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Bourke L, Wright K, Scott C, Patrick A. Can an advanced practice nursing framework address workforce shortages? A case study of a regional health service. Contemp Nurse 2024; 60:367-381. [PMID: 38300750 DOI: 10.1080/10376178.2024.2310255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/21/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Across the globe, shortages of nurses and midwives in rural regions persist. Advanced practice nursing has been found to address workforce shortages through career progression aimed at retention. A regional health service sought to consult with staff about developing an advanced practice nursing framework. AIMS This study aimed to explore the perspectives of nurses and midwives at a regional health service on (i) how their roles aligned with the modified Advanced Practice Role Delineation (APRD) tool and (ii) the potential for implementation of such a framework at their service. DESIGN A case study conducted at Goulburn Valley Health (GVH) in southeast Australia used a mixed method design with a survey of all nursing and midwifery staff and focus groups with senior staff. METHODS All nurses and midwives were asked to complete a validated modified ARPD questionnaire and those in Grades 3-6 were asked to participate in a focus group. RESULTS From 183 questionnaires and 38 participants in the focus group discussions, findings concurred that nurses and midwives at GVH reported spending most time on direct patient care and minimal time on research activities, publication and/or leadership. While education was strongly embraced and advanced practice usually supported, senior staff cited the lack of resources, the culture and staff shortages as restricting opportunities for education, career development and implementation of an advanced practice framework. CONCLUSIONS While an advanced practice framework could address staff shortages at this health service, implementation of such a framework is constrained by the lack of resources and workforce shortages common in rural health services. A national strategy that embeds advanced practice roles and resources implementation of advanced practice nursing and midwifery frameworks in areas of need is recommended.
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Affiliation(s)
- Lisa Bourke
- Department of Rural Health, The University of Melbourne, Shepparton, Vic, Australia
| | - Keryn Wright
- Department of Rural Health, The University of Melbourne, Shepparton, Vic, Australia
| | - Cathy Scott
- Goulburn Valley Health, Shepparton, Vic, Australia
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Glarcher M, Rihari-Thomas J, Duffield C, Tuqiri K, Hackett K, Ferguson C. Advanced practice nurses' experiences of patient safety: a focus group study. Contemp Nurse 2024:1-15. [PMID: 38861587 DOI: 10.1080/10376178.2024.2363911] [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: 02/09/2024] [Accepted: 05/30/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Patient harm from unsafe care is an increasingly global phenomenon leading to death or disability. Drawing on their expertise, Advanced Practice Nurses provide the opportunity to improve care quality and safety. AIM To explore Nurse Practitioners and Clinical Nurse Consultants' experiences in patient safety. DESIGN A qualitative design was used involving six audio-visually recorded focus group interviews. Participants working in an acute or community adult nursing speciality were involved. METHODS Twenty-eight Advanced Practice Nurses (female 82.1%, mean age 47.5 ± 10 years) were recruited by convenience and snowball sampling. After transcription of interview data, qualitative content analysis was conducted. RESULTS Six categories were identified: patient safety as the highest priority (1), special contribution to patient safety (2), patients/relatives role in safety (3), multidisciplinary team approach (4), government regulation in safety (5), and further needs to improve safety (6). Advanced Practice Nurses saw themselves as role models and leaders for other healthcare staff through their expertise and professional experience and thus able to see the bigger picture in health. They identified as change agents at the system-level due to their decision-making ability and multi-professional team connectivity. CONCLUSIONS This study emphasises the key position of extended nursing roles and the need for future development of patient safety strategies in hospitals and community care. As influential leaders, Advanced Practice Nurses are best placed to identify improvements. They play a central role in guiding the multi-professional team, the patient and their family, educating nursing staff, and identifying and addressing system-wide safety gaps to improve patient safety.
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Affiliation(s)
- Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 11, 5020 Salzburg, Austria
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | | | | | | | - Kate Hackett
- South Eastern Sydney Local Health District, Sydney, Australia
| | - Caleb Ferguson
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
- Blacktown Hospital, Western Sydney Local Health District, Sydney, Australia
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Geese F, Bryant-Lukosius D, Zwakhalen S, Hahn S. Advanced Practice Nurses and Their Roles in Swiss Cancer Care: A Cross-Sectional Study. Semin Oncol Nurs 2024; 40:151626. [PMID: 38641521 DOI: 10.1016/j.soncn.2024.151626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/25/2024] [Accepted: 03/08/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVES To examine the advanced practice nurse workforce in Swiss cancer care and how their roles are being implemented (eg, role structures, processes) to achieve optimal outcomes for patients and their families, care organizations, and the broader health care system. METHODS A cross-sectional study was conducted. The sample included master-prepared advanced practice nurses in cancer care, who completed an online questionnaire from December 2021 to January 2022. Thirty-nine items assessed structures (eg, role characteristics, utilization), processes (eg, role activities, interventions), and perceived outcomes (eg, for patients, the health care system) of advanced practice nurses in Swiss cancer care. Data from closed questions were analyzed using descriptive statistics. Data from open-ended questions were organized and summarized into categories related to domains of advanced practice nursing and its reported frequency by the advanced practice nurses. RESULTS The participating advanced practice nurses (n = 53), worked in half of the 26 Swiss cantons. Interventions were identified within nine categories, of which most were targeted to patients and their families (n = 7), followed by health care professionals (n = 2). Perceived positive outcomes were patient symptom management, length of hospital stay, and health care costs. Participants felt less confident in cancer care (eg, autonomous practice) and reported 15 professional development needs (eg, medical interventions, teaching). CONCLUSIONS This study provides a comprehensive examination of 53 advanced practice nurses, detailing the characteristics of their roles and utilization across various jurisdictions and health care settings. The results highlight the diverse dimensions of advanced practice nursing and its potential to enhance cancer services and outcomes in Switzerland. Opportunities for role development support and expansion are identified. IMPLICATIONS FOR NURSING PRACTICE More systematic health human resource planning is needed to expand the deployment of advanced practice nurses across jurisdictions, practice settings, and more diverse patient populations. Role development needs show the desire for specialized educational preparation in cancer care.
