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Whitfield MM, Bleah P, Concepcion Bachynski J, Macdonald D, Klein T, Ross-White A, Mimirinis M, Wilson R. Capability as a concept in advanced practice nursing and education: a scoping review. JBI Evid Synth 2024:02174543-990000000-00339. [PMID: 39175378 DOI: 10.11124/jbies-23-00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
OBJECTIVE The objective of this review was to map the literature about the concept of capability in advanced practice nursing education and practice to achieve greater clarity on the concept and its application. INTRODUCTION Advanced practice nursing roles make up a growing segment of the global nursing workforce. Capability has been proposed as an overarching description of the attributes of advanced practice nursing roles within complex workplace environments. Capability includes knowing how to learn, and the ability to creatively integrate prior knowledge, skills, judgment, and experience in both new and familiar situations. INCLUSION CRITERIA This review looked at the literature about capability applied to advanced practice nursing in any setting globally. We were guided by the International Council of Nurses' definition of advanced practice nursing, which includes nurses with both graduate education and an expanded scope of practice. Drawing from an initial review of the literature, we used a working definition of capability, which was a combination of knowledge, skills, experience, and competencies that enables advanced practice nurses to provide appropriate care for patients in both known and unfamiliar clinical settings. We included literature about individual capability as a concept in any setting related to advanced practice nursing and education. METHODS We searched 18 electronic databases and included qualitative, quantitative, and mixed methods study design methodologies, reviews, and reports. The gray literature search included policy and practice documents from the World Health Organization, the International Council of Nursing, and websites of 48 nursing and health organizations. Two reviewers independently completed title and abstract screening prior to full-text review and data extraction. Conflicts were resolved via discussion or with a third reviewer. Extraction was completed by 2 reviewers using a piloted data extraction tool. Articles published in English from 1975 to the present were included. Sources in languages other than English were not included in the review due to the difficulties in accurately translating the concept of capability. RESULTS Thirty-five sources were included in the review with publication dates from 2000 to 2023. Most sources originated from Australia, the United Kingdom, and the United States of America. Sources included frameworks and clinical guidelines, peer-reviewed articles, and gray literature. Capability was discussed in a range of settings, including specialized clinical roles. Applications of capability in educational settings included the use of capability frameworks to guide nurse practitioner education, nursing practice doctorates, and postgraduate nurse practitioner training. Definitions of capability, where provided, were relatively consistent. Capability was proposed as a distinguishing characteristic of advanced practice nursing, as a descriptor of clinical proficiency that moved beyond competency, and as a framework that accounted for complexity in health care settings. CONCLUSIONS Capability was used as a concept and framework to describe advanced practice nursing within complex practice environments that necessitate flexible approaches. Capability frameworks were applied holistically and to specific areas of practice or education, including in pre- and postgraduate advanced practice nursing education. Strategies for teaching and learning capability focused on flexibility, student-directed learning, and development of flexible learning pathways. SUPPLEMENTAL DIGITAL CONTENT A Norwegian-language version of this abstract of this review is available: http://links.lww.com/SRX/A58.
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Affiliation(s)
- Martha M Whitfield
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Community Nursing Department College of Nursing and Health Sciences University of Massachusetts Dartmouth Dartmouth, MA, United State
| | - Paulina Bleah
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Danielle Macdonald
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- The Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Tracy Klein
- College of Nursing, Washington State University Vancouver, Vancouver, WA, United States
| | - Amanda Ross-White
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- The Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Mike Mimirinis
- School of Human and Social Sciences, University of West London, London, United Kingdom
- Faculty of Humanities and Social Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Rosemary Wilson
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- The Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
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Saga E, Egilsdottir HÖ, Bing-Jonsson PC, Lindholm E, Skovdahl K. It's not the task, it's the shifting exploring physicians' and leaders' perspectives on task shifting in emergency departments in Norway. BMC Nurs 2024; 23:571. [PMID: 39152457 PMCID: PMC11330047 DOI: 10.1186/s12912-024-02246-8] [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: 05/28/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Task shifting is an approach where specific tasks are transferred, when convenient, from health workers with high qualifications to health workers with less training and lower qualifications. This approach is mainly used to utilize the available human resources for health. Tasks that are traditionally linked to the physician role have increasingly been transferred to registered nurses during the last decade. Knowledge regarding the experiences and reflections of physicians and their leaders related to giving up tasks or how such policies can best be implemented is limited. This study aimed to explore physicians' and their leaders' perspectives on task shifting, especially to registered nurses, in different Norwegian emergency departments. METHODS The study was carried out from June to October 2022. It had an explorative and descriptive qualitative design and an inductive approach, semi-structured interviews was used. The study involved ten physicians and leaders from three different regional hospitals in south-eastern Norway. Manifest and latent content analysis were used to analyse the data. The COREQ guidelines were applied in the study. RESULTS From the three categories 1) The rationale for task shifting, 2) Teambuilding and 3) Implementation of task shifting, with nine subcategories. One overall main theme emerged: It is not the task, it is the shifting - moving towards a person-centred culture. CONCLUSIONS The study indicates that developing a person-centred culture and fostering a team approach in emergency departments is more important than simply shifting tasks, as task shifting may lead to fragmented care and resistance from physicians. Hospital leaders must invest time and effort into organising teams and providing clear leadership to support the redesign of professional roles, recognising the cultural and traditional challenges involved. Policymakers should promote guideline development, team training programs, and cooperation methods to support a person-centred culture and effective task shifting in emergency departments.
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Affiliation(s)
- Elin Saga
- Division of Emergency Department, Vestfold Hospital Trust, Halfdan Wilhelmsens Allé 17, Tønsberg, 3103, Norway.
| | - H Ösp Egilsdottir
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, Drammen, 3045, Norway
| | - Pia C Bing-Jonsson
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Raveien 215, Borre, 3184, Norway
| | - Espen Lindholm
- Department of Anaesthesiology, Vestfold Hospital Trust, Halfdan Wilhelmsens Allé 17, Tønsberg, 3103, Norway
| | - Kirsti Skovdahl
- Faculty of Health, Welfare and Organisation, Østfold University College, Halden, NO-1757, Norway
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Howland K, Matricciani LA, Cornelius-Bell A, Kelly MA. The concept of capability in pre-registration nursing education: A scoping review. NURSE EDUCATION TODAY 2024; 139:106240. [PMID: 38761466 DOI: 10.1016/j.nedt.2024.106240] [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: 01/09/2024] [Revised: 04/26/2024] [Accepted: 05/05/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Capability in nursing education is an emerging concept that includes various requisites, which can be applied in complex or unfamiliar clinical settings. Despite growing research for practising nurses, the requisites of capability for pre-registration nursing students entering the workforce remain unclear. OBJECTIVE The objective was to identify the requisites that constitute capability for practice among pre-registration nursing students as well as the enablers to develop capabilities. DESIGN A scoping review was performed using the Joanna Briggs Institute methodology. DATA SOURCES Records published without date restriction were searched using MEDLINE, Embase, Emcare, CINAHL, and Scopus databases. Grey literature and reference list searching was conducted. REVIEW METHODS Sources explicitly reporting requisites of capability or enablers of capability development in pre-registration nursing education were eligible. All global sources written in English and available in full text were included. Data were extracted and synthesised using a specifically designed extraction tool. RESULTS The number of records reviewed totalled 896. Twenty-three studies met the criteria for inclusion in the synthesis. Nineteen capability requisites for practice were reported. Whilst various enablers to support development of capability requisites were reported, some challenges were also identified. CONCLUSION This study identified requisites of capability for practice and enablers that may support development of capability in pre-registration nursing education. This holistic set of capabilities has previously not been reported. Given the emerging nature of the concept, this collective set of requisites may not be indicative of all required capabilities of nursing students upon graduation. Efforts to develop a definitive set of requisites and explore strategies to support and enable capability development are needed to advance this concept in the pre-registration nursing education context.
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Affiliation(s)
- Kirstie Howland
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Lisa A Matricciani
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.
| | - Aidan Cornelius-Bell
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Teaching Innovation Unit, University of South Australia, Adelaide, South Australia, Australia.
| | - Michelle A Kelly
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
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Parker R, Gough H, Laakso EL. Utilising an Allied Health Practitioner Capability Audit and Confidence Survey to Identify Implications for Telehealth Safety and Risk-A Chronicle of a Health Service Improvement Activity. Healthcare (Basel) 2024; 12:1442. [PMID: 39057585 PMCID: PMC11276102 DOI: 10.3390/healthcare12141442] [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: 05/29/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Whilst the benefits of telehealth were identified during the COVID-19 pandemic, we noted barriers to its use at a vital time. Through a health service improvement approach, we sought to increase allied health professional capability in telehealth, but we also sought to understand if there were risks associated with its use. We designed and implemented tools to evaluate allied health professional competence and confidence in using telehealth with private and public patients in a metropolitan teaching hospital setting. With an emphasis on technology capability, we undertook audits over three consecutive years (2020 to 2022) of allied health professional telehealth occasions of service reporting on compliance with the audit criteria and investigating staff confidence in undertaking telehealth sessions using a co-designed survey. The audit tool and confidence survey results were used to identify risk factors to telehealth service delivery using a Modified Health Failure Modes, Effects Analysis. Although confidence levels were relatively high among staff, confidence in managing safety factors and technology risks associated with telehealth were not initially verified by the audit findings. Remedial efforts resulted in service improvements in many identified risk factors, yet technology performance and its troubleshooting remained a primary variable in the ability of staff to comply with the requirements of the real-time audits. Health workers using telehealth should have training to engage safely and effectively in telehealth care and the technology.
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Affiliation(s)
- Raeleen Parker
- Allied Health Service Development, Mater Health, South Brisbane, QLD 4101, Australia;
- Consumer Partnering, Metro South Hospital and Health Service, Eight Miles Plains, QLD 4113, Australia
| | - Hayley Gough
- Mater Education, South Brisbane, QLD 4101, Australia
| | - E-Liisa Laakso
- Mater Research Institute, University of Queensland, South Brisbane, QLD 4101, Australia
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Maneewat K, Kaewamporn N, Ren S, Bilalee S, Wasinwong W, Nimmanrat S, Siripituphum D, Swusdinaruenart S. Capabilities Toward Intravenous Patient-Controlled Analgesia: A Cross-Sectional Study of Registered Nurses Working in Two Tertiary Hospitals in China and Thailand. Pain Manag Nurs 2024:S1524-9042(24)00191-7. [PMID: 39004589 DOI: 10.1016/j.pmn.2024.06.004] [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: 01/04/2024] [Revised: 05/16/2024] [Accepted: 06/04/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND An increased interest has been observed in the wide use of intravenous patient-controlled analgesia (IV-PCA) to control acute postoperative pain in both China and Thailand. The safety and efficacy of IV-PCA in patient care requires competent and capable staff nurses. This study aimed to appraise the capabilities of Thai and Chinese registered nurses regarding IV-PCA as a guide to develop educational programs. METHOD A descriptive cross-sectional survey was conducted with 203 Chinese and 270 Thai registered nurses. An anonymous self-report questionnaire addressing 6 domains of capabilities toward IV-PCA was used to collect the data. Descriptive and inferential statistics were employed to analyze the data. RESULTS The study found that the mean percentage scores (MPS) of the overall capability on IV-PCA of the Thai and Chinese nurse participants were 55.5 (mean [M] = 57.3, standard deviation [SD] = 4.9) and 62.6 (M = 58.7, SD = 13.0), respectively, which indicated very low and low levels. Barriers to the use and care of patients receiving IV-PCA after surgery according to the Thai and Chinese nurse participants included a lack of knowledge and systematic training regarding IV-PCA and a lack of first-hand experience in providing care for IV-PCA patients. CONCLUSION The study results call for intensive and effective training and education concerning all domains for registered nurses involved with patients receiving IV-PCA.
