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Tibeica SC, Baciu ER, Lupu IC, Balcos C, Luchian I, Budala DG, Tibeica A, Surlari Z, Carausu EM. Creating and Validating a Questionnaire for Assessing Dentists' Self-Perception on Oral Healthcare Management-A Pilot Study. Healthcare (Basel) 2024; 12:933. [PMID: 38727490 PMCID: PMC11083331 DOI: 10.3390/healthcare12090933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/27/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Questionnaires designed to test knowledge and self-perception can be valuable tools for diagnosing a dentist's understanding of the management and administration of a practice. The objective of this study was to create and authenticate a questionnaire for assessing dentists' self-perception on oral healthcare management developed from discussions with experts in this field. MATERIAL AND METHODS In order to create and verify a questionnaire survey, a cross-sectional, descriptive, and analytical study was carried out. Participants' personal information and 31 statements across four categories made up the final questionnaire form. The answers to the questionnaire were in the form of a Likert scale. After refining the initial version, a total of 36 interviews were conducted at dental offices to verify the validity. For the Exploratory Factor Analysis (EFA), we used the Kaiser-Meyer-Olkin (KMO) index, the Bartlett sphericity test, and also Cronbach alpha coefficient for the validity of the questionnaire. RESULTS The accuracy of the instrument was measured by intrarater and interrater reliability. For the EFA, all the communalities exceeded the threshold of 0.05. With a Cronbach's alpha coefficient of 0.898, the questionnaire has sufficient internal consistency. CONCLUSIONS The questionnaire demonstrates robust reliability and validity, thereby affirming its suitability for its intended purpose.
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Affiliation(s)
- Silviu Catalin Tibeica
- Department of Health Management, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania (E.M.C.)
| | - Elena Raluca Baciu
- Department of Dental Materials, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Iulian Costin Lupu
- Department of Health Management, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania (E.M.C.)
| | - Carina Balcos
- Department of Oral Health, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ionut Luchian
- Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Dana Gabriela Budala
- Department of Dentures, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania;
| | - Andreea Tibeica
- Department of Implantology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Zinovia Surlari
- Department of Fixed Dentures, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Elena Mihaela Carausu
- Department of Health Management, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania (E.M.C.)
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Robertson S, Ryan T, Talpur A. Factors influencing early career nurses to adopt leadership roles: a literature review. Nurs Manag (Harrow) 2024; 31:20-26. [PMID: 37877178 DOI: 10.7748/nm.2023.e2105] [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] [Accepted: 08/23/2023] [Indexed: 10/26/2023]
Abstract
Effective nursing leadership has been shown to improve patient outcomes, but there has been little exploration of the factors that influence early career nurses to develop their leadership skills and adopt leadership roles. This article presents a rapid review of the literature on these factors, integrating data from 25 articles. Findings suggest that improving leadership confidence and self-efficacy, particularly in relation to system leadership, can increase nurses' motivation for adopting leadership roles. Supportive organisations that value leadership and give nurses opportunities to exercise it are equally important. Training and education, preceptorship, peer-to-peer shadowing, modelling and mentoring can all be useful in improving leadership skills and inspiring the next generation of nurse leaders.
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Affiliation(s)
- Steve Robertson
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, England
| | - Tony Ryan
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, England
| | - Ashfaque Talpur
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, England
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Duignan M, Drennan J, Mc Carthy VJC. Relationship between work-related psychosocial factors and self-leadership in advanced nurse practitioners: A cross-sectional study. J Adv Nurs 2024; 80:1120-1131. [PMID: 37837195 DOI: 10.1111/jan.15855] [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: 03/11/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 10/15/2023]
Abstract
AIM The aim of this study was to investigate the relationship between advanced nurse practitioners' self-leadership and commitment to the workplace, work engagement and influence at work. BACKGROUND The concept of self-leadership is particularly suited to ANPs, who are required to take responsibility for their work roles. An optimum balance between the ANPs' psychosocial work environment and self-leadership may positively impact work ability in this group and can be compromised by interactions between and among these variables. DESIGN A cross-sectional correlational study was conducted from July 2020 to August 2020 on 153 ANPs across a national health service. METHODS The survey was distributed to respondents online. The revised self-leadership questionnaire was used to measure self-leadership, and three scales from the Copenhagen Psychosocial Questionnaire were used to measure commitment to the workplace, work engagement and influence at work. Multiple linear regression was used to examine the association between self-leadership and the psychosocial variables. RESULTS ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. No relationship was found between self-leadership and influence at work. CONCLUSION Improving self-leadership among ANPs by involving them in strategic leadership activities at an organizational level could be an effective strategy for optimizing the role and facilitating ANPs to contribute at an organizational level beyond the clinical interface. However, organizational support is required to ensure that ANPs practise to the full potential of their training and capability. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. IMPACT This study provided new evidence of a relationship between ANPs' self-leadership and psychosocial factors. This study found that ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. Policymakers and organizational leaders can optimize the ANP role and facilitate ANPs to contribute strategically to improve care systems. This study identifies a relationship between ANPs' self-leadership and specific psychosocial variables.