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Affiliation(s)
- Franziska Geese
- Academic Practice Partnership, School of Health Professions, Bern University of Applied Sciences, Switzerland; University Hospital Bern, Inselspital, Insel Gruppe, Freiburgstrasse, Switzerland.
| | - Denise Bryant-Lukosius
- School of Nursing and Department of Oncology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sandra Zwakhalen
- Department of Health Services Research, Maastricht University, Netherlands
| | - Sabine Hahn
- Division of Nursing, School of Health Professions, Bern University of Applied Sciences, Switzerland
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Sholler GF, Selbie LA, Tallon M, Keating J, Ayer J, Burchill L, Cheung MMH, Cordina R, Culnane E, Donovan S, Eastaugh L, Elliott C, Fletcher J, Justo RN, Kasparian NA, Kelly A, Morsman D, Nicolae M, Orr Y, Pendrick E, Ramsay JM, Reményi B, Shipton S, Weintraub RG, Van Wijk E, Wheaton G, Venugopal P. Australian National Standards of Care for Childhood-onset Heart Disease (CoHD Standards). 1st Edition. Heart Lung Circ 2024; 33:153-196. [PMID: 38453293 DOI: 10.1016/j.hlc.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 03/09/2024]
Abstract
These first Australian National Standards of Care for Childhood-onset Heart Disease (CoHD Standards) have been developed to inform the healthcare requirements for CoHD services and enable all Australian patients, families and carers impacted by CoHD (paediatric CoHD and adult congenital heart disease [ACHD]) to live their best and healthiest lives. The CoHD Standards are designed to provide the clarity and certainty required for healthcare services to deliver excellent, comprehensive, inclusive, and equitable CoHD care across Australia for patients, families and carers, and offer an iterative roadmap to the future of these services. The CoHD Standards provide a framework for excellent CoHD care, encompassing key requirements and expectations for whole-of-life, holistic and connected healthcare service delivery. The CoHD Standards should be implemented in health services in conjunction with the National Safety and Quality Health Service Standards developed by the Australian Commission on Safety and Quality in Health Care. All healthcare services should comply with the CoHD Standards, as well as working to their organisation's or jurisdiction's agreed clinical governance framework, to guide the implementation of structures and processes that support safe care.
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Affiliation(s)
- Gary F Sholler
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia.
| | - Lisa A Selbie
- HeartKids Ltd, Parramatta, NSW, Australia; School of Biotechnology & Biomolecular Sciences University of NSW, Sydney, NSW, Australia and Johns Hopkins University, Baltimore, MD, USA
| | - Mary Tallon
- HeartKids Ltd, Parramatta, NSW, Australia; Perth Children's Hospital, Perth, WA, Australia; School of Nursing, Curtin University, Perth, WA, Australia
| | | | - Julian Ayer
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - Luke Burchill
- The Royal Melbourne Hospital, Melbourne, Vic, Australia and Mayo Clinic, Rochester, New York, NY, USA
| | - Michael M H Cheung
- The University of Melbourne, Melbourne, Vic, Australia; The Royal Children's Hospital, Melbourne, Vic, Australia
| | - Rachael Cordina
- The University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Evelyn Culnane
- The Royal Children's Hospital, Melbourne, Vic, Australia
| | | | - Lucas Eastaugh
- The Royal Children's Hospital, Melbourne, Vic, Australia
| | | | - Jeffery Fletcher
- Queensland Paediatric Specialists, Southport, Qld, Australia; Department of Paediatrics, The Tweed Hospital, Tweed Heads, NSW, Australia and Griffith University, Brisbane, Qld, Australia
| | - Robert N Justo
- Queensland Children's Hospital, South Brisbane, Qld, Australia; The University of Queensland, Herston, Qld, Australia; Queensland Paediatric Cardiac Research, Children's Health Queensland, South Brisbane, Qld, Australia
| | - Nadine A Kasparian
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Ohio, OH, USA
| | - Andrew Kelly
- Women's and Children's Hospital, North Adelaide, SA, Australia
| | | | - Mugur Nicolae
- The University of Queensland, Herston, Qld, Australia; Mater Hospital Services, Brisbane, Qld, Australia
| | - Yishay Orr
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | | | | | - Bo Reményi
- Menzies School of Health Research, Charles Darwin University, Darwin, NT and Royal Darwin Hospital, Darwin, NT, Australia
| | | | - Robert G Weintraub
- The University of Melbourne, Melbourne, Vic, Australia; The Royal Children's Hospital, Melbourne, Vic, Australia; Murdoch Children's Research Institute, Melbourne, Vic, Australia
| | - Elsa Van Wijk
- HeartKids Ltd, Parramatta, NSW, Australia; Australian Institute of Company Directors, NSW, Australia
| | - Gavin Wheaton
- Women's and Children's Hospital, North Adelaide, SA, Australia; University of Adelaide, Adelaide, SA, Australia
| | - Prem Venugopal
- Queensland Children's Hospital, South Brisbane, Qld, Australia; The University of Queensland, Herston, Qld, Australia
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Nahari A, Alhamed A, Moafa H, Aboshaiqah A, Almotairy M. Role delineation of advanced practice nursing: A cross-sectional study. J Adv Nurs 2024; 80:366-376. [PMID: 37449552 DOI: 10.1111/jan.15797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
AIMS To identify the roles and activities of nurses, including advanced practice nursing (APN), and to determine nursing practice patterns across health facilities in Saudi Arabia. METHODS A descriptive cross-sectional design was used to collect data from 207 nurses working in the Saudi health sector between November 2021 and March 2022 through an online questionnaire. The Advanced Practice Role Delineation tool was used to measure and delineate nursing practice patterns and activities. Data were analysed using descriptive statistics and analysis of variance. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. RESULTS Findings showed that participants, regardless of their current role, reported high scores across all domains of practice. The highest average score was obtained for the Clinical Care domain. Except for the leadership domain, findings showed that those reported working as advanced practice nurses had higher average scores across all domains than those working as staff nurses or being in managerial/administrative positions. There were significant differences in the average Clinical Care scores between advanced practice nurses and staff nurses. CONCLUSION Advanced practice nursing roles and activities are being practised in Saudi Arabia; however, there is no clear delineation of these roles and activities according to a unified and national-level APN scope of practice. IMPACTS Advanced practice nursing roles are evolving in Saudi Arabia; however, no study has examined the existing patterns of APN activities in Saudi Arabia. This study highlights the practice patterns of advanced practice nurses and adds to the international evidence base on the need for delineating APN activities under a unified scope of practice. The findings of this study are beneficial to practitioners, researchers, and stakeholders as well as the legislative and regulatory bodies. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Ahmed Nahari