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Affiliation(s)
- Khomapak Maneewat
- Surgical Nursing Department, Faculty of Nursing, Prince of Songkla University, Hat-Yai, Thailand
| | - Noppadon Kaewamporn
- Surgical Nursing Department, Faculty of Nursing, Prince of Songkla University, Hat-Yai, Thailand
| | - Shiyan Ren
- Graduate school, Prince of Songkla University, Hat-Yai, Thailand
| | - Sahas Bilalee
- Trauma and Burn Unit, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand.
| | - Wirat Wasinwong
- Anesthesiology Department Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand
| | - Sasikaan Nimmanrat
- Anesthesiology Department Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand
| | - Duangsuda Siripituphum
- Surgical Nursing Department, Faculty of Nursing, Prince of Songkla University, Hat-Yai, Thailand
| | - Sumamita Swusdinaruenart
- Surgical Nursing Department, Faculty of Nursing, Prince of Songkla University, Hat-Yai, Thailand
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Zulu A, Morton D, Campbell S. Perceptions of radiographers regarding professional development in clinical practice in KwaZulu-Natal, South Africa. Radiography (Lond) 2024; 30:723-730. [PMID: 38428196 DOI: 10.1016/j.radi.2024.02.011] [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: 05/22/2023] [Revised: 02/06/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION Professional development is a concept inclusive of all learning such as postgraduate qualifications, staff development, and reflective practice, pursued for the betterment of radiographers' professional expertise. Professional development is associated with professional capabilities and quality service delivery to the patient, and this understanding of professional development applies to the radiography profession. The study aimed to explore and describe the perceptions of KwaZulu-Natal (KZN) radiographers regarding the role of professional development in clinical practice. METHODS The study followed a qualitative exploratory-descriptive design, whereby the data was collected from 13 radiographers working in rural and urban KZN using one-on-one semi-structured interviews and analysed using Tesch's eight steps of thematic analysis. RESULTS Three principal themes emerged from the data analysis. The first theme was the radiographers' views of what constitutes professional development. The second theme highlighted radiographers' views of what promotes professional development among professionals and the final theme concerned the radiographers' views of what hinders professional development. CONCLUSION South African radiographers experience a range of challenges regarding professional development participation. There is a need to assist radiography managers to facilitate the professional development of their staff; to develop a culture of professional development among their staff; to recognise and reward radiographers for participating in professional development and to provide relevant and effective professional development opportunities for radiographers.
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Affiliation(s)
- A Zulu
- Nelson Mandela University, Summerstrand Port Elizabeth, South Africa.
| | - D Morton
- Nelson Mandela University, Summerstrand Port Elizabeth, South Africa.
| | - S Campbell
- Nelson Mandela University, Summerstrand Port Elizabeth, South Africa.
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Long JC, Roberts N, Francis-Auton E, Sarkies MN, Nguyen HM, Westbrook JI, Levesque JF, Watson DE, Hardwick R, Churruca K, Hibbert P, Braithwaite J. Implementation of large, multi-site hospital interventions: a realist evaluation of strategies for developing capability. BMC Health Serv Res 2024; 24:303. [PMID: 38448960 PMCID: PMC10918928 DOI: 10.1186/s12913-024-10721-w] [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: 04/17/2023] [Accepted: 02/14/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND This study presents guidelines for implementation distilled from the findings of a realist evaluation. The setting was local health districts in New South Wales, Australia that implemented three clinical improvement initiatives as part of a state-wide program. We focussed on implementation strategies designed to develop health professionals' capability to deliver value-based care initiatives for multisite programs. Capability, which increases implementers' ability to cope with unexpected scenarios is key to managing change. METHODS We used a mixed methods realist evaluation which tested and refined program theories elucidating the complex dynamic between context (C), mechanism (M) and outcome (O) to determine what works, for whom, under what circumstances. Data was drawn from program documents, a realist synthesis, informal discussions with implementation designers, and interviews with 10 key informants (out of 37 identified) from seven sites. Data analysis employed a retroductive approach to interrogate the causal factors identified as contributors to outcomes. RESULTS CMO statements were refined for four initial program theories: Making it Relevant- where participation in activities was increased when targeted to the needs of the staff; Investment in Quality Improvement- where engagement in capability development was enhanced when it was valued by all levels of the organisation; Turnover and Capability Loss- where the effects of staff turnover were mitigated; and Community-Wide Priority- where there was a strategy of spanning sites. From these data five guiding principles for implementers were distilled: (1) Involve all levels of the health system to effectively implement large-scale capability development, (2) Design capability development activities in a way that supports a learning culture, (3) Plan capability development activities with staff turnover in mind, (4) Increased capability should be distributed across teams to avoid bottlenecks in workflows and the risk of losing key staff, (5) Foster cross-site collaboration to focus effort, reduce variation in practice and promote greater cohesion in patient care. CONCLUSIONS A key implementation strategy for interventions to standardise high quality practice is development of clinical capability. We illustrate how leadership support, attention to staff turnover patterns, and making activities relevant to current issues, can lead to an emergent learning culture.
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Affiliation(s)
- Janet C Long
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
| | - Natalie Roberts
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Emilie Francis-Auton
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Mitchell N Sarkies
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Hoa Mi Nguyen
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Johanna I Westbrook
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jean-Frederic Levesque
- Centre for Primary Health Care and Equity, University of New South Wales, Kensington, NSW, Australia
- Agency for Clinical Innovation, St Leonards, NSW, Australia
| | - Diane E Watson
- Bureau of Health Information, St Leonards, NSW, Australia
| | - Rebecca Hardwick
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Kate Churruca
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Peter Hibbert
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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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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Oon JEL, Mok SF, Samarasekera DD, Teunissen P. Training infectious diseases senior residents during COVID-19: The impact and the lessons learnt. MEDICAL TEACHER 2023; 45:1005-1011. [PMID: 36688916 DOI: 10.1080/0142159x.2023.2168182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND The COVID-19 pandemic had major impact on the training of Infectious Diseases (ID) residents across the globe. They were part of the frontline staff, while at the same time training to be ID physicians. This study focused on identifying their capability, i.e. the ability to adapt existing competencies to new situations, which is now recognised as an essential element of professional practice. AIM This study explored what ID residents learnt and how they learnt as they adapted to working in this unpredictable and challenging COVID-19 pandemic. METHODS This qualitative explorative study was based in the Infectious Diseases Senior Residency Programme across three training institutions in Singapore. Individual semi-structured interviews were conducted. Data were analysed using a template analysis technique. RESULTS Nine ID residents participated in this study. They learnt to engage with uncertainty in a meaningful way by relying on prior training and rapidly learning how to most effectively learn (metacognition). Learning was enhanced by collaboration between multidisciplinary health professionals, strong leadership and intrinsic motivation from personal interest in ID. They learnt through observing how senior faculty approached and managed the COVID-19 situation. CONCLUSION When learning for future capability in a rapidly evolving situation, role-modelling and mentoring are essential as available information resources may still not provide the learning from skilled doctors with actual experiences managing complex, uncertain situations.
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Affiliation(s)
- Jolene Ee Ling Oon
- Department of Infectious Diseases, National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shao Feng Mok
- Department of Endocrinology, National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Pim Teunissen
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
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Plasse MJ, Peterson KS. Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies. J Prof Nurs 2023; 48:119-127. [PMID: 37775226 DOI: 10.1016/j.profnurs.2023.07.004] [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: 10/15/2022] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts. OBJECTIVE The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course. DESIGN/METHODS Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting. CONCLUSION Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.
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Affiliation(s)
- Mechelle J Plasse
- UMass Chan Medical School Tan Chingfen Graduate School of Nursing, S1-853, UMass Chan Medical School, 55 Lake Avenue, North, Worcester, MA 01655, USA.
| | - Kenneth S Peterson
- UMass Chan Medical School Tan Chingfen Graduate School of Nursing, S1-853, UMass Chan Medical School, 55 Lake Avenue, North, Worcester, MA 01655, USA.
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Aggarwal M, Scott G, Kokorelias KM, Kulasegaram K, Katz A, Upshur REG. Defining the capabilities and competencies of high-performing family physicians: a mixed methods study. BMJ Open 2023; 13:e072266. [PMID: 37591643 PMCID: PMC10441087 DOI: 10.1136/bmjopen-2023-072266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/27/2023] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION High-performing primary care is recognised as the foundation of an effective and efficient healthcare system. Many medical graduates report they are not prepared for independent practice. To date, no research has been conducted to identify the key capabilities and competencies of high-performing family medicine graduates in Canada. This pilot project aims to identify the capabilities and competencies of high-performing early-career family physicians in Ontario, Canada, and explore opportunities for enhancing learning, teaching and assessment within family medicine residency programmes. METHODS AND ANALYSIS Employing a mixed-methods explanatory sequential study design, this research will use a theory-driven Professional Capability Framework, previously validated in studies across nine professions, to guide the investigation. The first (quantitative) phase involves surveying ~50 high-performing early-career family physicians identified as high performing by educators, colleagues and leaders. The objective of the survey is to identify the key competencies and personal, interpersonal and cognitive capabilities of high-performing family physicians. The second (qualitative) phase involves conducting workshops with stakeholders, including educators, professional associations, regulators and colleges, to test the veracity of the results. Quantitative data will be analysed using descriptive statistics, and qualitative data will be analysed using Braun and Clarke's thematic analysis. The first and second phases will identify the key capabilities and competencies required to confidently adapt to the independent practice of comprehensive family medicine and inform fit-for-purpose educational strategies for teaching, learning and assessment. ETHICS AND DISSEMINATION The study is approved by the University of Toronto's Health Sciences Research Ethics Board (#41799). Research findings will be discussed with professional bodies, educators responsible for family medicine curricula and universities. Study findings will also be disseminated through academic conferences and academic publications in peer-reviewed journals. Project summaries and infographics will be developed and disseminated to key stakeholders.
