The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship

Occupational health nursing and political action

BACKGROUND

Occupational health and safety are central elements of work. Throughout its history as a speciality, occupational health nursing (OHN) has been expanding the development of academic competencies and the improvement of clinical skills.

SOURCES OF EVIDENCE

The literature highlights that OHN is more involved in the application of policies with a public health perspective focused on the well-being of the worker than in their design and development. REFLECTIONS FROM A SOCIO-OCCUPATIONAL AND PROFESSIONAL PERSPECTIVE OF OCCUPATIONAL HEALTH NURSING: From this premise, the current reality contributes to establishing priorities for action, generates consensus as a discipline, induces self-criticism and favours development as a profession. The article points out the strategies that favour political participation in companies, the factors that limit public representation and some of the benefits of establishing this type of initiative in organisations.

CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

The OHN is a key agent of change in the design and development of health policies in the workplace. From a panoramic view of how health strategies can influence companies, and the care of the working population, political awareness and civic participation in its different aspects are part of the commitment to this nursing speciality.

The process of developing and implementing health and nursing policy: Implications of research and opportunities to influence

AIM

To provide insight into the process of developing health and nursing policy and how that process can be influenced by both researchers and nursing leaders.

BACKGROUND

Nurses care for people across the life course from birth to death, in our communities, hospitals, care homes and schools. They have unique insight into how people live their lives and how this affects their health. Despite being well placed to influence health policy, nurses often fail to capitalise on this. At the same time, academics often struggle to identify the policy implications of their research resulting in further missed opportunities to use policy influence.

SOURCES OF EVIDENCE

Classical policy theory, which is predominantly drawn from economics and public administration together with a range of contemporary nursing and health policy studies, is used in this paper to discuss the policy process and opportunities to influence.

DISCUSSION

Researchers need to focus on realistic policy suggestions that aim to raise awareness, highlight policy problems or set the agenda. In turn, nursing leaders, from National Nursing Associations, need to harness evidence to support their efforts to influence policy. In terms of influence, a range of approaches exist, and each lends itself to different parts of the policy cycle.

CONCLUSION

The role nurses can play in health policy is not well developed in many countries. Nursing researchers and leaders are well placed to influence policy but must do so in a clear and pragmatic way recognising that policymakers make decisions despite being faced with conflicting evidence, competing demands and economic imperatives.

IMPLICATIONS FOR NURSING PRACTICE

Recognising that nurses can offer much in terms of policy development, the paper argues that a pragmatic approach based on different forms of influence at different stages is likely to be most successful.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The evidence reviewed in this paper suggests that nursing academics and leaders need to identify realistic policy interventions when examining their own empirical work or identifying ways to individually or collectively influence policymakers.

Original Research: Nurses' Knowledge and Attitudes Regarding the Sustainable Development Goals: A Global Study

BACKGROUND

Nurses have a critical role to play in achieving the United Nations' 17 Sustainable Development Goals (SDGs). While Goal 3 (good health and well-being) is of particular importance to nursing, every SDG contributes to the advancement of universal health and well-being. Yet many nurses are unfamiliar with the SDGs and how they relate to everyday nursing practices.

PURPOSE

The purpose of this study was to examine RNs' knowledge of and attitudes toward the SDGs.

METHODS

This study used a descriptive correlational cross-sectional design. A convenience sample of RNs from multiple countries completed an anonymous online survey that included eight demographic items and 25 items exploring participants' knowledge of and attitudes toward the SDGs. Descriptive, parametric, and nonparametric statistics were used to analyze the data.

RESULTS

The majority of nurses in this study perceived themselves as lacking knowledge of the SDGs. Most wanted to know more, including how they could take action to help achieve the goals. Overall, participants agreed that the SDGs are relevant to nursing practice and that nurses are integral to their advancement. Participants who were younger than age 50, those living in the United States, and those who practiced primarily in a clinical or community setting were more likely than others to self-report lower SDG knowledge scores.

CONCLUSIONS

The study findings contribute to our collective understanding of RNs' knowledge and attitudes regarding the SDGs. They can assist nurse educators and leaders worldwide in developing targeted strategies to better inform nurses and prepare them for actions that will advance these goals. Increasing nurses' knowledge of the SDGs, especially as these goals relate to daily clinical practice, may lead to greater nursing engagement and impact.