- Department of Medical-Surgical Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Arwa Alhamed
- College of Nursing, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hamza Moafa
- Department of Community and Psychiatric Mental Health Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Aboshaiqah
- Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Monir Almotairy
- Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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Bonner A, Douglas B, Brown L, Harvie B, Lucas A, Tomlins M, Gillespie K. Understanding the practice patterns of nephrology nurse practitioners in Australia. J Ren Care 2023; 49:278-287. [PMID: 36210458 DOI: 10.1111/jorc.12444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Nurse practitioners (NP) have an expanded scope of practice beyond that of a registered nurse. In kidney care, nephrology NP can manage patients at various points along the chronic kidney disease (CKD) trajectory. OBJECTIVES To profile the characteristics, service patterns, and domains of practice of nephrology NP in Australia. DESIGN A cross-sectional online secure survey. PARTICIPANTS Nephrology NP (NP students) who were members of the Renal Society of Australasia and working in Australia (n = 73). MEASUREMENTS Data collected were demographic and practice characteristics, and domains of practice (using the modified Strong Model of Advanced Practice). The survey also sought qualitative perspectives of the enablers and barriers to sustainability nurse practitioner healthcare delivery services. RESULTS Nephrology NP (n = 45) primarily worked in adult services, managing those receiving haemodialysis, peritoneal dialysis, or patients with earlier grades of CKD. Providing direct comprehensive care was the dominant domain of advanced practice although administrative activities took up considerable time each week. Support from nurse leaders and medical colleagues was identified as key enablers for sustainability of these services whereas succession planning, and workload were the main barriers. CONCLUSIONS This study found a highly qualified, experienced but older nephrology nurse practitioner workforce who provide an additional model of health service delivery which can meet the growing CKD burden. Internationally, this level of nurse provides an opportunity for a career pathway to maintain nurses in direct clinical roles and to expand the nephrology nursing workforce.
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Affiliation(s)
- Ann Bonner
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
- Kidney Health Service, Metro North Health, Brisbane, Queensland, Australia
| | - Bettina Douglas
- School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia
| | - Leanne Brown
- Cape York Kidney Care, Torres and Cape Hospital and Health Service, Weipa, St Lucia, Australia
| | - Barbara Harvie
- School of Nursing and Midwifery, University of Tasmania, Hobart, Tasmania, Australia
| | - Anthony Lucas
- Department of Renal Medicine, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Melinda Tomlins
- Department of Nephrology, Hunter New England Health District, Newcastle, New South Wales, Australia
| | - Kerri Gillespie
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
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Ozkaya M, Korukcu O. Effect of cold cabbage leaf application on breast engorgement and pain in the postpartum period: A systematic review and meta-analysis. Health Care Women Int 2023; 44:328-344. [PMID: 35766462 DOI: 10.1080/07399332.2022.2090567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The researchers' aims are to determine the effect of cold cabbage leaf application on breast engorgement and pain during the postpartum period through a systematic review and meta-analysis. Between June and September 2021, researchers systematically searched Turkish and English databases using a combination of keywords. We calculated individual and general effect sizes of the studies to evaluate effect sizes. We obtained 25,996 results with the databases search and we included a total of eight studies for analysis. According to the pooled results, we determined that cold cabbage leaf application caused a significant reduction in breast pain, though no significant reduction was seen in breast engorgement. In this systematic review and meta-analysis, we found that cold cabbage leaf application was effective in reducing breast pain, but that more experimental studies are needed to determine its effect on breast engorgement.CALLOUTSBreast engorgement is a common physiological problem for lactating mothers.Researchers state that the results of the eight studies included in the analysis suggested that cold cabbage leaf application was effective in reducing breast pain.More studies are needed to evaluate the effect of cold cabbage application on reducing breast engorgement.
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Affiliation(s)
- Meltem Ozkaya
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Oznur Korukcu
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Serra-Barril MA, Benito-Aracil L, Pla-Consuegra M, Ferro-García T. Delphi survey on the application of advanced practice nursing competencies: Strong points and unfinished business in cancer care. J Nurs Manag 2022; 30:4339-4353. [PMID: 36194472 PMCID: PMC10092559 DOI: 10.1111/jonm.13843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 12/30/2022]
Abstract
AIM This study assessed the application of advanced practice nursing competencies in cancer care to identify obstacles to their full implementation. BACKGROUND Internationally, the implementation of advanced practice nursing roles depends on the context and environment, which shape the definition, scope and competencies associated with these roles. METHODS Nurses participated in two rounds of an online Delphi survey about the competencies of advanced practice oncology nurses. The threshold for expert consensus was set at 75%. RESULTS Eleven competency domains were proposed; all yielded consensus of over 75%. However, for 57.8% of the specific competencies proposed in round 1 and for 62.2% in round 2, there was no consensus on which were applied in practice. There was more agreement on the competencies applied in the domains of direct clinical practice, consultation and collaboration and interprofessional relations than in dimensions such as health care promotion, quality improvement, evidence-based practice and research. Barriers related to unimplemented competencies were identified. CONCLUSIONS The competencies applied in advanced practice nursing reflect incomplete development of these roles. Domains related to direct clinical practice, consultation and collaboration and interprofessional relations are relatively well developed, whereas those related to leadership, research, evidence-based practice and quality improvement are not. The identified barriers hindering implementation of some competencies can inform strategies to develop this role in cancer care. IMPLICATIONS FOR NURSING MANAGEMENT Hospital administrators and nurse managers should reflect and be mindful of the development of advanced practice nurse (APN) competencies along with the challenges associated with implementing advanced practice roles.