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Affiliation(s)
- Monica Aggarwal
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Geoffrey Scott
- Learning Futures, University of Western Sydney, Penrith South, New South Wales, Australia
| | - Kristina Marie Kokorelias
- Department of Geriatric Medicine, Sinai Health and University Health Network, Toronto, Ontario, Canada
- Rehabiliation Sciences Institute and Department of Occupational Therapy and Occupational Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Kulamakan Kulasegaram
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alan Katz
- Department of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ross E G Upshur
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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12
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Javadi M, Gheshlaghi M, Bijani M. A comparison between the impacts of lecturing and flipped classrooms in virtual learning on triage nurses' knowledge and professional capability: an experimental study. BMC Nurs 2023; 22:205. [PMID: 37322487 DOI: 10.1186/s12912-023-01353-2] [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: 02/13/2023] [Accepted: 05/23/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The quality of triage in emergency department depends on regular evaluation of triage nurses' professional capabilities and development of programs to improve them. Flipped classrooms are a new approach to learning which can be employed to improve professional capabilities. The present study aims to compare the impact of lecturing to flipped classrooms in virtual learning on the knowledge and professional capabilities of triage nurses in the emergency departments of the state hospitals of Yazd province in south-western Iran in 2022. METHODS The present study is an experimental work of research. Seventy-four triage nurses participated in the study. Seventy-four triage nurses were randomly allocated to the two groups, including flipped classrooms (group B) and lecturing (group A). The data collection instruments were an emergency department triage nurses' professional capability questionnaire and a triage knowledge questionnaire. The collected data were analyzed in SPSS v.22 using independent t-test, chi-squared test, and repeated measures analysis of variance. Level of significance was set at p ≥ 0.05. RESULTS The participants' mean age was 33.1 ± 4.3 years. As measured one month after the education, the triage knowledge mean score of the nurses who were educated using the flipped classroom method (9.29 ± 1.73) was higher than that of the nurses who were educated via lecturing (8.45 ± 1.788), and the difference was statistically significant (p = 0.001). Also, measured one month after the education, the professional capability mean score of the nurses who were educated using the flipped classroom method (140.27 ± 11.744) was higher than that of the nurses who were educated via lecturing (132.84 ± 10.817), and the difference was statistically significant (p = 0.006). CONCLUSION There was a significant difference between the pretest and posttest knowledge and professional capability mean scores of both groups immediately after the education. However, measured one month after the education, the mean and standard deviation of the knowledge and professional capability scores of the triage nurses who had been educated via flipped classrooms were higher than those of the nurses in the lecturing group. Thus, virtual learning using flipped classrooms is more effective than lecturing in improving triage nurses' knowledge and professional capability in the long run.
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Affiliation(s)
- Mostafa Javadi
- Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Gheshlaghi
- Student Research Committee, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran.
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Naughton C, Hayes N, Ezhova I, Fitzpatrick JM. Evaluation of the feasibility of an Education-Career pathway in Healthcare for Older People (ECHO) for early career nurses. Int J Older People Nurs 2023; 18:e12526. [PMID: 36658469 DOI: 10.1111/opn.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 11/28/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Rapid population ageing is driving demand for qualified gerontological nurses. Yet, early career nurse attrition and limited focus on retention in the speciality limits supply. OBJECTIVES To test the feasibility and acceptability of an Education-Career pathway in Healthcare for Older People (ECHO) intervention for early career nurses to improve retention and capability in gerontological nursing. ECHO is a multicomponent intervention with integrated education, career planning and coaching components, tested over two 6-month cycles. METHODS A feasibility study with a pre-post design using a multi-methods evaluation. Twenty-nine early career nurse participants were recruited from eight NHS acute and community care Trusts in England. ECHO participants completed online questionnaires at baseline (Time 1), 6-month (T2, end of intervention) and follow-up at 18 months from baseline (T3). Outcome measures were career intention, self-reported knowledge, career planning confidence, and burnout using the Maslach Burnout Inventory. Qualitative interviews were undertaken with participants (n = 23) and organizational stakeholders (n = 16) who facilitated ECHO. Data analysis used descriptive statistics and non-parametric tests for paired data and thematic analysis for qualitative data. RESULTS Overall, 19 of 29 participants (65%) completed all aspects of the intervention. The evaluation was completed by 23 participants. ECHO was well received by participants and stakeholders. At T3, the 23 participants were working in the speciality, though two had changed organizations. There was a significant improvement in self-reported gerontological knowledge, pre 87 (IQR 81-102), post 107 (IQR 98-112) p = 0.006, but no significant changes in other outcomes. In qualitative data, participants and organizational stakeholders held similar views, presented under four main themes: intended outcomes (personal and professional development, raise gerontological profile, expand horizons); nurse retention-a double-edged sword, ECHO logistics, and sustainability. CONCLUSION Education-Career pathway in Healthcare for Older People was feasible and may positively impact early career nurse retention, capability and socialization into gerontological nursing. ECHO requires further refinement and piloting, but learning can contribute to retention strategies. IMPLICATIONS FOR PRACTICE Attracting and retaining early-career nurses to the gerontological speciality requires greater innovation, organizational and senior nurse leadership.
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Affiliation(s)
- Corina Naughton
- Clinical Nursing in Older People's Healthcare, School of Nursing and Midwifery, College of Medicine and Health, South SouthWest Hospital Group (SSWHG), Cork, Ireland
| | - Nicky Hayes
- King's College Hospital NHS Foundation Trust, London, UK
| | | | - Joanne M Fitzpatrick
- Older People's Healthcare, Care for Long Term Conditions Research Division, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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Hako L, Turunen H, Jokiniemi K. Advanced practice nurse capabilities: A mixed methods systematic review. Scand J Caring Sci 2023; 37:3-19. [PMID: 36479860 DOI: 10.1111/scs.13134] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/23/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Global health challenges demand the optimal use of nurses' professional competence and capability. Competencies related to the roles of advanced practice nurses have been developed, but research on these nurses' capabilities remains limited. AIM To summarise and compare the literature on the capabilities of advanced practice nurses and the dimensions of these capabilities. METHODS We carried out a mixed methods systematic review, using CINAHL, PubMed, and Scopus to search literature published between 1998 and 2021. The quality of the selected articles was evaluated with the JBI Critical Appraisal Tools. We employed abductive content analysis, including deductive and inductive analysis. The reporting was guided by the standards of the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. RESULTS Eleven articles out of 357 met the inclusion criteria. We identified all five dimensions of Hase and Davis's (1999) capability framework: can apply competencies in familiar as well as unfamiliar situations, is creative, has a high degree of self-efficacy, knows how to learn, and works well in teams. Additionally, we found a new dimension of capability: identifies factors affecting the scope of practice. LIMITATIONS This mixed methods systematic review was conducted about a little-studied topic. Because country-specific differences exist and consensus on advanced practice nursing roles is lacking, the concept of advanced practice nurse capabilities cannot be directly generalised. CONCLUSIONS Capability is a requirement and a necessity in the performance of advanced practice nurses. Identifying and defining the dimensions of advanced practice nurses' capabilities will lead the way in developing the roles, education, and capability assessments of advanced practice nurses. Identification of advanced practice nurses' capability will facilitate role understanding, visibility, and implementation in health care services. This can improve the quality and accessibility of care and improve the cost-effectiveness of the use of health care professionals.
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Affiliation(s)
- Laura Hako
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Lohja Hospital Area, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannele Turunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Kuopio University Hospital, Kuopio, Finland.,The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Krista Jokiniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Saghafi F, Bromley P, Guzys D, Harkness L, Phillips M, Mather C, Saunders A, Say R, Teare C, Tori K. Graduate nurses' capability upon entering the workforce: An integrative review. NURSE EDUCATION TODAY 2023; 121:105659. [PMID: 36470041 DOI: 10.1016/j.nedt.2022.105659] [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: 08/22/2022] [Revised: 10/27/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To clarify capability for work readiness in newly graduated registered nurses as viewed from the perspective of clinicians in practice, educators in tertiary institutions, and graduates. DESIGN Integrative review. DATA SOURCES Databases searched for peer-reviewed studies included PubMed, MEDLINE, ERIC, Campbell collaboration, Google Scholar, and Cochrane databases. REVIEW METHODS Pragmatism informed this integrative review. The five-stage method described by Whittemore and Knafl was used to enable rigorous examination of the expected capability of graduate nurses. A comprehensive database search was conducted using PRISMA guidelines. Eighteen articles were appraised and analysed for this review. The capability concept was used as a framework for analysis. RESULTS Eighteen articles met the inclusion criteria. Findings revealed that although there is no definition for graduate nurses' work readiness, there is a common theme. Graduate nurses are expected to have broad theoretical knowledge (knowing) along with practical knowledge (doing). They are also expected to demonstrate integrity, honesty, respect, compassion, and a moral compass. A list of personal attributes and organisational acumen was also reflective of graduate readiness upon entering the workforce and identified as necessary capabilities for graduates. CONCLUSIONS A picture of the perfect employee is illustrated in the definition of work readiness by the participants of the original studies. Yet there is a lack of stakeholder consensus on the capabilities expected from a graduate nurse.
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Affiliation(s)
- Farida Saghafi
- School of Nursing, College of Health and Medicine, University of Tasmania, Lilyfield, NSW 2040, Australia.
| | - Patricia Bromley
- College of Health and Medicine, University of Tasmania, Hobart, TAS 7001, Australia
| | - Diana Guzys
- College of Health and Medicine, University of Tasmania, Burnie, TAS 7320, Australia
| | - Leigh Harkness
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Michelle Phillips
- College of Health and Medicine, University of Tasmania, NSW 2040, Australia
| | - Carey Mather
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Annette Saunders
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Richard Say
- College of Health and Medicine, University of Tasmania, Lilyfield, NSW 2040, Australia
| | - Catherine Teare
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Kathleen Tori
- Faculty Health and Education, Torrens University, Melbourne, VIC 3000, Australia
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Ryder M, Smith R, Furlong E. Evaluation of a nurse practitioner clinical practicum module using a capability education framework: A case study design. J Clin Nurs 2023. [PMID: 36658779 DOI: 10.1111/jocn.16626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/04/2022] [Accepted: 12/31/2022] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES The aim of this research was to evaluate a nurse practitioner's clinical practicum module designed with a capability education framework. The objectives were to determine if the module prepared students adequately for their role and to determine if the Mini-CEX assessment tool was suitable for use with nurse practitioners. BACKGROUND Capability is a necessary part of expertise, where a capable person takes responsibility to develop their own education, knowledge and skills. The capability learning framework offers nurse practitioners flexible learning pathways between the student, the university and clinical practice. This capability learning framework focuses on the wider complexities of nurse practitioner practice as opposed to a point-in-time assessment. DESIGN A case study design was used. METHODS Mixed methods including, document review, focus group and field notes were used in the case study evaluation adhering to the standards for the reporting of organisational case studies. RESULTS A layered incremental approach to learning and assessments were applied. Students and assessors were satisfied with using the Mini-CEX assessment tool in the module. The Mini-CEX tool was familiar to clinical mentors, who compared students demonstrating competency in a similar manner to medicine. The feedback component of the tool provided deep and meaningful engagement for students. The module provided mentors with insight and understanding of the nurse practitioner role. Students identified the transitioning process from competent to capable practitioners. The module learning and assessments were mapped to regulatory nurse practitioner standards and requirements. CONCLUSIONS The module provided comprehensive preparation for students to develop their nurse practitioner role. The Mini-CEX assessment tool is a fitting assessment for nurse practitioner students, particularly when supplemented with a corresponding reflective exercise. The assessments and feedback provided the students with opportunities to focus on agreed learning outcomes in their specialist area of practice. RELEVANCE TO CLINICAL PRACTICE Nurse practitioners are required to practice autonomously and independently at a level of capability in clinical practice. The education preparation of nurse practitioner students must be directed appropriately.
