportunities and challenges because it is known little about the operational status of NLCs. AIMS To explore the experiences of nurses who work in NLC in TCM hospitals. MATERIALS & METHODS A focused ethnographic study was conducted in three TCM hospitals affiliated with Guangzhou University of Chinese Medicine. We interviewed eleven nurses in those hospitals and observed seven of them working with patients. We used snowball sampling for data collection including interview, non-participant observation and documents from medical records. All the data were processed as following steps: (a) coding for descriptive labels; (b) sorting for patterns; (c) identifying outliers or negative cases; (d) generalizing with construction and theories and (e) noting reflective remarks. RESULTS Nurse-led clinics help nurses develop their skills and knowledge that are highly recognized by public since they meet the growing needs of patients and also relieve the workload of physicians in the hospitals. However, lack of specialization is still a major challenge in NLCs due to insufficiency of full-time staff with specialized education, nurse-led practice without standardized guidelines, restrictions on prescription right of nurses, and also inadequate support from hospitals. DISCUSSIONS As a revolutionary innovation of working model for nurses in TCM hospitals, NLCs could improve quality of care and lead to a comprehensive promotion of nursing career. However, there are several challenges on providing high quality care for patients whilst improving educational development of nurses. This study suggests that nurses, hospital administration and the government should cooperate with each other to develop standard nursing programs for NLCs. CONCLUSIONS It is imperative to identify nursing roles, collect available resources, and develop supportive policies and training programs to enhance the quality of NLCs.
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Affiliation(s)
- Zhaoyang Dong
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
| | - Lin Wei
- Guangzhou University of Chinese MedicineGuangzhouChina,Guangdong Province Hospital of Traditional Chinese MedicineGuangzhouChina
| | - Xinglan Sun
- Guangzhou First People's HospitalGuangzhouChina
| | - Jiagen Xiang
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
| | - Yanan Hu
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
| | - Meizhen Lin
- Guangzhou University of Chinese MedicineGuangzhouChina,Guangdong Province Hospital of Traditional Chinese MedicineGuangzhouChina
| | - Yibing Tan
- School of Nursing, Guangzhou University of Chinese MedicineGuangzhouChina
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Quantitative interpretation of utterances and movements from videoed interactions between rheumatology nurses and patients commencing methotrexate: a pilot study. Clin Rheumatol 2022; 41:3869-3877. [PMID: 35982352 DOI: 10.1007/s10067-022-06336-3] [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: 07/05/2022] [Revised: 07/05/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Educating patients about methotrexate is a core role of rheumatology nurses. We have previously reported the scoring of videoed interviews of rheumatology nurses educating patients prior to commencing methotrexate in comparison with the Calgary-Cambridge consultation model, and the qualitative analysis of the transcripts (Robinson et al. Musculoskeletal Care 2021). We were interested to investigate what could be learned from a more quantitative analysis of utterances and movements in these consultations and how they related to the qualitative interpretations. AIM To investigate the frequency of utterances and body movements during interactions between rheumatology nurses and patients commencing methotrexate and to relate these to the qualitative interpretations of the interviews. METHODS Video-recordings of ten patients receiving methotrexate education from four different rheumatology nurses were available from the previous study. They were analysed using the Medical Interaction Process System (MIPS). This involved coding all utterances and body movements minute-by-minute by multiple inspections of the recordings. The first 10 min of each consultation was coded. The utterances and movements of the nurses and patients were compared. The thematic analysis based on the structure and content of the Calgary-Cambridge (C-C) consultation model was available from the previous study. This enabled the results from the MIPS to be compared between the interviews that scored higher on the C-C model and those scoring lower. RESULTS The inter-rater reliability between 2 raters for one video was satisfactory (80-100% agreement). Numerically, giving information dominated the nurse contribution and assent by positive utterances and head nodding dominated for the patients. The results were consistent with the nurse agenda dominating the interaction with little opportunity for patient involvement. Nurses in high-scoring interviews made more illustrative gestures and fewer batonic movements while patients did the opposite. Nurses in high-scoring consultations asked more open questions, with more checking of understanding and summarising but fewer interruptions. Patients in low-scoring consultations were much more animated with head movements and illustrative gestures. Patients also checked and interrupted more. CONCLUSIONS In this pilot study, the MIPS was usable and demonstrated verbal and non-verbal behaviours consistent with the qualitative assessments. It also showed some behaviours that are not intuitive but may indicate how effectively the interview was progressing. Some nurse behaviours identified that were associated with the higher scoring interviews may be useful indictors for training including making illustrative rather than batonic gestures and checking understanding. Patient behaviours, such as greater animation, were exhibited in low-scoring consultations, and could indicate that the interview was not addressing the patient perspective. Quantification of utterances and movements can be done and may give insights into the consultation process.
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Tiliander A, Olsson C, Kalèn S, Ponzer SS, Fagerdahl A. Factors affecting nurses' decision to undergo a specialist education and to choose a specialty. Nurs Open 2022; 10:252-263. [PMID: 35941100 PMCID: PMC9748047 DOI: 10.1002/nop2.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/05/2022] [Accepted: 07/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIMS The aims of the study were to identify factors affecting nurses' decision to undergo specialist education and choose a specialty and to describe differences between specialization areas with different types of care. DESIGN A descriptive cross-sectional design. METHODS A survey was conducted among specialist nurse students in three nursing colleges in Sweden (n = 227). Instruments such as Big Five Inventory and RAND-36 and items earlier used by Bexelius and Olsson were included. Survey data were analysed by using descriptive and analytical statistics, and for open-ended question qualitative content analysis was used. RESULTS Wage benefit during the education was regarded by 47% as an incentive to start studies. Most of the specialist nurse students considered an opportunity for new tasks (75%), new areas of responsibility (75%), intellectual challenges (72%) and higher wages (71%) to be of high importance when choosing a specialty. However, the students in specialization areas with transitory care-rated challenges regarding the practical skills (84%) and the occurrence of acute events (82%) higher. CONCLUSION Although higher wages were important to make nurses feel that they will get value from the education, there were also other important aspects, such as opportunity for new tasks, new areas of responsibility and intellectual challenges that influenced nurses' willingness to undergo a specialist education. Our findings provide employers with the useful information to guide and influence nurses' decisions to enter specialist education and their choice of specialist area.
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Affiliation(s)
- Annika Tiliander
- Department of Clinical Science and Education SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Caroline Olsson
- Department of Clinical Science and Education SödersjukhusetKarolinska InstitutetStockholmSweden,Unit of Intervention and Implementation Research for Worker HealthInstitute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Susanne Kalèn
- Department of Clinical Science and Education SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Sari Säisä Ponzer
- Department of Clinical Science and Education SödersjukhusetKarolinska InstitutetStockholmSweden
| | - Ann‐Mari Fagerdahl
- Department of Clinical Science and Education SödersjukhusetKarolinska InstitutetStockholmSweden
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Bruyneel A, Larcin L, Tack J, Van Den Bulke J, Pirson M. Association between nursing cost and patient outcomes in intensive care units: A retrospective cohort study of Belgian hospitals. Intensive Crit Care Nurs 2022; 73:103296. [PMID: 35871959 DOI: 10.1016/j.iccn.2022.103296] [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: 03/29/2022] [Revised: 06/07/2022] [Accepted: 06/28/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Hospitals with better nursing resources report more favourable patient outcomes with almost no difference in cost as compared to those with worse nursing resources. The aim of this study was to assess the association between nursing cost per intensive care unit bed and patient outcomes (mortality, readmission, and length of stay). METHODOLOGY This was a retrospective cohort study using data collected from the intensive care units of 17 Belgian hospitals from January 01 to December 31, 2018. Hospitals were dichotomized using median annual nursing cost per bed. A total of 18,235 intensive care unit stays were included in the study with 5,664 stays in the low-cost nursing group and 12,571 in the high-cost nursing group. RESULTS The rate of high length of stay outliers in the intensive care unit was significantly lower in the high-cost nursing group (9.2% vs 14.4%) compared to the low-cost nursing group. Intensive care unit readmission was not significantly different in the two groups. Mortality was lower in the high-cost nursing group for intensive care unit (9.9% vs 11.3%) and hospital (13.1% vs 14.6%) mortality. The nursing cost per intensive care bed was different in the two groups, with a median [IQR] cost of 159,387€ [140,307-166,690] for the low-cost nursing group and 214,032€ [198,094-230,058] for the high-cost group. In multivariate analysis, intensive care unit mortality (OR = 0.80, 95% CI: 0.69-0.92, p < 0.0001), in-hospital mortality (OR = 0.82, 95% CI: 0.72-0.93, p < 0.0001), and high length of stay outliers (OR = 0.48, 95% CI: 0.42-0.55, p < 0.0001) were lower in the high-cost nursing group. However, there was no significant effect on intensive care readmission between the two groups (OR = 1.24, 95% CI: 0.97-1.51, p > 0.05). CONCLUSIONS This study found that higher-cost nursing per bed was associated with significantly lower intensive care unit and in-hospital mortality rates, as well as fewer high length of stay outliers, but had no significant effect on readmission to the intensive care unit. .
