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Almotairy MM, Nahari A, Moafa H, Hakamy E, Alhamed A. Development of advanced practice nursing core competencies in Saudi Arabia: A modified Delphi study. NURSE EDUCATION TODAY 2024; 141:106315. [PMID: 39042982 DOI: 10.1016/j.nedt.2024.106315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 06/24/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Advanced practice nursing requires a diverse set of competencies that define what advanced practice nurses need to know and be able to do to deliver safe, effective, and high-quality healthcare. Given the lack of evidence regarding core competencies and the evolution of advanced practice nursing roles in Saudi Arabia, it is becoming increasingly important to develop core competencies to standardize educational and clinical training programs. OBJECTIVE To define the core competencies of advanced practice nursing in Saudi Arabia. DESIGN Utilizing a modified Delphi design and snowball sampling technique, data were collected between April and July 2023 using an online questionnaire consisting of 28 core competencies that was developed based on an in-depth literature review and a critical analysis of advanced practice nursing core competencies published by leading professional organizations. Two rounds of Delphi surveys were conducted. SETTINGS The study was set in clinical and academic settings in Saudi Arabia. PARTICIPANTS Nursing experts with graduate degrees as advanced practice nurses. RESULTS In Round 1, 34 advanced practice nursing experts reached full consensus on 24 of the 28 core competencies, and four core competencies reached partial consensus. Based on suggestions and feedback from the experts, the investigators revised ten core competencies to reflect the improvement suggestions and created three new core competencies. A total of 26 core competencies were used in Round 2, which achieved a full consensus among the 34 advanced practice nursing experts, under the following six core competency domains: knowledge of advanced practice nursing, person-centered care, professional improvement, professionalism, communication and interprofessional partnership, and leadership and system-based practice. CONCLUSIONS Given the need for a standardized competency framework, the 26 core competencies proposed in our study have the potential to guide education and training in academic programs and facilitate the implementation of advanced practice nursing in clinical settings.
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Affiliation(s)
- Monir M Almotairy
- Department of Nursing Administration and Education, King Saud University College of Nursing, Riyadh, P.O. Box 642, Saudi Arabia.
| | - Ahmed Nahari
- Department of Medical Surgical Nursing, King Saud University College of Nursing, Riyadh, P.O. Box 642, Saudi Arabia
| | - Hamza Moafa
- Department of Community and Psychiatric Mental Health Nursing, King Saud University College of Nursing, Riyadh, P.O. Box 642, Saudi Arabia
| | - Essa Hakamy
- Department of Nursing Administration and Education, King Saud University College of Nursing, Riyadh, P.O. Box 642, Saudi Arabia
| | - Arwa Alhamed
- Department of Pediatric Nursing. College of nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Wiik CK, Vifladt A, Høye S. Catalysts for change: A qualitative study of middle managers' perception of nursing professional competence in primary healthcare. Scand J Caring Sci 2024. [PMID: 39075018 DOI: 10.1111/scs.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/16/2024] [Indexed: 07/31/2024]
Abstract
AIM This study aims to explore middle managers' perception of nursing professional competence within the Norwegian primary healthcare service, a sector vital for managing complex patient needs. DESIGN/METHODS Semi-structured interviews were conducted with four middle managers across different municipalities in Norway. Qualitative content analyses, following Graneheim and Lundman, were used for analysing the transcription of the interviews and the data collected. FINDINGS The qualitative content analysis revealed three main themes: the significance of advanced competence, challenges related to competence development and the necessity for defining advanced competence. The findings indicate that middle managers recognise the importance of advanced nursing competence in providing comprehensive patient care, notwithstanding challenges in manpower and competence enhancement. CONCLUSION This research underlines the significance of investing in increased competence and improved management in primary healthcare and offers valuable insights for healthcare policy and practice to enhance patient care.
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Affiliation(s)
- Choi Kristian Wiik
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Anne Vifladt
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Sevald Høye
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Martinsen R, Ahlin-Søvde S, Grov EK, Andersson EK, Gardulf A. Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study. BMC Nurs 2024; 23:301. [PMID: 38693531 PMCID: PMC11064386 DOI: 10.1186/s12912-024-01930-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/10/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care. AIM The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience. METHODS A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data. RESULTS The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses. CONCLUSIONS The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern.
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Affiliation(s)
- Randi Martinsen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Section of Advanced Nursing, Inland Norway University of Applied Sciences, Elverum, P.B. 400, Norway.
| | - Sigrid Ahlin-Søvde
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Section of Advanced Nursing, Inland Norway University of Applied Sciences, Elverum, P.B. 400, Norway
| | - Ellen Karine Grov
- Faculty of Health Sciences, Oslo Metropolitan University, P.B. 4, St. Olavs plass, Oslo, Norway
| | - Ewa K Andersson
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Ann Gardulf
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Section of Advanced Nursing, Inland Norway University of Applied Sciences, Elverum, P.B. 400, Norway
- Division of Clinical Immunology and Transfusion Medicine, The Unit for Clinical Research, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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Guo H, Zhu W, Li J. Developing a core competency framework for advanced practice nursing in mainland China: a sequential exploratory study. BMC Nurs 2023; 22:179. [PMID: 37221496 DOI: 10.1186/s12912-023-01335-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Advanced Practice Nursing (APN) have been highly valued and an integral part of the health care system. Development and establishment of new APN roles is a complex process that has resulted from a wide variety of reasons, key component is a lack of a competency map delineation and role evaluation. Currently, however, competence framework has not been compared at an international level. In mainland China, APN have been introduced in some organizations but their competency domains have not yet been clearly defined, this study aimed to identify the core competencies for advanced practice nursing. METHODS This study was performed in two phases: first, in-depth and semi-structured individual interviews with 46 participants from key stakeholders were carried out followed by a qualitative content analysis, then an item pool of core competencies was constructed by extracting data from the first phase and the results from previous studies, scales and documents; second, a Delphi technique was conducted with the participation of 28 experts from 7 areas of China to form the final core competency framework for advanced practice nursing. RESULTS Through the qualitative phase, the core competency framework with six domains and 70 items emerged and then entered into the Delphi phase. Twenty-eight of 30 experts finished 2 rounds of Delphi approaches. The final core competencies for advanced practice nursing consisted of six domains with 61 items, including direct clinical nursing practice, research and evidence-based nursing practice, professional development, organization and management, mentoring and consultation, and ethical/legal practice. CONCLUSION This core competency framework consisted of six domains with 61 items can be used in competency-based education to cultivate advanced practice nurses as well as competency level assessment.
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Affiliation(s)
- Hongxia Guo
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
| | - Wei Zhu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Jiping Li
- Nursing Department of West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Emerson MR, Huber M, Mathews TL, Kupzyk K, Walsh M, Walker J. Improving Integrated Mental Health Care Through an Advanced Practice Registered Nurse-Led Program: Challenges and Successes. Public Health Rep 2023; 138:22S-28S. [PMID: 37226950 PMCID: PMC10226067 DOI: 10.1177/00333549221143094] [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] [Indexed: 05/26/2023] Open
Abstract
Integrated and collaborative care delivery models have demonstrated efficacy for the management of psychiatric conditions in the primary care environment, yet organizations struggle with implementation of integrated efforts in clinical practice. Delivering care with a population focus versus face-to-face encounters with individual patients requires financial investment and adjustment in care delivery. We discuss the early implementation process of an advanced practice registered nurse (APRN)-led integrated behavioral health care program, including the challenges, barriers, and successes in the first 9 months of the program (January-September 2021), for an academic institution in the Midwest. A total of 161 Patient Health Questionnaire 9 (PHQ-9) and 162 Generalized Anxiety Disorder (GAD-7) rating scales were completed on 86 patients. The mean PHQ-9 score at the initial visit was 11.3 (moderate depression); after 5 visits, it decreased significantly to 8.6 (mild depression) (P < .001). The mean GAD-7 score at the initial visit was 10.9 (moderate anxiety); after 5 visits, it decreased significantly to 7.6 (mild anxiety) (P < .001). A survey completed by 14 primary care physicians 9 months after program launch revealed improvements in satisfaction with collaboration but, most notably, in perception of access to and overall satisfaction with behavioral health consultation/patient care services. Program challenges included adapting the environment to enhance leadership roles for the program and adjusting to virtual availability of psychiatric support. A case example highlights the value of integrated care along with improved depression and anxiety-related outcomes. Next steps should include efforts that capitalize on nursing leadership strengths while also promoting equity among integrated populations.