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Affiliation(s)
- M Antònia Serra-Barril
- Innovation and Quality Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Fundamental Care and Medical-Surgical Nursing Department, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Llúcia Benito-Aracil
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,IDIBELL, Institute of Biomedical Research, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Margarida Pla-Consuegra
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Tarsila Ferro-García
- Innovation and Quality Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Fundamental Care and Medical-Surgical Nursing Department, School of Nursing. University of Barcelona, Health Sciences Campus Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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Jokiniemi K, Chair SY, Wong FKY, Bryant‐Lukosius D. Advanced practice role delineation within Hong Kong: A cross-sectional study. Nurs Health Sci 2022; 24:679-689. [PMID: 35699666 PMCID: PMC9545430 DOI: 10.1111/nhs.12964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/26/2022] [Accepted: 06/04/2022] [Indexed: 11/30/2022]
Abstract
A career ladder for nurses, including several levels of nursing practice and specific roles for advanced practice nurses, was introduced in Hong Kong around the start of the 21st century. To date no studies have distinguished the practices of advanced practice nurses in Hong Kong. This cross-sectional study, conducted between November 2020 and March 2021, aims to identify and differentiate the practice patterns of advanced practice nurses by utilizing the Advanced Practice Role Delineation tool. A total of 191 responses were obtained. Three roles were identified: nurse consultant, advanced practice nurse, and advanced practice nurse in management. Among the five advanced practice nursing domains, nurses were most frequently involved in Education and in Direct Comprehensive Care activities, while least active in Research and in Publication and Professional Leadership. Identifying activities in various nursing roles helps to differentiate their responsibilities and provides new insights for role utilization and support. Although the role characteristics are shaped by country contexts, research evidence on practice patterns may be used to support international discussion and efforts to promote role clarity and effective role introduction and optimization.
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Affiliation(s)
- Krista Jokiniemi
- Department of Nursing Science, Faculty of Health SciencesUniversity of Eastern FinlandKuopioFinland
| | - Sek Ying Chair
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
- The Hong Kong Academy of NursingLai Chi KokHong Kong SARChina
| | - Frances Kam Yuet Wong
- Faculty of Health & Social Sciences, Chair Professor of Advanced Nursing Practice, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
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Patricia KM, Victoria MK, Connie MM, Marjorie KM, Violet K, Elliot K, Moses S, Emmanuel M, Christabel M, Kampata L, Nzala SH, Zyaambo C, Kaile T, Fastone G. Contextualisation of Early and Enhanced Clinical Exposure Model through Development of Curricula for Advanced Practice Nursing and Midwifery. OPEN JOURNAL OF NURSING 2022; 12:525-536. [PMID: 37333034 PMCID: PMC10275584 DOI: 10.4236/ojn.2022.127035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master's degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods The curricula development/review process utilized a modified Taba's Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master's level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.
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Affiliation(s)
| | | | | | | | - Kayamba Violet
- School of Medicine, University of Zambia, Lusaka, Zambia
| | | | - Simuyemba Moses
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Musenge Emmanuel
- School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | | | - Linda Kampata
- School of Public Health, University of Zambia, Lusaka, Zambia
| | | | - Cosmas Zyaambo
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Trevor Kaile
- School of Medicine, South Valley University, Mazabuka, Zambia
| | - Goma Fastone
- School of Medicine and Health Sciences, Eden University, Lusaka, Zambia
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Jokiniemi K, Heikkilä A, Meriläinen M, Junttila K, Peltokoski J, Tervo-Heikkinen T, Mattila E, Mikkonen S. Advanced practice role delineation within Finland: A comparative descriptive study. J Adv Nurs 2021; 78:1665-1675. [PMID: 34655100 DOI: 10.1111/jan.15074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/18/2021] [Accepted: 09/16/2021] [Indexed: 01/10/2023]
Abstract
AIM To identify and differentiate the practice patterns of generalist, specialist and advanced practice nursing roles in specialist and central hospital contexts. BACKGROUND In Finland, as in other Nordic countries, advanced practice nursing roles emerged around 2000. There are over 60,000 registered nurses/midwives in Finland and the clinical career pathway from a registered nurse to advanced practice nurse has been described yet not fully implemented in healthcare organizations. However, the number and activities of nonadvanced and advanced practitioner roles are not well known. DESIGN A descriptive comparative study. METHODS An online self-report survey was conducted between August and October 2020 using an advanced practice role delineation tool. A census sample of registered nurses, registered midwives, specialist nurses and advanced practice nurses in five university hospitals and one central hospital was recruited. Descriptive statistics were used to summarize the characteristics of participants and group differences were compared using analysis of variance (ANOVA). The STROBE checklist was used as the reporting guideline. RESULTS A total of 1497 responses were obtained (response rate = 10%). Overall, nurses used comprehensive care and education activities most frequently. The least used activities were research and publication and professional leadership. Univariate analysis of variance test between role effects, when education and grouped age were taken into account, showed statistically significant difference in all of the observed five activities (p < .001). CONCLUSION Identifying activities in different levels of nursing is a crucial first step in delineating nursing roles thus improving the governance of the human resource management. IMPACT The study results add to the international literature, delineating nursing roles in the spectrum of generalist to advanced practice nursing. As these roles become more formalized, we may incorporate novel ways of promoting the career development and optimal use and assessment of nursing roles and practice in various career levels.
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Affiliation(s)
- Krista Jokiniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Asta Heikkilä
- Development Services, Hospital District of Southwest Finland, Turku, Finland
| | - Merja Meriläinen
- Oulu University Hospital, Medical Research Center (MRC) Oulu, Oulu, Finland
| | - Kristiina Junttila
- Nursing Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Tarja Tervo-Heikkinen
- Clinical Development, Education and Research Centre of Nursing, Kuopio University Hospital, Kuopio, Finland
| | | | - Santtu Mikkonen
- Department of Environmental and Biological Sciences and Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Sevilla Guerra S, Zabalegui A, Comellas Oliva M, Estrem Cuesta M, Martín-Baranera M, Ferrús Estopà L. Advanced practice nurses: Analysis of their role from a multicentre cross-sectional study. Int Nurs Rev 2021; 69:30-37. [PMID: 34402064 DOI: 10.1111/inr.12706] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/04/2021] [Accepted: 07/19/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Stronger healthcare models are increasingly sought to address new population needs, health workforce inefficiencies and nursing shortages. One strategy is to focus on employees' strengths to capitalize on their competencies and maximize their scope of practice. INTRODUCTION Globally, there is an exponential demand for advanced practice nursing services. This study aimed to identify the roles and positions of nurses who align with APN defining criteria at all levels of care in Catalonia, Spain. METHODS The first step of the study included the translation and validation to Catalan of the Advanced Practice Nurse Role Delineation Tool (IDREPA) and step 2 comprised a multicentre cross-sectional study, in which 126 healthcare centres participated: 1209 nurses were included in the study. The STROBE checklist was used to report this study. RESULTS Transcultural equivalence and validation of the instrument showed a content validity index of 0.958 and the reliability of the questionnaire. The instrument identified 269 nurses who align with international APN defined criteria. They worked in specialized care, mental healthcare and primary and community care, especially in chronic conditions, ageing and end-of-life care. DISCUSSION Most areas of Catalonia have access to nurses practicing at APN defining criteria. These nurses were developed as an optimal resource to respond to patient needs in the context of study. Both recognition and strategic implementation are necessary to apply their full competencies to solve healthcare problems. CONCLUSION Understanding the supply of services delivered by nurses practicing at an advanced level and their scope of practice may lay the foundations for effective workforce planning in a dynamic context. Nurses who align with APN defining criteria are working mainly in large acute services without regulation and recognition. IMPLICATIONS FOR NURSING Advanced practice nurses show the value of their role and activities in healthcare services. IMPLICATIONS FOR HEALTH POLICY Promoting the establishment of APN defining criteria that includes credentialing and a regulatory framework within international guidelines should be a priority to make an impact on healthcare policy.