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Affiliation(s)
- Arnaud Bruyneel
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium; CHU Tivoli, La Louvière, Belgium. https://twitter.com/@ArnaudBruyneel
| | - Lionel Larcin
- Research Centre for Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Jérôme Tack
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium; Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - Julie Van Den Bulke
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
| | - Magali Pirson
- Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium
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Temper the Specialist Nurses Heterogeneity in the Interest of Quality Practice and Mobility—18 EU Countries Study. Healthcare (Basel) 2022; 10:healthcare10030435. [PMID: 35326913 PMCID: PMC8953535 DOI: 10.3390/healthcare10030435] [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: 01/14/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The position of the specialist nurse profession varies across the European Union. Action is required to address the challenges to promote mobility and the contribution of specialist nurses to quality of care. The purpose of the study is to identify the interfaces of the specialist nurse profession across the European Union. Methods: A mixed method study was conducted in October 2019 and total of 40 answers from 18 different European Union countries were selected using a purposive sampling method. Results: The participants had completed various Bologna degree cycles and 57.2% had followed a specific educational programme to become a specialist nurse. More professional autonomy was acquired by 81.9% participants. Conclusion: A striving for homogeneity in the interpretation of the specialist nurses role and competencies is needed to achieve better quality of care provision and facilitate their mobility around the European Union. The lack of recognition identified in this study should encourage nurse managers to consider specialist nurse roles with the aim of capitalizing on the advanced care and expertise that specialist nurses provide. These results are an opportunity to improve the specialist nurses profession with an ultimate impact on management practices of streamlined, cost-effective clinical services.
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BAGNASCO A, CATANIA G, ZANINI M, POZZI F, ALEO G, WATSON R, HAYTER M, SASSO L, Rodrigues C, Alvino S, Musian D, Roba I, Turunen H, Popa A, Vicente M, Papathanasiou IV, Fradelos EC, Kastanidou S, Kleisiaris C, Evangelidou ES, Daglas A, Stavropoulos K. Core competencies for family and community nurses: a European e-Delphi study. Nurse Educ Pract 2022; 60:103296. [DOI: 10.1016/j.nepr.2022.103296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 10/04/2021] [Accepted: 01/12/2022] [Indexed: 01/02/2023]
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Zhang M, Chen H, Wang N, Li Y, Li X, Liu Y. The mediating role of job satisfaction between psychological capital and work engagement among Chinese nurses during COVID-19 outbreak: A comparative study between nurse specialists and general nurses. Front Psychiatry 2022; 13:990216. [PMID: 36713893 PMCID: PMC9878697 DOI: 10.3389/fpsyt.2022.990216] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 12/15/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The outbreak of COVID-19 has become a global public health emergency, causing great psychological distress to nurses. It is unknown whether the pandemic will affect the work engagement of nurses, the relationship between psychological capital, job satisfaction, and work engagement among nurses, and whether there are differences between nurse specialists and general nurses during the pandemic. OBJECTIVES The purpose of this study was to compare psychological capital, job satisfaction, and work engagement among nurse specialists and general nurses during the pandemic, as well as to test the role of job satisfaction as a mediator in the association between psychological capital and work engagement among nurses, and to examine whether the underlying mechanism of the relationship between psychological capital and job satisfaction differs between nurse specialists and general nurses. MATERIALS AND METHODS A convenience sampling was used to assess a sample of 372 nurse specialists and 318 general nurses from nine provincial general hospitals in China to participate in the online survey. Data were collected using self-report questionnaires, including the following tools: self-designed socio-demographic questionnaire, psychological capital scale, job satisfaction scale, and work engagement scale. RESULTS Compared with general nurses, the nurse specialists had higher psychological capital, job satisfaction, and work engagement. Job satisfaction partially mediated the positive association between psychological capital and work engagement and the indirect effect was stronger in nurse specialists in comparison to general nurses during the COVID-19 pandemic. CONCLUSION The findings provide important practical implications for future intervention programs aimed at enhancing nurses' work engagement, which may be realized through strengthening psychological capital and job satisfaction during the pandemic. Moreover, considering the cost-effectiveness of limited health care spending, nursing managers should pay more attention to the continuing professional development of young general nurses.
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Affiliation(s)
- Minyi Zhang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Hongyu Chen
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Ning Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Yao Li
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Xiaofei Li
- Department of Transplantation/Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Yan Liu
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
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18
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Jokiniemi K, Heikkilä A, Meriläinen M, Junttila K, Peltokoski J, Tervo-Heikkinen T, Mattila E, Mikkonen S. Advanced practice role delineation within Finland: A comparative descriptive study. J Adv Nurs 2021; 78:1665-1675. [PMID: 34655100 DOI: 10.1111/jan.15074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/18/2021] [Accepted: 09/16/2021] [Indexed: 01/10/2023]
Abstract
AIM To identify and differentiate the practice patterns of generalist, specialist and advanced practice nursing roles in specialist and central hospital contexts. BACKGROUND In Finland, as in other Nordic countries, advanced practice nursing roles emerged around 2000. There are over 60,000 registered nurses/midwives in Finland and the clinical career pathway from a registered nurse to advanced practice nurse has been described yet not fully implemented in healthcare organizations. However, the number and activities of nonadvanced and advanced practitioner roles are not well known. DESIGN A descriptive comparative study. METHODS An online self-report survey was conducted between August and October 2020 using an advanced practice role delineation tool. A census sample of registered nurses, registered midwives, specialist nurses and advanced practice nurses in five university hospitals and one central hospital was recruited. Descriptive statistics were used to summarize the characteristics of participants and group differences were compared using analysis of variance (ANOVA). The STROBE checklist was used as the reporting guideline. RESULTS A total of 1497 responses were obtained (response rate = 10%). Overall, nurses used comprehensive care and education activities most frequently. The least used activities were research and publication and professional leadership. Univariate analysis of variance test between role effects, when education and grouped age were taken into account, showed statistically significant difference in all of the observed five activities (p < .001). CONCLUSION Identifying activities in different levels of nursing is a crucial first step in delineating nursing roles thus improving the governance of the human resource management. IMPACT The study results add to the international literature, delineating nursing roles in the spectrum of generalist to advanced practice nursing. As these roles become more formalized, we may incorporate novel ways of promoting the career development and optimal use and assessment of nursing roles and practice in various career levels.
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Affiliation(s)
- Krista Jokiniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Asta Heikkilä
- Development Services, Hospital District of Southwest Finland, Turku, Finland
| | - Merja Meriläinen
- Oulu University Hospital, Medical Research Center (MRC) Oulu, Oulu, Finland
| | - Kristiina Junttila
- Nursing Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Tarja Tervo-Heikkinen
- Clinical Development, Education and Research Centre of Nursing, Kuopio University Hospital, Kuopio, Finland
| | | | - Santtu Mikkonen
- Department of Environmental and Biological Sciences and Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Mei N, Chang L, Zhu Z, Dong M, Zhang M, Zeng L. Core competency scale for operating room nurses in China: Scale development, reliability and validity evaluation. Nurs Open 2021; 9:2814-2825. [PMID: 34247455 DOI: 10.1002/nop2.985] [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: 08/07/2020] [Revised: 03/30/2021] [Accepted: 06/08/2021] [Indexed: 11/06/2022] Open
Abstract
AIMS To develop a competency scale for operating room nurses and test its reliability and validity. BACKGROUND The existing Chinese Registered Nurse Competency Scale and the core competency scale for operating room nurses developed abroad cannot fully meet the capacity needs of Chinese operating room nurses. METHODS The scale was developed based on the results of qualitative interview and the Delphi method. Ten experts were selected for expert consultation, and 300 operating room nurses were recruited by convenience sampling for a cross-sectional survey to test the reliability and validity of instrument.The reliability and validity of the scale was assessed based on internal consistency reliability, test-retest reliability and confirmatory factor analysis. Data collection was conducted between March to July, 2015. RESULTS An initial scale with 42 items was confirmed, and 36 items remained. The internal consistency Cronbach's α was 0.97 for the overall scale and 0.88-0.94 for the subscales. The retest reliability ranged from 0.55-0.96. Five factors were extracted by exploratory factor analysis, and they explained 66% of the total variance. The fitting indices of the confirmatory factor analysis were as follows: χ2/df = 3.47, CFI = 0.83, TLI = 0.81, SRMR = 0.06 and RMSEA = 0.09. CONCLUSIONS The core competency scale for operating room nurses with 5 components and 36 items had acceptable reliability and validity. The scale could continue to be optimized in the future.