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Affiliation(s)
- Margaret R Emerson
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Melanie Huber
- Department of Internal Medicine, The Nebraska Medical Center, Omaha, NE, USA
| | - Therese L Mathews
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kevin Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael Walsh
- Department of Internal Medicine, The Nebraska Medical Center, Omaha, NE, USA
| | - Jerry Walker
- Department of Neurological Sciences, The Nebraska Medical Center, Omaha, NE, USA
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Drott J, Engström M, Jangland E, Fomichov V, Malmström M, Jakobsson J. Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study. BMC Nurs 2023; 22:79. [PMID: 36949475 PMCID: PMC10031911 DOI: 10.1186/s12912-023-01258-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/20/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND A high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development. METHOD This was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%. RESULTS Five domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021). CONCLUSIONS Quality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.
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Affiliation(s)
- Jenny Drott
- Division of Nursing Science, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
- Department of Surgery, Linköping University Hospital, Linköping, Sweden.
| | - My Engström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery Sahlgrenska, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Jangland
- Department of Surgical Sciences, Nursing Research, Uppsala University, Uppsala, Sweden
| | - Victoria Fomichov
- Unit for Public Health and Statistics, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Marlene Malmström
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
| | - Jenny Jakobsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Chair SY, Wong FKY, Bryant-Lukosius D, Liu T, Jokiniemi K. Construct validity of advanced practice nurse core competence scale: an exploratory factor analysis. BMC Nurs 2023; 22:57. [PMID: 36864420 PMCID: PMC9979114 DOI: 10.1186/s12912-023-01203-1] [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: 11/15/2022] [Accepted: 02/08/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Determining the core competence of advanced practice nurses is foundational for promoting optimal design and implementation of advanced practice nursing roles. Core competencies specific to the contexts of the advanced practice nurse in Hong Kong have been developed, but not yet validated. Thus, this study aims to assess the construct validity of advanced practice nurse core competence scale in Hong Kong. METHODS We performed a cross-sectional study using an online self-report survey. Exploratory factor analysis was used to examine the factor structure of a 54-item advanced practice nurse core competence scale through principal axis factoring with direct oblique oblimin rotation. A parallel analysis was conducted to determine the number of factors to be extracted. The Cronbach's α was computed to evaluate the internal consistency of the confirmed scale. The STROBE checklist was used as reporting guideline. RESULTS A total of 192 advanced practice nurse responses were obtained. Exploratory factor analysis led to the final 51-item scale with a three-factor structure, which accounted for 69.27% of the total variance. The factor loadings of all items ranged from 0.412 to 0.917. The Cronbach's alpha of the total scale and three factors ranged from 0.945 to 0.980, indicating robust internal consistency. CONCLUSION This study identified a three-factor structure of the advanced practice nurse core competency scale: client-related competencies, advanced leadership competencies, and professional development and system-related competencies. Future studies are recommended to validate the core competence content and construct in different contexts. Moreover, the validated scale could provide a cornerstone framework for advanced practice nursing roles development, education, and practice, and inform future competency research nationally and internationally.
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Affiliation(s)
- Sek Ying Chair
- grid.10784.3a0000 0004 1937 0482The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, N.T. Shatin, Hong Kong SAR, China ,The Hong Kong Academy of Nursing, Lai Chi Kok, Kowloon, Hong Kong SAR China
| | - Frances Kam Yuet Wong
- The Hong Kong Academy of Nursing, Lai Chi Kok, Kowloon, Hong Kong SAR China ,grid.16890.360000 0004 1764 6123School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR China
| | - Denise Bryant-Lukosius
- grid.25073.330000 0004 1936 8227School of Nursing, McMaster University, Hamilton, ON Canada
| | - Ting Liu
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China.
| | - Krista Jokiniemi
- grid.9668.10000 0001 0726 2490Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Woodman H, Spencer S. Advanced clinical practice in paediatric haematology and oncology: developing a capability document. Nurs Child Young People 2023; 35:27-33. [PMID: 35875922 DOI: 10.7748/ncyp.2022.e1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 01/06/2023]
Abstract
Specialist roles have been developed to provide holistic care to children and young people with cancer, one of which is the advanced clinical practitioner (ACP) in paediatric oncology and haematology. A survey showed that paediatric oncology and haematology ACPs in the UK work in a wide variety of roles and that their numbers vary greatly between treatment centres. The survey also confirmed the need for a national standardised framework delineating the knowledge, skills and expertise required of ACPs working in paediatric oncology and haematology. This article describes the development of a capability document to support and standardise advanced practice in paediatric oncology and haematology. The document reflects the advanced level of critical thinking, autonomy and decision-making required of ACPs and has been endorsed by the Children's Cancer and Leukaemia Group and by the Royal College of Nursing. It is hoped that it will support ACPs to consistently deliver high-quality, safe care for the benefit of children and young people with cancer and their families.
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Affiliation(s)
- Helen Woodman
- oncology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, England
| | - Sally Spencer
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, England
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Zúñiga F, Wicki R, Staudacher S, Basinska K. Wie Pflegeexpert_innen in Deutschschweizer Pflegeheimen ihre Rollenentwicklung gestalten. Pflege 2022; 35:337-343. [DOI: 10.1024/1012-5302/a000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Hintergrund: Die Entwicklung und Aufrechterhaltung der Pflegequalität wird in Schweizer Pflegeheimen oft von Pflegeexpert_innen übernommen. Dabei handelt es sich um diplomierte Pflegefachpersonen mit heterogenem Bildungshintergrund und langjähriger Berufserfahrung. Wie diese ihre Rollenentwicklung in den Pflegeheimen gestalten, ist nicht bekannt. Fragestellung/Ziel: Ziel der Studie ist es darzulegen, wie Pflegeexpert_innen in Pflegeheimen ihre berufliche Rollenentwicklung gestalten. Methode: Wir führten eine qualitative, konstruktivistische Sekundärdatenanalyse von 14 semistrukturierten Interviews mit Pflegeexpert_innen aus Deutschschweizer Pflegeheimen durch. Die Daten wurden induktiv mit einer reflexiven thematischen Analyse ausgewertet. Ergebnisse: Aus den Berichten der 14 Pflegeexpert_innen konnten wir das konstituierende Thema „Vision als Motivation“ und drei Phasen der Rollenentwicklung ableiten. Die Vision, eine gute Pflegequalität für die Bewohner_innen sicherzustellen, motiviert Pflegeexpert_innen zum Rollenaufbau und zur Weiterentwicklung in drei Phasen: 1) „Rolle sukzessive gestalten“; 2) „Rolle kontinuierlich weiterentwickeln“; 3) „Rolle neu ausrichten“. Schlussfolgerungen: Pflegeexpert_innen passen ihre Rolle kontinuierlich an den sich verändernden Kontext an, um an der Pflegequalität arbeiten zu können. Zum Gelingen benötigen sie eine gemeinsame Vision mit ihren Vorgesetzten für die Pflegequalität.
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Affiliation(s)
- Franziska Zúñiga
- Pflegewissenschaft – Nursing Science, Universität Basel, Schweiz
| | - Ruth Wicki
- Pflegewissenschaft – Nursing Science, Universität Basel, Schweiz
- Alterswohnheim Ruswil, Schweiz
| | - Sandra Staudacher
- Pflegewissenschaft – Nursing Science, Universität Basel, Schweiz
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, The Netherlands
| | - Kornelia Basinska
- Pflegewissenschaft – Nursing Science, Universität Basel, Schweiz
- Kantonsspital Aarau, Schweiz
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Phenomenological Study on the Study Experience of Part-Time Nursing Postgraduates. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1948691. [PMID: 35251560 PMCID: PMC8890854 DOI: 10.1155/2022/1948691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022]
Abstract
In this paper, we have explored the experience of studying part-time nursing master degree students and provided a basis for improving the training of domestic part-time nursing master degree students. Using phenomenological research methods, we have conducted face-to-face and semistructured interviews with 14 part-time nursing graduate students, including postgraduate motivation, obstacles, gains, and expectations after postgraduate study. Part-time nursing master’s graduate students are mostly motivated by promotion, self-improvement, solving clinical problems, and role models; barriers to entry include role conflicts, time pressure, economic pressure, curriculum settings that cannot meet needs, unclear responsibilities for training process management, and personal value (cannot reflect, etc.). Study gains include enhancing scientific research confidence, stimulating learning interest, and increasing professional identity. In the training of part-time nursing master’s students, we should correctly guide students’ learning motivation, mobilize social support, and solve students’ learning obstacles. The curriculum of part-time nursing master’s students should be targeted, along with establishing a training management system jointly directed by the training unit and the employer, improving the career planning of nursing master’s students, and making a good connection with the training of senior practical nurses.