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Affiliation(s)
- Mary Ryder
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Rita Smith
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Eileen Furlong
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
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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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Wright C, Matthews K. An intentional approach to the development and implementation of meaningful assessment in advanced radiation therapy practice curricula. Tech Innov Patient Support Radiat Oncol 2022; 24:13-18. [PMID: 36124225 PMCID: PMC9482137 DOI: 10.1016/j.tipsro.2022.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/16/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022] Open
Abstract
Creating meaningful assessment for advanced radiation therapy practice training programs is a challenge. This is because it requires a balance of formative and summative assessments, which meet the academic and professional needs of the practitioner, as well as the requirements of local service delivery, educational and professional standards. This paper discusses educational strategies and models used to integrate assessment into theoretical and clinical curricula, allowing practitioners to demonstrate higher order cognitive knowledge, advanced level clinical performance and attitudes/values associated with advanced practice. The discussion draws upon concepts of constructive alignment and programmatic approaches to assessment, which use Bloom's taxonomy, Benner's beginner to competent model of skill development, and Miller's pyramid of clinical competence. These models are analysed with respect to an advanced practice program in adaptive radiation therapy to provide context.
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Affiliation(s)
| | - Kristie Matthews
- Department of Medical Imaging and Radiation Sciences, 10 Chancellor's Walk, Monash University, Clayton Vic 3800, Australia
- Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne VIC 3000 Australia
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Xu H, Dong C, Yang Y, Sun H. Developing a professional competence framework for the master of nursing specialist degree program in China: A modified Delphi study. NURSE EDUCATION TODAY 2022; 118:105524. [PMID: 36084450 DOI: 10.1016/j.nedt.2022.105524] [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: 03/24/2022] [Revised: 07/26/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The urgency of ensuring adequate professional competence in clinical nursing practice is evident. However, there is little formal professional competence framework for the education of master's degree students in nursing specialist programs in China. OBJECTIVE To develop a professional competence framework for the Master of Nursing Specialist (MNS) degree program in China. DESIGN A modified Delphi study. PARTICIPANTS An expert panel discussion was held with 12 experts, and Delphi rounds were conducted with 24 experts. METHODS A literature review and an expert panel discussion were conducted to develop an initial competence framework. A two-round Delphi survey was employed to obtain a consensus on the framework through either an online or paper questionnaire. Descriptive statistics were used to analyze the data. The consensus threshold was set according to the mean (≥ 4.0), coefficient of variation (< 0.25), and consensus level of agreement (≥70 %). RESULTS A consensus on seven domains and 54 items of the professional framework for the MNS degree program was achieved. The framework domains included clinical practice (12 items), professional attitude (8 items), collaboration and communication (5 items), professional development (8 items), research (7 items), education (7 items), and administration (7 items). CONCLUSION The professional competence framework offers guidelines for MNS degree programs in China. Future research should focus on imbedding these competences in MNS degree programs to prepare qualified advanced practice nurses.
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Affiliation(s)
- Huan Xu
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China.
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China.
| | - Yeqin Yang
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China.
| | - Hongyu Sun
- School of Nursing, Wenzhou Medical University, Chashan Town, Ouhai District, Wenzhou, Zhejiang, China; 38 Xueyuan Road, School of Nursing, Peking University, Haidian District, Beijing 100191, China.
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Scott PA, Orton H, Daw R. ACP-supported redeployment in response to the COVID-19 pandemic: a service evaluation of staff experience. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:940-946. [PMID: 36227788 DOI: 10.12968/bjon.2022.31.18.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, healthcare organisations around the world had to optimise resources and redeploy staff to meet unprecedented demands on services. This service evaluation aims to establish the experiences of nurses redeployed to a COVID-negative Nightingale ward during the first wave of the pandemic in the UK. METHODS Purposive sampling using a survey was used to capture nurses' experiences. Data were extrapolated to meet the aims of the thematic line of enquiry and descriptive statistics used to analyse the data set. RESULTS The response rate was 34.0% (n=30). The majority of redeployees (76.7%; n=23) strongly agreed or agreed the trust induction had been beneficial. Informal learning, including from colleagues, was said to be very helpful by 50.0% (n=15) and helpful by 36.7% (n=10) of participants. Most (90.0%; n=27) agreed they were able to maintain safety, with 93.3% (n=28) satisfied with the quality of their care. Regarding giving the care they aspired to, 46.7% (n=14) strongly agreed and 40.0% (n=12) agreed they had been able to do this. CONCLUSION The advanced clinical practitioner role was central to successful redeployment, in preparing redeployees through induction and education. These practitioners facilitated the acquisition of the knowledge and skills to deliver competent care, ensuring staff had the capacity and capability to undertake their job. Patient safety was not compromised by redeployment.
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Affiliation(s)
- Paul Anthony Scott
- Advanced Clinical Practitioner: Acute Medicine, Liverpool University Hospitals NHS Foundation Trust
| | - Helen Orton
- Academic Lead for Continuing Professional Development, University of Liverpool School of Health Sciences
| | - Rachael Daw
- Postgraduate Lecturer, University of Liverpool School of Health Sciences
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Harorani M, Jadidi A, Zand S, Khoshkhoutabar T, Rafiei F, Beheshti SZ. Spiritual Care in Hospitalized Patients in Iran: An Action Research Study. JOURNAL OF RELIGION AND HEALTH 2022; 61:3822-3839. [PMID: 34136966 DOI: 10.1007/s10943-021-01302-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 05/17/2023]
Abstract
Religious practices can raise the sense of merit and hope through overcoming the feeling of isolation. Studies conducted in this area have indicated that patients may desire to have their spiritual needs met. Nonetheless, sufficient attention has not been paid to these special needs. Therefore, this study aimed to identify the barriers to the provision of spiritual care for hospitalized patients. This is an action research study in which a total of 11 nurses and 76 hospitalized patients were recruited using purposive and convenience sampling, respectively. Data were collected using a combination of qualitative and quantitative methods. In the action cycles, the participants' concerns were examined, constructed, then evaluated, and re-constructed using reflective assessment. The qualitative and quantitative data were analyzed using the content analysis approach and the Mann-Whitney U, Chi-squared, and t-tests, respectively. At the first stage, the results of the content analysis showed the lack of professional knowledge and the existence of organizational barriers in the provision of spiritual care for patients. Reflection in the final stage led to the discovery of four concepts including (a) perceived advantages of change in performance, (b) being capable of providing spiritual care, (c) getting positive feedback, and (d) preparation for improving the provision of spiritual care. The results of the quantitative analysis indicated a significant increase in the mean score of patient satisfaction after the provision of spiritual care (p = .001). The results of this study led the authors to a deeper understanding of various dimensions of spiritual care among patients hospitalized in the cardiology ward and ultimately improved the patients and their families' level of satisfaction.
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Affiliation(s)
- Mehdi Harorani
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arāk, Iran
| | - Ali Jadidi
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
- School of Nursing, Arak University of Medical Sciences, Arāk, Iran
| | - Soleiman Zand
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arāk, Iran.
- PhD Student in Higher Education Development Planning, Department of Educational Sciences, Faculty of Humanities, Mazandaran University, Mazandaran, Iran.
| | - Tayebeh Khoshkhoutabar
- Department of Education Districts One of Arak, Central Province Department of Education, Arāk, Iran
| | - Fatemeh Rafiei
- Department of Biostatistics, School of Medicine, Arak University of Medical Sciences, Arāk, Iran
| | - Seyedeh Zeinab Beheshti
- Department of Occupational Therapy School of Rehabilitation, Arak University of Medical Sciences, Arāk, Iran
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Murfet G, Ng AH, Hagger V, Davidson S, Ward G, Fenton B, Rasmussen B. Enhancing the capacity of the health workforce to deliver best practice diabetes care. AUST HEALTH REV 2022; 46:496-500. [PMID: 35850725 DOI: 10.1071/ah22040] [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: 02/25/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022]
Abstract
Diabetes prevalence is increasing; the technologies and medicines used to manage diabetes have become more complex, and the specialist health workforce with qualifications in diabetes is insufficient. Generalist health professionals have limited diabetes knowledge, despite engaging with people with diabetes in healthcare daily. An innovative framework is needed to align with the Australian National Diabetes Strategy to build a competent, flexible and adaptive workforce to promote excellence in diabetes care. A three-staged modified Delphi technique was used to identify a consensus Capability Framework for Diabetes Care (the 'Framework'). An implementation phase followed, involving representation from people with diabetes and key health professional organisations to co-design and implement the 'Framework'. The 'Framework' can guide curricula at universities and TAFE institutes, and the professional development and practice of Australian nurses, allied health professionals, First Nations Australians health workers and practitioners, pharmacists, midwives and health assistants when delivering care to people living with diabetes. The 'Framework' defines nine core capabilities that healthcare providers require to deliver diabetes care effectively, underpinned by three sets of attributes for seven practice levels to enable the workforce. Information within the practice levels provides a nationally consistent approach to learning and training different healthcare providers in the essential elements of diabetes care. A 'living' evidence-based national 'Framework' for the whole health workforce and associated online resources will help promote a more responsive health workforce delivering better and more equitable diabetes care.
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Affiliation(s)
- Giuliana Murfet
- School of Public Health, University of Technology Sydney, Ultimo, NSW, Australia; and Present address: Diabetes Centre, Tasmanian Health Service, Burnie, Tas. 7250, Australia
| | - Ashley H Ng
- Department of Dietetics, Human Nutrition and Sport, La Trobe University, Bundoora, Vic., Australia
| | - Virginia Hagger
- School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia; and Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Vic., Australia
| | - Susan Davidson
- Australian Diabetes Educators Association, Chifley, ACT, Australia
| | - Grace Ward
- Aboriginal and Torres Strait Islander Engagement, Diabetes Australia, Canberra, ACT, Australia
| | - Brett Fenton
- Diabetes Services, Central Coast Local Health District, Gosford, NSW, Australia
| | - Bodil Rasmussen
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Vic., Australia; and Department of Public Health, University of Copenhagen, Nørregade 10, DK-1017 Copenhagen, Denmark; and Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark
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Errasti-Ibarrondo B, Choperena A, Wilson DM. Reading and reflecting on experiential accounts of hospital patients to foster a person-centered care approach: A novel educational method. TEACHING AND LEARNING IN NURSING 2022. [DOI: 10.1016/j.teln.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Whitfield MM, Bleah P, Bachynski JC, Macdonald D, Klein T, Ross-White A, Wilson R. Capability as a concept in advanced practice nursing and education: a scoping review protocol. JBI Evid Synth 2022; 20:2079-2086. [DOI: 10.11124/jbies-21-00443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Is Teleaudiology Achieving Person-Centered Care: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127436. [PMID: 35742684 PMCID: PMC9224155 DOI: 10.3390/ijerph19127436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
Digital health and person-centered care are unquestionably linked in today’s Australian healthcare landscape. Teleaudiology is the application of digital health in the field of audiology, and it has become a popular component of standard audiological care. Behavior modification is essential in audiology intervention. Guidance on achieving behavior change, which is dependent on digitally enabled intervention, is a valuable resource when used in tandem to achieve person-centered care. The aim of this review is to determine whether teleaudiology achieves person-centered care. A qualitative review was conducted, followed by mapping and analysis. Analysis identified evidence of teleaudiology use, and ascertained guiding principles are appropriate to behavior change dependent digital intervention supported or enabled person-centered care. In conclusion, teleaudiology will continue to be a promising technology for promoting relatedness, a positive user experience, confidence and capability, and appropriate levels of autonomy for the user to choose from among the person-centered care options available.
