Determining the role and responsibilities of the community epilepsy nurse in the management of epilepsy

Professional nurses' experiences of managing epilepsy at limited resource rural facilities in Limpopo and Mpumalanga Provinces, South Africa

BACKGROUND

Epilepsy is a neurological disorder affecting approximately 50 million individuals globally, contributing significantly to the global disease burden. Professional nurses play a crucial role in the care and treatment of people living with epilepsy, ensuring their safety and well-being. Professional nurses frequently encounter challenges, such as restricted access to drugs, specialised equipment, and epilepsy treatment training. Despite these obstacles, professional nurses are essential to providing high-quality care to patients with epilepsy in remote locations.

METHODS

A qualitative design using explorative, descriptive, and contextual design was employed to achieve the objectives of the study. The sample comprised 20 professional nurses working in selected rural communities in Limpopo and Mpumalanga. Data was collected through in-depth individual interviews and analysed using Tesch's eight steps of data analysis.

RESULTS

Four themes emerged from the data: experiences of professional nurses during management of epilepsy; inadequate training in management of epilepsy; insufficient supply of antiepileptic drugs and late presentation to local clinics.

CONCLUSION

The study found that professional nurses experienced several challenges hindering the effective management of epilepsy. Cultural beliefs in supernatural causes of epilepsy significantly influence treatment preferences, consequently delaying diagnosis and treatment. Despite limited resources and cultural barriers experienced by professional nurses, they strive to provide appropriate care to minimise seizures. Ongoing education and training on epilepsy management is vital to enable professional nurses to keep up-to-date with current methods and new developments.

Healthcare leaders navigating complexity: a scoping review of key trends in future roles and competencies

BACKGROUND

As healthcare systems rapidly become more complex, healthcare leaders are navigating expanding role scopes and increasingly varied tasks to ensure the provision of high-quality patient care. Despite a range of leadership theories, models, and training curricula to guide leadership development, the roles and competencies required by leaders in the context of emerging healthcare challenges (e.g., disruptive technologies, ageing populations, and burnt-out workforces) have not been sufficiently well conceptualized. This scoping review aimed to examine these roles and competencies through a deep dive into the contemporary academic and targeted gray literature on future trends in healthcare leadership roles and competencies.

METHODS

Three electronic databases (Business Source Premier, Medline, and Embase) were searched from January 2018 to February 2023 for peer-reviewed literature on key future trends in leadership roles and competencies. Websites of reputable healthcare- and leadership-focused organizations were also searched. Data were analyzed using descriptive statistics and thematic analysis to explore both the range and depth of literature and the key concepts underlying leadership roles and competencies.

RESULTS

From an initial 348 articles identified in the literature and screened for relevance, 39 articles were included in data synthesis. Future leadership roles and competencies were related to four key themes: innovation and adaptation (e.g., flexibility and vision setting), collaboration and communication (e.g., relationship and trust building), self-development and self-awareness (e.g., experiential learning and self-examination), and consumer and community focus (e.g., public health messaging). In each of these areas, a broad range of strategies and approaches contributed to effective leadership under conditions of growing complexity, and a diverse array of contexts and situations for which these roles and competencies are applicable.

CONCLUSIONS

This research highlights the inherent interdependence of leadership requirements and health system complexity. Rather than as sets of roles and competencies, effective healthcare leadership might be better conceptualized as a set of broad goals to pursue that include fostering collaboration amongst stakeholders, building cultures of capacity, and continuously innovating for improved quality of care.

Implementation of consensus-based perioperative care pathways to reduce clinical variation for elective surgery in an Australian private hospital: a mixed-methods pre-post study protocol

INTRODUCTION

Addressing clinical variation in elective surgery is challenging. A key issue is how to gain consensus between largely autonomous clinicians. Understanding how the consensus process works to develop and implement perioperative pathways and the impact of these pathways on reducing clinical variation can provide important insights into the effectiveness of the consensus process. The primary objective of this study is to understand the implementation of an organisationally supported, consensus approach to implement perioperative care pathways in a private healthcare facility and to determine its impact.

METHODS

A mixed-methods Effectiveness-Implementation Hybrid (type III) pre-post study will be conducted in one Australian private hospital. Five new consensus-based perioperative care pathways will be developed and implemented for specific patient cohorts: spinal surgery, radical prostatectomy, cardiac surgery, bariatric surgery and total hip and knee replacement. The individual components of these pathways will be confirmed as part of a consensus-building approach and will follow a four-stage implementation process using the Exploration, Preparation, Implementation and Sustainment framework. The process of implementation, as well as barriers and facilitators, will be evaluated through semistructured interviews and focus groups with key clinical and non-clinical staff, and participant observation. We anticipate completing 30 interviews and 15-20 meeting observations. Administrative and clinical end-points for at least 152 participants will be analysed to assess the effectiveness of the pathways.

ETHICS AND DISSEMINATION

This study received ethical approval from Macquarie University Human Research Ethics Medical Sciences Committee (Reference No: 520221219542374). The findings of this study will be disseminated through peer-reviewed publications, conference presentations and reports for key stakeholders.