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Ljungbeck B, Sjögren Forss K, Finnbogadóttir H, Carlson E. Content in nurse practitioner education - A scoping review. NURSE EDUCATION TODAY 2021; 98:104650. [PMID: 33203544 DOI: 10.1016/j.nedt.2020.104650] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 10/14/2020] [Accepted: 10/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Globally, the role of nurse practitioner is evolving to meet increased healthcare demands. Nevertheless, there are factors hindering the development of this role, one of which involves differences in nurse practitioner education worldwide. Therefore, the objective of the present study is to identify what is known in the research field on the content of nurse practitioner educational programmes. DESIGN AND DATA SOURCES The literature scoping review follows a six-stage methodological framework including: i) formulate research questions, ii) identify relevant studies, iii) select studies, iv) chart data, v) collate, summarize and report the results, vi) consultations. Data bases searched included CINAHL, PubMed and ERIC and were followed by manual searching of reference list in the included papers. Of the 1553 papers identified, 16 met the aim of this study. REVIEW METHODS To answer the research questions 'what is the content of curricula in nurse practitioner education?' a deductive content analysis was used. RESULTS Two main categories emerged. The first was related to the professional nurse practitioner role and includes research and nursing theories, leadership and collaboration, and organizational, political, economic, regulatory and legislative issues. The second is related to becoming an autonomous practitioner and includes health promotion and disease prevention, and other medically oriented content. CONCLUSIONS The content identified is consistent with the core competencies that nurse practitioners are expected to have after graduation, which have been described by the International Council of Nurses and by other researchers. Given the lack of recent research in nurse practitioner education, the results of the present study advance knowledge in this research field. Additionally, this study may be of practical value in developing new nurse practitioner educational programmes.
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Affiliation(s)
- Birgitta Ljungbeck
- Department of Care Science, Faculty of Health and Society, SE 20506 Sweden and Society, Malmö University, SE 20506, Sweden; Municipal Healthcare in Hässleholm, Management of Care and Welfare, Löjtnants Granlunds Väg 12, SE 28152, Sweden.
| | - Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, SE 20506 Sweden and Society, Malmö University, SE 20506, Sweden.
| | - Hafrún Finnbogadóttir
- Department of Care Science, Faculty of Health and Society, SE 20506 Sweden and Society, Malmö University, SE 20506, Sweden.
| | - Elisabeth Carlson
- Department of Care Science, Faculty of Health and Society, SE 20506 Sweden and Society, Malmö University, SE 20506, Sweden.
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Liang HY, Tang FI, Wang TF, Yu S. Evaluation of Nurse Practitioners' Professional Competence and Comparison of Assessments Using Multiple Methods: Self-Assessment, Peer Assessment, and Supervisor Assessment. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 15:30-36. [PMID: 33249140 DOI: 10.1016/j.anr.2020.10.004] [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: 09/19/2019] [Revised: 08/24/2020] [Accepted: 10/14/2020] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Nurse practitioners (NPs) are increasingly important in healthcare as they play a key role in leading advanced nursing practices. Assessing their professional competence is essential. The aim of this study was to evaluate NPs' professional competencies based on at a collaborative model around NP self and compare different methods of assessment. METHODS This is a cross-sectional study, and a purposive sample of 211 participants in the teaching hospital was used. Methods used were self-assessment (nurse practitioners), peer assessment (physicians and nurses) and supervisor assessment (head nurses). RESULTS The competence of nurse practitioners was rated as moderate (mean score = 3.45 of a possible 5; SD = 0.59). However, each method resulted in differences in competence for total scores and dimensions. The highest competence was in direct patient care (mean = 3.55, SD = 0.53), and the lowest score was in monitoring the quality of patient care (mean = 3.30, SD = 0.82). post hoc analysis shown that supervisor assessment rated professional competence significantly lower than the method of self-assessment and peer assessment (F = 10.07, p < .001). CONCLUSION NPs require an increased effort to continuous learning for enhancing professional competencies. Moreover, using multiple methods for assessment to obtain a more comprehensive and accurate evaluation of NPs' professional competence.
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Affiliation(s)
- Hui Yu Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipai, Taiwan
| | - Fu In Tang
- School of Nursing, National Yang Ming University, Taipai, Taiwan
| | - Tze Fang Wang
- School of Nursing, National Yang Ming University, Taipai, Taiwan
| | - Shu Yu
- School of Nursing, National Yang Ming University, Taipai, Taiwan.
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Vo R, Smith M, Patton N. The role of dietitian clinical judgement in the nutrition care process within the acute care setting: a qualitative study. J Hum Nutr Diet 2020; 34:124-133. [PMID: 33009683 DOI: 10.1111/jhn.12820] [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: 06/28/2020] [Revised: 09/05/2020] [Accepted: 09/06/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dietitian clinical decision making in the acute care setting likely incorporates a practitioner's clinical judgement to effectively support patient care. The term 'dietitian clinical judgement' is well used in clinical practice, yet is poorly defined and often used interchangeably with other concepts. The aim of this research was to describe the nature of dietitians' clinical judgement in the acute care setting. METHODS A qualitative design within the interpretative paradigm was used guided by principles of philosophical hermeneutics. Dietitians with at least 3 years experience were invited to participate in two 60-min in-depth semi-structured interviews which were recorded, transcribed and interpreted using hermeneutic principles. A reference group was used to increase rigour and further interpretation of the findings. RESULTS Ten dietitians participated in the interviews and five of these same participants in the reference focus group. The findings revealed clinical judgement to be a sophisticated practitioner dependent meta-reasoning process that helps the dietitian manage complexity, guide interpersonal interactions and individualise patient care. It is characterised by tacit and efficient use of various reasoning strategies reliant on the dietitian's clinical experience, used to synthesise and weigh up various types of information and knowledge with respect to delivering context-relevant care. CONCLUSIONS Dietitian clinical judgement is a necessary part of clinical decision making that extends beyond logical or critical thinking. It facilitates a person-centredness to patient care and professional relationships that are key dimensions to dietitian clinical decision making. These findings provide training and professional development insights to managers, educators and supervisors.
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Affiliation(s)
- R Vo
- Faculty of Science, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - M Smith
- Faculty of Science, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - N Patton
- Faculty of Science, Charles Sturt University, Wagga Wagga, NSW, Australia
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Blanck-Köster K, Roes M, Gaidys U. [Clinical leadership competencies in advanced nursing practice : Scoping review]. Med Klin Intensivmed Notfmed 2020; 115:466-476. [PMID: 32870328 DOI: 10.1007/s00063-020-00716-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/23/2020] [Accepted: 06/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The competencies of advanced practice nurses (APN) include clinical activity in a special field, coaching and consulting, collaboration, leadership, ethical decision-making, and research competence. Clinical leaders initiate and implement changes in the healthcare system and respond to the needs of patients and healthcare institutions. Clinical leadership based on advanced nursing practice can challenge existing management and care structures. OBJECTIVES The aim of the review is to provide an overview of clinical leadership competencies based on advanced nursing practice. The investigated question deals with which roles and competencies of APN are associated with clinical leadership from a national and international perspective. METHODS A systematic search in MEDLINE®(US National Center for Biotechnology Information (NCBI))/PubMed, CINAHL and the Cochrane Library as well as a hand search in library catalogs and journals (April 2019 to January 2020) produced a total of 235 hits. Eight studies were included in the review and analyzed. RESULTS Clinical leadership competencies are increasingly a topic of international studies and can be described and recognized in clinical practice on the basis of leadership models, and the role and leadership domains of APNs. Clinical leadership in nursing practice is recognized when APNs independently control treatment processes in complex nursing situations, exert influence, develop and implement change strategies, consult, coach, train, collaborate, and establish a connection to other health professionals and management. In order for clinical leadership competencies to be effective in nursing care processes, broad support in the multiprofessional team, structural support of the organization and legal legitimation are required. CONCLUSIONS There are hardly any studies in the German-language literature on the relevance, interpretation, and legitimacy of APN clinical leadership. Further research is needed on the interpretation of the roles of APNs, especially clinical leadership competencies, their influence on nursing care processes, leadership structures, and their interaction within the organizational culture.