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Affiliation(s)
- Na Mei
- The First Affiliated Hospital of Xi 'an Jiaotong University, Xi'an City, China
| | - Ling Chang
- Xi'an Center for Diseases Control and Prevention, Xi'an City, China
| | - Zhonghai Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Xi 'an Jiaotong University Health Science Center, Xi'an City, China
| | - Min Dong
- Data Management and Biometric Department, EDETEK, Inc., Beijing City, China
| | - Min Zhang
- Periodicals Publishing House of Xi'an Jiaotong University, Xi'an City, China
| | - Lingxia Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Xi 'an Jiaotong University Health Science Center, Xi'an City, China
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Egerod I, Kaldan G, Nordentoft S, Larsen A, Herling SF, Thomsen T, Endacott R. Skills, competencies, and policies for advanced practice critical care nursing in Europe: A scoping review. Nurse Educ Pract 2021; 54:103142. [PMID: 34265667 DOI: 10.1016/j.nepr.2021.103142] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Management of critically ill patients is changing due a rise in population age, comorbidity and complexity. To accommodate these changes, the demand is increasing for advanced practice nurses. More knowledge is needed regarding the role of advanced practice critical care nurses in European countries. The aim of the study was to review the literature describing skills and competencies required for advanced practice critical care nursing in Europe and to investigate related policy. REVIEW METHOD We performed a scoping review including papers published in 1992-2019 targeting policy and the intersection of advanced practice nursing (level of practice), critical care nursing (specialty area) and Europe (geographical origin). DESIGN AND DATA SOURCES Main sources of evidence were PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, SweMed+, Scopus, ERIC and Social Sciences Citation Index. We also searched grey literature, webpages, reference lists and performed hand-search. RESULTS The search identified 11,478 papers/references of which 42 were included. Four levels of practice were identified with unclear boundaries: professional nurse, specialized nurse, advanced practice nurse and advanced critical care practitioner (nurse or other). Most skills and competencies described in the literature were generic to advanced practice and only few were area specific to critical care. Advanced practice critical care nurses were often unable to fulfil their role because education, supportive policy and legislation were lacking. CONCLUSIONS This scoping review informs the policy makers and the INACTIC study of existing advanced practice in critical care nursing in Europe. The advanced role in critical care nursing is characterized by inconsistency regarding policy, education, titles, roles, scope of practice, skills and competencies. Levels of practice and areas of specialization need to be clarified. Most skills and competencies identified were generic for advanced practice nursing and many were generic for any profession. Task-shifting from physician to nurse needs to be more clearly defined and patient outcomes described. Given the scarcity of papers in our target area, we believe it might be too early to conduct a systematic review at this time.
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Affiliation(s)
- Ingrid Egerod
- Department of Intensive Care, University of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
| | - Gudrun Kaldan
- Department of Neurology, Copenhagen University Hospital Rigshospitalet Glostrup, Denmark.
| | - Sara Nordentoft
- Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Denmark.
| | - Anders Larsen
- The University Hospitals Centre for Health Research, UCSF, Copenhagen University Hospital Rigshospitalet, Copenhagen Denmark.
| | | | - Thordis Thomsen
- Herlev Acute, Critical and Emergency Care Science Unit (Herlev-ACES), Copenhagen University Hospital Herlev-Gentofte, Denmark.
| | - Ruth Endacott
- School of Nursing and Midwifery, Plymouth University, UK.
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Jokiniemi K, Hølge-Hazelton B, Kristofersson GK, Frederiksen K, Kilpatrick K, Mikkonen S. Core competencies of clinical nurse specialists: A comparison across three Nordic countries. J Clin Nurs 2021; 30:3601-3610. [PMID: 34096111 DOI: 10.1111/jocn.15882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/25/2021] [Accepted: 05/07/2021] [Indexed: 01/10/2023]
Abstract
AIM To describe and compare the clinical nurse specialist core competency use in Finland, Denmark and Iceland. BACKGROUND Clinical nurse specialist roles were first developed more than 60 years ago in the United States. Within the Nordic countries, the clinical nurse specialist role emerged around 2000. There is scarcity of clinical nurse specialist competency descriptions outside of North America, and research has been limited to examine or validate established competencies across different countries. DESIGN A descriptive correlational study. METHODS An online survey was conducted from May to September 2019. A population sample of clinical nurse specialists in Finland, Denmark and Iceland was recruited. A validated self-report questionnaire of clinical nurse specialist competencies was used. The data were analysed using descriptive and inferential statistics, and the STROBE checklist was used as the reporting guideline. RESULTS A total sample of 184 clinical nurse specialists, 52 from Finland, 95 from Denmark and 37 from Iceland, participated in the study (response rate = 72%, 35% and 48%, respectively). Overall, clinical nurse specialists utilised the organisational competency most frequently followed by the patient, clinical nursing leadership and scholarship competency. Univariate analysis of variance test between-country effects showed statistically significant difference in patient competency (p = .000) and in organisational competency (p < .05). There were no statistically significant differences between counties in the utilisation of clinical nursing leadership and scholarship competency. CONCLUSION A small variability was found in the comparison of the clinical nurse specialist use of core competency in the spheres of patient, nursing, organisation and scholarship within three Nordic countries. RELEVANCE TO CLINICAL PRACTICE The CNS competency scale may be utilised in benchmarking clinical nurse specialist roles and practice within and across countries. The long-term goal for the competency descriptions is to enhance the clinical nurse specialist role clarity, integration and evaluation as well as inform post-graduate education.
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Affiliation(s)
- Krista Jokiniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Bibi Hølge-Hazelton
- Institute of Regional Health Research at University of Southern Denmark, Denmark.,Research Support Unit, Zealand University Hospital, Roskilde, Denmark
| | | | | | - Kelley Kilpatrick
- Ingram School of Nursing McGill University, Susan E. French Chair in Nursing Research and Innovative Practice, Montreal, QC, Canada
| | - Santtu Mikkonen
- Department of Environmental and Biological Sciences and Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Dahlberg K, Jaensson M, Flodberg M, Månsson S, Nilsson U. Levels of education and technical skills in registered nurses working in post-anaesthesia care units in Sweden. Scand J Caring Sci 2021; 36:71-80. [PMID: 33559915 DOI: 10.1111/scs.12964] [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: 09/10/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Specialized nursing care should be provided by nurses working in post-anaesthesia care units to ensure safe and successful recovery after surgery and anaesthesia. However, there is no consensus regarding the competence and education needed by nurses working in post-anaesthesia care units. AIM The aim of this study is to describe and compare levels of education and technical skills in registered nurses working in post-anaesthesia care units in Sweden, as well as the education that post-anaesthesia care unit nurse managers' desire for registered nurses working in post-anaesthesia care units. METHODS This descriptive cross-sectional study was conducted in Sweden between September and December of 2019. A web-based survey was developed that included questions about the levels of education and technical skills possessed by registered nurses working in Swedish post-anaesthesia care units and desired by nurse managers for these nurses. The survey was evaluated for content validity by four experts. The survey was distributed to the nurse manager of each studied post-anaesthesia care unit. All nurse managers received written information and were informed that submitting the survey was considered as consenting to participate in the study. RESULTS Most surveyed nurses held a postgraduate diploma in specialist nursing. Registered nurses performed many tasks autonomously; however, there was a significant difference between specialist nurses and registered nurses, with specialist nurses being more autonomous than registered nurses. Most of the nurse managers (n = 31/45) wanted the registered nurses in their units to have education in postoperative care. The relatively low overall response rate of 58% is a study limitation. CONCLUSIONS Registered nurses working in post-anaesthesia care units in Sweden must have various technical skills. Some of these skills are only performed by specialist nurses, indicating that postoperative care is an advanced level of nursing care.