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Affiliation(s)
- Martin Duignan
- Our Lady's Hospital, Navan, Co. Meath, Dublin, Ireland
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Jonathan Drennan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Whitehead L, Twigg DE, Carman R, Glass C, Halton H, Duffield C. Factors influencing the development and implementation of nurse practitioner candidacy programs: A scoping review. Int J Nurs Stud 2021; 125:104133. [PMID: 34837730 DOI: 10.1016/j.ijnurstu.2021.104133] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND To meet the growing needs of a diverse population, it is critical that healthcare service provision is underpinned by innovative, cost-effective, and sustainable services and solutions. The role of the nurse practitioner creates an opportunity to meet the increasing demands of complex care and enables greater access to high quality care. Understanding how best to support nurse practitioner candidates to develop into the nurse practitioner role will create greater opportunities to transform service delivery and improve healthcare outcomes. AIM To identify key factors that support and positively impact the implementation of nurse practitioner candidacy programs and candidate experiences. METHODS A scoping review of research and grey literature was conducted using Joanna Briggs Institute methodology. For the research literature, eight electronic databases (Embase, Medline, CINAHL, Web of Science, Cochrane Library, Joanna Briggs Institute, PubMed and PsycINFO) were searched followed by a hand search of the reference lists of published systematic reviews and relevant topical papers. A review of national and international grey literature sources was completed. FINDINGS Identification of a service gap, developing and promoting a clear role for the nurse practitioner candidate, integration into a multi-disciplinary team with strong mentorship/preceptorship support, continuing professional development, and evaluation of the program were identified as key factors in the research and grey literature. CONCLUSION A well-designed candidacy program can facilitate transition of the candidate into an autonomous, fully independent nurse practitioner. Recommendations to support the implementation of these roles into the clinical setting have been generated. Tweetable abstract: Key to nurse practitioner candidate programs: Identification of a service gap, clear role, integration, mentorship, training and evaluation.
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Affiliation(s)
- Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia.
| | - Diane E Twigg
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia.
| | - Rebecca Carman
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia.
| | - Courtney Glass
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia.
| | - Helena Halton
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia.
| | - Christine Duffield
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia.
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THE IMPACT OF CLINICAL LEADERSHIP ON QUALITY AND ACCREDITATION STUDIES IN HEALTH SERVICES. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.955272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Duignan M, Drennan J, McCarthy VJC. Impact of clinical leadership in advanced practice roles on outcomes in health care: A scoping review. J Nurs Manag 2020; 29:613-622. [PMID: 33098329 DOI: 10.1111/jonm.13189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/19/2020] [Accepted: 10/15/2020] [Indexed: 11/27/2022]
Abstract
AIM To undertake a scoping review of the literature exploring the impact of clinical leadership in advanced practice roles in relation to patient, staff and organisational outcomes. BACKGROUND An increasing number of publications as well as job specifications have identified clinical leadership as a cornerstone of advanced practice roles. However, it is unclear whether embedding clinical leadership in such roles has led to improvements in patient, staff or organisational outcomes. Therefore, identifying the extent to which clinical leadership in advanced practice roles relates to patient, staff and organisational outcomes is needed. METHOD A scoping review examining the relationship between clinical leadership in advanced practice roles and health care outcomes. Searching in SCOPUS, PubMed, Psychinfo and CINAHL Plus and Web of Science identified 765 potential articles. Independent selection, data extraction tabulation of findings and analysis were completed. RESULTS Seven studies were identified that met the inclusion criteria. Only studies reporting on nurses in advanced practice roles were included; no studies were identified that reported on the advanced practice roles of allied health professionals. The results indicate that there is no objective evidence of the impact of advanced practitioners' clinical leadership on patient, staff or organisational outcomes. CONCLUSION There is a paucity of objective evidence to identify the extent to which clinical leadership is enacted in advanced practice roles. The review indicates a need for closer alignment of AP clinical leadership policy aspirations and formal operational leadership opportunities for APs. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers have a key role in supporting and equipping APs with leadership competencies and opportunities to enable both capability and capacity building of such roles. Nurse managers should involve APs in health care leadership at an organisational level to maximize their contribution to health, quality practice environments and health care reform. Additionally, a distinct involvement in staff development, change, operational strategic decisions and policy development should be part of the AP role, which is facilitated by management.
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Affiliation(s)
- Martin Duignan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.,Emergency Department, Our Lady's Hospital, Navan, Ireland
| | - Jonathan Drennan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Vera J C McCarthy
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Goemaes R, Beeckman D, Verhaeghe S, Van Hecke A. Sustaining the quality of midwifery practice in Belgium: Challenges and opportunities for advanced midwife practitioners. Midwifery 2020; 89:102792. [PMID: 32653612 DOI: 10.1016/j.midw.2020.102792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/10/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Midwifery practice is essential in achieving high-quality maternal and newborn care in all settings and countries. However, midwifery practice has become more complex over the past decades. Considerable demands are being placed on midwives to meet increasing epidemiological, socio-economic, and technological challenges. These require a well-trained midwifery workforce ready to shape the care in the near and long-term future. OBJECTIVE To discuss advanced midwife practitioner role implementation in Belgium as a possible answer to healthcare-related challenges that impact midwifery practice. Furthermore, to stimulate a debate within the profession at all levels in Belgium and in countries considering advanced midwife practitioner roles. METHOD The framework by De Geest et al. (2008) served as a basis for discussing the drivers for advanced midwife practitioner role implementation: the legal, policy and economic context, workforce issues, education, practice patterns, and healthcare needs of the population. FINDINGS A legal basis for advanced midwife practitioner role implementation is lacking in Belgium. Remuneration opportunities for the non-clinical part of these roles (e.g. leadership and innovation activities) are missing. It might be challenging for healthcare organisations to support the implementation of such roles, as immediate revenues of non-clinical activities are absent. However, sufficient potential resources are available to fill in future advanced midwife practitioner positions. Additionally, advanced midwife practitioner specific master programmes are being planned in the near future. CONCLUSIONS Although several barriers for the implementation of advanced midwife practitioner roles were identified, a discussion should be held on the opportunities of implementing these roles to facilitate the development of new models of care that meet current and future challenges in midwifery practice and healthcare. After initial discussions amongst midwives in academic, managerial, and policy positions, stakeholders such as obstetricians, general practitioners, associations representing healthcare organisations, and policy makers should be involved as a next step.