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Affiliation(s)
- Katrin Blanck-Köster
- Department Pflege & Management, Hochschule für Angewandte Wissenschaften Hamburg, Alexanderstraße 1, 20099, Hamburg, Deutschland. .,Universität Witten/Herdecke, Witten, Deutschland.
| | - Martina Roes
- Universität Witten/Herdecke, Witten, Deutschland
| | - Uta Gaidys
- Department Pflege & Management, Hochschule für Angewandte Wissenschaften Hamburg, Alexanderstraße 1, 20099, Hamburg, Deutschland
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Allvin R, Bisholt B, Blomberg K, Bååth C, Wangensteen S. Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey. BMC Nurs 2020; 19:74. [PMID: 32774153 PMCID: PMC7397675 DOI: 10.1186/s12912-020-00466-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (≤ 0,5 year, > 0,5-5 years, and ≥ 6 years). METHODS A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out. RESULTS Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. CONCLUSIONS Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.
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Affiliation(s)
- Renée Allvin
- Clinical Skills Center, Örebro University Hospital, S-701 85 Örebro, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-702 81 Örebro, Sweden
| | - Birgitta Bisholt
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, S-651 88 Karlstad, Sweden
- Department of Health care Sciences, Ersta Sköndal Bräcke University College, S-100 61 Stockholm, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-702 81 Örebro, Sweden
| | - Carina Bååth
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, S-651 88 Karlstad, Sweden
- Faculty of Health and Welfare, Östfold University College Fredrikstad, N-1757 Halden, Norway
| | - Sigrid Wangensteen
- Department of Health Sciences in Gjøvik, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Abstract
Norwegian municipal health care has large public service offerings, funded by tax revenues; however, the current Norwegian welfare model is not perceived as sustainable and future-oriented. First-line nurse managers in Norwegian municipal health care are challenged by changes due to major political and government-initiated reforms requiring expanded utilization of home nursing. The aim of this theoretical study was to describe challenges the first-line nurse managers in a Nordic welfare country have encountered on the basis of government-initiated reforms and to describe strategies to maintain their responsibilities in nursing care. First-line nurse managers' competence, clinical presence, and support from superiors were identified as prerequisites to maintain sight of the patients in leadership when reforms are implemented. The strategies first-line nurse managers in Norwegian municipal health care use to implement multiple reforms, regulations, and new acts require solid competencies in nursing, leadership, and administration. Competence in nursing enables focus on the patient while leading the staff. Supports from superiors and formal leadership networks are described as prerequisites for managing the challenges posed by change and to persist in leadership positions.
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Henni SH, Kirkevold M, Antypas K, Foss C. Perceptions of the scope of practice of nurse practitioners caring for older adults: level of agreement among different healthcare providers. Scand J Caring Sci 2020; 35:492-501. [PMID: 32323373 DOI: 10.1111/scs.12861] [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: 10/16/2019] [Accepted: 03/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Globally, new nurse practitioner roles have been introduced into interdisciplinary teams. Research indicates that agreement among the different healthcare providers regarding one another's role and scope of practice is important for establishing interdisciplinary teamwork. Lack of agreement regarding a new nurse practitioner's scope of practice may hinder collaboration. AIM To investigate the level of agreement among advanced geriatric nurses (AGNs), their colleagues and their leaders regarding which activities related to direct and indirect care, teaching/supervision, coordination and research and development work are perceived as appropriate for AGNs. DESIGN A cross-sectional descriptive survey. METHODS The total population of AGNs in Norway (n = 26) and a sample of their colleagues, including leaders (n = 465), were invited to answer an online questionnaire. Twenty-three (88.5%) AGNs and 195 (42%) colleagues answered the questionnaires. A series of cross-tabulations were conducted to identify the respondents reporting on the appropriateness of different activities. RESULTS The respondents identified all of the activities related to coordination, teaching/supervision and research and development work as appropriate for AGNs. Although the respondents considered several of the direct and indirect care activities as appropriate, there were conflicting views on the activities that traditionally fall within the medical field vs. those that traditionally fall within the nursing field. The AGNs saw most of the nursing and medical activities as appropriate, but their colleagues and leaders saw only some of the nursing activities as appropriate. The results also showed that there was high disagreement among the leaders regarding appropriate activities. CONCLUSION The results indicate that healthcare providers agree on which activities related to teaching/supervision, coordination, and research and development work are appropriate to include in AGNs' scope of practice, but that there are conflicting views regarding activities related to direct and indirect care.
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Affiliation(s)
- Silje Havrevold Henni
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marit Kirkevold
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Konstantinos Antypas
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Christina Foss
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Intensive care nurses’ experiences of withdrawal of life-sustaining treatments in intensive care patients: A qualitative study. Intensive Crit Care Nurs 2020; 56:102768. [DOI: 10.1016/j.iccn.2019.102768] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/18/2019] [Accepted: 10/25/2019] [Indexed: 11/19/2022]
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Aggari MI, Diño MJS, Orte CJS. Leaders shaping leadership: Knowledge, professional values and competency as prognosticators of career growth and development among nurses. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gözütok Konuk T, Tanyer D. Investigation of Nursing Students' Perception of Caring Behaviors. J Caring Sci 2019; 8:191-197. [PMID: 31915620 PMCID: PMC6942651 DOI: 10.15171/jcs.2019.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 07/28/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction: Nursing is a caring profession. Developing nursing student’s perception of the care remains one of the most important goals of the education process. Methods: A descriptive-correlational study was carried out in order to identify the caring behaviors, perceptions and associated factors of the nursing students. The target group of the study consisted of 530 nursing students. The data were collected by using the "demographic characteristics form" and "Caring Assessment Questionnaire" (Care-Q). T-test and ANOVA were used in the statistical analysis of the data. Multiple Regression Analysis - Hierarchical Model was used for the analysis of determination. Results: Mean (SD) of total Care-Q points of the students was 5.0 (0.9), the highest average score of the sub-groups was 5.5 (1.1) in the trusting relationship sub-group; and the lowest average points was 4.5 (1.2) points in the Anticipates sub-group. It was concluded that the perceptions of the students about the caring behaviors is at a good level, and the perceptions of the students about the caring behaviors was affected by the attitudes, plans and experiences of the students about the profession. Conclusion: Developing the confidence of the students during the nursing education, ensuring the opportunities for empathy and developing the course contents on the bases of the concept of care are the applicable results of this study.
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Affiliation(s)
| | - Deniz Tanyer
- Department of Nursing, Faculty of Health Sciences, Konya, Turkey
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Heinen M, van Oostveen C, Peters J, Vermeulen H, Huis A. An integrative review of leadership competencies and attributes in advanced nursing practice. J Adv Nurs 2019; 75:2378-2392. [PMID: 31162695 PMCID: PMC6899698 DOI: 10.1111/jan.14092] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/10/2019] [Accepted: 04/08/2019] [Indexed: 12/17/2022]
Abstract
Aim To establish what leadership competencies are expected of master level‐educated nurses like the Advanced Practice Nurses and the Clinical Nurse Leaders as described in the international literature. Background Developments in health care ask for well‐trained nurse leaders. Advanced Practice Nurses and Clinical Nurse Leaders are ideally positioned to lead healthcare reform in nursing. Nurses should be adequately equipped for this role based on internationally defined leadership competencies. Therefore, identifying leadership competencies and related attributes internationally is needed. Design Integrative review. Methods Embase, Medline and CINAHL databases were searched (January 2005–December 2018). Also, websites of international professional nursing organizations were searched for frameworks on leadership competencies. Study and framework selection, identification of competencies, quality appraisal of included studies and analysis of data were independently conducted by two researchers. Results Fifteen studies and seven competency frameworks were included. Synthesis of 150 identified competencies led to a set of 30 core competencies in the clinical, professional, health systems. and health policy leadership domains. Most competencies fitted in one single domain the health policy domain contained the least competencies. Conclusions This synthesis of 30 core competencies within four leadership domains can be used for further development of evidence‐based curricula on leadership. Next steps include further refining of competencies, addressing gaps, and the linking of knowledge, skills, and attributes. Impact These findings contribute to leadership development for Advanced Practice Nurses and Clinical Nurse Leaders while aiming at improved health service delivery and guiding of health policies and reforms.