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Affiliation(s)
- Karuna Dahlberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Magnus Flodberg
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Månsson
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrica Nilsson
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.,Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden
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Jansson J, Josse Eklund A, Larsson M, Nilsson J. Prehospital care nurses' self reported competence: A cross-sectional study. Int Emerg Nurs 2020; 52:100896. [PMID: 32763799 DOI: 10.1016/j.ienj.2020.100896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/22/2020] [Accepted: 07/01/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The Swedish ambulance service has undergone major changes in recent decades due to advancements being made in medical and technical resources, professional competence, and patient care. Registered and specialist nurses share the same role, accountabilities, and responsibilities in the ambulance service, and their professional competence has not yet been evaluated. OBJECTIVES The aim of the study was to investigate and compare self-reported professional competence among nurses working in the ambulance service and to explore associations between potentially predictive background factors and self-reported professional competence. METHOD A cross-sectional study with a digital questionnaire was used for collecting data from 34 registered nurses and 71 specialist nurses. The Ambulance Nurse Competence Scale and the Research Utilization Questionnaire were used for data collection. RESULTS Significant differences were found among the nursing categories in terms of age, gender, education, and work experience. Prehospital emergency nurses reported the highest professional competence. Nurses with a master's degree did not report significantly higher professional competence than nurses with a bachelor's degree. CONCLUSIONS The findings indicated that there are differences in the professional competence of registered nurses and specialist nurses. Length of work experience in the ambulance service is an important factor associated with higher professional competence.
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Affiliation(s)
- Jörgen Jansson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, SE-651 88 Karlstad, Sweden.
| | - Anna Josse Eklund
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, SE-651 88 Karlstad, Sweden
| | - Maria Larsson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, SE-651 88 Karlstad, Sweden
| | - Jan Nilsson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, SE-651 88 Karlstad, Sweden; Department of Health Promotion Sciences, Sophiahemmet University, SE-114 86 Stockholm, Sweden
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Mårtensson G, Lind V, Edin K, Hedberg P, Löfmark A. Development and validation of a clinical assessment tool for postgraduate nursing education: A consensus-group study. Nurse Educ Pract 2020; 44:102741. [PMID: 32145493 DOI: 10.1016/j.nepr.2020.102741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 10/23/2019] [Accepted: 02/19/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Gunilla Mårtensson
- Faculty of Engineering and Sustainable Development, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden.
| | - Viveca Lind
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Kerstin Edin
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Pia Hedberg
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Anna Löfmark
- Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22, Uppsala, Sweden
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Wallin K, Hörberg U, Harstäde CW, Elmqvist C, Bremer A. Preceptors´ experiences of student supervision in the emergency medical services: A qualitative interview study. NURSE EDUCATION TODAY 2020; 84:104223. [PMID: 31726285 DOI: 10.1016/j.nedt.2019.104223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/30/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Clinical placements play a central part in the education of future emergency medical services (EMS) staff and their development of clinical skills and competence. A key aspect of students' integration of theory and praxis and development into an independent clinician is a supportive mentorship with the preceptor. However, students report barriers for learning within the EMS, while the preceptors' experiences of their role have received scant attention in research. OBJECTIVES To describe preceptors' experiences of student supervision in the EMS during clinical placements. DESIGN A descriptive qualitative design was used. Twenty specialist nurses were recruited among EMS staff from all parts of Sweden. METHODS Data were collected using individual interviews and analyzed with latent qualitative content analysis. FINDINGS EMS preceptors develop a competence in combining caring and learning adapted to individual student needs when facing students with varying needs in an ever-changing healthcare setting. A trustful relationship between student and preceptor is fundamental when coping with a dual responsibility for student and patient needs. However, several aspects in the EMS setting hinders the preceptors' ability to support the development of the students' independence. Surrounding support structures are important if the preceptors are to feel safe and secure in their role as assessor, teacher and ambulance nurse. CONCLUSIONS Preceptors need to develop a didactic flexibility through preceptor courses adapted to the complex premises found in the EMS. Ambulance services and universities should recognize the importance of preceptors´ colleagues, student continuity, university support and cooperation for improving quality and clarity in supervision during clinical placements.
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Affiliation(s)
- Kim Wallin
- Centre of Interprofessional Cooperation within Emergency care (CICE), Sweden; Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
| | - Ulrica Hörberg
- Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
| | | | - Carina Elmqvist
- Centre of Interprofessional Cooperation within Emergency care (CICE), Sweden; Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
| | - Anders Bremer
- Centre of Interprofessional Cooperation within Emergency care (CICE), Sweden; Faculty of Health and Life sciences, Linnaeus University, 351 95 Växjö, Sweden.
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Gutiérrez-Rodríguez L, García Mayor S, Cuesta Lozano D, Burgos-Fuentes E, Rodríguez-Gómez S, Sastre-Fullana P, de Pedro-Gómez JE, Higuero-Macías JC, Pérez-Ardanaz B, Morales-Asencio JM. Competencias en enfermeras Especialistas y en Enfermeras de Práctica Avanzada. ENFERMERIA CLINICA 2019; 29:328-335. [DOI: 10.1016/j.enfcli.2019.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 10/01/2019] [Indexed: 11/15/2022]
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Boman E, Levy‐Malmberg R, Fagerström L. Differences and similarities in scope of practice between registered nurses and nurse specialists in emergency care: an interview study. Scand J Caring Sci 2019; 34:492-500. [DOI: 10.1111/scs.12753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Erika Boman
- Department of Nursing and Health Sciences Faculty of Health and Social Sciences University of South‐Eastern Norway Drammen Norway
- Department of Nursing Åland University of Applied Sciences Mariehamn Finland
| | - Rika Levy‐Malmberg
- Department of Nursing and Health Sciences Faculty of Health and Social Sciences University of South‐Eastern Norway Drammen Norway
- Department of Health Care Novia University of Applied Sciences Vaasa Finland
| | - Lisbeth Fagerström
- Department of Nursing and Health Sciences Faculty of Health and Social Sciences University of South‐Eastern Norway Drammen Norway
- Department of Caring Science Faculty of Education and Welfare Studies Åbo Akademi University Vaasa Finland
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Jokiniemi K, Suutarla A, Meretoja R, Kotila J, Axelin A, Flinkman M, Heikkinen K, Fagerström L. Evidence-informed policymaking: Modelling nurses' career pathway from registered nurse to advanced practice nurse. Int J Nurs Pract 2019; 26:e12777. [PMID: 31486193 DOI: 10.1111/ijn.12777] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 07/05/2019] [Accepted: 07/12/2019] [Indexed: 01/10/2023]
Abstract
AIM To formulate, validate, and disseminate policy, modelling nurses' career pathway from registered to advanced practice nurse. METHOD The evidence-informed policy and practice pathway framework was utilized. Multiple methods were used, including scoping review of literature, consultation of key informants, survey study, and expert group round-table discussions during 5-year project between 2013 and 2018. RESULTS Through (a) sourcing, (b) using, and (c) implementing the evidence, the expert group worked systematically to formulate a policy on a career pathway from registered to advanced practice nurse. The formulated career pathway includes three competence levels: registered nurse, specialized nurse, and advanced practice nurse, which includes the roles of nurse practitioner and clinical nurse specialist. In addition, validation and dissemination of the policy, as well as its effective implementation and the process of integrating it into practice, were examined. CONCLUSION Evidence-informed policymaking is an effective, interactive way to work collaboratively in achieving consensus and translating knowledge into practice. The formulated policy will contribute to the increased awareness, acknowledgement, and implementation of the registered nurses' traditional and new roles within health care environments. Implementing and integrating the policy in national health care policy, legislation, education, and organizations across the country is a work in progress.