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Affiliation(s)
- Régine Goemaes
- PhD student University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University. University Centre for Nursing & Midwifery Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Dimitri Beeckman
- University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University Centre for Nursing & Midwifery Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000, Ghent, Belgium.
| | - Sofie Verhaeghe
- University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University Centre for Nursing & Midwifery, Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000, Ghent, Belgium.
| | - Ann Van Hecke
- University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University Centre for Nursing & Midwifery, Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000, Ghent, Belgium; Nursing Department, University Hospital Ghent, Corneel Heymanslaan 10, B-9000, Ghent, Belgium..
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Kerr L, Macaskill A. Advanced Nurse Practitioners' (Emergency) perceptions of their role, positionality and professional identity: A narrative inquiry. J Adv Nurs 2020; 76:1201-1210. [PMID: 32017199 DOI: 10.1111/jan.14314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/12/2019] [Accepted: 01/29/2020] [Indexed: 11/30/2022]
Abstract
AIMS To explore Advanced Nurse Practitioners' (ANP) (Emergency) perceptions of their role, positionality and professional identity. BACKGROUND Advanced nursing practice was formally established in the Republic of Ireland in 2001 with 336 ANPs currently registered, projection increasing to a critical mass of 750 by 2021. Advanced practitioners (Emergency) give full emergency care for a specific cohort of clients with unscheduled, undifferentiated and undiagnosed conditions. DESIGN Qualitative narrative inquiry using Bourdieu's concepts of habitus, field and capital as the theoretical framework was undertaken. METHODS Data were collected in 10 in-depth interviews and thematic analysis applied. RESULTS Five key themes emerged: participants' career pathways, personal and professional transitions, role dimensions and core concepts, and position in the organization and emergent professional identity. Role transitioning and a change in habitus, field and capital revealed the uniqueness of their nursing role. Minimizing waiting times, timely patient care and patient satisfaction were key performance indicators. A heightened awareness regarding higher-level decision-making, autonomy and accountability is integral to advanced practice. CONCLUSION This study presents unique insights into the ANP role covering recruitment, organizational culture changes required and support to ease transition emerged. IMPACT Better understanding the motivation to undertake the role, the transition experience and use of advanced practice skills sets will inform the targets for the future recruitment and retention of ANPs are met nationally and internationally. Dissatisfaction with previous management roles and wanting to be clinically close to patients were motivations to follow an advanced practice clinical career trajectory. Positionality and emergent professional identity are key enablers ensuring that advanced practitioners' roles demonstrate the attributes of advanced practice. Educators could use the findings to develop recruitment, retention and progression strategies. Disseminating the role and scopes of practice could positively influence collaborative models of service delivery and policy development.
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Affiliation(s)
- Lisa Kerr
- Department of Nursing and Healthcare, Faculty of Science and Health, Athlone Institute of Technology, Athlone, County Westmeath, Ireland
| | - Ann Macaskill
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
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Higgins A, Murphy R, Downes C, Varley J, Begley C, Elliott N. Factors influencing the implementation of Epilepsy Specialist Nurse role: Using the Consolidation Framework for Implementation Research. J Clin Nurs 2020; 29:1352-1364. [PMID: 31972049 DOI: 10.1111/jocn.15197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/20/2019] [Accepted: 01/10/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research to support the added value of including Epilepsy Specialist Nurses as members of the multidisciplinary team is developing, yet little information exists on factors influencing the translation of these roles into practice. AIM To describe the enabling and inhibiting factors to the implementation of the Epilepsy Specialist Nurse role in the Republic of Ireland. METHODS A qualitative design involving semi-structure interviews, observation and analysis of documents, such as portfolios was used. The sample included 12 Epilepsy Specialist Nurses, 24 multidisciplinary team members, and 35 individuals with epilepsy and family members. Data were analysed using the Consolidation Framework for Implementation Research. Reporting rigour is demonstrated using the COREQ checklist (See Appendix S1). RESULTS While there was overwhelming support for the role, barriers and enablers were identified across all domains of the Consolidation Framework for Implementation Research. Enablers included national policies and guidelines, leadership from senior nursing and medical colleagues, climate of learning and mentorship, networking opportunities, infrastructural supports and competence of Epilepsy Specialist Nurses. Barriers included the limited consideration of service expansion and the increasingly complex nature of clinical cases on workload capacity. Deficits in infrastructural supports, challenges in relation to role preparation, role implementation and role responsibility, including concerns around lone practitioner models and concerns that the role was a cost-saving measure, also emerged as potential barriers to future sustainability. CONCLUSION The Consolidation Framework for Implementation Research offers researchers a pragmatic typology for analysing interrelationships between enabling and inhibiting factors that impact implementation of advanced practice roles, across different evidence sources, disciplines and boundaries. RELEVANCE TO CLINICAL PRACTICE In order to secure role sustainability, managers need to address the rate of service expansion, models of role development, deficits in supports and perceived motivations for role development on the quality, acceptability and sustainability of services provided.