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Affiliation(s)
- Maud Heinen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
| | - Catharina van Oostveen
- Spaarne Gasthuis Hospital, Spaarne Gasthuis Academy, Haarlem, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jeroen Peters
- Hogeschool van Arnhem en Nijmegen, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Anita Huis
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
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Karimi‐Shahanjarini A, Shakibazadeh E, Rashidian A, Hajimiri K, Glenton C, Noyes J, Lewin S, Laurant M, Colvin CJ. Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis. Cochrane Database Syst Rev 2019; 4:CD010412. [PMID: 30982950 PMCID: PMC6462850 DOI: 10.1002/14651858.cd010412.pub2] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Having nurses take on tasks that are typically conducted by doctors (doctor-nurse substitution, a form of 'task-shifting') may help to address doctor shortages and reduce doctors' workload and human resource costs. A Cochrane Review of effectiveness studies suggested that nurse-led care probably leads to similar healthcare outcomes as care delivered by doctors. This finding highlights the need to explore the factors that affect the implementation of strategies to substitute doctors with nurses in primary care. In our qualitative evidence synthesis (QES), we focused on studies of nurses taking on tasks that are typically conducted by doctors working in primary care, including substituting doctors with nurses or expanding nurses' roles. OBJECTIVES (1) To identify factors influencing implementation of interventions to substitute doctors with nurses in primary care. (2) To explore how our synthesis findings related to, and helped to explain, the findings of the Cochrane intervention review of the effectiveness of substituting doctors with nurses. (3) To identify hypotheses for subgroup analyses for future updates of the Cochrane intervention review. SEARCH METHODS We searched CINAHL and PubMed, contacted experts in the field, scanned the reference lists of relevant studies and conducted forward citation searches for key articles in the Social Science Citation Index and Science Citation Index databases, and 'related article' searches in PubMed. SELECTION CRITERIA We constructed a maximum variation sample (exploring variables such as country level of development, aspects of care covered and the types of participants) from studies that had collected and analysed qualitative data related to the factors influencing implementation of doctor-nurse substitution and the expansion of nurses' tasks in community or primary care worldwide. We included perspectives of doctors, nurses, patients and their families/carers, policymakers, programme managers, other health workers and any others directly involved in or affected by the substitution. We excluded studies that collected data using qualitative methods but did not analyse the data qualitatively. DATA COLLECTION AND ANALYSIS We identified factors influencing implementation of doctor-nurse substitution strategies using a framework thematic synthesis approach. Two review authors independently assessed the methodological strengths and limitations of included studies using a modified Critical Appraisal Skills Programme (CASP) tool. We assessed confidence in the evidence for the QES findings using the GRADE-CERQual approach. We integrated our findings with the evidence from the effectiveness review of doctor-nurse substitution using a matrix model. Finally, we identified hypotheses for subgroup analyses for updates of the review of effectiveness. MAIN RESULTS We included 66 studies (69 papers), 11 from low- or middle-income countries and 55 from high-income countries. These studies found several factors that appeared to influence the implementation of doctor-nurse substitution strategies. The following factors were based on findings that we assessed as moderate or high confidence.Patients in many studies knew little about nurses' roles and the difference between nurse-led and doctor-led care. They also had mixed views about the type of tasks that nurses should deliver. They preferred doctors when the tasks were more 'medical' but accepted nurses for preventive care and follow-ups. Doctors in most studies also preferred that nurses performed only 'non-medical' tasks. Nurses were comfortable with, and believed they were competent to deliver a wide range of tasks, but particularly emphasised tasks that were more health promotive/preventive in nature.Patients in most studies thought that nurses were more easily accessible than doctors. Doctors and nurses also saw nurse-doctor substitution and collaboration as a way of increasing people's access to care, and improving the quality and continuity of care.Nurses thought that close doctor-nurse relationships and doctor's trust in and acceptance of nurses was important for shaping their roles. But nurses working alone sometimes found it difficult to communicate with doctors.Nurses felt they had gained new skills when taking on new tasks. But nurses wanted more and better training. They thought this would increase their skills, job satisfaction and motivation, and would make them more independent.Nurses taking on doctors' tasks saw this as an opportunity to develop personally, to gain more respect and to improve the quality of care they could offer to patients. Better working conditions and financial incentives also motivated nurses to take on new tasks. Doctors valued collaborating with nurses when this reduced their own workload.Doctors and nurses pointed to the importance of having access to resources, such as enough staff, equipment and supplies; good referral systems; experienced leaders; clear roles; and adequate training and supervision. But they often had problems with these issues. They also pointed to the huge number of documents they needed to complete when tasks were moved from doctors to nurses. AUTHORS' CONCLUSIONS Patients, doctors and nurses may accept the use of nurses to deliver services that are usually delivered by doctors. But this is likely to depend on the type of services. Nurses taking on extra tasks want respect and collaboration from doctors; as well as proper resources; good referral systems; experienced leaders; clear roles; and adequate incentives, training and supervision. However, these needs are not always met.
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Affiliation(s)
- Akram Karimi‐Shahanjarini
- Hamadan University of Medical SciencesDepartment of Public HealthMahdeieh Ave. Hamadan, IranHamadanHamadanIran
- Hamadan University of Medical SciencesSocial Determinants of Health Research CenterHamadanIran
| | - Elham Shakibazadeh
- Tehran University of Medical SciencesDepartment of Health Education and Health PromotionTehranTehranIran
| | - Arash Rashidian
- Tehran University of Medical SciencesDepartment of Health Management and Economics, School of Public HealthPoursina AveTehranIran1417613191
| | - Khadijeh Hajimiri
- School of Public Health, Zanjan University of Medical SciencesDepartment of Health Education and Health PromotionZanjanIran
| | - Claire Glenton
- Norwegian Institute of Public HealthPO Box 7004 St Olavs plassOsloNorwayN‐0130
| | - Jane Noyes
- Bangor UniversityCentre for Health‐Related Research, Fron HeulogBangorWalesUKLL57 2EF
| | - Simon Lewin
- Norwegian Institute of Public HealthPO Box 7004 St Olavs plassOsloNorwayN‐0130
- South African Medical Research CouncilHealth Systems Research UnitPO Box 19070TygerbergSouth Africa7505
| | - Miranda Laurant
- Radboud Institute for Health Sciences, IQ healthcareRadboud University Medical CenterPO Box 9101NijmegenNetherlands6500 HB
- Institute of Nursing StudiesHAN University of Applied SciencesNijmegenNetherlands
| | - Christopher J Colvin
- School of Public Health and Family Medicine, University of Cape TownDivision of Social and Behavioural SciencesCape TownSouth Africa
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Cassiani SHDB, Aguirre-Boza F, Hoyos MC, Barreto MFC, Peña LM, Mackay MCC, Silva FAMD. Competências para a formação do enfermeiro de prática avançada para a atenção básica de saúde. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Determinar um conjunto de competências centrais para a formação do enfermeiro de prática avançada na atenção básica de saúde, na América Latina e no Caribe. Métodos Estudo quantitativo descritivo, com análise qualitativa de dados, realizado em 2017. Participaram 830 enfermeiros da América Latina e do Caribe. Para a coleta de dados, utilizou-se um questionário com sete domínios, dimensões e competências do enfermeiro de prática avançada. A análise dos dados foi realizada por meio de estatística descritiva. Resultados Dos 830 enfermeiros que responderam à pesquisa, 40,7% ocupavam um cargo na área da educação; 41,4% trabalhavam em áreas clínicas e 17,8% ocupavam cargos de direção ou ministeriais. Quanto à escolaridade, 45,7% apresentavam mestrado e 17,3%, doutorado. Das 64 competências avaliadas, 59 foram consideradas centrais para a formação do enfermeiro de prática avançada e cinco como não indispensáveis ou muito relevantes. Conclusão O estudo apresenta um conjunto de competências centrais para o enfermeiro de prática avançada e contribui para a discussão sobre as competências centrais em sua formação na Assistência Primária à Saúde - APS. Quanto maior a escolaridade dos indivíduos, mais marcada foi a tendência de considerar as competências de ética e pesquisa relevantes, enquanto que a competência de prescrever medicamentos foi considerara relevante apenas para participantes cujos países regulamentam o papel de enfermeiros de prática avançada. As competências propostas devem ser consideradas dentro do contexto específico e regulado pela legislação de cada país.