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Jadidi A, Khatiban M, Oshvandi K, Khodaveisi M, Maghsoudi Z, Razavi M. Transcendence, the Most Important Spiritual Need of Muslim Older Adults: A Content Analysis Study. JOURNAL OF RELIGION AND HEALTH 2022; 61:1529-1547. [PMID: 35028812 PMCID: PMC8758234 DOI: 10.1007/s10943-021-01474-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 06/03/2023]
Abstract
Healthcare providers agree that promoting spirituality among older adults while caring for them increases their quality of life. However, there is little knowledge about the spiritual needs of the elderly, especially in the Muslim community. This qualitative study attempted to explore the spiritual needs of Muslim older adults. Fifteen non-hospitalized Muslim older adults from Hamadan City, Iran, were interviewed. The semi-structured interviews were analyzed using conventional content analysis. After identifying semantic units from the text, related codes were extracted and placed in subcategories and categories based on their similarities. Once the data were analyzed, one theme was formed. The study's findings showed that the spiritual needs of older adults fell into three main categories: religious needs, the need for transcendence, and the need for connection. Religious needs included subcategories of religious practices and beliefs, and the need for transcendence included the search for meaning and purpose in life, and the need for peace and stability and balance. Also, the need for connection included the need to connect with nature and connect with others. Healthcare professionals and family caregivers should be trained in the specific competence of recognizing older people's unmet spiritual needs and fulfilling them.
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Affiliation(s)
- Ali Jadidi
- School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Mahnaz Khatiban
- Mother and Child Care Research Center, Department of Ethics Education in Medical Sciences, & Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Khodaveisi
- Chronic Disease (Home Care) Research Center, Community Health Nursing Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Maghsoudi
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammadreza Razavi
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Vatnøy TK, Dale B, Sundlisaeter Skinner M, Karlsen TI. Associations between nurse managers' leadership styles, team culture and competence planning in Norwegian municipal in-patient acute care services: A cross-sectional study. Scand J Caring Sci 2022; 36:482-492. [PMID: 34997785 PMCID: PMC9306531 DOI: 10.1111/scs.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/24/2021] [Accepted: 12/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increased complexity in the primary healthcare services has followed in the wake of health reforms and reveals the need for competence enhancement in the nursing services. Effective and visionary leadership, sufficiently qualified staff and cooperation among professionals are considered as key measures to safeguard quality in the services. AIMS To identify which leadership styles characterise first-line nurse managers in Norwegian municipal in-patient acute care (MipAC) units and to investigate how first-line nurse managers' leadership styles are associated with team culture and documented nursing competence planning. METHODS A cross-sectional survey was distributed to all the first-line nurse managers in Norwegian MipAC units (n = 229). Data were collected between March and June 2019. The response rate was 80.5% (n = 182). First-line managers' background information and data about their focus on team culture and competence planning were recorded. Furthermore, we noted organisational structural characteristics, and managers' transformational (relational) leadership and transactional (task-oriented) leadership styles. RESULTS The managers exhibited a high degree of transformational leadership behaviour, which was significantly associated with team culture. No significant associations between leadership behaviours and documented competence planning were found. Notably, we found a significant correlation between transformational and transactional leadership styles, indicating that the managers adapt their leadership behaviours to actual requirements and situations. Organisational structural factors: the share of registered nurses (RNs) on the staff and having a position for a professional development nurse were positively associated with competence planning. CONCLUSION A relational leadership style promotes team culture and both factors may empower the professional nursing environment. However, first-line nurse managers need to acknowledge nursing competence planning as a central part of effective leadership. Having a professional development nurse position seems to complement leadership and ease the manager's responsibilities regarding team culture and competence planning.
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Affiliation(s)
- Torunn Kitty Vatnøy
- Department of Health and Nursing Science, University of Agder, Grimstad, Norway.,Centre for Caring Research, South Norway, Grimstad, Norway
| | - Bjørg Dale
- Department of Health and Nursing Science, University of Agder, Grimstad, Norway.,Centre for Caring Research, South Norway, Grimstad, Norway
| | - Marianne Sundlisaeter Skinner
- Centre for Care Research, East Norway and Department of Health Sciences NTNU -Norwegian University of Science and Technology, Gjøvik, Norway
| | - Tor-Ivar Karlsen
- Department of Health and Nursing Science, University of Agder, Grimstad, Norway
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Canales MK, Drevdahl DJ. A Sisyphean task: Developing and revising public health nursing competencies. Public Health Nurs 2022; 39:1078-1088. [PMID: 35395106 PMCID: PMC9543881 DOI: 10.1111/phn.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Competencies are intended to enhance the public health workforce's skills. Competencies used to evaluate public health nursing (PHN) practice and education have been promoted by several nursing organizations. Having multiple sets of competencies raises questions about redundancies and their usefulness in evaluating PHN, as well as the central question about the value of the competencies themselves. METHODS A literature review of psychometric evaluation research of the competencies was performed. Qualitative content analyses were conducted of seven documents: Association of Community Health Nursing Educators', 2000 and 2010 essentials; Quad Council Coalition's 2004, 2011, and 2018 competencies; and the American Nurses Association's, 2013 and the 2021 draft of PHN scope and standards of practice with respect to competency definition, conceptual basis, and use of an established taxonomy. RESULTS No psychometric evaluations of the competency sets were found. Textual content analysis revealed inconsistent and or missing competency definitions and theoretical frameworks with competencies proliferating over time. Taxonomy analysis identified minimal competencies at higher complexity levels according to Bloom's revised taxonomy. CONCLUSIONS Analyzed competencies lack reliability and validity testing, making assessment difficult for PHN educators and practitioners. Multiple and competing competencies further erode PHN's visibility, even among public health nurses. With unending revisions of PHN competencies and lack of supporting evidence regarding their effect and their integration into education or practice, recommendations for future efforts are offered.
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Say R, Visentin D, Cummings E, Carr A, King C. Formative online multiple-choice tests in nurse education: An integrative review. Nurse Educ Pract 2021; 58:103262. [PMID: 34902804 DOI: 10.1016/j.nepr.2021.103262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/03/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
AIM The aim of this integrative review is to explore how formative online multiple-choice tests used in nurse education promote self-regulated learning and report on pedagogies that support their design. BACKGROUND Online multiple-choice tests are widely used as learning and formative assessment tools in a range of educational contexts. However, little is known about how these tools are used to promote patterns of learner self-regulation. It is important that nurses and nursing students develop the capability to self-regulate learning to be effective lifelong learners and navigate complex and unfamiliar practice environments. DESIGN A five-stage approach guided this integrative review: problem identification, literature search, data evaluation, data analysis and presentation. METHOD A systematic search of ERIC, Web of Science, Ovid Medline, Scopus, PubMed, Embase and CINAHL was conducted in February 2021. Seventeen peer-reviewed papers were identified that discussed formative online multiple-choice tests in nurse education. Purposive sampling and ancestry searching identified an additional paper. Articles were analysed and sorted into themes of outcomes (presented as components of self-regulated learning theory) and pedagogy. RESULTS Formative online multiple-choice tests are used with good effect in nurse education as measured by knowledge gain and exam performance, increased confidence and learner satisfaction. There was no literature that explored metacognitive outcomes and minimal literature considered behavioural outcomes. Pedagogy supporting the implementation of multiple-choice tests was lacking in most articles. CONCLUSIONS Formative online multiple-choice tests are widely used with good effect in nurse education. However, opportunities for further research on how these tools can encourage metacognition and self-regulatory behaviours is warranted.
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Affiliation(s)
- Richard Say
- College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, 2015 NSW, Australia.
| | - Denis Visentin
- College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, 2015 NSW, Australia.
| | - Elizabeth Cummings
- College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, 2015 NSW, Australia.
| | - Andrea Carr
- University College, University of Tasmania, Private Bag 70, Hobart, 7001 Tasmania, Australia.
| | - Carolyn King
- University College, University of Tasmania, Private Bag 70, Hobart, 7001 Tasmania, Australia.
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Ungpakorn R, Sehmbi K, MacLaine K. Taking advanced clinical practice to the streets: an evaluation of the benefits and challenges in homeless health care. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:1184-1188. [PMID: 34761981 DOI: 10.12968/bjon.2021.30.20.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Homelessness in the UK continues to rise. People who are homeless are more likely to have poor health and die early, and face multiple barriers to accessing health care. Ten years have passed since the Marmot review recommended action on these disparities. In the context of significant health inequalities, advanced clinical practitioners (ACPs) offer a different approach to homeless health care, providing complete episodes of care in complex situations and leading in integrating multiple agencies, service development and strategic advocacy. ACPs can use their expertise in this specialty to deliver education that raises awareness and reduces prejudice. Their research skills can identify gaps and expand the evidence base to improve practice at local and national levels. However, ACPs must promote their own roles, work closely with people with lived experience and be supported by their employers to embrace all four pillars of advanced clinical practice for the full benefits to be realised.
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Affiliation(s)
- Rosa Ungpakorn
- Homeless Health Nurse Practitioner, Central London Community Healthcare NHS Trust, London
| | - Kirit Sehmbi
- Homeless Health Nurse Practitioner, Guy's & St Thomas' NHS Foundation Trust, London
| | - Katrina MacLaine
- Associate Professor Advanced Practice, Institute of Health & Social Care, London South Bank University
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Batt AM, Williams B, Brydges M, Leyenaar M, Tavares W. New ways of seeing: supplementing existing competency framework development guidelines with systems thinking. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1355-1371. [PMID: 34003391 DOI: 10.1007/s10459-021-10054-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
Competency frameworks provide a link between professional practice, education, training, and assessment. They support and inform downstream processes such as curriculum design, assessment, accreditation and professional accountability. However, existing guidelines are limited in accounting for the complexities of professional practice potentially undermining utility of such guidelines and validity of outcomes. This necessitates additional ways of "seeing" situated and context-specific practice. We highlight what a conceptual framework informed by systems thinking can offer when developing competency frameworks. Mirroring shifts towards systems thinking in program evaluation and quality improvement, we suggest that similar approaches that identify and make use of the role and influence of system features and contexts can provide ways of augmenting existing guidelines when developing competency frameworks. We framed a systems thinking approach in two ways. First using an adaptation of Ecological Systems Theory which offers a realist perspective of the person and environment, and the evolving interaction between the two. Second, by employing complexity thinking, which obligates attention to the relationships and influences of features within the system, we can explore the multiple complex, unique, and context-embedded problems that exist within and have stake in real-world practice settings. The ability to represent clinical practice when developing competency frameworks can be improved when features that may be relevant, including their potential interactions, are identified and understood. A conceptual framework informed by systems thinking makes visible features of a practice in context that may otherwise be overlooked when developing competency frameworks using existing guidelines.
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Affiliation(s)
- Alan M Batt
- Department of Paramedicine, Monash University, Frankston, VIC, Australia.