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Affiliation(s)
- Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Murphy
- ALL Institute, Department of Psychology, National University of Ireland Maynooth, Maynooth, Ireland
| | - Carmel Downes
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Jarlath Varley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Naomi Elliott
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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van Kraaij J, van Oostveen C, Vermeulen H, Heinen M, Huis A, Adriaansen M, Peters J. Nurse practitioners' perceptions of their ability to enact leadership in hospital care. J Clin Nurs 2019; 29:447-458. [PMID: 31738466 DOI: 10.1111/jocn.15105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 09/26/2019] [Accepted: 11/10/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVE To gain insight into nurse practitioners' (NP) leadership roles in Dutch hospital care, by exploring the perceptions regarding their current leadership role and the differences with their previous role as a registered specialised nurse. BACKGROUND To meet today's challenges of the increasing healthcare demands, the employment of NPs is proliferating. NPs have the ideal position to play a pivotal role within healthcare reforms, yet full expansion of their scope of practice and expertise is having limited success. Long-term sustainability of NPs depends on the ability to perform and develop a leading role. DESIGN AND METHODS This qualitative descriptive study was conducted in fifteen Dutch hospitals. Data were collected from April-July 2018, and purposive sampling was used for eighteen semi-structured interviews. This study is conducted and reported according to the COREQ checklist. RESULTS Three main themes concerning NPs' current leadership role emerged, and they were all linked to a successful positioning of NPs. All themes seemed to be of influence on NPs' scope of daily practice. Direct patient care was emphasised, and leadership on other levels appeared to be underused. Most NPs desired to reshape their profession. However, unprofitable use of their leadership skills especially on professional and organisational level and lack of supportive factors seemed to hinder them. CONCLUSIONS An adequate use of leadership is crucial for role development and positioning of NPs. Further development of the NP profession can help to better differentiate between the tasks of registered specialised nurses and NPs. RELEVANCE TO CLINICAL PRACTICE Leadership in nursing contributes to the improvement of the quality and efficiency of health care. Further positioning of the NP profession depends on a profitable use of leadership competencies. Besides, NPs should collaborate with healthcare organisations, educational institutions and professional associations to value the NP profession in the current healthcare system.
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Affiliation(s)
- Julia van Kraaij
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Catharina van Oostveen
- Spaarne Gasthuis Academy, Spaarne Gasthuis Hospital, Haarlem, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hester Vermeulen
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Maud Heinen
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Anita Huis
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - Jeroen Peters
- HAN University of Applied Sciences, Master Advanced Nursing Practice, Nijmegen, Netherlands
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Heinen M, van Oostveen C, Peters J, Vermeulen H, Huis A. An integrative review of leadership competencies and attributes in advanced nursing practice. J Adv Nurs 2019; 75:2378-2392. [PMID: 31162695 PMCID: PMC6899698 DOI: 10.1111/jan.14092] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/10/2019] [Accepted: 04/08/2019] [Indexed: 12/17/2022]
Abstract
Aim To establish what leadership competencies are expected of master level‐educated nurses like the Advanced Practice Nurses and the Clinical Nurse Leaders as described in the international literature. Background Developments in health care ask for well‐trained nurse leaders. Advanced Practice Nurses and Clinical Nurse Leaders are ideally positioned to lead healthcare reform in nursing. Nurses should be adequately equipped for this role based on internationally defined leadership competencies. Therefore, identifying leadership competencies and related attributes internationally is needed. Design Integrative review. Methods Embase, Medline and CINAHL databases were searched (January 2005–December 2018). Also, websites of international professional nursing organizations were searched for frameworks on leadership competencies. Study and framework selection, identification of competencies, quality appraisal of included studies and analysis of data were independently conducted by two researchers. Results Fifteen studies and seven competency frameworks were included. Synthesis of 150 identified competencies led to a set of 30 core competencies in the clinical, professional, health systems. and health policy leadership domains. Most competencies fitted in one single domain the health policy domain contained the least competencies. Conclusions This synthesis of 30 core competencies within four leadership domains can be used for further development of evidence‐based curricula on leadership. Next steps include further refining of competencies, addressing gaps, and the linking of knowledge, skills, and attributes. Impact These findings contribute to leadership development for Advanced Practice Nurses and Clinical Nurse Leaders while aiming at improved health service delivery and guiding of health policies and reforms.