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Lamb A, Martin‐Misener R, Bryant‐Lukosius D, Latimer M. Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nurs Open 2018; 5:400-413. [PMID: 30191074 PMCID: PMC6121481 DOI: 10.1002/nop2.150] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/14/2018] [Indexed: 11/08/2022] Open
Abstract
AIM The aim of this study is to explore advanced practice nurses' perceptions of their leadership capabilities. DESIGN A qualitative descriptive methodology informed by a well-established leadership framework was used to explore advanced practice nurses' perceptions of their leadership. METHODS Purposive sampling of advanced practice nurses working in tertiary acute care facilities in Eastern Canada was employed. Data sources included face-to-face interviews and document analysis. Fourteen advanced practice nurses participated in two audio-taped semi-structured interviews from March 2013-January 2014. Data were transcribed and analysed using NVIVO 10 software and content analysis. RESULTS Two main themes were identified: "Patient-focused leadership" and "organization and system-focused leadership". These two themes are further described through leadership domains and capabilities that clearly articulate advanced practice nursing leadership and its contribution to improving the care environment for patients and families, nurses and other healthcare providers, organizations and the healthcare system.
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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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Developing the role of Swedish advanced practice nurse (APN) through a blended learning master's program: Consequences of knowledge organisation. Nurse Educ Pract 2018; 28:196-201. [DOI: 10.1016/j.nepr.2017.10.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 10/17/2017] [Accepted: 10/26/2017] [Indexed: 11/23/2022]
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Ljungbeck B, Sjögren Forss K. Advanced nurse practitioners in municipal healthcare as a way to meet the growing healthcare needs of the frail elderly: a qualitative interview study with managers, doctors and specialist nurses. BMC Nurs 2017; 16:63. [PMID: 29176932 PMCID: PMC5689167 DOI: 10.1186/s12912-017-0258-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/03/2017] [Indexed: 01/24/2023] Open
Abstract
Background The number of frail elderly people with complex nursing and medical care needs is increasing, and consequently, the healthcare burden. The implementation of Advanced Nurse Practitioners globally has been shown to make healthcare more effective and increase patient safety, continuity of care and access to care. In Sweden, research about Advanced Nurse Practitioners is limited. Thus, this study aimed to investigate the opinions of managers, doctors and nurses in primary care and municipal healthcare about the role of ANPs in municipal healthcare as a way to meet the increasing healthcare needs of the frail elderly. Methods Managers, doctors and specialist nurses in primary care and municipal healthcare adopted a qualitative, descriptive design through 12 semi-structured interviews. The data were analysed using content analysis. Results The participants expressed both opportunities as well as challenges with Advanced Nurse Practitioners in municipal healthcare. This role considered to satisfy frail elderly people’s healthcare needs and making the healthcare more effective as the doctors would have more time for other patients. The challenges mainly consist of doubts from the managers whether the nurses would be motivated to pursue further education to become an Advanced Nurse Practitioner if the role becomes a reality. The doctors were unsure if the nurses would consider taking the responsibility the role would imply. Conclusions Advanced Nurse Practitioner is considered to be a valuable resource not only for the frail elderly but also for the nurses in the municipal healthcare and for the doctors in primary care as they probably would make healthcare more effective. They might be a way to meet the increasing healthcare needs of frail elderly, however there are also challenges to overcome before they can become a reality in a Swedish healthcare context. Consequently, this role deserves further investigation. Electronic supplementary material The online version of this article (10.1186/s12912-017-0258-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Birgitta Ljungbeck
- Municipal Healthcare in Hässleholm, Management of Care and Welfare, Hässleholm, Sweden
| | - Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, -205 06 Malmö, SE Sweden
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Wolf LA, Delao AM, Perhats C, Moon MD, Carman MJ. The Experience of Advanced Practice Nurses in US Emergency Care Settings. J Emerg Nurs 2017; 43:426-434.e16. [DOI: 10.1016/j.jen.2017.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 04/12/2017] [Accepted: 04/19/2017] [Indexed: 11/29/2022]
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Lee H, Kim A, Meong A, Seo M. Pediatric nurse practitioners' clinical competencies and knowing patterns in nursing: Focus group interviews. Contemp Nurse 2017; 53:515-523. [PMID: 28415900 DOI: 10.1080/10376178.2017.1315827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The generic competency domains of advanced nursing practice have been reported on in numerous countries, but rather few studies have examined competencies specific to pediatric nurse practitioners (PNPs). OBJECTIVES We identified the core clinical competencies of PNPs in South Korea and related these identified competencies to the five patterns of knowing in nursing. DESIGN Focus group interviews were conducted with five PNP students and four PNPs using two thematic questions, one on clinical competencies required for PNPs and the other on competencies specific to Korean PNPs. A purposive sampling method was used to choose nurses with varying work experience and age from different hospital units. The inclusion criterion for PNP students was having at least two years of clinical experience and that for PNPs was having at least two years of clinical experience as a PNP in pediatric units in tertiary hospitals. The verbatim transcriptions of these interviews were analysed by two researchers using inductive content analysis. RESULTS Six clinical competency domains were identified including advanced pediatric-specific knowledge and clinical skills, education and counseling, utilization and engagement in research, professional identity development, clinical and professional leadership, and holistic care. Some competencies identified were related to empirical and ethical knowledge that could be taught in nursing, whereas others were based on esthetic and personal knowledge, which can be mastered through professional experience. CONCLUSIONS To provide holistic care for children and families, PNPs must acquire all necessary patterns of knowing through continuing education and individual reflection on personal practice.
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Affiliation(s)
- Hyejung Lee
- a College of Nursing , Mo-Im Kim Nursing Research Institute, Yonsei University , Seoul , South Korea
| | - Anna Kim
- b College of Nursing , Yonsei University , Seoul , South Korea
| | - Anna Meong
- b College of Nursing , Yonsei University , Seoul , South Korea
| | - Minjeong Seo
- c College of Nursing, Gerontological Health Research Center in Institute of Health Science , Gyeongsang National University , Jinju , Korea
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Skela-Savič B, Hvalič-Touzery S, Pesjak K. Professional values and competencies as explanatory factors for the use of evidence-based practice in nursing. J Adv Nurs 2017; 73:1910-1923. [DOI: 10.1111/jan.13280] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Brigita Skela-Savič
- Fakulteta za zdravstvo Angele Boškin/Angela Boškin; Faculty of Health Care; Slovenia
| | - Simona Hvalič-Touzery
- Fakulteta za zdravstvo Angele Boškin/Angela Boškin; Faculty of Health Care; Slovenia
| | - Katja Pesjak
- Fakulteta za zdravstvo Angele Boškin/Angela Boškin; Faculty of Health Care; Slovenia
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Harper C, Maher J. Investigating Philosophies Underpinning Dietetic Private Practice. Behav Sci (Basel) 2017; 7:E11. [PMID: 28257036 PMCID: PMC5371755 DOI: 10.3390/bs7010011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/06/2017] [Accepted: 02/21/2017] [Indexed: 11/25/2022] Open
Abstract
There is limited theory or knowledge regarding dietitians' practice philosophies and how these philosophies are generated and incorporated into their professional practices. For the purposes of this study, a conceptual framework will explain and define the 'philosophies' as three different types of knowledge; episteme, techne, and phronesis. This study aimed to develop an explanatory theory of how dietitians in private practice source, utilise, and integrate practice philosophies. A grounded theory qualitative methodology was used to inform the sampling strategy, data collection, and analytical processes. Semi-structured interviews with dietitians in private practice were undertaken and data were collected and analysed concurrently. The results show that dietitians form collaborative relationships with their clients, in order to nurture change over time. They use intrinsic and intertwined forms of episteme, techne, and phronesis, which allow them to respond both practically and sensitively to their clients' needs. The learning and integration of these forms of knowledge are situated in their own practice experience. Dietitians adapt through experience, feedback, and reflection. This study highlights that private practice offers a unique context in which dietitians deal with complex issues, by utilising and adapting their philosophies.
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Affiliation(s)
- Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Level 2, Charles Perkins Centre, John Hopkins Drive, Camperdown, NSW 2006, Australia.
| | - Judith Maher
- Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia.