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Affiliation(s)
| | | | - Montserrat Comellas Oliva
- University School of Nursing and Occupational Therapy (EUIT), Autonomous University of Barcelona (UAB), Barcelona, Spain
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Currie J, Carter MA, Lutze M, Edwards L. Preparing Australian Nurse Practitioners to Meet Health Care Demand. J Nurse Pract 2020. [DOI: 10.1016/j.nurpra.2020.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Rocafort TB. Following the Path; A Grounded Theory Study Regarding Doctoral Roles. J Prof Nurs 2020; 36:251-258. [PMID: 32819552 DOI: 10.1016/j.profnurs.2019.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Decades after the AACN (2004) position statement regarding the clinical doctorate, the DNP, shows ongoing dialogue without professional consensus regarding the two terminal degrees. The lack of understanding and confusion surrounding the two doctoral degrees in nursing subsequently projects a negative image about the profession; suggesting a lack of cohesiveness; promotes an environment of distrust, thereby creating confusion for the public about the nursing profession. PURPOSE The purpose of this qualitative research was to develop a substantive theory about the perceptions and the attitudes of doctoral nurses regarding their roles. METHOD An adapted approach of Strauss and Corbin's grounded theory methodology was used. Sampling was purposive, snowball, and theoretical. Theoretical sampling with an expert group validated concepts, themes, and categories. RESULTS The main categories of advancing, collaborating, transforming, and stewarding emerged from the data. The basic social process of Following the Path identified and explained the meaning ascribed by DNP and PhD nurses about their doctoral roles. CONCLUSIONS The theoretical framework provides information about the DNP and PhD nurse. The findings support evidence the nursing profession is moving forward towards self-definition. Acceptance and need for the doctoral roles were identified. Understanding the perspectives of the doctoral nurses in the profession has identified forward movement in practice and cohesion of the nursing discipline.
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Affiliation(s)
- Terri B Rocafort
- Chamberlain College of Nursing, 583 Dakota Drive, Jupiter, FL 33458, United States of America.
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López-Liria R, Vega-Ramírez FA, Aguilar-Parra JM, Padilla-Góngora D, Trigueros-Ramos R, Rocamora-Pérez P. Evaluation of the Effectiveness of a Nursing/Physiotherapy Program in Chronic Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2236. [PMID: 31242616 PMCID: PMC6617027 DOI: 10.3390/ijerph16122236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 11/20/2022]
Abstract
This study aimed to evaluate the functional impact of a shared intervention model by the mobile physiotherapy and rehabilitation team (MPRT) and primary care case management nurses (PCCMNs) on chronic patients. This was a prospective, observational study involving 1086 patients (mean age, 80 years; 63.7% females) in the province of Almeria, which was conducted between 2004 and 2018. Most of the registered diseases included cerebrovascular and neurological diseases (56.7%), osteoarticular diseases (45.3%), diabetes mellitus (25.7%), cardiovascular diseases (25.5%), and chronic respiratory diseases. The study included a home care intervention by the MPRT and PCCMNs and included the following main outcome measures: age, sex, main caregiver, disabling process (ICD-9), type and number of inclusion categories for chronic disease, initial and final Barthel index (BI), treatment or intervention on the patient (techniques), objectives, and number of sessions. The main techniques used were kinesiotherapy (44.6%) and caregiver training (23%), along with technical aid. An equation predicting the patients' final BI, according to the initial BI, was constructed using multiple linear regression modelling. A marked improvement in functional capacity was found after an average of 10 physiotherapy sessions. A lower patient age was correlated with a higher functional capacity, both initial and final BI, as well as a greater number of sessions.
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Affiliation(s)
- Remedios López-Liria
- Health Research Centre, Department of Nursing, Physiotherapy and Medicine, University of Almería, Carretera del Sacramento s/n, La Cañada de San Urbano, 04120 Almería, Spain.
| | | | - José Manuel Aguilar-Parra
- Department of Psychology, University of Almería, Carretera del Sacramento s/n, La Cañada de San Urbano, 04120 Almería, Spain.
| | - David Padilla-Góngora
- Department of Psychology, University of Almería, Carretera del Sacramento s/n, La Cañada de San Urbano, 04120 Almería, Spain.
| | - Rubén Trigueros-Ramos
- Department of Psychology, University of Almería, Carretera del Sacramento s/n, La Cañada de San Urbano, 04120 Almería, Spain.
| | - Patricia Rocamora-Pérez
- Health Research Centre, Department of Nursing, Physiotherapy and Medicine, University of Almería, Carretera del Sacramento s/n, La Cañada de San Urbano, 04120 Almería, Spain.
