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Bales G, Hasemann W, Kressig RW, Mayer H. Impact, scope of practice and competencies of Advanced Practice Nurses within APN-led models of care for young and middle-aged adult patients with multimorbidity and/or complex chronic conditions in hospital settings: a scoping review protocol. BMJ Open 2023; 13:e077335. [PMID: 37907288 PMCID: PMC10619075 DOI: 10.1136/bmjopen-2023-077335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/04/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION The increase of young and middle-aged adult patients with multimorbid and/or complex chronic conditions has created new challenges for healthcare systems and services. Advanced Practice Nurses (APNs) play an essential role in treating these patients because of their expertise and advanced nursing skills. Little is known about competencies, scope of practice and impact of APNs within APN-led care models for young and middle-aged adult patients with multimorbidity and/or complex chronic conditions in hospital settings. The objective of this scoping review is to describe the impact, scope of practice and competencies of APNs within APN-led care models for young and middle-aged adult patients in hospital settings. METHODS AND ANALYSIS This scoping review will be conducted using the methodological framework proffered by Arksey and O'Malley, incorporating the methodological enhancement of Levac et al. It will comply with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) for Scoping Reviews' guidelines of Tricco et al. Systematic research will be conducted in the databases MEDLINE (PubMed), CINAHL (EBSCO), EMBASE (Ovid), CENTRAL and PsycINFO (Ovid) using all recognised keywords, index terms and search strings. Grey literature will be scanned. Bibliography of all selected studies will be hand searched. Studies will be selected based on defined inclusion and exclusion criteria, screened by title and abstracts. Data from full-text articles meeting the inclusion criteria will be extracted independently by two authors. Disagreements in evaluation will be discussed and resolved by consensus. Results will be reported in the form of descriptive tables. Narrative summery is used to present the results of the review in the context of the study's objectives and questions. ETHICS AND DISSEMINATION This scoping review does not require ethics approval. The review will be handed in as part of a doctoral thesis and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER OSF 4PM38.
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Affiliation(s)
- Gabriele Bales
- University Department of Geriatric Medicine, FELIX PLATTER, Basel, Switzerland
- Faculty of Social Sciences, Department of Nursing Science, University of Vienna, Vienna, Austria
| | - Wolfgang Hasemann
- University Department of Geriatric Medicine, FELIX PLATTER, Basel, Switzerland
| | - Reto W Kressig
- University Department of Geriatric Medicine, FELIX PLATTER, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Hanna Mayer
- Department of General Health Studies, Division Nursing Science with focus on Person-Centered-Care-Research, Karl Landsteiner University of Health Sciences, Krems, Austria
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A Current Gap Analysis of Education for Clinical Nutrition Managers. TOP CLIN NUTR 2020. [DOI: 10.1097/tin.0000000000000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Giles M, Parker V, Mitchell R, Conway J. How do nurse consultant job characteristics impact on job satisfaction? An Australian quantitative study. BMC Nurs 2017; 16:51. [PMID: 28912667 PMCID: PMC5594556 DOI: 10.1186/s12912-017-0246-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/04/2017] [Indexed: 11/10/2022] Open
Abstract
Background There is a direct link between job satisfaction, nurses’ job performance and improved patient outcomes. Understanding what job characteristics influence job satisfaction is vital if health organizations are to optimize individual employee satisfaction and performance. This is particularly necessary in the Nurse Consultant role, which is a multifaceted role that has evolved to meet the dynamic and changing needs of health services. This study aims to examine how job characteristics influence Nurse Consultant job satisfaction and identify differences across metropolitan and rural contexts. Methods This paper presents quantitative findings that are part of a larger prospective cross sectional mixed method study. An online survey consisting of a variety of job characteristic factors was administered to all NCs working in a large Local Health District in New South Wales, Australia over an 8-week period in 2010. Descriptive analysis identified NC’s perceptions of job satisfaction and job characteristics in their current role and factor and regression analysis identified relationships between these factors. Results Job satisfaction was identified as high (mean 4.3) and is strongly correlated with job autonomy, role clarity, role conflict and job support. A high level of role clarity has a moderating effect on the relationship between job autonomy and job satisfaction. Conclusions Study findings inform how we prepare nurses for the NC role and how managers engage with and support NCs in their role taking into account context. Understanding the factors that influence job satisfaction and role effectiveness gives managers valuable information to assist in positioning and supporting these roles to maximize effectiveness across integrated and contemporary models of health care delivery. Electronic supplementary material The online version of this article (10.1186/s12912-017-0246-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle Giles