Politics of Health Care Politics: A Call to Action

Nursing has been perceived as an apolitical profession. Although some advancements in legislation and political engagement for nursing have occurred, the perception remains; it is considered to be a relatively silent profession in the political and policy arenas. Authors, when trying to describe this phenomenon, have raised questions about whether the nursing profession is political. In addition, the motivation for participation and advocacy, as well as the barriers to these activities, have limited investigation, making it difficult to understand the real reasons behind nursing's political and policy immobility. The purpose of this article is to familiarize readers with politics, policy, and advocacy; levels of state and federal government; and the lawmaking process in different states. The goal is to offer information and identify factors that increase confidence and efficacy when engaging with the political system.

The Level of Political Astuteness in Nursing Leaders: A Baseline Assessment

OBJECTIVE

To assess the baseline knowledge of nursing leaders regarding political advocacy and healthcare policy.

BACKGROUND

Although there has been considerable attention to the need for nurses' involvement in health policy, there has not been a prior assessment of the political astuteness of nursing leaders.

METHODS

Researchers analyzed self-reported data from 101 nursing leaders collected via electronic survey from American Organization for Nursing Leadership members. Descriptive, correlational analysis of data assessing political astuteness and background information was completed.

RESULTS

Half of the nurse leader participants demonstrated slight political astuteness. Nurse executives, including those in chief nursing officer, chief nurse executive, and vice president positions, had higher levels of political astuteness than those in nurse director and manager positions.

CONCLUSION

Nursing leaders have beginning levels of political astuteness. Formal education is recommended to increase the knowledge base of nurse leaders in the areas of understanding the political and legislative process and the skills needed to advocate regarding healthcare policy, thus increasing their level of political astuteness.

Assessing the country-level involvement of nurses in COVID-19 vaccination campaigns: A qualitative study

BACKGROUND

As each country individually manages the COVID-19 pandemic, mass vaccination campaigns have varied considerably. Implementation campaigns often depend on nurses; however, nurses are not consistently involved in higher-level planning, prioritization, and policy development decisions. This study aimed to examine the involvement and engagement of nurses in country-level COVID-19 mass vaccination policies and practices in 10 Office of Economic Cooperation and Development countries, identify barriers and factors to enhancing the engagement of nurses in the evidence-informed mass vaccination decision-making processes, and suggest areas for improvement.

METHODS

A qualitative study using in-depth semi-structured interviews was conducted as a follow-up study to an International Council of Nurses survey. The study sample included a purposeful sample of 14 country-representative nurses from 10 Office of Economic Cooperation and Development countries. Interview questions focused on each country's overall COVID-19 vaccination campaign and policies, participants' perspectives regarding the involvement of nurses in the planning, design, and implementation of the mass vaccination program observed outcomes, and the impact of nursing on the outcomes. Interviews were recorded, transcribed, translated where necessary, coded, and thematically analyzed.

RESULTS

Main areas of involvement identified by participants were membership in advising and decision-making committees, operationalization planning, implementation and coordination processes, education efforts, and nurses' interactions with the media. Seven themes emerged among perceived facilitators of nursing involvement: existing systems and infrastructure, nursing profession-related skills and competencies, communication and messaging, multidisciplinary and interagency work, recognition and visibility of nurses and nursing, trust in nurses, and nursing pride. Meanwhile, perceived barriers included lack of a voice, recognition and appreciation for nursing, workforce-related challenges, decentralization of responsibility and authority, supply and access issues, downstream effects of the pandemic, and non-COVID-related nursing barriers. Three main themes emerged among suggestions made by participants for improved involvement of nursing: culture change within nursing and healthcare, opportunities and momentum to build upon, and perceptions of responsible parties.

CONCLUSIONS

Nurses play a central role in providing health services but are inconsistently included in the policy, planning, and decision-making processes. Findings highlighted the critical importance of nursing leadership roles and expanded roles for nurses. Nursing should be represented by high-level leaders as part of multidisciplinary decision-making groups, educational initiatives for involvement in health policy should be implemented in nursing schools and continuing education, and advocacy and inclusion efforts should utilize bottom-up and top-down approaches concurrently.