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Sevilla-Guerra S, Zabalegui A. Instrumentos de análisis para el desempeño de la enfermera de práctica avanzada. ENFERMERIA CLINICA 2019; 29:90-98. [DOI: 10.1016/j.enfcli.2017.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 08/22/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
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Spooner AJ, Booth N, Downer TR, Gordon L, Hudson AP, Bradford NK, O’Donnell C, Geary A, Henderson R, Franks C, Conway A, Yates P, Chan RJ. Advanced practice profiles and work activities of nurse navigators: An early-stage evaluation. Collegian 2019. [DOI: 10.1016/j.colegn.2018.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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18
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Beyond competencies: Practice standards for emergency nurse practitioners—A model for specialty care clinicians, educators, and employers. J Am Assoc Nurse Pract 2018; 30:570-578. [DOI: 10.1097/jxx.0000000000000139] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sevilla Guerra S, Risco Vilarasau E, Galisteo Giménez M, Zabalegui A. Spanish version of the modified Advanced Practice Role Delineation tool, adaptation and psychometric properties. Int J Nurs Pract 2018; 24:e12635. [DOI: 10.1111/ijn.12635] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/26/2017] [Accepted: 01/15/2018] [Indexed: 11/29/2022]
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20
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Carryer J, Wilkinson J, Towers A, Gardner G. Delineating advanced practice nursing in New Zealand: a national survey. Int Nurs Rev 2017; 65:24-32. [DOI: 10.1111/inr.12427] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J. Carryer
- School of Nursing College of Health Massey University Palmerston North New Zealand
| | - J. Wilkinson
- School of Public Health College of Health Massey University Palmerston North New Zealand
| | - A. Towers
- School of Nursing College of Health Massey University Wellington New Zealand
| | - G. Gardner
- Faculty of Health School of Nursing Queensland University of Technology Brisbane QLD Australia
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Sevilla Guerra S, Miranda Salmerón J, Zabalegui A. Profile of advanced nursing practice in Spain: A cross-sectional study. Nurs Health Sci 2017; 20:99-106. [DOI: 10.1111/nhs.12391] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 08/28/2017] [Accepted: 08/30/2017] [Indexed: 11/29/2022]
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Petersen PA, Way SM. The role of physician oversight on advanced practice nurses’ professional autonomy and empowerment. J Am Assoc Nurse Pract 2017; 29:272-281. [DOI: 10.1002/2327-6924.12444] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/16/2016] [Indexed: 11/06/2022]
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Parker JM, Hill MN. A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong Special Administrative Region (SAR), China. Int J Nurs Sci 2017; 4:196-204. [PMID: 31406742 PMCID: PMC6626099 DOI: 10.1016/j.ijnss.2017.01.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 01/11/2017] [Indexed: 11/25/2022] Open
Abstract
This paper provides an overview of Advanced Practice Nursing (APN) in the USA, Canada, Australia and Hong Kong. It is based upon documents presented to the China Medical Board (CMB) China Nursing Network (CNN) as background for discussions held by the CNN in Shanghai. It discusses the APN role in these countries and regions according to topics identified by the CNN. These are APN educational preparation; role legitimacy; capacity requirements; scope of practice, domains of activities and limited rights for prescription and referral; professional promotion ladder; accreditation system; and, performance evaluation system. Both Canada and Australia have adapted many aspects of the USA model of APN to fit their specific legislative requirements and local conditions. Hong Kong has taken a different path which may be of interest in the Chinese context.
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Affiliation(s)
| | - Martha N. Hill
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
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Duffield C, Chapman S, Rowbotham S, Blay N. Nurse-Performed Endoscopy: Implications for the Nursing Profession in Australia. Policy Polit Nurs Pract 2017; 18:36-43. [PMID: 28558517 DOI: 10.1177/1527154417700740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Increasing demands for health care globally often lead to discussions about expanding the involvement of nurses in a range of nontraditional roles. Several countries have introduced nurse endoscopists as a means of easing the burden of demand for a range of endoscopic procedures. A shortage of medical staff in Australia combined with increasing demand for endoscopy led to the implementation of nurse endoscopists as a pilot program in the state of Queensland, where a nurse practitioner model was implemented, and Victoria, where an advanced practice model was used. This article will discuss the implementation of and responses from the nursing, medical, and policy community to nurse-performed endoscopy in this country. Regarding health policy, access to cancer screening may be improved by providing nurses with advanced training to safely perform endoscopy procedures. Moreover, issues of nurse credentialing and payment need to be considered appropriate to each country's health system model.
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Affiliation(s)
- Christine Duffield
- 1 Centre for Health Services Management, Faculty of Health, University of Technology Sydney, NSW, Australia.,2 Nursing and Health Services Management, School of Nursing and Midwifery, Edith Cowan University, Joondaalup, WA, Australia
| | - Susan Chapman
- 3 Center for Health Professions and the Institute for Health Policy Studies, UCSF School of Nursing, CA, USA.,4 Department of Social and Behavioral Sciences, UCSF School of Nursing, CA, USA
| | - Samantha Rowbotham
- 5 Menzies Centre for Health Policy, The University of Sydney, NSW, Australia
| | - Nicole Blay
- 6 Faculty of Health, University of Technology Sydney, NSW, Australia.,7 Centre for Applied Nursing Research, Western Sydney University, Sydney, NSW, Australia
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Adams M, Gardner G, Yates P. Investigating nurse practitioners in the private sector: a theoretically informed research protocol. J Clin Nurs 2017; 26:1608-1620. [DOI: 10.1111/jocn.13492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Margaret Adams
- School of Nursing; Institute of Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Qld Australia
| | - Glenn Gardner
- School of Nursing; Institute of Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Qld Australia
| | - Patsy Yates
- School of Nursing; Institute of Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Qld Australia
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MacLellan L, Higgins I, Levett‐Jones T. An exploration of the factors that influence nurse practitioner transition in Australia. J Am Assoc Nurse Pract 2017; 29:149-156. [DOI: 10.1002/2327-6924.12423] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 08/07/2016] [Accepted: 09/06/2016] [Indexed: 11/05/2022]
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Gardner G, Duffield C, Doubrovsky A, Bui UT, Adams M. The structure of nursing: a national examination of titles and practice profiles. Int Nurs Rev 2017; 64:233-241. [PMID: 28239841 DOI: 10.1111/inr.12364] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To identify the practice patterns of the Australian registered nurse workforce according to position title and to map these disparate titles across all jurisdictions of the country. INTRODUCTION Effective nursing workforce planning can contribute to improved patient care and increased effectiveness and efficiency of healthcare systems. BACKGROUND The prevailing approach to nursing workforce planning focuses on number of nursing staff needed in relation to the number of patients. The level of expertise and skill mix of registered nurses as a variable in workforce planning is rarely considered. METHODS A national cross-sectional electronic survey of registered nurses in Australia was conducted using the validated Advanced Practice Role Delineation tool developed from the Strong Model of Advanced Practice. The study involved a sample of 5599 registered nurses. RESULTS Sixty-six nursing position titles nationally were mapped using cluster analysis technique and gave rise to seven clusters of equivalent Australian jurisdictional nursing position titles and practice profiles. DISCUSSION Effective workforce policy and planning is reliant upon access to reliable evidence. This research is an international first in that it has provided comprehensive knowledge of the clinical level and practice profiles of a national nursing workforce. IMPLICATIONS FOR NURSING POLICY Effective, patient-centred workforce planning must consider both the numerical and expertise mix of a nursing workforce. This research provides Australian health service and policy planners with evidence-base knowledge of the nursing workforce. Internationally, this research establishes a platform from which to develop validated tools and established processes to support replication of this research.