- Centre for Nursing and Midwifery Research, Hunter New England Local Health District, Newcastle, NSW 2300 Australia
| | - Vicki Parker
- Centre for Nursing and Midwifery Research, Hunter New England Local Health District, Newcastle, NSW 2300 Australia.,School of Health, University of New England, Armidale, 2351 NSW Australia
| | - Rebecca Mitchell
- School of Business and Law, University of Newcastle, Callaghan, Australia
| | - Jane Conway
- School of Health, University of New England, Armidale, 2351 NSW Australia
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Transition to a New Neonatal Intensive Care Unit: Positive Effects on Staff Working Environment and How the Physical Environment Facilitates Family-Centered Care. J Perinat Neonatal Nurs 2017; 31:75-85. [PMID: 28121762 DOI: 10.1097/jpn.0000000000000232] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
To optimize family-centered care and the staff working environment, the physical care environment should be designed to meet the needs of the infants, their families, and staff. It is important to evaluate the effects of a purpose-built neonatal ward on staff perceptions of job strain, the psychosocial climate, and the appropriateness of the physical environment. This study collected information from staff at a neonatal intensive care unit (NICU), before and after the ward was relocated to a new NICU. Effects were measured using the following variables: job strain, person-centered climate and appropriateness-of-the-physical-environment questionnaires. Data were analyzed using repeated-measures generalized estimating equations and factor analysis. After staff began to work in the new NICU, their job strain significantly increased. At the 2-year follow-up, staff stress levels had returned to preintervention levels. Participating staff perceived the purpose-built neonatal ward as being a significantly more appropriate physical environment for family-centered care of the infants and their families. The staff also perceived the psychosocial climate of the new NICU as significantly more person-centered in terms of having a more homey, comfortable, and everyday ambience and thus experienced as being more supportive. An NICU built according to recommended standards optimized the physical care environment for family-centered care and increased the staff working climate.
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Abraham J, Whiteman B, Coad J, Kneafsey R. Development and implementation of non-medical practitioners in acute care. ACTA ACUST UNITED AC 2016; 25:1129-1134. [DOI: 10.12968/bjon.2016.25.20.1129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jenny Abraham
- Lead Advanced Clinical Practitioner–Surgical Care Practitioner, University Hospitals Coventry and Warwickshire NHS Trust
| | - Becky Whiteman
- Clinical Research Fellow, Centre for Technology Enabled Health Research, Coventry University
| | - Jane Coad
- Associate Dean of Research and Professor in Children and Family Nursing Coventry University
| | - Rosie Kneafsey
- Head of School of Nursing, Midwifery and Health, Coventry University
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Brady AM, Fealy G, Casey M, Hegarty J, Kennedy C, McNamara M, O'Reilly P, Prizeman G, Rohde D. Am I covered?': an analysis of a national enquiry database on scope of practice. J Adv Nurs 2015; 71:2402-12. [DOI: 10.1111/jan.12711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 01/04/2023]
Affiliation(s)
| | - Gerard Fealy
- School of Nursing, Midwifery & Health Systems; University College Dublin; Ireland
| | - Mary Casey
- School of Nursing, Midwifery & Health Systems; University College Dublin; Ireland
| | | | - Catriona Kennedy
- School of Nursing and Midwifery; University of Limerick; Ireland
| | - Martin McNamara
- School of Nursing, Midwifery & Health Systems; University College Dublin; Ireland
| | - Pauline O'Reilly
- Department of Nursing and Midwifery; University of Limerick; Ireland
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Creedon R, McCarthy S, Kennedy J. Nurse prescribers' experiences of recording prescribing data to the Minimum Data Set in Ireland. Br J Community Nurs 2014; 19:594-600. [PMID: 25475674 DOI: 10.12968/bjcn.2014.19.12.594] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study aimed to investigate and enhance understanding of nurse prescribers' experiences of working with the Irish national data gathering system for nurse prescribing: the Minimum Data Set (MDS) in Irish clinical practice. A phenomenological research design was used, collecting data via semi-structured interviews using a purposive sample of practising nurse prescribers. The study identified three recurrent themes: communication, workload/time, and attitudes. The MDS produces only standard national reports (lists) on nurse/midwife prescribing that cannot be utilised efficiently to inform practice or understand health service needs. Nurses have reacted to this situation and evaluate the MDS in the context of their clinical setting, identifying conflicting demands and expectations and an increased workload as factors that correlated negatively with the process of collecting nurse prescribing data. Consultation and evaluation is required, particularly to analyse the nurse prescribers' views of collecting data and working with the MDS in the context of the major adjustments that the Irish health service has experienced over the past 6 years.