- McNally Project for Paramedicine Research, Toronto, ON, Canada.
- Fanshawe College, London, ON, Canada.
| | - Brett Williams
- Department of Paramedicine, Monash University, Frankston, VIC, Australia
| | - Madison Brydges
- McNally Project for Paramedicine Research, Toronto, ON, Canada
- Department of Health, Ageing and Society, McMaster University, Hamilton, ON, Canada
| | - Matthew Leyenaar
- McNally Project for Paramedicine Research, Toronto, ON, Canada
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Walter Tavares
- McNally Project for Paramedicine Research, Toronto, ON, Canada
- The Wilson Centre, Department of Medicine, University of Toronto/University Health Network, Toronto, ON, Canada
- Post‑MD Education (Post‑Graduate Medical Education/Continued Professional Development), University of Toronto, Toronto, ON, Canada
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Cox R, Molineux M, Kendall M, Tanner B, Miller E. Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review. BMJ Qual Saf 2021; 31:134-146. [PMID: 34253682 PMCID: PMC8784995 DOI: 10.1136/bmjqs-2020-012729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Internationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration. OBJECTIVES The research questions for this scoping review were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities? METHODS A six-stage scoping review was completed. Five electronic databases were searched for publications from January 2010 to February 2020. The database searches incorporated relevant terms for the following concepts: capabilities for PPI in healthcare QI; and best practice learning and development strategies to support those capabilities. Data were analysed using descriptive statistics and qualitative content analysis. RESULTS Forty-nine papers were included. Very little peer-reviewed literature focused explicitly on capabilities for QI partnerships and thus implicit paper content was analysed. A Capability framework for successful partnerships in healthcare quality improvement was developed. It includes knowledge, skills and attitudes across three capability domains: Personal Attributes; Relationships and Communication; and Philosophies, Models and Practices, and incorporates 10 capabilities. Sharing power and leadership was discussed in many papers as fundamental and was positioned across all of the domains. Most papers discussed staff and patients' co-learning (n=28, 57.14%). Workshops or shorter structured training sessions (n=36, 73.47%), and face-to-face learning (n=34, 69.38%) were frequently reported. CONCLUSION The framework developed here could guide individualised development or learning plans for patient partners and staff, or could assist organisations to review learning topics and approaches such as training content, mentoring guidelines or community of practice agendas. Future directions include refining and evaluating the framework. Development approaches such as self-reflection, communities of practice, and remote learning need to be expanded and evaluated.
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Affiliation(s)
- Ruth Cox
- Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia .,Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia
| | - Melissa Kendall
- School of Health Sciences and Social Work, Griffith University, Queensland, Queensland, Australia.,Acquired Brain Injury Outreach Service and Transitional Rehabilitation Program, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Bernadette Tanner
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
| | - Elizabeth Miller
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia
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Jones T, Curtis K, Shaban RZ. Practice expectations for Australian graduate emergency nursing programs: A Delphi study. NURSE EDUCATION TODAY 2021; 99:104811. [PMID: 33636653 DOI: 10.1016/j.nedt.2021.104811] [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: 07/31/2020] [Revised: 12/20/2020] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Practice standards in nursing provide minimum expectations to enable the provision of high quality and safe care. There are currently no practice standards for post-registration graduate emergency nursing programs in Australia, leading to variation in graduate attributes and clinical expectations on completion of their program. OBJECTIVES The aim of this study was to establish consensus-based practice standards for graduate emergency nursing programs in Australia. DESIGN Delphi approach. PARTICIPANTS Australian nurses who identified as an emergency nurse and currently worked, or previously worked, in an emergency care environment. METHODS A modified two-round Delphi method was used. The survey was divided into four sections of data collection, including demographics, graduate emergency nursing course entry requirements, graduate expectations, and clinical care capabilities. Data were analysed using descriptive statistics including calculation of content validity index (CVI). RESULTS There were 204 respondents in Round One and 153 respondents in Round Two. Respondents agreed that nurses wanting to undertake graduate studies in emergency nursing require prior experience in the emergency care environment and should be working a minimum of 0.5 full time equivalent (FTE) whilst completing their studies. Thirty-nine statements presented under graduate attributes achieved a CVI of >0.8. All 70 clinical care capability statements presented in Round Two achieved a CVI of >0.8. CONCLUSION This study generated the evidence to establish minimum practice standards for Australian graduate emergency nursing programs. The standards centre around three key areas: graduate entry requirements, graduate attributes and clinical care capabilities. The standards provide a clear guide for employers, educators and clinicians, and inform capabilities for early career emergency nurses.
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Affiliation(s)
- Tamsin Jones
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia.
| | - Kate Curtis
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Emergency services, Illawarra Shoalhaven Local Health District, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead. NSW, Australia
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Gardner A, Helms C, Gardner G, Coyer F, Gosby H. Development of nurse practitioner metaspecialty clinical practice standards: A national sequential mixed methods study. J Adv Nurs 2021; 77:1453-1464. [PMID: 33617021 PMCID: PMC7898871 DOI: 10.1111/jan.14690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/10/2020] [Accepted: 11/05/2020] [Indexed: 11/27/2022]
Abstract
AIM To achieve profession-wide consensus on clinical practice standards for six broad Australian nurse practitioner specialty areas (termed metaspecialties). DESIGN Sequential mixed methods with initial interpretive study (Interpretive Phase) followed by modified three-round Delphi study (Survey Phase). METHODS Participants from all Australian jurisdictions were recruited. Main eligibility criterion was current endorsement as a nurse practitioner for 12 or more months. Interpretive Phase comprised in-depth interviews of purposeful sample of nurse practitioners to identify clinical care activities and practice processes. Six sets of draft clinical practice standards relevant to six previously identified metaspecialties were developed. Outcome informed Round 1 of Survey Phase (six nested web-based Delphi surveys), with draft standards reviewed profession-wide. Responses comprised scoring using Likert scales to calculate content validity indexes for individual standards with qualitative responses supporting decision-making. For Rounds 2 and 3, participants rated relevancy of original or revised standards after consideration of individual and group feedback. The study was conducted 2014-2017. RESULTS Interpretive Phase: Analysis of interview data with 16 nurse practitioners provided 75 draft standards. Survey Phase: 221 nurse practitioners completed Round 1 (20% of then eligible Australian nurse practitioners). Weighted respondent retention was 92%. Seventy-three standards were validated, with final content validity indices of 92-100%. Scale-level indices were 98%, strongly validating metaspecialty taxonomy. CONCLUSION A research-derived, professionally endorsed suite of nurse practitioner clinical practice standards was developed. This provides a broad clinical learning structure with metaspecialties guiding nurse practitioner student clinical education. IMPACT The clinical practice standards and metaspecialty taxonomy strengthen nurse practitioner clinical education and professional development nationally and internationally. These novel study methods and findings are applicable to advanced specialty roles in other health professions.
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Affiliation(s)
- Anne Gardner
- Queensland University of Technology (QUT)BrisbaneQldAustralia
| | | | - Glenn Gardner
- Queensland University of Technology (QUT)BrisbaneQldAustralia
- Edith Cowan UniversityPerthWAAustralia
| | - Fiona Coyer
- School of Nursing, and Intensive Care Services (ICS)Queensland University of Technology (QUT)Royal Brisbane and Women's HospitalBrisbaneQldAustralia
- Institute for Skin Integrity and Infection PreventionUniversity of HuddersfieldHuddersfieldUK
| | - Helen Gosby
- The Sydney Children’s Hospital NetworkSydneyNSWAustralia
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Brice S, Almond H. Health Professional Digital Capabilities Frameworks: A Scoping Review. J Multidiscip Healthc 2020; 13:1375-1390. [PMID: 33173300 PMCID: PMC7646414 DOI: 10.2147/jmdh.s269412] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/09/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction The term “digital healthcare professional” alludes to a health professional with the additional digital capabilities such as information and technology. The assumption that attaining technical knowledge and skills to meet the available professional standards in digital healthcare, will engage and empower healthcare users, thus deliver person-centered digital healthcare (PCDHc), is flawed. Identifying where digital healthcare and technologies can genuinely support person-centered care may lead to future discourse and practical suggestions to build person-centered integrated digital healthcare environments. This review examines current digital health and informatics capability frameworks and identifies the opportunity to include additional or alternative principles. Methods A scoping review was conducted. Literature valuing person-centered digital healthcare requirements, digital health capabilities, and competencies were identified between 2000 and 2019 inclusive, then collated and considered. Using a PRISMA approach for eligibility screening, thirteen articles met the study inclusion criteria. Analysis used a thematic framework approach, which assisted in the data management, abstraction and description, and finally the explanations. Results Analysis indexed fifty-nine (59) capabilities, charted thirteen (n13) categories, mapped four (n4) themes, which were then interpreted as findings. Findings The four themes identified were Change Management; User Application; Data, Information, and Knowledge; and Innovation. The themes recognize the opportunity to align the application of technical skills towards the capabilities required to deliver authentic PCDHc. Discussion Holistic mindsets are imperative in maintaining the objective of PCDHc. The authors propose that debates regarding professional digital capability persist in being “siloed” and “paternalistic” in nature. They also recommend that the transition to authentic PCDHc requires refocusing (rather than rewriting) current capabilities. The realignment of capabilities towards individual healthcare outcomes, rather than professional obligation, can steer the perspective towards a genuine PCDHc system. Conclusion This scoping review confirms the assumption that digital skills will empower all healthcare stakeholders is incorrect. This review also draws attention to the need for more research to enable digital healthcare systems and services to be designed to realize complex human behaviors and multiple person-centered care requirements. Now more than ever, it is imperative to align healthcare capabilities with technologies to ensure that the practice of PCDHc is the empowering journey for the healthcare user that theory implies.
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Affiliation(s)
- Sophie Brice
- Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Helen Almond
- Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, VIC, Australia
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Bijani M, Rakhshan M, Fararouei M, Torabizadeh C. Development and psychometric assessment of the triage nurses' professional capability questionnaire in the emergency department. BMC Nurs 2020; 19:82. [PMID: 32884445 PMCID: PMC7465389 DOI: 10.1186/s12912-020-00476-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Evaluation of triage nurses' professional capability is integral to identifying potentials for professional development and nurses' educational needs, thus, there is a need for valid instruments to assess their professional capability. The present study was conducted to develop and measure the reliability and validity of a triage nurses' professional capability questionnaire. METHODS This exploratory research was conducted in two stages: in the first stage (the qualitative phase), the concept of professional capability in triage nurses was defined and the items of the questionnaire were developed through conventional content analysis. In the second stage (the quantitative phase), the psychometric properties of the questionnaire were assessed based on analyses of its face validity, content validity, construct validity, internal homogeneity, and consistency. RESULTS The initial item pool consisted of 90 items, while the final scale was comprised of 35 items. The S-CVI/Ave of the questionnaire was found to be 0.96.The exploratory factor analysis showed that the factor loading of the items was between 0.46-0.89, all of which were significant, and the three dimensions introduced in the main instrument were verified with acceptable values. The overall intraclass correlation coefficient of the instrument was calculated to be 0.90. The reliability of the instrument was assessed in terms of its internal homogeneity where the Cronbach's alpha of the whole instrument was found to be 0.89. CONCLUSIONS The results showed that the questionnaire developed for assessment of triage nurses' professional capability is sufficiently reliable and valid and can be employed by nurse administrators to evaluate triage nurses' professional capability.