Socioecological Analysis of a Nursing Advocacy Skills-Building Activity

BACKGROUND

Advocacy is an expectation of the nursing profession. Nursing curricula should include opportunities for advocacy skills building at multiple levels of potential effect. Analyses of student performances during these advocacy exercises provide insight into how well students understand the multifactorial nature of most public health issues.

METHOD

A socioecological model was used to evaluate nursing students' advocacy responses to food-insecurity scenarios during a guided online discussion activity aimed at advocacy skills building.

RESULTS

Student recommendations were categorized as individual, interpersonal, organizational, community, and policy interventions, with subcategories at each socioecological level.

CONCLUSION

Recommendations are given for future educational research specific to advocacy skills building. Implications for nursing education at each socioecological level also are discussed. [J Nurs Educ. 2023;62(9):509-515.].

Engaging Leadership Competencies Through Population Health Policy Advocacy: A Review of the Evidence

The purpose of this article is to identify the gaps in prelicensure nursing curriculum regarding the teaching and learning of policy advocacy and the necessary nursing leadership competencies that are significant in addressing social determinants of health at an upstream, policy level and to discuss how current prelicensure nursing curricula integrates and applies concepts of population health, policy advocacy, and nursing leadership competencies. The authors performed a conceptual review of the literature, analyzing the current, evidence-based scholarship on the topic in an effort to categorize and describe relevant concepts and outline a relationship between them, by combining the concept terms nursing leadership, policy advocacy, population health policy, nursing education, and social determinants of health. The conceptual review identified gaps in nursing education regarding the preparation of nursing graduates for leadership engagement at the policy level, which presents opportunities for future research and exploration. This article shares the thematic gaps, major findings, and recommendations that resulted. Continued effort should be invested into the development of more robust discussions and curriculum related to population health advocacy and the impact on population health in baccalaureate nursing educational programming.

Relationship between nurses' professional values, empathy, and patience: A descriptive cross-sectional study

AIM

The aim of this study was to determine the relationships between the nurses' professional values and their empathy and patience levels, and the factors affecting them.

METHODS

This descriptive cross-sectional study was conducted with 215 nurses working at a university hospital between February and April 2021. Data were collected using the "Nurse Information Form," "Nurses' Professional Values Scale," "Patience Scale," and "The Toronto Empathy Questionnaire."

FINDINGS

Results of our study revealed that nurses had high scores for the perception of professional values, empathy levels, and patience levels.

CONCLUSIONS

Nurses had high scores for perceptions of professional values, empathy levels, and patience levels. Nurses' demographic characteristics influenced the scores.

Clustering the engagement of Brazilian nurses in political advocacy

OBJECTIVES

to analyze the level of nurses' engagement in political advocacy by performing cluster analysis.

METHODS

observational study, with a quantitative approach. A total of 184 nurses working in primary, secondary, and tertiary care in a city in the south of Brazil completed the Policy Advocacy Engagement Scale. Data analysis consisted of descriptive statistics, cluster analysis, analysis of variance, and chi2. The Institutional Review Board approved the study.

RESULTS

four differentiated clusters were found according to professional experience, level of healthcare complexity, and unit. The cluster analysis revealed that patient advocacy for community-based obtained the highest mean, indicating that political advocacy is effective in organizational environments and that professional qualification favors greater engagement in political advocacy.

CONCLUSIONS

the results reveal that nurses play an active role in political advocacy, seeking to promote positive changes in health, especially those working in tertiary care, the nurse group that obtained the highest means.

Necessary political competences for nurses from the perception of the student body: Cross-sectional study in Spain

BACKGROUND

Nursing should have a fundamental role in the development of health policies. The current state of the educational system regarding leadership-related skills and political competence in nursing students is a field to explore.

OBJECTIVES

To explore Spanish nursing students' perceptions about their political competence.

DESIGN

Cross-sectional study that was carried out between December 2019 and June 2020.

SETTINGS AND PARTICIPANTS

Students of the Degree in Nursing at the Universitat Jaume I (Spain).