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Affiliation(s)
- Krista Jokiniemi
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | | | - Riitta Meretoja
- Department of Nursing Science, University of Turku, Turku, Finland.,Research Management, Helsinki University Hospital, Helsinki, Finland
| | - Jaana Kotila
- Neurocenter, Helsinki University Hospital, Helsinki, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Mervi Flinkman
- Branch of Societal Relations and Development, Tehy-The Union of Health and Social Care Professions, Helsinki, Finland
| | - Katja Heikkinen
- Faculty of Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
| | - Lisbeth Fagerström
- Faculty of Education and Welfare, Åbo Akademi University, Vaasa, Finland.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Kaldan G, Nordentoft S, Herling SF, Larsen A, Thomsen T, Egerod I. Evidence characterising skills, competencies and policies in advanced practice critical care nursing in Europe: a scoping review protocol. BMJ Open 2019; 9:e031504. [PMID: 31494624 PMCID: PMC6731915 DOI: 10.1136/bmjopen-2019-031504] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The management of critically ill patients is challenged by increasing population age and prevalence of comorbid diseases. High-quality intensive care nursing practice is imperative to accommodate these issues. The roles of the nurse practitioner (NP) and the acute care NP have existed for decades in the USA, Canada and Australia but are still evolving in Europe. Some European countries have introduced the advanced practice nurse (APN), but the current standard of the advanced level of nursing is variable and consensus regarding the framework, role and definition is lacking. Literature and evidence are sparse as well. Identification of skills and competencies required for the APN is warranted. Mapping skills and competencies will enable future educational harmonisation and facilitate mobility of the advanced-level intensive care nursing workforce across Europe. The aim of our scoping review is to identify literature describing skills, competencies and policies characterising advanced nursing practice in intensive care across Europe. METHODS AND ANALYSIS We will apply a five-stage scoping review methodology with a comprehensive systematic literature search as outlined by Arksey and O'Malley. In collaboration with a research librarian, we will search nine interdisciplinary databases and grey literature for publications originating in European countries in 1992-2018. Using a two-stage screening process with Covidence to remove duplicates, we will first scan the title and abstract and then perform full-text review to determine the eligibility of the papers. Qualitative content analysis will be used to chart the data. ETHICS AND DISSEMINATION Our study is a part of the European Union-funded INACTIC project (International Nursing Advanced Competency-based Training for Intensive Care) with the overall aim of developing a common European curriculum for advanced practice critical care nursing. Results from this scoping review mapping the evidence of APNs in Europe will be presented at national and international conferences and published in a peer-reviewed journal.
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Affiliation(s)
- Gudrun Kaldan
- Research Unit 7831, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sara Nordentoft
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Anders Larsen
- Department UCSF 9701, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Thordis Thomsen
- Department of Anaesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark
| | - Ingrid Egerod
- Intensive Care Unit 4131, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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Sundler AJ, Blomberg K, Bisholt B, Eklund A, Windahl J, Larsson M. Experiences of supervision during clinical education among specialised nursing students in Sweden: A cross-sectional study. NURSE EDUCATION TODAY 2019; 79:20-24. [PMID: 31085423 DOI: 10.1016/j.nedt.2019.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 03/22/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The importance of the clinical learning environment in nurse education has gained increasing attention over the last decades. However, there is a lack of research on the learning environment, its significance and meaning in specialist nurse education. OBJECTIVE The objectives of the study were to investigate specialised nursing students' experiences of supervision during clinical practice and to compare students who were satisfied with the supervision with those who were dissatisfied with respect to a) organisation of supervision and number of preceptors, as well as time allocated by preceptors for b) supervision, c) reflection, d) discussion of intended learning outcomes, and e) assessments of students' performance by preceptors. DESIGN This study used a cross-sectional design. SAMPLE AND SETTINGS A convenience sample of specialised nursing students was derived from five Swedish universities in the years 2016 and 2017. METHODS Data were collected using a questionnaire. Statistical analyses and a qualitative conventional content analysis were performed. RESULTS While almost all specialised nursing students reported that there had been time for discussion on their performance assessment, almost half of the students reported not getting time for supervision, or time for reflections and discussions on intended learning outcomes with the preceptor. Students reporting having time allocated for supervision by preceptors were found to be more satisfied with supervision. It was described as important that the preceptor(s) acknowledged the students previous work experiences. Even though being a registered nurse, reflections and feedback were described as valuable for the students learning. Several preceptors were described as positive allowing a broader picture and different views regarding working as a specialist nurse. CONCLUSIONS This study indicates that supervision, in terms of discussions and reflections, of specialised nursing students is significant for learning experiences and satisfaction during clinical placement.
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Affiliation(s)
- Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
| | - Birgitta Bisholt
- Faculty of Health, Science and Technology, Department of Health Sciences, Karlstad University, Sweden
| | - Anna Eklund
- Faculty of Health, Science and Technology, Department of Health Sciences, Karlstad University, Sweden
| | - Jenny Windahl
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
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Vejzovic V. Professionals' experiences with paediatric colonoscopy: an interview study. BMC Nurs 2019; 18:7. [PMID: 30911284 PMCID: PMC6416969 DOI: 10.1186/s12912-019-0331-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 02/25/2019] [Indexed: 12/31/2022] Open
Abstract
Background Colonoscopy plays a crucial role in the diagnosis of paediatric inflammatory bowel disease (IBD), adolescents comprise 25% of all cases of IBD. Several studies have found that a safe, informative, and effective colonoscopy, performed in a child-friendly atmosphere with minimal distress to the child, is difficult to achieve. The aim of this study was to describe nurse’s experiences of the pre-colonoscopy procedure prior in children. Methods A qualitative design with a thematic content analysis approach was used. Fifteen nurses at a children’s hospital participated in interviews regarding their experiences of the bowel cleansing procedure with PEG in children. Results Four key themes were extracted from the nurses’ experiences; lack of knowledge, challenges surrounding information, responsibility without control and assembly line- like procedure.. Conclusions This study shows that nurses feel that they need more time and education opportunities before involved in paediatric colonoscopies.
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Affiliation(s)
- Vedrana Vejzovic
- Department of Care Science, Malmö University, Faculty of Health and Society, SE-205 06 Malmö, Sweden
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Marcinowicz L, Andersson EK, Bohman DM, Hjelm M, Skarbalienė A, Shpakou A, Kalinowska P, Jamiolkowski J. Nursing students' perception of the professional nurse's role in four European countries. Int Nurs Rev 2018; 66:250-258. [PMID: 30378683 DOI: 10.1111/inr.12494] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Understanding how nursing students in European countries perceive their future professional role is an important step in creating awareness of the diversity and similarities between countries. Investigating nursing students' perceptions of their future profession could help in the design of education and the retention of nurses. AIM To compare nursing students' perceptions of the professional nurse's role between Belarus, Lithuania, Poland and Sweden. METHOD A cross-sectional design was implemented. The study used two scales of the Professional Nursing Image Survey, which has questions about 10 skills and abilities and 14 functions and duties of a nurse. RESULTS A total of 392 final-year nursing students in four countries participated in the study. Statistically significant differences were found between countries in terms of all 10 skills and abilities and in the distribution of responses concerning functions and duties of a nurse. CONCLUSIONS Nursing students in Belarus, Lithuania, Poland and Sweden perceive differently the role of a nurse in terms of some functions and responsibilities. This may influence the adaptation of nurses who enjoy freedom of movement among the countries. IMPLICATIONS FOR NURSING POLICY The knowledge gained in this study could be beneficial in improving nursing education, as it could illuminate the discrepancy between educational goals and students' perceptions of their future professional role.
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Affiliation(s)
- L Marcinowicz
- Department of Primary Health Care, Medical University of Bialystok, Białystok, Poland
| | - E K Andersson
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - D M Bohman
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - M Hjelm
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - A Skarbalienė
- Department of Nursing, Klaipeda University, Klaipeda, Lithuania
| | - A Shpakou
- Department of Sport Medicine and Rehabilitation, Yanka Kupala State University of Grodno, Grodno, Belarus
| | - P Kalinowska
- Department of Primary Health Care, Medical University of Bialystok, Białystok, Poland
| | - J Jamiolkowski
- Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Białystok, Poland
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Irish Respiratory Clinical Nurse Specialists' Experiences of Their Role: A Qualitative Exploration. CLIN NURSE SPEC 2018; 32:240-248. [PMID: 30095523 DOI: 10.1097/nur.0000000000000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM AND OBJECTIVES The aim of this study was to explore respiratory clinical nurse specialists' (CNSs') experiences of their role. BACKGROUND Respiratory illnesses are currently 1 of the top 3 causes of mortality resulting in 1 in 5 deaths and are associated with significant human burden. Respiratory CNSs play a vital role in the management of respiratory disease through supporting improvements in quality of life, reduction of exacerbations, and subsequent hospital admission. While published literature exists regarding the CNS role, there is a dearth of published literature on the respiratory CNS role. DESIGN A qualitative descriptive design allowed the researcher to elicit respiratory CNSs' experiences of their role. METHODS Ethical approval was obtained, CNSs were purposively sampled (n = 10), and data were collected by semistructured interviews, transcribed, and analyzed using content thematic analysis. RESULTS Three themes were identified within the findings: "multidimensional role," "interacting and collaborating," and "advancing the role." CONCLUSIONS Overall the study highlights that respiratory CNSs are active in the role as clinical experts, advocators, educators, collaborators, consultants, and health promoters. These findings recognize the importance of evaluating and building on the current CNS workforce in respiratory care and evaluating future development of the CNS role in specialized aspects of respiratory care in line with population and service needs.