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Affiliation(s)
- Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Mahnaz Rakhshan
- Community-based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Camellia Torabizadeh
- Community-based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Sockalingam S, Chaudhary ZK, Barnett R, Lazor J, Mylopoulos M. Developing a Framework of Integrated Competencies for Adaptive Expertise in Integrated Physical and Mental Health Care. TEACHING AND LEARNING IN MEDICINE 2020; 32:159-167. [PMID: 31482737 DOI: 10.1080/10401334.2019.1654387] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Phenomenon: Despite the emergence of the integrated care (IC) model, IC is variably taught and is challenged by current siloed competency domains. This study aimed to define IC competencies spanning multiple competency domains. Approach: Iterative facilitated discussions were conducted at a half-day education retreat with 25 key informants including clinician educators and education scientists. Seven one-on-one semistructured interviews were subsequently conducted with different interprofessional providers in IC settings within a Canadian context. Data collection grounded in patient cases with a physical illness and concurrent mental illness (medical psychiatry) were used to elicit identification of complex patient needs and the key medical psychiatry knowledge and skills required to address these needs. A thematic analysis of transcripts was performed using constant comparison to iteratively identify themes. Findings: Participants described 4 broad competency domains necessary for expertise in IC: (a) extensive integrated knowledge of biopsychosocial aspects of disease, systems of care, and social determinants of care; (b) skills to establish a longitudinal alliance with the patient and functional relationships with colleagues; (c) constructing a comprehensive understanding of individual patients' complex needs and how these can be met within their health and social systems; and (d) the ability to effectively meet the patient's needs using IC models. These 4 domains were linked by an overarching philosophy of care encompassing key enabling attitudes such as proactively pursuing depth to understand patient and system complexity while maintaining a patient-centered approach. Insights: The study addresses how development of IC expertise can be fostered by integration of individual IC competency domains. The findings align with previous research suggesting that competencies from existing frameworks are being enacted jointly in expert capabilities to meet the complex needs of patients, in this case with comorbid physical and mental health concerns.
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Affiliation(s)
- Sanjeev Sockalingam
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Zarah K Chaudhary
- The Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rachael Barnett
- MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jana Lazor
- MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Maria Mylopoulos
- The Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Vatnøy TK, Sundlisæter Skinner M, Karlsen TI, Dale B. Nursing competence in municipal in-patient acute care in Norway: a cross-sectional study. BMC Nurs 2020; 19:70. [PMID: 32704236 PMCID: PMC7374816 DOI: 10.1186/s12912-020-00463-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/12/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The primary health care services are becoming increasingly complex, which presents challenges for the municipal nursing services. In Norway, municipal in-patient acute care (MipAC) has been introduced in all municipalities, and the competence at the services has been questioned. Few studies have examined the nursing services in the units. This study aims to get an overview of the nursing competence in those units across geographical regions, and different groups of organisation and localisation. METHODS A cross-sectional study was conducted, and an ad hoc questionnaire was distributed to first-line leaders in all the MipAC units in Norway. Data were collected in the period between 6 March 2019 to 6 June 2019. Measures to get an overview of the nursing competence were ratio of registered nurses (RNs) in staff, count of shifts with only one RN on duty and count of RNs with master's degrees/specialisation. Descriptive comparative statistics were used. RESULTS Of all 226 first-line leaders invited to participate, 207 (91.6%) responded to the questionnaire. Overall a considerable variance across the sample was revealed. The median ratio of RNs in staff was 56 (IQR = 40-70), the count of shifts with only one RN on duty median 28 (IQR = 5-49), and the count of RNs with a master's degree or specialisation median 3 (IQR = 0-5). The regions of Northern and Central Norway, MipACs located in nursing home and MipACs organised at long-term care units, showed significantly lower nursing competence in staff compared to the remaining institution and organisations. CONCLUSION This study generates knowledge that can inform planning, priorities and interventions that may be initiated at all organisational and political levels concerning the MipAC services. An overall conclusion is that advanced nursing competence is lacking. The study also highlights the most urgent direction for improvements regarding nursing competence in the services. It seemed to be MipACs in Northern and Central Norway, and those located at nursing homes organised together with long-term care units, that needed improvements the most.
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Affiliation(s)
- Torunn Kitty Vatnøy
- grid.23048.3d0000 0004 0417 6230Centre for Care Research, Southern Norway and Department of Health and Nursing Science, University of Agder, Box 509, NO-4898 Grimstad, Norway
| | - Marianne Sundlisæter Skinner
- Center for Care Research, Eastern Norway and Department of Health Sciences NTNU – Norwegian University of Science and Technology, Box 191, NO-2802 Gjøvik, Norway
| | - Tor-Ivar Karlsen
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, University of Agder, Box 509, NO-4898 Grimstad, Norway
| | - Bjørg Dale
- grid.23048.3d0000 0004 0417 6230Centre for Care Research, Southern Norway and Department of Health and Nursing Science, University of Agder, Box 509, NO-4898 Grimstad, Norway
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Mather CA, Cummings E. Developing and sustaining digital professionalism: a model for assessing readiness of healthcare environments and capability of nurses. BMJ Health Care Inform 2019; 26:bmjhci-2019-100062. [PMID: 31676494 PMCID: PMC7062341 DOI: 10.1136/bmjhci-2019-100062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/15/2019] [Accepted: 10/23/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Technological change in healthcare demands new ways of working. Access to, and use of, digital technology by nurses in Australia lags behind other professions. Governance frameworks and professional standards guide scopes of practice; however, there is an urgent need for current registered nurses to master using digital technology and model digital professionalism to the next generation. Sustaining digital professionalism requires organisational readiness to accommodate changing technological environments. Methods Previous original research findings investigating the nature and scope of digital technology use by nurses were systematically analysed. With reference to current understandings of capability, a matrix for assessing organisational readiness of capability of digital technology use by nurses was developed. Results The 4E3P digital professionalism model articulates the elements necessary for establishing organisational readiness and assessing the capability development of individuals and groups. When the physical and social environment is conducive and the 4E elements of equipment, electronic access, engagement and education are present, preparedness, proficiency and professional behaviours can be nurtured and supported. Discussion The model describes the physical and social attributes that enable capability development for sustaining digital professionalism to advance nursing practice. When elements of the matrix are lacking, both individuals and groups miss opportunities to develop and sustain digitally professional behaviour. Conclusion It is imperative that healthcare environments in Australia support the development of digital professionalism. Deployment of the 4E3P digital professionalism model will enable identification and remediation of challenges, barriers or risks to promote sustainability found within physical and social healthcare environments.
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Affiliation(s)
- Carey Ann Mather
- School of Nursing, University of Tasmania, Launceston, Tasmania, Australia
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Mitchell P, Nightingale J, Reeves P. Competence to capability: An integrated career framework for sonographers. Radiography (Lond) 2019; 25:378-384. [PMID: 31582248 DOI: 10.1016/j.radi.2019.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Within the United Kingdom sonographers, with ultrasound as their core role, currently have a primary registration as a radiographer or another health professional. Entering with masters level qualifications, and often exhibiting a higher career banding, the sonographer career structure does not align comfortably with the existing health professional frameworks. This study aimed to explore the attitudes and opinions of a sample of practicing sonographers concerning a potential graduate sonographer role and the development of a clinical competence framework required to provide a skills escalator. METHODS A qualitative study using an interpretative framework was undertaken using semi-structured interviews. A homogeneous sample population of ten participants was selected using theoretical purposive sampling. The interview transcripts were thematically analyzed and coded. RESULTS The themes of implementing change and clinical frameworks were identified along with a sub-theme of clinical competence boundaries. All participants found it challenging to identify a role or clinical competences that a band 5/graduate sonographer could undertake, though more suggestions were offered for a band 6 sonographer. CONCLUSION Whilst, within the literature, clinical competences were agreed to provide the cornerstone for defining clinical roles there was some dispute as to the appropriateness of the use of core clinical competences for defining the scope of practice of health professionals above entry level to the profession. The data collected in this study demonstrated that there were skills development between graduate, specialist, advanced and consultant practitioners. Participants were focussed on clinical skills rather than wider capability skills. It is recommended that in order for advanced practice sonographers to map to the new ACP framework less focus on competence and a greater consideration of capabilities is required.
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Affiliation(s)
- P Mitchell
- Sheffield Hallam University, Sheffield, South Yorkshire, SB10 2BQ, England, UK.
| | - J Nightingale
- Sheffield Hallam University, Sheffield, South Yorkshire, SB10 2BQ, England, UK.
| | - P Reeves
- Sheffield Hallam University, Sheffield, South Yorkshire, SB10 2BQ, England, UK.
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Liu YP, Jensen D, Chan CY, Wei CJ, Chang Y, Wu CH, Chiu CH. Development of a nursing-specific Mini-CEX and evaluation of the core competencies of new nurses in postgraduate year training programs in Taiwan. BMC MEDICAL EDUCATION 2019; 19:270. [PMID: 31319845 PMCID: PMC6639917 DOI: 10.1186/s12909-019-1705-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Modern nursing requires a broad set of academic and practical skills, and an effective nurse must integrate these skills in a wide range of healthcare contexts. Cultivation of core competencies has recently become a key issue globally in the development of nursing education. To assess the performance of new nurses, this study developed a nursing-specific Mini-Clinical Evaluation Exercise (Mini-CEX) to evaluate the effect of postgraduate year (PGY) nurse training programs in Taiwan. METHODS A nursing-specific Mini-CEX was developed based on the required core competencies of nurses. Reliability and validity were confirmed in evaluator workshops carried out prior to the administration of the pilot test and final test. Thirty-two PYG trainees were recruited with a supervisor-to-trainee ratio of 1:1.94. Data were collected from February to June 2012 and analyzed using the Kruskal-Wallis test. RESULTS The 32 PGY trainees scored highest in the "nursing professionalism" dimension and the lowest in the "physical examination" dimension. The overall competency score was satisfactory. The trainee nurses with 19-24 months of experience scored higher than the other two groups in overall performance. CONCLUSION The results of this research indicate the feasibility of using our Mini-CEX tool to evaluate the competencies of PGY trainees.