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Affiliation(s)
- G Gardner
- School of Nursing, Institute for Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - C Duffield
- Nursing and Health Services Management, Centre for Health Services Management, University of Technology Sydney, Sydney, NSW, Australia
| | - A Doubrovsky
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - U T Bui
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - M Adams
- School of Nursing, Institute for Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 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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Birks M, Davis J, Smithson J, Cant R. Registered nurse scope of practice in Australia: an integrative review of the literature. Contemp Nurse 2016; 52:522-543. [DOI: 10.1080/10376178.2016.1238773] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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West SK. Advanced Practice Nursing Committee on Process Improvement in Trauma: An Innovative Application of the Strong Model. J Trauma Nurs 2016; 23:227-30. [PMID: 27414145 DOI: 10.1097/jtn.0000000000000220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article aims to summarize the successes and future implications for a nurse practitioner-driven committee on process improvement in trauma. The trauma nurse practitioner is uniquely positioned to recognize the need for clinical process improvement and enact change within the clinical setting. Application of the Strong Model of Advanced Practice proves to actively engage the trauma nurse practitioner in process improvement initiatives. Through enhancing nurse practitioner professional engagement, the committee aims to improve health care delivery to the traumatically injured patient. A retrospective review of the committee's first year reveals trauma nurse practitioner success in the domains of direct comprehensive care, support of systems, education, and leadership. The need for increased trauma nurse practitioner involvement has been identified for the domains of research and publication.
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Poitras ME, Chouinard MC, Fortin M, Gallagher F. How to report professional practice in nursing? A scoping review. BMC Nurs 2016; 15:31. [PMID: 27231437 PMCID: PMC4880971 DOI: 10.1186/s12912-016-0154-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 05/17/2016] [Indexed: 11/22/2022] Open
Abstract
Background Nursing professional practice in different contexts of care has been widely described in evidence-based literature. Currently, there is no consensus on a common structure for these descriptions. Understanding and comparing similar practices is made difficult by the varying nature of descriptions provided in scientific literature. Purpose of the study: 1) to report research methods found in the scientific literature that were used to describe the practice of different health professionals; 2) to report on the main concepts used to describe the practice of these health professionals; 3) to propose a structure for the description of the practice in nursing. Methods A scoping review following a five-stage approach: 1) identifying the research question; 2) identifying relevant studies; 3) selecting studies; 4) charting data; 5) reporting results. The Medline, CINAHL, psychARTICLES, psyCRITIQUES, psycEXTRA, Psychology and Behavioral Science Collection and psycINFO databases were searched. Each study was analyzed and extracted data were classified by categories and structures used to describe the health professional practices. Results Forty-nine studies were included. In these studies, quantitative, qualitative or mixed methods were used to describe professional practice in different health disciplines. Three major concepts were reported most frequently in describing professional practice: roles, domains and activities. The concepts varied greatly among authors. We found that to define roles or to characterize a professional practice, activities must be described and organized on the basis of different domains. Conclusions A promising structure for describing nursing professional practice is proposed by the authors of this review. The structure facilitates the accurate description of all domains and activities performed by nurses in different contexts of practice, and will contribute to the development of knowledge about nursing practice in different contexts based on shared concepts. Electronic supplementary material The online version of this article (doi:10.1186/s12912-016-0154-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marie-Eve Poitras
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada
| | | | - Martin Fortin
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada ; Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Hôpital de Chicoutimi, 305, Saint-Vallier, Chicoutimi, G7H 5H6 Québec Canada
| | - Frances Gallagher
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Québec, Canada
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Gray A. Advanced or advancing nursing practice: what is the future direction for nursing? ACTA ACUST UNITED AC 2016; 25:8, 10, 12-3. [PMID: 26768039 DOI: 10.12968/bjon.2016.25.1.8] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Advanced nursing practice roles have emerged over the last 25 years in response to two major challenges: first, the significant reduction in available doctors; and, second, the rise in numbers of patients with complex health needs. It is suggested that, with a major drive to respond to the first problem, with its emphasis on the development of medical skills, the development of advanced nursing practice (which has the potential to have a significant impact on the second challenge of the rise in long-term conditions) has very much taken second place. Moreover, advanced nursing practice roles have become so medically focused that not only is advanced nursing practice not evident, but neither are the recognised sub-roles that are fundamental to advancing practice. These include innovation, education, research and clinical leadership. This article argues that in the current climate it is essential that advanced nurse practitioners not only demonstrate advanced practice, but also actively embrace the concept of 'advancing' nursing practice as the dominant feature of new roles.
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Affiliation(s)
- Alastair Gray
- Senior Lecturer (Emergency & Advancing Practice), Department of Nursing, Midwifery & Healthcare Practice, Faculty of Health and Life Sciences, Coventry University
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Identifying advanced practice: A national survey of a nursing workforce. Int J Nurs Stud 2016; 55:60-70. [DOI: 10.1016/j.ijnurstu.2015.12.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 12/03/2015] [Accepted: 12/04/2015] [Indexed: 11/22/2022]
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Morilla-Herrera JC, Garcia-Mayor S, Martín-Santos FJ, Kaknani Uttumchandani S, Leon Campos Á, Caro Bautista J, Morales-Asencio JM. A systematic review of the effectiveness and roles of advanced practice nursing in older people. Int J Nurs Stud 2015; 53:290-307. [PMID: 26542652 DOI: 10.1016/j.ijnurstu.2015.10.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To identify, assess and summarize available scientific evidence about the effect of interventions deployed by advanced practice nurses when providing care to older people in different care settings, and to describe the roles and components of the interventions developed by these professionals. BACKGROUND In older people, evidence of advanced practice roles remains dispersed along different contexts, approaches and settings; there is little synthesis of evidence, and it is not easy to visualize the different practice models, their components, and their impact. DESIGN Systematic review. DATA SOURCES Sixteen electronic databases were consulted (1990-2014). The research also included screening of original studies in reviews and reports from Centers of Health Services Research and Health Technology Agencies. REVIEW METHODS Studies were assessed by two reviewers with the Cochrane risk of bias tool. They were classified depending on the type of follow-up (long and short-term care) and the scope of the service (advanced practice nurses interventions focused on multimorbid patients, or focused on a specific disease). RESULTS Fifteen studies were included. In long-term settings, integrative, multi-component and continuous advanced practice nursing care, reduced readmissions, and increased patients' and caregivers' satisfaction. Advanced practice nurses were integrated within multidisciplinary teams and the main interventions deployed were patient education, multidimensional assessments and coordination of multiple providers. CONCLUSION Positive results have been found in older people in long-term care settings, although it is difficult to discern the specific effect attributable to them because they are inserted in multidisciplinary teams. Further investigations are needed to evaluate the cost-effectiveness of the two modalities detected and to compare internationally the interventions developed by advanced practice nurses.