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Affiliation(s)
- Rena Creedon
- Lecturer and Nurse Prescribing Programme Coordinator, School of Nursing, University College Cork, Ireland
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Polivka BJ, Chaudry RV. Public Health Nursing Position Descriptions Congruence with ANA Standards, Public Health Essential Services, and Quad Council Domains. Public Health Nurs 2014; 32:532-42. [PMID: 25080134 DOI: 10.1111/phn.12148] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To map position descriptions (PDs) for staff public health (PH) nurses to two national frameworks for PH nursing and one framework for PH. DESIGN AND SAMPLE This descriptive study included PDs (N = 161) from 66 Ohio local health departments. MEASURES Statements in each PD were analyzed for congruence with the twenty 2007 American Nurses Association Public Health Nursing Standards/Substandards (ANA Standards), the 10 Essential Services of Public Health (ES), and the eight 2003 Quad Council Public Health Nursing Skills Domains (QC domains). Health department and PD characteristics also were obtained. RESULTS PDs addressed an average of 6.1 of the 20 ANA Standards, 4 of the 10 ES, and 1.9 of the 10 QC domains. The most commonly addressed ANA Standards, ES, and QC domains focused on assessment, linkages, health education, and regulation enforcement. About 78% of the PDs included task statements that did not correspond to any of the professional frameworks. CONCLUSIONS Findings from this study demonstrate a lack of congruence between the organizational and the disciplinary expectations for PH nurses. Given the increasing focus on PH department accreditation, performance management, and workforce development, PH nursing must address this incongruence to strengthen the profession and the public's health.
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Gardner G, Chang AM, Duffield C, Doubrovsky A. Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice. J Adv Nurs 2012. [DOI: 10.1111/jan.12054] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Glenn Gardner
- Institute for Health & Biomedical Innovation; Queensland University of Technology; Brisbane Queensland Australia
- Centre for Clinical Nursing; Royal Brisbane and Women's Hospital; Queensland Australia
| | - Anne M. Chang
- Institute for Health & Biomedical Innovation; Queensland University of Technology; Brisbane Queensland Australia
- Mater Health Services; Brisbane Queensland Australia
| | - Christine Duffield
- Centre for Health Services Management; University of Technology Sydney; New South Wales Australia
| | - Anna Doubrovsky
- Queensland University of Technology; Brisbane Queensland Australia
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Chang AM, Gardner GE, Duffield C, Ramis MA. Advanced practice nursing role development: factor analysis of a modified role delineation tool. J Adv Nurs 2011; 68:1369-79. [DOI: 10.1111/j.1365-2648.2011.05850.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ross F, Redfern S, Harris R, Christian S. The impact of nursing innovations in the context of governance and incentives. J Res Nurs 2011. [DOI: 10.1177/1744987110387743] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This discursive paper is a structured analysis of four completed national and regional studies carried out in the UK. It sets out retrospectively to explore the impact of key contextual, professional and personal features and mechanisms on innovation and outcomes in nursing and the extent to which these are common or diverge across the studies (cases). As successive governments across the world turn their attention to developing nursing as a means of increasing productivity and effectiveness in health care, there is a need for evidence to inform workforce policy and planning about the circumstances that enable positive levers and mechanisms, which influence outcomes to operate. This analysis takes advantage of recent conceptual work on organisational governance and incentives by asking new questions of established data to illuminate our understanding of the pathway to innovation in nursing. Data from the four evaluations (cases) were aggregated and explored thematically within Davies et al.’s framework (Studying health care organisations — links between governance, incentives and outcomes: a review of the literature. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO). http://www.sdo.nihr.ac.uk/files/project/66-final-report.pdf, 2005) of governance, incentives and outcomes. The themes were grouped into three categories: contextual, professional and personal, and interrogated by inter-researcher scrutiny. Taking account of the limitations of comparing studies carried out for different purposes and in different policy circumstances, there are compelling messages emerging about the organisational support, professional leadership and factors that motivate change and innovation in nursing. The analysis suggests that separating governance from incentives oversimplifies what is a complex interplay between organisational governance and the professional and personal enabling factors supporting innovation. The nature of these relationships deserves further study.