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Affiliation(s)
- Yueh-Ping Liu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Dana Jensen
- School of Health Care Administration, Taipei Medical University, 250 Wu-hsing St., Taipei, Taiwan
| | - Cho-yu Chan
- Center for Teaching Excellence, Changhua Christian Hospital, Changhua City, Taiwan
| | - Chung-jen Wei
- Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yuanmay Chang
- Institute of Long Term Care, MacKay Medical College, New Taipei City, Taiwan
| | - Chih-Hsiung Wu
- College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chiung-hsuan Chiu
- School of Health Care Administration, Taipei Medical University, 250 Wu-hsing St., Taipei, Taiwan
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Duff E. A structural equation model of empowerment factors affecting nurse practitioners competence. Nurse Educ Pract 2019; 38:145-152. [DOI: 10.1016/j.nepr.2019.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/25/2019] [Accepted: 06/03/2019] [Indexed: 11/24/2022]
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Nilsen ER, Söderhamn U, Dale B. Facilitating holistic continuity of care for older patients: Home care nurses’ experiences using checklists. J Clin Nurs 2019; 28:3478-3491. [DOI: 10.1111/jocn.14940] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/16/2019] [Accepted: 05/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Elin R. Nilsen
- Faculty of Health and Sport Sciences, Centre for Caring Research University of Agder Grimstad Norway
| | - Ulrika Söderhamn
- Faculty of Health and Sport Sciences, Centre for Caring Research University of Agder Grimstad Norway
| | - Bjørg Dale
- Faculty of Health and Sport Sciences, Centre for Caring Research University of Agder Grimstad Norway
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Vatnøy TK, Karlsen TI, Dale B. Exploring nursing competence to care for older patients in municipal in-patient acute care: A qualitative study. J Clin Nurs 2019; 28:3339-3352. [PMID: 31090955 DOI: 10.1111/jocn.14914] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 02/20/2019] [Accepted: 05/03/2019] [Indexed: 11/28/2022]
Abstract
AIM To identify critical aspects of nursing competence to care for older patients in the context of municipal in-patient acute care. BACKGROUND An increasingly complex and advanced primary healthcare system requires attention to the extent of nursing competence in municipal services. However, competence in complex and advanced care settings must be explored using perspectives which acknowledge the complexity of nurses' performance. DESIGN A phenomenological hermeneutic, qualitative approach with individual in-depth interviews was used. COREQ reporting guidelines have been applied. METHODS A sample of eight nurses and two physicians employed in municipal in-patient acute care units (MAUs) were purposively recruited to participate. Data were collected between May and June of 2017. Analysis and interpretation were conducted systematically in three steps: naïve reading, structural analysis and comprehensive understanding. FINDINGS Two main themes were revealed. The first was the following: "The meaning of the individual nursing competence" including the themes "Having competence in clinical assessments, decision-making, and performing interventions"; "Having competence to collaborate, coordinate and facilitate"; and "Being committed." The second was the following: "The meaning of environmental and systemic factors for nursing competence," included the themes "Having professional leadership"; "Having a sufficiently qualified staff"; and "Working in an open, cooperative and professional work environment." CONCLUSION Individual nursing competence in MAUs should include the capability to detect patient deterioration and to care for older patients in a holistic perspective. In addition, the professional environmental culture, supportive leadership and systemic factors seemed to be crucial to success. RELEVANCE TO CLINICAL PRACTICE This study illustrates the nurses' responsibility for older patients' safety and quality of care in the MAUs. These findings can act as a foundation for the development and adaptation of educational programmes to accommodate requirements for nursing competence in MAUs. The broad perspective of nursing competence can give directions for quality improvements in MAUs.
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Affiliation(s)
- Torunn Kitty Vatnøy
- Centre for Caring Research, Southern Norway and Department of Health and Nursing Science, University of Agder, Grimstad, Norway
| | - Tor-Ivar Karlsen
- Department of Health and Nursing Science, University of Agder, Grimstad, Norway
| | - Bjørg Dale
- Centre for Caring Research, Southern Norway and Department of Health and Nursing Science, University of Agder, Grimstad, Norway
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Raeissi P, Zandian H, Mirzarahimy T, Delavari S, Zahirian Moghadam T, Rahimi G. Relationship between communication skills and emotional intelligence among nurses. Nurs Manag (Harrow) 2019; 26:31-35. [PMID: 31468761 DOI: 10.7748/nm.2019.e1820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 11/09/2022]
Abstract
AIM Nurses' emotional intelligence (EI) affects many of their behavioural skills. Given the importance of communication skills, the aim of this study is to investigate the relationship between EI and the communication skills of emergency department nurses. METHOD 253 nurses working in five hospitals affiliated to Ardabil University of Medical Sciences took part in this cross-sectional analytical study. Participants completed Goleman's EI Scale and a researcher-designed communication skills questionnaire. Validity and reliability of the tools were measured throughout the study. Data analysis was carried out using analysis of variance, Pearson correlation and Spearman correlation tests in SPSS v18. FINDINGS The mean EI score was estimated to be 78.31 with the highest and lowest scores related to self-awareness (20.83) and self-management (18.19) dimensions respectively. The mean total score of communication skills was estimated to be 70.91. There was a significant relationship between total EI score and total communication skills score ( r =0.775, P <0.01) and a strong significant relationship between the four dimensions of EI and the total score of communication skills. CONCLUSION Since EI and its dimensions have a positive effect on nurses' communication skills hospital managers can enhance EI by organising training sessions and promoting communication skills and provide the ground for continuous improvement of hospital services.
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Affiliation(s)
- Pouran Raeissi
- Department of Health Service Management, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Tiba Mirzarahimy
- Obstetrics and Gynecology, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sajad Delavari
- Health and Human Resource Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Telma Zahirian Moghadam
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Giti Rahimi
- Obstetrics and Gynecology, Ardabil University of Medical Sciences, Ardabil, Iran
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Nelson LE, McMahon JM, Leblanc NM, Braksmajer A, Crean HF, Smith K, Xue Y. Advancing the case for nurse practitioner-based models to accelerate scale-up of HIV pre-exposure prophylaxis. J Clin Nurs 2018; 28:351-361. [PMID: 30230068 DOI: 10.1111/jocn.14675] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 09/09/2018] [Accepted: 09/13/2018] [Indexed: 01/25/2023]
Abstract
AIMS To explore the factors that position nurse practitioners (NPs) to lead the implementation of HIV pre-exposure prophylaxis. BACKGROUND The HIV epidemic represents a global health crisis. Reducing new HIV infections is a public health priority, especially for Black and Latino men who have sex with men (MSM). When taken as directed, co-formulated emtricitabine and tenofovir have over 95% efficacy in preventing HIV; however, substantial gaps remain between those who would benefit from pre-exposure prophylaxis (PrEP) and current PrEP prescribing practices. DESIGN This is a position paper that draws on concurrent assessments of research literature and advanced practice nursing frameworks. METHOD The arguments in this paper are grounded in the current literature on HIV PrEP implementation and evidence of the added value of nurse-based models in promoting health outcomes. The American Association of Colleges of Nursing's advanced nursing practice competencies were also included as a source of data for identifying and cross-referencing NP assets that align with HIV PrEP care continuum outcomes. CONCLUSIONS There are four main evidence-based arguments that can be used to advance policy-level and practice-level changes that harness the assets of nurse practitioners in accelerating the scale-up of HIV PrEP. RELEVANCE TO CLINICAL PRACTICE Global public health goals for HIV prevention cannot be achieved without the broader adoption of PrEP as a prevention practice among healthcare providers. NPs are the best hope for closing this gap in access for the populations that are most vulnerable to HIV infection.
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Affiliation(s)
| | | | | | | | | | | | - Ying Xue
- University of Rochester, Rochester, New York
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Peddle M, Bearman M, Radomski N, Mckenna L, Nestel D. What non-technical skills competencies are addressed by Australian standards documents for health professionals who work in secondary and tertiary clinical settings? A qualitative comparative analysis. BMJ Open 2018; 8:e020799. [PMID: 30082346 PMCID: PMC6078249 DOI: 10.1136/bmjopen-2017-020799] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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
OBJECTIVES At minimum, safe patient outcomes are recognised as resulting from a combination of technical and non-technical skills. Flin and colleagues provide a practical framework of non-technical skills, cognitive, social and interpersonal, that complement technical skills, with categories identified as situational awareness, communication, team working, decision-making, leadership, coping with stress and managing fatigue. The aim of this research was to explore the alignment of categories and elements of non-technical skills with those in the published standards documents of several health professions in Australia. DESIGN A qualitative comparative analysis using document analysis and deductive coding examined, extracted and interpreted data from competency standards documents focusing on non-technical skills categories and elements. PARTICIPANTS A purposive sample of 11 health professions competency standards documents required for registration in Australia. FINDINGS The 11 competency standards documents contained 1616 statements. Although standards documents addressed all non-technical skills categories, there was limited reporting of managing stress and coping with fatigue. Of the 31 elements included in the non-technical skills framework, 22 were not common to all health professions and 3 elements were missing from the standards documents. Additionally, the documents were composed differently with no common taxonomy and multifaceted statements. CONCLUSION While commonalities identified in the standards documents related to non-technical skills categories are likely to support patient safety, gaps in associated elements may undermine their effectiveness. The notable lack of reference to stress and fatigue requires further attention for health professional well-being in Australia. A shared taxonomy with clear statements may offer the best support for collaborative practice and positive patient outcomes. Competency standards need to be flexible to respond to the emerging demands of current healthcare practice along with consumer and health service needs.
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Affiliation(s)
- Monica Peddle
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Margaret Bearman
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Victoria, Australia
| | - Natalie Radomski
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Lisa Mckenna
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Debra Nestel
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute for Health and Clinical Education, Monash University, Clayton, Victoria, Australia
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Jokiniemi K, Meretoja R, Pietilä AM. Constructing content validity of clinical nurse specialist core competencies: exploratory sequential mixed-method study. Scand J Caring Sci 2018; 32:1428-1436. [PMID: 29963720 DOI: 10.1111/scs.12588] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/13/2018] [Indexed: 11/29/2022]
Abstract
RATIONAL The demand to increase nursing competence is brought on by the requirement of safe, accessible and more effective use of healthcare provider expertise. Clinical nurse specialist competency development dates back to the late 20th century; however, an examination of the literature reveals a lack of research and discussion to support the competency development. OBJECTIVES To describe the formulation and validation process of the clinical nurse specialist core competencies. DESIGN Exploratory sequential mixed-method design. METHODS This mixed-method study, conducted between 2013 and 2017 in Finland, involved four phases: I) a Policy Delphi study (n = 25, n = 22, n = 19); II) cross-mapping of preliminary competency criteria against international competency sets; III) content validity study of expanded competency criteria (n = 7, n = 10); and IV) verification of competency criteria with practicing CNSs (n = 16). Data were analysed by both qualitative and quantitative analysis methods. RESULTS Seventy-four preliminary clinical nurse competency criteria were formulated in the first phase of the study. Through cross-mapping the competencies against the US and Canadian clinical nurse specialist competency sets, they were further concised to 61 criteria. The examination of Content Validity Indexes and experts' comments led to the clarification and consequent inclusion of 50 criteria to the final scale, with Scale Content Validity Index Average of 0.94. The competency criteria were evaluated to be a solid set with potential to clarify and uniform the clinical nurse specialist roles. CONCLUSIONS Through a rigorous research process, validated clinical nurse specialist competency criteria were formed with a high Scale Content Validity Index Average. The results allude to the potential of formulating international competency criteria to support global role clarity and understanding. However, further research is needed to validate the content and construct of the formulated competencies with a larger population across countries.
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Affiliation(s)
- Krista Jokiniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Riitta Meretoja
- University of Turku, Turku, Finland.,Helsinki University Hospital, Helsinki, Finland
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Social and Health Care Services, Kuopio, Finland
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Bromley P. Capability: How is it recognised in student nurses undertaking postgraduate studies in neonatal intensive care? ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.jnn.2017.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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