METHODS

An ad hoc scale composed of 33 items was designed. Sociodemographic variables of interest for the study were collected, such as participation in organizations. A descriptive analysis of the sample and the scale and a bivariate analysis were carried out.

RESULTS

91.8% (n = 90) of items were answered by women. The 2nd (40.8%, n = 40) and 4th (29.6%, n = 29) courses were the most represented. 29.6% (n = 29) belonged to some association or organization, with sports (31.1%, n = 9), NGOs (17.2%, n = 5), cultural (17.2%, n = 5) and student organizations (13.8%, n = 4) being the most represented. Within these associations, 48.3% (n = 14) of participants claimed to have an active role. Statistically significant differences were observed by course in the Political Knowledge category (p = 0.030). The variables "belonging to an organization" and "having an active role" in it seemed to have more influence on the scale than the rest of the sociodemographic variables.

CONCLUSIONS

Learning strategies must benefit from skills and prior experiences of students to strengthen new learning. It also seems to be important to emphasize that the theoretical basis is important, but that promoting civic participation among students can be very relevant for the acquisition of political competence.

Cluster do engajamento dos enfermeiros brasileiros na advocacia política

RESUMO Objetivos: analisar o nível de engajamento dos enfermeiros na advocacia política por meio da análise de cluster. Métodos: estudo observacional, com abordagem quantitativa. Um total de 184 enfermeiros que atuam na atenção primária, secundária e terciária em uma cidade do sul do Brasil preencheram a Policy Advocacy Engagement Scale. A análise dos dados consistiu em estatística descritiva, análise de cluster, análise de variância e chi2. O Comitê de Ética em Pesquisa aprovou o estudo. Resultados: foram encontrados quatro clusters diferenciados de acordo com a experiência profissional, nível de complexidade assistencial e unidade. A análise de agrupamento revelou que a advocacia do paciente para a comunidade obteve a maior média, indicando que a advocacia política é efetiva em ambientes organizacionais e que a qualificação profissional favorece maior engajamento na advocacia política. Conclusões: os resultados revelam que os enfermeiros exercem um papel ativo na advocacia política, buscando promover mudanças positivas na saúde, principalmente os que atuam na atenção terciária, grupo de enfermeiros que obteve as maiores médias.

The 'sleeping elephant': The role of mentorship of critical care nurses in Zambia

AIM

To develop and evaluate a Zambian context-specific mentorship model that supports registered nurses completing emergency, trauma and critical care programmes in Zambia.

BACKGROUND

In Zambia, emergency and trauma and critical care nursing are relatively new specialties, with education and training programmes less than a decade old. A train the trainer mentorship programme was developed and delivered at two colleges of nursing. Ethics approval was gained in both Zambia and the UK.

SOURCES OF EVIDENCE

Documentary data analysis and focus groups were used. Focus groups included stakeholders and nurses in practice who had completed the train the trainer programme and were using the mentorship model.

DISCUSSION

The critical review of the literature revealed there was a paucity of evidence on the role of mentors in critical care. However, national documentation identified that most post basic education programmes are at Diploma Level with limited content that focuses on bedside teaching, mentorship and assessment content.

CONCLUSION

Feedback from representatives attending the stakeholder workshops and focus groups which included participants who had completed the training programme enabled the mentorship model and workshop to be developed and evaluated.

IMPLICATIONS FOR NURSING PRACTICE

Nurses are the backbone of healthcare systems in Africa and the world. Mentorship and assessment in practice enables nurses to develop the competence and skills to lead practice, support peers and junior colleagues.

IMPLICATIONS FOR NURSING POLICY

This paper has identified the need for a context-specific formalised mentorship model to support specialist practice and this project has provided the foundations for mentorship of emergency, trauma and critical care nurses in Zambia.