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Affiliation(s)
- Maud Heinen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
| | - Catharina van Oostveen
- Spaarne Gasthuis Hospital, Spaarne Gasthuis Academy, Haarlem, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jeroen Peters
- Hogeschool van Arnhem en Nijmegen, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Anita Huis
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
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Van Hecke A, Goemaes R, Verhaeghe S, Beyers W, Decoene E, Beeckman D. Leadership in nursing and midwifery: Activities and associated competencies of advanced practice nurses and midwives. J Nurs Manag 2019; 27:1261-1274. [DOI: 10.1111/jonm.12808] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/01/2019] [Accepted: 05/27/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Nursing Department Ghent University Hospital Ghent Belgium
| | - Régine Goemaes
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Department Health Care VIVES University College Roeselare Belgium
| | - Wim Beyers
- Department of Developmental, Personality and Social Psychology Ghent University Ghent Belgium
| | - Elsie Decoene
- Cancer Centre Ghent University Hospital Ghent Belgium
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT) University Centre for Nursing and Midwifery, Ghent University Ghent Belgium
- School of Health Sciences Örebro University Sweden
- School of Nursing and Midwifery Royal College of Surgeons in Ireland Ireland
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Irajpour A, Khorasani P, Bagheri M, Eshaghian A, Ziaee ES, Saberi Z, Afshari A. The framework for developing nursing specialist roles in the health care system of Iran. Nurs Outlook 2019; 68:45-54. [PMID: 31445752 DOI: 10.1016/j.outlook.2019.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/13/2019] [Accepted: 06/22/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND A key step to the development of a roadmap for developing nursing specialist roles is to create its framework based on the immediate context. PURPOSE This study aimed to create the framework for developing nursing specialist roles in the health care system of Iran. METHODS This was a descriptive qualitative study. A purposeful sample of 81 nursing and nonnursing experts was recruited. The directed content analysis approach was used for data analysis. FINDINGS The framework for developing nursing specialist roles in the health care system include eight main categories. These categories are role titles, prioritization of the necessary specialties, the necessary competencies of nurses at specialist level, the scope of nursing specialist practice, expected authorizations, requirements for role development, and its barriers and facilitators. DISCUSSION Creating a context-based framework for nursing specialist role development based on the characteristics of each country is recommended.
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Affiliation(s)
- Alireza Irajpour
- Department of Critical Care Nursing, School of Nursing And Midwifery, Nursing Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvaneh Khorasani
- Department Of Community Health Nursing, School of Nursing And Midwifery, Nursing Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Bagheri
- Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azam Eshaghian
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Sadat Ziaee
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Saberi
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atefeh Afshari
- Department Of Community Health Nursing, School of Nursing And Midwifery, Nursing Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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14
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Wardani E, Ryan T. Barriers to nurse leadership in an Indonesian hospital setting. J Nurs Manag 2019; 27:671-678. [DOI: 10.1111/jonm.12728] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/22/2018] [Accepted: 10/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Elly Wardani
- Faculty of Nursing Syiah Kuala University Banda Aceh Indonesia
| | - Tony Ryan
- School of Nursing & Midwifery University of Sheffield Sheffield UK
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15
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Higgins A, Downes C, Varley J, Doherty CP, Begley C, Elliott N. Rising to the challenge: Epilepsy specialist nurses as leaders of service improvements and change (SENsE study). Seizure 2018; 63:40-47. [PMID: 30399460 DOI: 10.1016/j.seizure.2018.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/05/2018] [Accepted: 10/25/2018] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To report the leadership role and change activities of epilepsy specialist nurses (ESNs) in Ireland; findings from the SENsE study. METHOD A mixed methods study design was used, involving 12 epilepsy specialist nurses working in five units in Ireland, 24multidisciplinary team members working with them, and 35 people with epilepsy and their family members. Data were collected using individual and focus group interviews, observation and documentary analysis. RESULTS Five key areas in which ESNs demonstrated leading on the change agenda were identified. These included: Initiating new clinical practice developments; Building capability within the multidisciplinary team; Developing education programmes and resources for people with epilepsy, family and the public; Exerting influence through membership of committees and lobbying; and Advancing the ESN role. CONCLUSION Though the epilepsy specialist nurse role was first established in the UK in 1988, much of the literature that discusses or describes the ESN role is founded on anecdotal evidence, or focusses on their clinical expertise. Findings from this study provide empirical evidence that the ESNs were involved as key players in leading changes within the services, in the education of others, and the continuous advancement of epilepsy care.
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Affiliation(s)
- Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Carmel Downes
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Jarleth Varley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Colin P Doherty
- Department of Neurology, St. James's Hospital, James's Street, Dublin 8, Ireland.
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Naomi Elliott
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
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16
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Casey M, O'Connor L, Cashin A, Fealy G, Smith R, O'Brien D, Stokes D, McNamara M, O'Leary D, Glasgow ME. Enablers and challenges to advanced nursing and midwifery practice roles. J Nurs Manag 2018; 27:271-277. [PMID: 30252173 DOI: 10.1111/jonm.12697] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/30/2018] [Accepted: 07/13/2018] [Indexed: 11/30/2022]
Abstract
AIM To describe the enablers and challenges to the development and implementation of advanced nursing and midwifery practice roles in Ireland. BACKGROUND Leadership strategies need to be put in place to enhance the development and implementation of advanced nursing and midwifery practice roles. METHOD A descriptive qualitative approach using semi-structured interviews with key stakeholders (n = 15) was undertaken with nurses and midwives working in specialist and advanced practice roles and participants from other areas such as legislative, regulatory, policy, pharmacy, medicine and education. RESULTS Participant's perspectives on the enablers and challenges to enacting specialist and advanced practice roles resulted in the generation of three themes: organisational factors; collegial, interprofessional and interpersonal support; and role clarity, economic and regulatory contexts. CONCLUSION Addressing organisational factors, encouraging collegial and interprofessional support and establishing role clarity contribute to the effective development and implementation of the role of advanced practitioners. IMPLICATIONS FOR NURSING AND MIDWIFERY MANAGEMENT Managers of nursing services need to provide leadership in developing strategies to enhance the enablers and overcome the challenges to advanced practice role development in their own organisation.