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Kinsella D, Fry M, Zecchin A. Motivational factors influencing nurses to undertake postgraduate hospital-based education. Nurse Educ Pract 2018; 31:54-60. [DOI: 10.1016/j.nepr.2018.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 02/19/2018] [Accepted: 04/30/2018] [Indexed: 11/25/2022]
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Maier CB, Köppen J, Busse R. Task shifting between physicians and nurses in acute care hospitals: cross-sectional study in nine countries. HUMAN RESOURCES FOR HEALTH 2018; 16:24. [PMID: 29801452 PMCID: PMC5970499 DOI: 10.1186/s12960-018-0285-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 04/20/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND Countries vary in the extent to which reforms have been implemented expanding nurses' Scopes-of-Practice (SoP). There is limited cross-country research if and how reforms affect clinical practice, particularly in hospitals. This study analyses health professionals' perceptions of role change and of task shifting between the medical and nursing professions in nine European countries. METHODS Cross-sectional design with surveys completed by 1716 health professionals treating patients with breast cancer (BC) and acute myocardial infarction (AMI) in 161 hospitals across nine countries. Descriptive and bivariate analysis on self-reported staff role changes and levels of independence (with/without physician oversight) by two country groups, with major SoP reforms implemented between 2010 and 2015 (Netherlands, England, Scotland) and without (Czech Republic, Germany, Italy, Norway, Poland, Turkey). Participation in 'medical tasks' was identified using two methods, a data-driven and a conceptual approach. Individual task-related analyses were performed for the medical and nursing professions, and Advanced Practice Nurses/Specialist Nurses (APN/SN). RESULTS Health professionals from the Netherlands, England and Scotland more frequently reported changes to staff roles over this time period vs. the other six countries (BC 74.0% vs. 38.7%, p < .001; AMI 61.7% vs. 37.3%, p < .001), and higher independence in new roles (BC 58.6% vs. 24.0%, p < .001; AMI 48.9% vs. 29.2%, p < .001). A higher proportion of nurses and APN/SN from these three countries reported to undertake tasks related to BC diagnosis, therapy, prescribing of medicines and information to patients compared to the six countries. Similar cross-country differences existed for AMI on prescribing medications and follow-up care. Tasks related to diagnosis and therapy, however, remained largely within the medical profession's domain. Most tasks were reported to be performed by both professions rather than carried out by one profession only. CONCLUSIONS Higher levels of changes to staff roles and task shifting were reported in the Netherlands, England and Scotland, suggesting that professional boundaries have shifted, for instance on chemotherapy or prescribing medicines. For most tasks, however, a partial instead of full task shifting is practice.
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Affiliation(s)
- Claudia B. Maier
- Department of Healthcare Management, Technische Universität Berlin, H 80, Straße des 17. Juni 135, 10623 Berlin, Germany
- Center for Health Outcomes and Policy Research, University of Pennsylvania, School of Nursing, Claire Fagin Hall, 418 Curie Blvd., Philadelphia, PA 19104 United States of America
| | - Julia Köppen
- Department of Healthcare Management, Technische Universität Berlin, H 80, Straße des 17. Juni 135, 10623 Berlin, Germany
| | - Reinhard Busse
- Department of Healthcare Management, Technische Universität Berlin, H 80, Straße des 17. Juni 135, 10623 Berlin, Germany
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Bruce JC, Schmollgruber S, Baumann J. Intercountry master's degree in nursing: policy implications for the Mozambican health system. Int Nurs Rev 2018; 65:425-433. [PMID: 29574806 DOI: 10.1111/inr.12439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE Within an overarching evaluation framework, this study explored the experiences of course participants and administrators of an intercountry master's degree in nursing between South Africa and Mozambique. The lessons learnt were used to inform nursing and health policy for the Mozambican health system. METHODS Kirkpatrick's four levels of training evaluation and a results-oriented approach to capacity change were integrated to form a hybrid evaluation framework to capture information about course implementation and the context/environment within which it was delivered. The study used quantitative and qualitative methods including a self-administered survey of course participants, document review, in-depth, semi-structured interviews with course administrators and two focus group discussions with course participants. FINDINGS Participants enrolled in the course primarily to gain new knowledge and to improve health outcomes; course participants and administrators responded positively to the course design, course implementation and the quality of teaching. Knowledge and skills gained help to build graduates' confidence and boost their attitude towards nursing. Paradoxically, graduates felt powerless to transfer knowledge and effect change in practice. CONCLUSION This collaborative, capacity development project produced postgraduate nurses in two areas of specialization, namely, critical care and trauma nursing and maternal and neonatal health. While course participants gained significant benefits in new skills and knowledge and a higher degree qualification, the rewards available to them in the public health system remain unclear. IMPLICATIONS FOR NURSING AND HEALTH POLICY Lessons learnt may serve to influence policy decisions about the role of the Ministry of Health and other stakeholders in sustaining the output and quality of postgraduate nurses for the Mozambican health system. A strategic approach informed by multilevel policies at government, organizational and managerial levels should be adopted to systematically minimize and remove barriers to the transfer and utilization of knowledge and skills in the workplace.
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Affiliation(s)
- J C Bruce
- School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - S Schmollgruber
- School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - J Baumann
- School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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37
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Wangensteen S, Finnbakk E, Adolfsson A, Kristjansdottir G, Roodbol P, Ward H, Fagerström L. Postgraduate nurses' self-assessment of clinical competence and need for further training. A European cross-sectional survey. NURSE EDUCATION TODAY 2018; 62:101-106. [PMID: 29306748 DOI: 10.1016/j.nedt.2017.12.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 11/15/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Nursing practice requires application of knowledge, skills and values in various combinations and has undergone substantial changes the last decades. An increased focus on inter-professional collaboration and possible new and more independent roles for nurses are described. A variety of programs have been developed in order to educate registered nurses (RN) to meet the changes and demands in health and nursing care throughout the world. AIM The aims were to 1) describe nurses' self-assessment of clinical competence and need for further training, and 2) explore possible differences between nurses in specialist vs master's programs. METHODS A cross-sectional survey design was applied. 97 nurses in postgraduate programs from five countries responded (response rate 45%). A revised version of the Professional Nurse Self-Assessment Scale of clinical core competencies (PROFFNurseSASII) was used for data collection. Independent student t-test and regression analyses were carried out. RESULTS The respondents rated their competence highest in taking full responsibility, cooperation with other health professionals and in acting ethically. Items where they considered themselves needing further training most were competence on medications, interaction and side effects and differential diagnoses. For all items, nurses in master's programs rated their competence higher than nurses in the specialist programs. Nurses in specialist programs rated their need for more training for all items higher than nurses in master's degree programs, and for 47 out of the 50 items these differences were statistically significant. CONCLUSION Even though the nurses rated their competence high for important competence aspects such as taking responsibility and cooperation with other health professionals, it is worrying that their need for further training was highest for effects and interaction of various types of medications. Further studies are needed to conclude if and how master's education improves patient outcome.
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Affiliation(s)
- Sigrid Wangensteen
- NTNU, Norwegian University of Science and Technology, Department of Health Sciences in Gjøvik, Norway.
| | - Elisabeth Finnbakk
- Lovisenberg Diaconal University College, Norway, School of Health and Medicine, Örebro University, Sweden.
| | - Annsofie Adolfsson
- School of Health and Medicine, Örebro University, Sweden; Center for Women's Family and Child Health, Faculty of Health Science, University College of Southeast Norway, Norway.
| | | | | | - Helen Ward
- London South Bank University, United Kingdom.
| | - Lisbeth Fagerström
- University College of Southeast Norway, Norway; Åbo Academy University, Finland.