Political power and awareness of nursing during the COVID-19 pandemic from the views of senior nursing students

Studying the impact of the COVID-19 pandemic on the current nursing workforce and the training of future nurses is important. This study aimed to assess the views of senior nursing students pursuing health policy courses on the effects of the COVID-19 pandemic on the political power and awareness of nursing profession. Document analysis method, one of the qualitative enhancement patterns, was employed in this study. This study was conducted in a nursing school with a sample comprising 34 nursing students. The data were collected from online homework documents and evaluated with thematic analysis. Students on the effects of the COVID-19 pandemic on the nursing profession were categorized into three main themes and nine subthemes. Students reported that although the visibility of nursing increased during the COVID-19 pandemic, the problems of this profession did not change. The results showed that depoliticization was an important obstacle in the fight against these problems and students stated that the struggle could be realized together with a unified and strong political voice. Students suggested being organized in the struggle against problems, addressing unions and associations, and political awareness and political participation as a remedy.

Development and implementation of a Pacific Island-centred COVID-19 Health Worker Safety Guide

OBJECTIVE

Healthcare workers in Pacific Island Countries face unique workload and infection control hazards because of limited resources, cultural practices and local disease burden. In the context of COVID-19, concern around healthcare worker safety escalated in the region, triggering the need for a relevant resource.

METHODS

We describe a collaborative, participatory action-research approach with a diverse range of local clinicians in Pacific Island Countries to design, develop and implement a practical guideline assisting clinicians to work safely during the pandemic.

RESULTS

The resulting Health Worker Safety Guide for COVID-19 is a relevant and usable protocol developed using local knowledge and now available in several Pacific languages.

CONCLUSION

We recommend a creative approach to facilitate meaningful communication with this group of clinicians, including low resolution technology and use of social media platforms.

Nurses' and midwives' perspectives on participation in national policy development, review and reforms in Ghana: a qualitative study

Background

The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana.

Methods

A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed and analyzed inductively using the content analysis procedures.

Results

Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raised.

Conclusion

The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00545-y.

Privacy, confidentiality, security and patient safety concerns about electronic health records

AIMS

This study explored concerns among nurses working in the United Arab Emirates associated with the use of electronic health records, including privacy, confidentiality, security and patient safety.

BACKGROUND

Given the widespread implementation of electronic health records, there are concerns about data integrity that could jeopardize healthcare quality. Addressing nurses' concerns about data integrity and safety is critical to inform health policies and promote public trust.

METHODS

Nurses working in healthcare settings in the United Arab Emirates (N = 562) were invited to share their concerns about data integrity and patient safety using a mixed-method approach. Data were collected between January and June 2018 via questionnaires and focus group interviews. Following a survey of nurses' concerns about privacy, confidentiality, security and patient safety in electronic health records, six focus groups were held to gain deeper insights about their concerns. Major themes that emerged from the focus groups were extracted to align with the main sections of the questionnaire.

RESULTS

Nurses expressed concern over the security of electronic health records (n = 270, 48%). Administrative-related security, inadequate training and access by unauthorized users were the most frequently reported concerns. The main patient safety concerns were associated with non-technological factors, including lack of audit by staff, poor communication with technology vendors and length of time required for documentation. The focus group results reflected similar issues, with an additional theme being inconsistency in data integrity policies.

CONCLUSIONS AND IMPLICATIONS FOR NURSING/HEALTH POLICY

Frontline nurse managers need to integrate pragmatic policies to support staff compliance with the code of ethics when using online data. Nurses must follow workplace policies that foster reporting of risks to online incident systems to ensure data integrity. A unified health policy based on multidisciplinary partnership is critical to safeguard online data and promote public trust.

Internationalizing nursing curricula in a rapidly globalizing world

Rapid transformations in our globalizing world means there is an urgency for nurse educators to revitalize curricula to prepare nurses better for practice and the emphasis on achieving global health for all has never been greater. Nurses are being urged to collaborate across borders to achieve the United Nations' Sustainable Development Goals, through research, practice, policy and education. Thus, nurse educators and leaders need to consider the critical importance of internationalizing nurses' education at all levels, as well being committed to their roles in curricula reform and using innovative technology. There are challenges to internationalization, but the benefits include helping nurses to grow cultural competence, developing strength in nursing voices globally, capacity building in global health, health policy and advocacy, growing scholarship in nursing across borders, developing the skills and knowledge of nurses from low-income countries, and forming partnerships to work together to achieve global health.