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Affiliation(s)
- Mary Casey
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Laserina O'Connor
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Andrew Cashin
- Southern Cross University, East Lismore, New South Wales, Australia
| | - Gerard Fealy
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Rita Smith
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Denise O'Brien
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | | | - Martin McNamara
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Denise O'Leary
- School of Hospitality Management & Tourism, Dublin Institute of Technology, Dublin 6, Ireland
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17
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Fealy GM, Casey M, O'Leary DF, McNamara MS, O'Brien D, O'Connor L, Smith R, Stokes D. Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers. J Clin Nurs 2018; 27:3797-3809. [PMID: 29893441 DOI: 10.1111/jocn.14550] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To collate, synthesise and discuss published evidence and expert professional opinion on enablers and barriers to the development and sustainability of specialist and advanced practice roles in nursing and midwifery. BACKGROUND Expanded practice is a response to population health needs, healthcare costs and practitioners' willingness to expand their scope of practice through enhanced responsibility, accountability and professional autonomy. DESIGN This discursive paper is based on a rapid review of literature on enablers and barriers to the development and sustainability of specialist and advanced practice roles and is part of a wider policy analysis. METHODS We analysed and synthesised of 36 research articles, reviews and discussion papers on enablers and barriers in the development and sustainability of expanded practice roles. RESULTS Several factors enable role expansion, including: role clarity; credentialing and endorsement; availability of education for expanded roles; individual practitioners' dispositions towards role expansion; support from peers, other professionals and the work organisation; and costs. Where limited or absent, these same factors can constrain role expansion. CONCLUSIONS Enabling nurses and midwives to practice to their full scope of education and expertise is a global challenge for disciplinary leadership, a national challenge for professional regulation and a local challenge for employers and individual clinicians. These challenges need to be addressed through multistakeholder coordinated efforts at these four levels. RELEVANCE TO CLINICAL PRACTICE This discursive paper synthesises empirical evidence and expert professional opinion on the factors that enable or hinder the development and sustainability of specialist and advanced practice roles. Providing a critical appraisal of current knowledge, it provides a reference source for disciplinary debate and policy development regarding the nursing and midwifery resource and informs clinicians of the myriad issues that can impact on their capacity to expand their scope of practice.
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Affiliation(s)
- Gerard M Fealy
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Mary Casey
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Denise F O'Leary
- School of Hospitality Management and Tourism, Dublin Institute of Technology, Dublin, Ireland
| | - Martin S McNamara
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Denise O'Brien
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Laserina O'Connor
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rita Smith
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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18
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Anderson C. Exploring the role of advanced nurse practitioners in leadership. Nurs Stand 2018; 33:29-33. [PMID: 29676876 DOI: 10.7748/ns.2018.e11044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 06/08/2023]
Abstract
There have been several changes to healthcare services in the UK over recent years, with rising NHS costs and increasing demands on healthcare professionals to deliver high-quality care. Simultaneously, public inquiries have identified suboptimal leadership throughout the NHS, which has been linked to a lack of clear leadership across the healthcare professions. In nursing, the role of the advanced nurse practitioner is regarded as a solution to this leadership challenge. This article examines the background to the development of the advanced nurse practitioner role. It also explores the various factors that may affect nurse leadership and the role of the advanced nurse practitioner, including professional identity, gender, nursing's strategic influence, clinical outcomes, and recruitment and retention. The article concludes that while advanced nurse practitioners can positively influence clinical outcomes and cost efficiency, they must also be adequately prepared to undertake a leadership role.