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Sastre-Fullana P, Morales-Asencio JM, Sesé-Abad A, Bennasar-Veny M, Fernández-Domínguez JC, De Pedro-Gómez J. Advanced Practice Nursing Competency Assessment Instrument (APNCAI): clinimetric validation. BMJ Open 2017; 7:e013659. [PMID: 28235968 PMCID: PMC5337725 DOI: 10.1136/bmjopen-2016-013659] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To describe the development and clinimetric validation of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) through several evidence sources about reliability and validity in the Spanish context. DESIGN AND SETTING APNCAI development was based on a multisequential and systematic process: literature review, instrument content consensus through qualitative Delphi method approach (a panel of 51 Advanced Practice in Nursing -APN- experts was selected) and the clinimetric validation process based on a sample of 600 nurses from the Balearic Islands public healthcare setting. METHODS An initial step for tool's content development process based on Delphi method approach of expert consensus was implemented. A subsequent phase of tool validation started from the analysis of APN core competencies latent measurement model, including exploratory and confirmatory techniques. Reliability evidence for each latent factor was also obtained. Items' scores were submitted to descriptive analysis, plus univariate and multivariate normality tests. RESULTS An eight-factor competency assessment latent model obtained adequate fit, and it was composed by 'Research and Evidence-Based Practice', 'Clinical and Professional Leadership', 'Interprofessional Relationship and Mentoring', 'Professional Autonomy', 'Quality Management', 'Care Management', 'Professional Teaching and Education' and 'Health Promotion'. CONCLUSIONS Adequate empirical evidence of reliability and validity for APNCAI makes it useful for application in healthcare policy programmes for APN competency assessment in Spain.
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Affiliation(s)
| | | | - Albert Sesé-Abad
- Faculty of Psychology, University of Balearic Islands, Palma, Spain
| | - Miquel Bennasar-Veny
- Nursing and Physiotherapy Department, Universitat de les Illes Balears, Palma, Spain
| | - Juan Carlos Fernández-Domínguez
- Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Universitat de les Illes Balears, Palma, Spain
| | - Joan De Pedro-Gómez
- Nursing and Physiotherapy Department, Universitat de les Illes Balears, Palma, Spain
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Jangland E, Yngman Uhlin P, Arakelian E. Between two roles – Experiences of newly trained nurse practitioners in surgical care in Sweden: A qualitative study using repeated interviews. Nurse Educ Pract 2016; 21:93-99. [DOI: 10.1016/j.nepr.2016.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/23/2016] [Accepted: 10/12/2016] [Indexed: 11/30/2022]
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Finnbakk E, Wangensteen S, Skovdahl K, Fagerström L. The Professional Nurse Self-Assessment Scale: Psychometric testing in Norwegian long term and home care contexts. BMC Nurs 2015; 14:59. [PMID: 26578847 PMCID: PMC4647290 DOI: 10.1186/s12912-015-0109-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 11/02/2015] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Nurses' clinical competence is vital to ensure safe and high quality care, and the continuous assessment of nurses' clinical competence is of major concern. A validated instrument for the self-assessment of nurses' clinical competence at different educational levels across specialties and countries is lacking. The aim of this study was to test the reliability and construct validity of the new Professional Nurse Self-Assessment Scale (ProffNurse SAS) questionnaire in long term and home care contexts in Norway. The questionnaire is based on the Nordic Advanced Practice Nursing model, in which the nurse-patient relationship is central. METHODS The study has a cross-sectional survey design. A purposive sample of 357 registered nurses who worked in long term and home care contexts in two geographical regions encompassing eight municipalities and three counties was included. The respondents completed the 74-item ProffNurse SAS questionnaire and demographic background data was collected. Data collection was conducted in two phases: first region autumn 2011 and second region spring 2012. Exploratory factor analyses (EFA) were used to test the psychometric properties of the questionnaire and included the following steps: assessment of the factorality of the data, factor extraction by Principal Component Analysis (PCA), oblimin (oblique) factor rotation, and interpretation. Cronbach's alpha was used to estimate the internal consistency. RESULTS The PCA revealed a six-component structure, reducing the number of items in the questionnaire from 74 to 51. Based on the content of the highest-loading items, the six components were named: Direct Clinical Practice, Professional Development, Ethical Decision-Making, Clinical Leadership, Cooperation and Consultation, and Critical Thinking. The Cronbach's alpha values ranged from 0.940 (highest; Direct Clinical Practice) to 0.737 (lowest; Critical Thinking), leading to the estimation that the ProffNurse SAS is reliable. CONCLUSIONS The six components support the study's theoretical framework. The ProffNurse SAS showed acceptable reliability and construct validity and may therefore be a promising instrument for the assessment of practicing nurses' clinical competence. However, we recommend further psychometric testing in other countries and contexts and the inclusion of larger samples of nurses at various levels of education, particularly master's level APNs.
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Affiliation(s)
- Elisabeth Finnbakk
- />School of Health and Medical Sciences, Örebro University, Fakultetsgatan 1, Örebro, 702 81 Sweden
- />Lovisenberg Diaconal University College, Lovisenberggt. 15 b, Oslo, 0456 Norway
| | - Sigrid Wangensteen
- />Faculty of Health, Care and Nursing, Gjövik University College, Postbox 191, Gjövik, 2802 Norway
| | - Kirsti Skovdahl
- />Faculty of Health Sciences, Buskerud and Vestfold University College, Postbox 7053, Drammen, 3007 Norway
| | - Lisbeth Fagerström
- />School of Health and Medical Sciences, Örebro University, Fakultetsgatan 1, Örebro, 702 81 Sweden
- />Faculty of Health Sciences, Buskerud and Vestfold University College, Postbox 7053, Drammen, 3007 Norway
- />Åbo Akademi University, Vasa Campus, Postbox 311, Vasa, 65101 Finland
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Abstract
This review article will describe the methods used in a fully online NP program with curricular framework based on experiential and adult learning theories using problem-based learning. The focus is on faculty facilitation, preceptor preparation, student evaluation, and the development of engaging clinical partnerships.
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Sastre-Fullana P, De Pedro-Gómez JE, Bennasar-Veny M, Fernández-Domínguez JC, Sesé-Abad AJ, Morales-Asencio JM. [Consensus on competencies for advanced nursing practice in Spain]. ENFERMERIA CLINICA 2015; 25:267-75. [PMID: 26260265 DOI: 10.1016/j.enfcli.2015.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 05/10/2015] [Accepted: 06/30/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION There is a lack of international consensus on the exact definition and core competencies of advanced practice nursing (APN) roles, a problem particularly acute in our national context due to the lack of APN role development, which has a significantly short history in our country. The main objective of this paper was the delineation of the competence framework for Advanced Practice Nurses in our national context based on expert consensus through the Delphi method METHOD Based on a preliminary literature review process, a conglomerate of 17 domains of competence (clusters of related competencies) were identified. This initial set was revised, refined and validated by a group of expert panellists on the subject (clinicians, researchers, managers, and teachers) through successive rounds in search of a suitable consensus on each of the various proposed items RESULTS The results helped to establish a solid foundation in the form of a skills map that could identify those sets of more specific competencies for advanced practice roles, regardless of regulatory and professional practice context, identifying domains such as Research and Evidence Based Practice, Clinical and Professional Leadership, or Care Management DISCUSSION This set of skills related to advanced practice roles in our environment can delineate competency standards common to this level of nursing practice, and serve as a reference for policy development, a review of roles, or the establishment of academic profiles.