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Bernez L, Batt M, Yzoard M, Jacob C, Trognon A, Verhaegen F, Danan JL, Fescharek R, Rivasseau-Jonveaux T. Jardin thérapeutique, outil de prévention du burnout. PSYCHOLOGIE FRANCAISE 2018. [DOI: 10.1016/j.psfr.2017.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Adibelli D, Turan GS, Çınar H. A new system for nursing specialisation: the thoughts and opinions of nurses. J Res Nurs 2017. [DOI: 10.1177/1744987117706723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Derya Adibelli
- Assistant Professor, Kumluca Health Science Faculty, Akdeniz University, Turkey
| | - Gökçe S Turan
- Instructor, Söke Vocational School of Health Services, Adnan Menderes University, Turkey
| | - Halise Çınar
- Instructor, Söke Vocational School of Health Services, Adnan Menderes University, Turkey
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Abstract
OBJECTIVES This survey had three key objectives: 1) To describe responsibility for key ventilation and weaning decisions in European PICUs and explore variations across Europe; 2) To describe the use of protocols, spontaneous breathing trials, noninvasive ventilation, high-flow nasal cannula use, and automated weaning systems; and 3) To describe nurse-to-patient staffing ratios and perceived nursing autonomy and influence over ventilation decision making. DESIGN Cross-sectional electronic survey. SETTING European PICUs. PARTICIPANTS Senior ICU nurse and physician from participating PICUs. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Response rate was 64% (65/102) representing 19 European countries. Determination of weaning failure was most commonly based on collaborative decision making (81% PICUs; 95% CI, 70-89%). Compared to this decision, selection of initial ventilator settings and weaning method was least likely to be collaborative (relative risk, 0.30; 95% CI, 0.20-0.47 and relative risk, 0.45; 95% CI, 0.32-0.45). Most PICUs (> 75%) enabled physicians in registrar (fellow) positions to have responsibility for key ventilation decisions. Availability of written guidelines/protocols for ventilation (31%), weaning (22%), and noninvasive ventilation (33%) was uncommon, whereas sedation protocols (66%) and sedation assessment tools (76%) were common. Availability of protocols was similar across European regions (all p > 0.05). High-flow nasal cannula (53%), noninvasive ventilation (52%) to avoid intubation, and spontaneous breathing trials (44%) were used in approximately half the PICUs greater than 50% of the time. A nurse-to-patient ratio of 1:2 was most frequent for invasively (50%) and noninvasively (70%) ventilated patients. Perceived nursing autonomy (median [interquartile range], 4 [2-6]) and influence (median [interquartile range], 7 [5-8]) for ventilation and weaning decisions varied across Europe (p = 0.007 and p = 0.01, respectively) and were highest in Northern European countries. CONCLUSIONS We found variability across European PICUs in interprofessional team involvement for ventilation decision making, nurse staffing, and perceived nursing autonomy and influence over decisions. Patterns of adoption of tools/adjuncts for weaning and sedation were similar.
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Harris M, Frey P, Esteva M, Gašparović Babić S, Marzo-Castillejo M, Petek D, Petek Ster M, Thulesius H. How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes. Scand J Prim Health Care 2017; 35:27-34. [PMID: 28277044 PMCID: PMC5361416 DOI: 10.1080/02813432.2017.1288692] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE European cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates. DESIGN Seventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates. SETTING A total of 14 countries. SUBJECTS Consensus groups of PCPs. MAIN OUTCOME MEASURES Probability of initial presentation to a PCP for four clinical vignettes. RESULTS There was no significant correlation between overall national 1-year relative cancer survival rates and the probability of initial presentation to a PCP (r = -0.16, 95% CI -0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r = -0.57, 95% CI -0.83 to -0.12; ovary: r = -0.13, 95% CI -0.57 to 0.38; breast r = 0.14, 95% CI -0.36 to 0.58; bowel: r = 0.20, 95% CI -0.31 to 0.62). CONCLUSIONS There were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a "PCP-as-gatekeeper" system. While there was case-by-case variation, there was no overall evidence of a link between a higher probability of initial consultation with a PCP and poorer cancer survival. KEY POINTS European cancer survival rates vary widely, and health system factors may account for some of these differences. The data from 14 European countries show a wide variation in the probability of initial presentation to a PCP. The degree to which PCPs act as gatekeepers varies considerably from country to country. There is no overall evidence of a link between a higher probability of initial presentation to a PCP and poorer cancer survival.
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Affiliation(s)
- Michael Harris
- Department for Health, University of Bath, Bath, United Kingdom
- CONTACT Michael Harris Gore Cottage, Old Gore Lane, Emborough, Radstock, BA3 4SJ, UK
| | - Peter Frey
- Berner Institut für Hausarztmedizin, Universität Bern, Bern, Switzerland
| | - Magdalena Esteva
- Majorca Primary Health Care Department & Instituto de Investigación sanitaria Illes Balears (idISBA), Palma Mallorca, Spain
| | - Svjetlana Gašparović Babić
- Department for Health Education and Health Promotion, Teaching Institute of Public Health of Primorsko-Goranska County, University of Rijeka, Rijeka, Croatia
| | - Mercè Marzo-Castillejo
- Unitat de Suport a la Recerca, IDIAP Jordi Gol, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Cornellà de Llobregat, 08940, Spain
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Marija Petek Ster
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Lund, Sweden
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Baeza JI, Boaz A, Fraser A. The roles of specialisation and evidence-based practice in inter-professional jurisdictions: A qualitative study of stroke services in England, Sweden and Poland. Soc Sci Med 2016; 155:15-23. [DOI: 10.1016/j.socscimed.2016.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 11/26/2015] [Accepted: 03/01/2016] [Indexed: 10/22/2022]
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Edmonds L, Cashin A, Heartfield M. Comparison of Australian specialty nurse standards with registered nurse standards. Int Nurs Rev 2016; 63:162-79. [PMID: 26748880 DOI: 10.1111/inr.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to determine whether registered nurse Australian specialty competency standards identified unique capabilities of nursing practice. BACKGROUND Use of the term specialist in nursing commenced early in the twentieth century with the growth and diversification of postgraduate nursing education. Courses in speciality nursing were associated with the development of specialty competency standards in Australia. METHOD Australian specialty standards were mapped against the current national competency standards for the registered nurse. Content analysis was used to cross-map the standards to the national standard domains of professional practice, critical thinking and analysis, provision and coordination of care, and collaborative and therapeutic practice. FINDINGS Of the 28 sourced speciality standards, only the nursing informatics standards displayed unique elements of nursing practice. Other nursing capabilities such as leadership and person-centred care were prominent in speciality standards, while more difficult to interpret in the national standards. In addition, developmental and intellectual disability nursing was not evident in the national competency standards. DISCUSSION The findings above identified that nursing informatics were the only specialty standards that displayed unique capabilities of nursing practice when compared with the national competency standards. This raises the question of the value add specialty standards have on practice. CONCLUSION Very few unique capabilities of specialty nursing were expressed in these standards. The study identified that they had more potential in assisting registered nurses to interpret their national competency standards into specialist practice contexts. IMPLICATIONS FOR NURSING AND HEALTH POLICY It is proposed that specific performance indicators of how the registered nurse standards are applied in the specialty context are developed in place of multiple specialty standards.