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Affiliation(s)
- Claire Anderson
- College of Nursing Midwifery and Healthcare, University of West London, Middlesex, England
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19
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Casey M, O'Connor L, Nicholson E, Smith R, O'Brien D, O'Leary D, Fealy GM, Mcnamara MS, Stokes D, Egan C. The perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners. J Adv Nurs 2017; 73:3007-3016. [DOI: 10.1111/jan.13359] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Mary Casey
- UCD School of Nursing, Midwifery and Health Systems; University College Dublin; Belfield Dublin Ireland
| | - Laserina O'Connor
- School of Nursing, Midwifery & Health Systems; University College Dublin; Belfield Dublin Ireland
| | - Emma Nicholson
- School of Nursing, Midwifery & Health Systems; University College Dublin; Belfield Dublin Ireland
| | - Rita Smith
- School of Nursing, Midwifery & Health Systems; University College Dublin; Belfield Dublin Ireland
| | - Denise O'Brien
- School of Nursing, Midwifery & Health Systems; University College Dublin; Belfield Dublin Ireland
| | - Denise O'Leary
- School of Hospitality Management and Tourism; Dublin Institute of Technology; Dublin Ireland
| | - Gerard M Fealy
- School of Nursing, Midwifery & Health Systems; University College Dublin; Belfield Dublin Ireland
| | - Martin S Mcnamara
- School of Nursing, Midwifery & Health Systems; University College Dublin; Belfield Dublin Ireland
| | | | - Claire Egan
- School of Nursing, Midwifery & Health Systems; University College Dublin; Belfield Dublin Ireland
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20
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Affiliation(s)
- Martin Beirne
- Professor of management and organizational Behaviour, Adam Smith Business School, University of Glasgow, Scotland
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21
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Sastre-Fullana P, Morales-Asencio JM, Sesé-Abad A, Bennasar-Veny M, Fernández-Domínguez JC, De Pedro-Gómez J. Advanced Practice Nursing Competency Assessment Instrument (APNCAI): clinimetric validation. BMJ Open 2017; 7:e013659. [PMID: 28235968 PMCID: PMC5337725 DOI: 10.1136/bmjopen-2016-013659] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To describe the development and clinimetric validation of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) through several evidence sources about reliability and validity in the Spanish context. DESIGN AND SETTING APNCAI development was based on a multisequential and systematic process: literature review, instrument content consensus through qualitative Delphi method approach (a panel of 51 Advanced Practice in Nursing -APN- experts was selected) and the clinimetric validation process based on a sample of 600 nurses from the Balearic Islands public healthcare setting. METHODS An initial step for tool's content development process based on Delphi method approach of expert consensus was implemented. A subsequent phase of tool validation started from the analysis of APN core competencies latent measurement model, including exploratory and confirmatory techniques. Reliability evidence for each latent factor was also obtained. Items' scores were submitted to descriptive analysis, plus univariate and multivariate normality tests. RESULTS An eight-factor competency assessment latent model obtained adequate fit, and it was composed by 'Research and Evidence-Based Practice', 'Clinical and Professional Leadership', 'Interprofessional Relationship and Mentoring', 'Professional Autonomy', 'Quality Management', 'Care Management', 'Professional Teaching and Education' and 'Health Promotion'. CONCLUSIONS Adequate empirical evidence of reliability and validity for APNCAI makes it useful for application in healthcare policy programmes for APN competency assessment in Spain.
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Affiliation(s)
| | | | - Albert Sesé-Abad
- Faculty of Psychology, University of Balearic Islands, Palma, Spain
| | - Miquel Bennasar-Veny
- Nursing and Physiotherapy Department, Universitat de les Illes Balears, Palma, Spain
| | - Juan Carlos Fernández-Domínguez
- Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Universitat de les Illes Balears, Palma, Spain
| | - Joan De Pedro-Gómez
- Nursing and Physiotherapy Department, Universitat de les Illes Balears, Palma, Spain
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22
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Elliott N. Building leadership capacity in advanced nurse practitioners - the role of organisational management. J Nurs Manag 2016; 25:77-81. [PMID: 27873383 DOI: 10.1111/jonm.12444] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 11/26/2022]
Abstract
AIM To highlight the organisation-level management's role in building leadership capacity in advanced nurse practitioners and the need for appropriate supports to increase their becoming leaders. BACKGROUND Little is published about the role of organisation-level management in building leadership capacity and in developing the next generation of nurse leaders. In times of economic constraint, organisations need to focus their efforts on targeted leadership initiatives. Advanced nurse practitioners are ideally positioned to act as leaders both within and beyond the health care organisation. EVALUATION From the available research evidence, several support structures and mechanisms are identified as enablers for advanced nurse practitioners to enact their leadership role. CONCLUSION Health care organisations need to include building leadership capacity as a priority in their strategic plan and take action to build-up the level of advanced nurse practitioner leadership. IMPLICATIONS FOR NURSING MANAGEMENT Nurse executives have a vital role in influencing the organisation's strategic plan and making a business case for prioritising leadership capacity building within advanced nurse practitioners. A challenge for nurse executives faced with competing service and leadership development demands, involves strategic decision-making regarding whether the advanced nurse practitioner's role is limited to service delivery or its potential in leading health care reforms is realised.
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Affiliation(s)
- Naomi Elliott
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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23
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Goemaes R, Beeckman D, Goossens J, Shawe J, Verhaeghe S, Van Hecke A. Advanced midwifery practice: An evolutionary concept analysis. Midwifery 2016; 42:29-37. [DOI: 10.1016/j.midw.2016.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 09/02/2016] [Accepted: 09/11/2016] [Indexed: 11/24/2022]
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Coyne I, Comiskey CM, Lalor JG, Higgins A, Elliott N, Begley C. An exploration of clinical practice in sites with and without clinical nurse or midwife specialists or advanced nurse practitioners, in Ireland. BMC Health Serv Res 2016; 16:151. [PMID: 27117714 PMCID: PMC4847185 DOI: 10.1186/s12913-016-1412-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 04/19/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Clinical specialist (CS) and advanced practitioner (AP) roles have increased in nursing and midwifery internationally. This study explored clinical practice in sites with and without clinical nurse or midwife specialists or advanced nurse practitioners in Ireland. METHODS Using a case study design, interview, observational and documentary data from postholding sites (CSs or APs employed) were compared with data from non-postholding sites (no CSs or APs employed). Interviews and observations were conducted with postholders (n = 23), and compared with data from healthcare professionals (nurses or midwives, doctors) (n = 23) in matched services. Interviews were held with Directors of Nursing and Midwifery (n = 23), healthcare professionals (n = 41), service users (n = 41) with experience of receiving care or working with postholders, and non-postholders in matched services. The data were analysed using Nvivo (Version 8). RESULTS The findings suggest that postholders' practice appeared to differ from non-postholders' in relation to case management and service provision. Postholders were seen as having an impact on readmission rates, waiting lists/times, collaborative decision-making, continuity of care and workload management. Postholders' autonomy to manage caseloads was perceived to lead to smoother transition of patients/clients through the healthcare system. Service-users' self-reports appeared to appreciate the individualised holistic care provided by postholders. Postholders' role in facilitating person-centred care and promoting interprofessional team working, are essential elements in quality care provision and in global healthcare workforce planning. CONCLUSIONS To meet changing healthcare demands, promote person-centred care, and improve service delivery, more specialist and advanced practice posts in nursing and midwifery should be developed and supported within healthcare.