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Affiliation(s)
- Juan Carlos Morilla-Herrera
- Primary Health Care District of Málaga, Spain; Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | - Silvia Garcia-Mayor
- Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | - Francisco Javier Martín-Santos
- Primary Health Care District of Málaga, Spain; Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | | | - Álvaro Leon Campos
- Department of Nursing, Faculty of Health Sciences, University of Málaga, Spain
| | - Jorge Caro Bautista
- Health Care Centre El Limonar, Primary Health Care District of Málaga, Spain
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Parry YK, Ullah S, Raftos J, Willis E. Deprivation and its impact on non-urgent Paediatric Emergency Department use: are Nurse Practitioners the answer? J Adv Nurs 2015; 72:99-106. [DOI: 10.1111/jan.12810] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Yvonne Karen Parry
- School of Nursing & Midwifery; Faculty of Medicine, Nursing and Health Sciences; School of Nursing & Midwifery; Flinders University; Adelaide South Australia Australia
| | - Shahid Ullah
- Flinders Centre for Epidemiology and Biostatistics; Faculty of Health Sciences; Flinders University; Adelaide South Australia Australia
| | - Jeremy Raftos
- Emergency Department; Women's and Children's Hospital; North Adelaide South Australia Australia
| | - Eileen Willis
- School of Health Science; Faculty of Medicine, Nursing and Health Sciences; Flinders University; Adelaide South Australia Australia
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Elliott EC, Walden M. Development of the transformational advanced professional practice model. J Am Assoc Nurse Pract 2015; 27:479-87. [DOI: 10.1002/2327-6924.12171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 08/25/2013] [Indexed: 11/10/2022]
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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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Martin-Misener R, Donald F, Wickson-Griffiths A, Akhtar-Danesh N, Ploeg J, Brazil K, Kaasalainen S, McAiney C, Carter N, Schindel Martin L, Sangster-Gormley E, Taniguchi A. A mixed methods study of the work patterns of full-time nurse practitioners in nursing homes. J Clin Nurs 2014; 24:1327-37. [DOI: 10.1111/jocn.12741] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Ruth Martin-Misener
- School of Nursing; Dalhousie University; Halifax NS Canada
- Canadian Centre for Advanced Practice Nursing Research; School of Nursing; McMaster University; Hamilton ON Canada
| | - Faith Donald
- Daphne Cockwell School of Nursing; Ryerson University; Toronto ON Canada
- Canadian Centre for Advanced Practice Nursing Research; School of Nursing; McMaster University; Hamilton ON Canada
| | | | | | - Jenny Ploeg
- Aging, Community and Health Research Unit; School of Nursing; McMaster University; Hamilton ON Canada
| | - Kevin Brazil
- School of Nursing and Midwifery; Queen's University Belfast, Medical Biology Centre; Belfast UK
| | | | - Carrie McAiney
- Department of Psychiatry and Behavioural Neurosciences; McMaster University; Hamilton ON Canada
- Seniors Mental Health Services; St. Joseph's Healthcare Hamilton; Hamilton ON Canada
| | - Nancy Carter
- Canadian Centre for Advanced Practice Nursing Research; School of Nursing; McMaster University; Hamilton ON Canada
| | - Lori Schindel Martin
- Research and Creative Activities; Daphne Cockwell School of Nursing; Ryerson University; Toronto ON Canada
- Gerontological Nursing Association Ontario; Toronto ON Canada
| | | | - Alan Taniguchi
- Department of Family Medicine; McMaster University; Hamilton ON Canada
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Jokiniemi K, Haatainen K, Meretoja R, Pietilä AM. The Future of the Clinical Nurse Specialist Role in Finland. J Nurs Scholarsh 2014; 47:78-86. [DOI: 10.1111/jnu.12109] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Krista Jokiniemi
- Doctoral student; University of Eastern Finland; Faculty of Health Sciences; Department of Nursing Science, and Assistant Head Nurse; Kuopio Finland
| | - Kaisa Haatainen
- Docent; University of Eastern Finland; and Patient Safety Manager; Kuopio University Hospital; Kuopio Finland
| | - Riitta Meretoja
- Docent; Universtity of Turku; and Development Manager; Corporate Headquarters; Hospital District of Helsinki; Uusimaa Helsinki Finland
| | - Anna-Maija Pietilä
- Professor; University of Eastern Finland; Faculty of Health Sciences; Department of Nursing Science; Social and Health Care Services; Kuopio 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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Noordman J, van der Weijden T, van Dulmen S. Effects of video-feedback on the communication, clinical competence and motivational interviewing skills of practice nurses: a pre-test posttest control group study. J Adv Nurs 2014; 70:2272-83. [DOI: 10.1111/jan.12376] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2014] [Indexed: 12/25/2022]
Affiliation(s)
- Janneke Noordman
- NIVEL; Netherlands Institute for Health Services Research; Utrecht The Netherlands
| | - Trudy van der Weijden
- Department of General Practice; School for Public Health and Primary Care (CAPHRI); Maastricht University; The Netherlands
| | - Sandra van Dulmen
- NIVEL; Netherlands Institute for Health Services Research; Utrecht The Netherlands
- Department of Primary and Community Care; Radboud University Nijmegen Medical Centre; The Netherlands
- Department of Health Science; Buskerud University College; Drammen Norway
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