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Affiliation(s)
- Pedro Sastre-Fullana
- Departamento de Enfermería, Facultad de Enfermería y Fisioterapia, Universitat de les Illes Balears, Palma de Mallorca, España.
| | - Joan E De Pedro-Gómez
- Departamento de Enfermería, Facultad de Enfermería y Fisioterapia, Universitat de les Illes Balears, Palma de Mallorca, España
| | - Miquel Bennasar-Veny
- Departamento de Enfermería, Facultad de Enfermería y Fisioterapia, Universitat de les Illes Balears, Palma de Mallorca, España
| | - Juan C Fernández-Domínguez
- Departamento de Fisioterapia, Facultad de Enfermería y Fisioterapia, Universitat de les Illes Balears, Palma de Mallorca, España
| | - Albert J Sesé-Abad
- Departamento de Psicología, Facultad de Psicología, Universitat de les Illes Balears, Palma de Mallorca, España
| | - José M Morales-Asencio
- Departamento de Enfermería, Facultad de las Ciencias de la Salud,Universidad de Málaga, Málaga, España
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Jeon Y, Lahtinen P, Meretoja R, Leino-Kilpi H. Anaesthesia nursing education in the Nordic countries: Literature review. NURSE EDUCATION TODAY 2015; 35:680-688. [PMID: 25676736 DOI: 10.1016/j.nedt.2015.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 12/15/2014] [Accepted: 01/19/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The purpose of this review was to analyse post-registration anaesthesia nursing education in the Nordic countries. The analysis was based on key determinants fundamental to analysing nursing education: 1) the sys]tem of anaesthesia nursing education, 2) entry requirements, 3) credits, the duration and the title or degree awarded, and 4) the amount of practical training. METHODS A scoping review was approached in a systematic manner. The literature was analysed using deductive content analysis. Data was gathered based on key determinants. The data were quantified into frequencies and percentages to compare the similarities and differences of anaesthesia nursing. RESULTS The Nordic countries have different types of post-registration anaesthesia nursing education from non-degree supplementary programmes to Master's degree programmes. Even though the entry requirements correspond between countries, many more differences than similarities in anaesthesia nursing education were noted. A title granting the right to work as a nurse anaesthetist can be obtained through a variety of educational systems, credit requirements, the duration, and the amount of practical training in post-registration anaesthesia nursing programmes. CONCLUSION This aim of the study was to analyse post-registration anaesthesia nursing education from the Nordic perspective. Harmonising the educational system and minimum education requirements in anaesthesia nursing education is recommended in order to facilitate free movement and assure the quality of care from the Nordic perspective. Since each Nordic country has its own native language, it was difficult to gather information from all the Nordic countries. Therefore, creating common educational database published in English can help to bench mark each country's educational system.
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Affiliation(s)
- Yunsuk Jeon
- Department of Nursing Science, University of Turku, 20014 Turku, Finland.
| | - Pia Lahtinen
- Department of Nursing Science, University of Turku, 20014 Turku, Finland.
| | | | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, 20014 Turku, Finland; Turku University Hospital, Turku, Finland.
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Sastre-Fullana P, De Pedro-Gómez J, Bennasar-Veny M, Serrano-Gallardo P, Morales-Asencio J. Competency frameworks for advanced practice nursing: a literature review. Int Nurs Rev 2014; 61:534-42. [DOI: 10.1111/inr.12132] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- P. Sastre-Fullana
- Department of Nursing; University of Balearic Islands; Palma de Mallorca Spain
| | - J.E. De Pedro-Gómez
- Faculty of Nursing and Physiotherapy; University of Balearic Islands; Palma de Mallorca Spain
| | - M. Bennasar-Veny
- Department of Nursing; University of Balearic Islands; Palma de Mallorca Spain
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Maddox BL, Waller-Wise R, Weed LD. Perinatal nurses' perceptions of competency assessments. J Contin Educ Nurs 2014; 45:453-60. [PMID: 25280194 DOI: 10.3928/00220124-20140925-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 05/28/2014] [Indexed: 11/20/2022]
Abstract
Competency assessment should be a changing and continuing process. In addition, it should be appropriate for the organization and the nursing staff. Nursing educators are challenged to provide a competency assessment process that is relevant and meaningful. This qualitative research study describes perinatal nurses' perceptions of a change from a traditional testing competency assessment to a hands-on competency assessment. The setting was a medical center in southeastern Alabama. Thirteen nurses participated in the study. Focus groups were used to explore the new assessment method. Three themes were identified: I am learning, multidimensional learning together, and increasing professional confidence. As the medical center perinatal nursing competency assessment program continues to improve, the expectation is for other departments to assess and revise their competency assessment program.
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Abstract
Home health care faces challenges that could affect job satisfaction and quality of care. The aim of the study was to describe nurses’ experiences of competence in home health care. The study sample comprised of interviews with six nurses and was analyzed using manifest qualitative content analysis. The category “Being prepared” and subcategories “Importance of leadership strategies,” “Training promotes safety and independence,” and “Co-operation for professional development” were identified. Organizing and planning continuous learning activities at a managerial level, such as collaborations with a focus on supervision and sense of coherence (SOC) training, could develop patient safety within home health care. The results demonstrate that professionally competent nurses working in home health care environments contribute to safe working practices to meet quality care outcomes.
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Atsalos C, Biggs K, Boensch S, Gavegan FL, Heath S, Payk M, Trapolini G. How clinical nurse and midwifery consultants optimise patient care in a tertiary referral hospital. J Clin Nurs 2014; 23:2874-85. [DOI: 10.1111/jocn.12567] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Christine Atsalos
- Diabetes & Endocrinology Ambulatory Care Centre; Westmead Hospital; Wentworthville NSW Australia
| | - Karen Biggs
- Western Sydney Sexual Health Centre; Parramatta NSW Australia
| | - Sabine Boensch
- Chronic Pain Service; Department of Rehabilitation Medicine; Westmead Hospital; Wentworthville NSW Australia
| | - Fiona Lee Gavegan
- Stomal Therapy Service; Westmead Hospital; Wentworthville NSW Australia
| | - Susan Heath
- Westmead Hospital; Wentworthville NSW Australia
| | - Marlene Payk
- Diabetes & Endocrinology Ambulatory Care Centre; Westmead Hospital; Wentworthville NSW Australia
| | - Grace Trapolini
- Department Respiratory Medicine; Westmead Hospital; Wentworthville NSW Australia
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Mollon D. Feeling safe during an inpatient hospitalization: a concept analysis. J Adv Nurs 2014; 70:1727-37. [PMID: 24383463 DOI: 10.1111/jan.12348] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2013] [Indexed: 11/28/2022]
Abstract
AIM This paper aims to explore the critical attributes of the concept feeling safe. BACKGROUND The safe delivery of care is a high priority; however; it is not really known what it means to the patient to 'feel safe' during an inpatient hospitalization. This analysis explores the topic of safety from the patient's perspective. DESIGN Concept analysis. DATA SOURCES The data bases of CINAHL, Medline, PsychInfo and Google Scholar for the years 1995-2012 were searched using the terms safe and feeling safe. METHODS The eight-step concept analysis method of Walker and Avant was used to analyse the concept of feeling safe. Uses and defining attributes, as well as identified antecedents, consequences and empirical referents, are presented. Case examples are provided to assist in the understanding of defining attributes. RESULTS Feeling safe is defined as an emotional state where perceptions of care contribute to a sense of security and freedom from harm. Four attributes were identified: trust, cared for, presence and knowledge. Relationship, environment and suffering are the antecedents of feeling safe, while control, hope and relaxed or calm are the consequences. Empirical referents and early development of a theory of feeling safe are explored. CONCLUSION This analysis begins the work of synthesizing qualitative research already completed around the concept of feeling safe by defining the key attributes of the concept. Support for the importance of developing patient-centred models of care and creating positive environments where patients receive high-quality care and feel safe is provided.
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Affiliation(s)
- Deene Mollon
- SharpHealth Care, La Mesa, California, USA; University of San Diego, California, USA
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Thornton P. Twenty years on: Cochrane and nursing. Scand J Caring Sci 2013; 27:773. [PMID: 24164275 DOI: 10.1111/scs.12084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Pediatric oncology has become a highly specialized area, and the transition from novice nurse to expert can be complicated. The aim of this study was to describe the perceptions of nurses in pediatric oncology regarding the role of an expert nurse in pediatric oncology. Nurses (n = 66) working in pediatric oncology participated by writing their narratives. The data were analyzed by means of content analysis, and 3 categories were found: an expert has confidence in his or her knowledge, an expert provides high-quality care, and an expert is given possibilities for professional growth. It can be concluded that when nurses are given possibilities for continuous education and reflection, and have a feeling of satisfaction at being able to fulfill a child and his or her family’s needs, this enhances their possibility to become experts and maintain expert competence.
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Affiliation(s)
- Karin Enskär
- Jönköping University, Jönköping, Sweden
- University of Skövde, Skövde, Sweden
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FAGERSTRÖM LISBETH, GLASBERG ANNLOUISE. The first evaluation of the advanced practice nurse role in Finland - the perspective of nurse leaders. J Nurs Manag 2011; 19:925-32. [DOI: 10.1111/j.1365-2834.2011.01280.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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