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Affiliation(s)
- Imelda Coyne
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Catherine M Comiskey
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
| | - Joan G Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
| | - Naomi Elliott
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin 2, Ireland
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25
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Elliott N, Begley C, Sheaf G, Higgins A. Barriers and enablers to advanced practitioners' ability to enact their leadership role: A scoping review. Int J Nurs Stud 2016; 60:24-45. [PMID: 27297366 DOI: 10.1016/j.ijnurstu.2016.03.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/29/2016] [Accepted: 03/04/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Advanced roles such as nurse practitioner, nurse consultant and advanced nurse or midwife practitioner are increasing across the world. In most countries, clinical practice, education, leadership and research are the four components that define the advanced practitioner's role. Of these, leadership is perhaps the most important part of the role, but its study has largely been neglected. There is a risk that failure to identify and respond to barriers to enacting the advanced practitioners' leadership role will limit the extent to which they can become strategic leaders for professional development, and jeopardise the long-term sustainability of the role. OBJECTIVES To identify the barriers and enablers to advanced practitioner's ability to enact their leadership role. DATA SOURCES A search of the research literature was undertaken in electronic databases (PubMed, CINAHL, PsycINFO, ProQuest Dissertation and Theses, from inception to 4-6th June 2015), unpublished research in seventeen online research repositories and institutes, and hand search of 2 leadership journals (March/April 2010-4th June 2015). REVIEW METHODS Using pre-set inclusion criteria, the 1506 titles found were screened by two authors working independently. The 140 full text reports selected were reviewed by two authors separately and 34 were included, and data extracted and cross-checked. Any disagreements were discussed by the scoping team until consensus was reached. Using content analysis, the barriers and enablers relating to leadership enactment were sorted into themes based on their common characteristics, and using a Structure-Process-Outcome conceptual framework were categorised under the four structural layers: (1) healthcare system-level, (2) organisational-level, (3) team-level, and (4) advanced practitioner-level. RESULTS Thirteen barriers to, and 11 enablers of, leadership were identified. Of these a majority (n=14) were related to organisational-level factors such as mentoring, support from senior management, opportunity to participate at strategic level, structural supports for the role, and size of clinical caseload. Advanced practitioner-level factors relating to personal attributes, knowledge, skills and values of the advanced practitioner were identified. CONCLUSIONS Although building leadership capabilities at advanced practitioner-level and team-level are important, without key inputs from healthcare managers, advanced practitioners' leadership enactment will remain at the level of clinical practice, and their contribution as change agents and innovators at the strategic level of service development and development of the nursing profession will be not be realised.
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Affiliation(s)
- Naomi Elliott
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Ireland.
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Ireland; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Greg Sheaf
- The Library of Trinity College Dublin, The University of Dublin, Ireland.
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Ireland.
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Sayers J, Lopez V, Howard PB, Escott P, Cleary M. The leadership role of nurse educators in mental health nursing. Issues Ment Health Nurs 2015; 36:718-24. [PMID: 26440875 DOI: 10.3109/01612840.2015.1033040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Leadership behaviors and actions influence others to act, and leadership in clinical practice is an important mediator influencing patient outcomes and staff satisfaction. Indeed, positive clinical leadership has been positioned as a crucial element for transformation of health care services and has led to the development of the Practice Doctorate Movement in the United States. Nurse educators in health care have a vital leadership role as clinical experts, role models, mentors, change agents, and supporters of quality projects. By enacting these leadership attributes, nurse educators ensure a skilled and confident workforce that is focused on optimizing opportunities for students and graduates to integrate theory and practice in the workplace as well as developing more holistic models of care for the consumer. Nurse educators need to be active in supporting staff and students in health care environments and be visible leaders who can drive policy and practice changes and engage in professional forums, research, and scholarship. Although nurse educators have always been a feature of the nursing workplace, there is a paucity of literature on the role of nurse educators as clinical leaders. This discursive article describes the role and attributes of nurse educators with a focus on their role as leaders in mental health nursing. We argue that embracing the leadership role is fundamental to nurse educators and to influencing consumer-focused care in mental health. We also make recommendations for developing the leadership role of nurse educators and provide considerations for further research such as examining the impact of clinical leaders on client, staff, and organizational outcomes.
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Affiliation(s)
- Jan Sayers
- a University of Western Sydney, School of Nursing and Midwifery , Sydney , New South Wales , Australia
| | - Violeta Lopez
- b National University of Singapore, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine , Singapore
| | - Patricia B Howard
- c University of Kentucky, College of Nursing , Lexington , Kentucky , USA
| | - Phil Escott
- d Sydney Local Health District Mental Health Service , Sydney , Australia
| | - Michelle Cleary
- a University of Western Sydney, School of Nursing and Midwifery , Sydney , New South Wales , Australia
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