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Affiliation(s)
- Fiona Ross
- Dean and Professor of Primary Care Nursing, (Faculty of Health and Social Care Sciences), Kingston University and St George’s, University of London, UK,
| | - Sally Redfern
- Emeritus Professor of Nursing, (National Nursing Research Unit), King’s College London, UK
| | - Ruth Harris
- Reader in Nursing, (Faculty of Health and Social Care Sciences), Kingston University and St George’s, University of London, UK
| | - Sara Christian
- Research Associate, (Faculty of Health and Social Care Sciences), Kingston University and St George’s, University of London, UK
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Onishi M, Kanda K. Expected roles and utilization of specialist nurses in Japan: the nurse administrators' perspective. J Nurs Manag 2011; 18:311-8. [PMID: 20546471 DOI: 10.1111/j.1365-2834.2010.01070.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This study explored (1) expected roles for specialist nurses in Japan and (2) nurse administrators' experience-based management strategies for effective implementation of these roles. Background In Japan, specialist nurses have begun to be recognized as valuable human resources. However, managerial issues in utilizing specialist nurses, including unclear roles and lack of reports on effective management strategies, remain. METHOD Three focus-group discussions were conducted. Nine nurse administrators participated. Data were analysed using qualitative content analysis techniques. RESULTS The expected roles for specialist nurses were: (1) facilitating general nurses' learning; (2) monitoring and improving the patient care standard; and (3) developing new roles for nursing. Two management strategies were: (1) enhancing specialist nurses' influence, and (2) enhancing specialist nurses' motivation. CONCLUSIONS Specialist nurses are important human resources able to assume responsibility for process improvement in nursing care. Effective ways to enhance specialist nurses' influence and motivation include developing their management and communication skills, and coordinating their workload and relationships with other health care professionals. IMPLICATIONS FOR NURSING MANAGEMENT Process improvement indicators may be useful for evaluating specialist nurses' work. Nurse administrators can contribute to effective implementation of specialist nurses' roles not only by clarifying their roles but also by empowering them to keep up with changing organizational needs.
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Affiliation(s)
- Mami Onishi
- Graduate School of Medicine, The University of Tokyo, Tokyo 113-003, Japan.
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McElhinney E. Factors which influence nurse practitioners ability to carry out physical examination skills in the clinical area after a degree level module - an electronic Delphi study. J Clin Nurs 2010; 19:3177-87. [DOI: 10.1111/j.1365-2702.2010.03304.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Redfern S, Coster S, Evans A, Dewe P. An exploration of personal initiative theory in the role of consultant nurses. J Res Nurs 2010. [DOI: 10.1177/1744987110364916] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim in this paper is to investigate the contribution personal initiative theory makes in understanding the consultant nurse role. The role was introduced in the UK in 2000 to improve patient outcomes, clinical leadership and retention of experienced clinicians. A larger study used a multi-method approach to collect quantitative and qualitative data from focus groups, interviews and a questionnaire administered nationally at two time points. Findings from longitudinal telephone interviews with 30 consultant nurses are the focus of this paper. Three consultant nurses were selected as case studies to examine the potential of personal initiative theory when applied to new nursing roles. The activities of two of the three demonstrated a high level of personal initiative in the job. They persisted in overcoming problems faced in improving practice. The third scored lower: she emerged as a reactive conformist and less likely than the other two to pursue initiatives of her own. Personal initiative theory has potential as a framework for evaluating the consultant nurse role, although further research is needed to test it. The longitudinal analysis revealed a determination to stay in the job and overcome difficult challenges when consultants show initiative and are making progress in achieving change.
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Affiliation(s)
- Sally Redfern
- Professor Emeritus, King’s College London, UK, Visiting Professor, Kingston University and St George’s University of London, Faculty of Health & Social Care Sciences, London, UK,
| | - Samantha Coster
- Research Fellow, King’s College London, School of Nursing and Midwifery, London, UK
| | - Amanda Evans
- Postgraduate Research Student, King’s College London, Division of Applied Biomedical Research, London, UK
| | - Philip Dewe
- Vice-Master of Birkbeck College and Professor of Organizational Behaviour, Birkbeck College, Department of Organizational Psychology, University of London, UK
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McKENNA HUGH, KEENEY SINEAD, HASSON FELICITY. Health care managers’ perspectives on new nursing and midwifery roles: perceived impact on patient care and cost effectiveness. J Nurs Manag 2009; 17:627-35. [DOI: 10.1111/j.1365-2834.2008.00948.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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