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Affiliation(s)
- Lisa Edmonds
- School of Health & Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Andrew Cashin
- School of Health & Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Marie Heartfield
- School of Health & Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
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Rautiainen E, Vallimies-Patomäki M. A review of the organization, regulation, and financing practices of postgraduate education in clinical nursing in 12 European countries. NURSE EDUCATION TODAY 2016; 36:96-104. [PMID: 26323886 DOI: 10.1016/j.nedt.2015.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 08/05/2015] [Indexed: 06/04/2023]
Abstract
AIM The aim of this study was to generate information of postgraduate education in clinical nursing in the EU member states. METHODS Data were collected via a structured electronic questionnaire and the questionnaire was sent to the government chief nurses in 26 EU countries in May 2013. Response rate was 46% (n=12). FINDINGS In total, 42 domains of specialization were identified. The most common domains were intensive care, mental health, operating room, emergency care, and pediatrics. Specialization programs were organized by university in two of the respondent countries, as residency program in one country, and as a mix of them in four countries. Regulation practices varied remarkably between the countries: scope of practice, subjects, entry requirements, length of education, description of the minimum competence requirements, and education standards related to the specialization programs were most often regulated by act, decree or other regulation. In some of the countries, no registration was required beyond the initial registration, whereas in some others, registration practices varied depending on the specialization program. New information was gathered on the regulation practices of postgraduate education in clinical nursing in the European Region concerning title provision, entry requirements, and financing practices. The awarded title on specialization programs depended on the level of postgraduate education, and the title might vary between the domains. General clinical experience was included in the entry requirements in seven countries. The government was mainly responsible for financing the postgraduate education in four countries, employer in three countries, and in the rest of the countries, there was a combination of different financiers. CONCLUSIONS The importance of knowledge exchange on postgraduate education across the European countries needs to be acknowledged. Information provided by this study on international regulation practices provides useful information for the policy-makers regarding the organization of the postgraduate education in clinical nursing.
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Affiliation(s)
- Elina Rautiainen
- Department of Clinical Nutrition and Public Health, University of Eastern Finland, Kuopio, Finland
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Duarte SDCM, Queiroz ABA, Büscher A, Stipp MAC. Human error in daily intensive nursing care. Rev Lat Am Enfermagem 2015; 23:1074-81. [PMID: 26625998 PMCID: PMC4664007 DOI: 10.1590/0104-1169.0479.2651] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 06/19/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To identify the errors in daily intensive nursing care and analyze them according to the theory of human error. METHOD Quantitative, descriptive and exploratory study, undertaken at the Intensive Care Center of a hospital in the Brazilian Sentinel Hospital Network. The participants were 36 professionals from the nursing team. The data were collected through semistructured interviews, observation and lexical analysis in the software ALCESTE®. RESULTS Human error in nursing care can be related to the approach of the system, through active faults and latent conditions. The active faults are represented by the errors in medication administration and not raising the bedside rails. The latent conditions can be related to the communication difficulties in the multiprofessional team, lack of standards and institutional routines and absence of material resources. CONCLUSION The errors identified interfere in nursing care and the clients' recovery and can cause damage. Nevertheless, they are treated as common events inherent in daily practice. The need to acknowledge these events is emphasized, stimulating the safety culture at the institution.
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Affiliation(s)
- Sabrina da Costa Machado Duarte
- Doctoral student, Escola de Enfermagem Anna Nery, Universidade Federal
do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Assistant Professor, Escola de Enfermagem
Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Scholarship holder from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
(CAPES), Brazil
| | - Ana Beatriz Azevedo Queiroz
- PhD, Adjunct Professor, Escola de Enfermagem Anna Nery, Universidade
Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andreas Büscher
- PhD, Professor, Hochschule Osnabrück, University of Applied Sciences,
Osnabrück, Germany
| | - Marluci Andrade Conceição Stipp
- PhD, Associate Professor, Escola de Enfermagem Anna Nery, Universidade
Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Endacott R, Jones C, Bloomer MJ, Boulanger C, Ben Nun M, Lliopoulou KK, Egerod I, Blot S. The state of critical care nursing education in Europe: an international survey. Intensive Care Med 2015; 41:2237-40. [PMID: 26429380 PMCID: PMC4626533 DOI: 10.1007/s00134-015-4072-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Ruth Endacott
- School of Nursing and Midwifery, Monash University, Frankston, VIC, Australia.,Plymouth University, Plymouth, UK
| | - Christina Jones
- Institute of Aging and Chronic Disease, Department of Musculoskeletal Biology, University of Liverpool, Liverpool, UK
| | - Melissa J Bloomer
- School of Nursing and Midwifery, Monash University, Frankston, VIC, Australia.
| | | | | | - Katerina K Lliopoulou
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - Ingrid Egerod
- Trauma Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stijn Blot
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia
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Harrington C, Bedford M, Andritschke K, Barrie A, Elfvinge P, Grønhaug S, Mueller-Kagi E, Leenders B, Schrijvers LH. A European curriculum for nurses working in haemophilia. Haemophilia 2015; 22:103-9. [PMID: 26278710 DOI: 10.1111/hae.12785] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Currently, there is no consensus on education required to develop haemophilia nursing. The aim was to develop a curriculum for haemophilia nurses that could be used as a resource in Europe. This could form a basis for continuous professional development and used in the preparation of specialized educational programmes. METHODS The EAHAD nurses working group set out to describe the skills and knowledge needed for a nurse to work in this specialty. This was considered at two levels: basic requirements and at a more advanced level. The working group acted as a focus group for this project drawing on existing specialist training, national role definitions, competencies and results of the EAHAD Nurses survey (2012). A template was populated with the knowledge base and the skills required. RESULTS Themes were analysed and information generated organized into domains: content of curriculum; learning outcomes, defined in terms of knowledge, skills, behaviour and attitudes; and suggestions for teaching methods. For curriculum content the following domains were identified: Applied biological science; treatment and management of haemophilia and associated disorders; genetic practice; care management of affected carriers and women; the impact of living with bleeding disorders; evidence base and applied research in haemophilia practice; and, the specialist role of the haemophilia nurse. Examples are given for teaching and learning process. CONCLUSION This curriculum is intended for use as a strategic resource to outline education for the haemophilia nurse and contribute to the standardization and benchmarking of haemophilia nursing care and thus to improvement in the quality of patient care.
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Affiliation(s)
| | - C Harrington
- The Katharine Dormandy Haemophilia Centre & Thrombosis Unit, Royal Free London NHS Foundation Trust, London, UK
| | - M Bedford
- Canterbury Christ Church University, Kent, UK
| | - K Andritschke
- Haemophilia Centre Rhine Main, Frankfurt-Moerfelden, Germany
| | - A Barrie
- Haemophilia Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - P Elfvinge
- Coagulation Unit, Karolinska University Hospital, Stockholm, Sweden
| | - S Grønhaug
- Centre for Rare Disorders, Department of Rare Disorders and Disabilities, Oslo University Hospital, Rikshopitalet, Norway
| | - E Mueller-Kagi
- Haemophilia treatment centre, University Children's Hospital, Zurich, Switzerland
| | - B Leenders
- The Children's University Hospital, Brussels, Belgium
| | - L H Schrijvers
- Van Creveldkliniek, University Medical Center Utrecht, Utrecht, the Netherlands
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Ranchal A, Jolley M, Keogh J, Lepiesová M, Rasku T, Zeller S. The challenge of the standardization of nursing specializations in Europe. Int Nurs Rev 2015. [DOI: 10.1111/inr.12204] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Ranchal
- Nursing Department; Faculty of Medicine and Nursing; Cordoba University; Cordoba Spain
| | - M.J. Jolley
- Faculty of Health and Social Care; University of Hull; Hull UK
| | - J. Keogh
- Department of Nursing and Health Sciences; Fulda University of Applied Sciences; Fulda Germany
| | - M. Lepiesová
- Jessenius Faculty of Medicine in Martin; Comenius University in Bratislava; Bratislava Slovakia
| | - T. Rasku
- Nursing and Emergency Care; Tampere University of Applied Sciences; Tampere Finland
| | - S. Zeller
- Nursing Department; Winona State University; Winona MN USA
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Richards EA, Cai Y. Integrative Review of Nurse-Delivered Physical Activity Interventions in Primary Care. West J Nurs Res 2015; 38:484-507. [PMID: 25903812 DOI: 10.1177/0193945915581861] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Promotion of physical activity has been a public health priority for decades. The purpose of this integrative review is to examine the effectiveness of nurse-delivered physical activity interventions conducted in primary care settings. Computerized database and ancestry search strategies located distinct intervention trials between 1990 and 2014. Nineteen national and international studies with 7,350 participants were reviewed. The most common intervention was physical activity counseling with supportive or motivational contacts. Few studies utilized exercise training, device-based exercise monitoring, or exercise prescriptions. The most common follow-up durations were 3 to 12 months. Half the studies integrated health behavior theoretical frameworks into the intervention. Almost 80% of the studies reported significant increases in walking, moderate or vigorous physical activity, or overall physical activity in the intervention groups. Interventions successful in increasing physical activity most often utilized tailored techniques such as providing “stage of change”–specific strategies or helping patients set individualized goals.
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Affiliation(s)
| | - Yun Cai
- Purdue University, West Lafayette, IN, USA
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