Expansion of the interprofessional clinical practice of Primary Care nurses

Defining Physician-Nurse Efforts toward Collaboration as Perceived by Medical Students

Collaboration between physicians and nurses is essential to healthcare delivery and is associated with high-quality patient care, greater patient satisfaction, and better health outcomes. Hence, it is imperative that doctors and nurses have a particular set of interprofessional collaboration skills. This descriptive cross-sectional study assessed how medical students in the pre-clinical and clinical years perceived attitudes toward collaboration between physicians and nurses in a hospital setting. The Jefferson Scale of Attitude toward Physician-nurse Collaboration (JSAPNC) was reverse-translated into Arabic for the current study. The results showed a total JSAPNC mean score of 46.55, lower than other medical students in other universities. In general, the results of the study showed no significant difference in the total JSAPNC score among medical students when analyzed according to age, clinical exposure, and year level, except in the two factors of JSAPNC: shared education and teamwork (p = 0.038) and caring as opposed to curing (p = 0.043). The findings of this study suggest the necessity of integrating interprofessional education (IPE) across the medical school curriculum because, as future physicians, medical students would be well equipped to treat their patients in partnership with their nursing colleagues.

Preceptorship contributions to the development of clinical and managerial skills in nursing residency

OBJECTIVES

to analyze the experience of resident nurses with preceptorship contributions to the development of common clinical and managerial skills acquired in pedagogical projects.

METHODS

exploratory qualitative research developed in two stages: document analysis of pedagogical projects and semi-structured interviews with residents. Content analysis was carried out based on the framework of the nurse's work process and skills.

RESULTS

the pedagogical projects of the three programs foresee the development of common skills, mostly clinical and only two managerial skills. The 22 residents reported the contributions of preceptorship in the development of competences centered on clinical practice, focusing on technical procedures disjointed from clinical reasoning and the managerial dimension of the nurse's work.

FINAL CONSIDERATIONS

it is necessary to train preceptors and involve all social actors linked to residency programs to expand preceptorship potential.

Nurse's Role from Medical Students' Perspective during Their Interprofessional Clinical Practice: Evidence from Lithuania

Background: Attitudes towards interprofessional education are key factors that shape students' behaviour during interprofessional practice. An interprofessional approach to training and practice is "unique", important, and challenging. Interprofessional education allows for a deeper understanding and analysis of problems from perspectives different to those of "us". The aim of the study was to assess medical students' attitudes toward the nurse's role during their interprofessional clinical practice. Methods: This study used a descriptive, correlational design. Results: Lithuanian medical students were statistically significantly more likely to think that the role of a nurse was clear and transparent to other professionals and that nurses exuded a high degree of professionalism, sought a high degree of involvement with the patient, and built deep relationships with the patients. Foreign medical students were statistically significantly more likely to believe that nurses worked more effectively alone than in a team and that they worked with the patients within their own professional field of knowledge rather than referring patients to other professionals. Conclusions: After 6 months of interprofessional training with nurses in the hospital, medical students gain a more clear professional picture of the role of the nurse.

Situational analysis and reflections on the introduction of advanced practice nurses in Brazilian primary healthcare

BACKGROUND

The shortage of doctors and their unequal distribution serve as challenges to advancing primary healthcare (PHC) and achieving effective universal healthcare coverage in Brazil. In an effort to use nurses' potential more efficiently, the country is investigating the introduction of the advanced practice nurse (APN) into PHC. This paper presents a situational analysis of the practices of Brazilian nurses based on the following components: regulation, practice, and education.

METHODS

This is a national multi-method study with triangulated data from a documentary study, a scoping review, and an exploratory study. The regulation component involved the analysis of official normative documents on the regulation of nursing education and nurses' scope of practice. The practice component aimed to identify the practices performed by nurses in Brazilian PHC based on primary studies. The education component intended to identify the practices taught in nursing training based on a survey and interviews with directors of undergraduate nursing programs.

RESULTS

Federal legislation in Brazil authorizes nursing graduates to perform a set of advanced practices as part of the PHC nurse's daily routine. They can request and interpret complementary tests and prescribe medication. However, in the local context, municipalities define the scope of this assistance based on technical norms or nursing protocols. Furthermore, this study indicates that undergraduate nursing programs do not fully prepare students to adequately execute these tasks.

CONCLUSIONS

In the context of Brazilian PHC, advanced practices have already been implemented and respond to main healthcare demands. Therefore, it is unnecessary to introduce the APN as a new professional category. Upon detecting deficiencies in the training process, the current education model should undergo reforms that seek to incorporate the skills compatible with the regulated advanced practices and in-service training for practicing nurses. Regarding the introduction of APN along international lines, this article presents recommendations that may support the operationalization of a Brazilian APN model.

Obstacles to the educational praxis of nurses in the Family Health Strategy

OBJECTIVE

To analyze the obstacles to the educational praxis of nurses in the Family Health Strategy of the Eastern Health District, Manaus, Amazonas, Brazil.

METHOD

Qualitative, exploratory, and descriptive study that used the Word Café technique for data production, with 26 nurses, between June and August 2018. The data were organized in the Atlas.ti8 software, and the analysis was categorical-thematic.

RESULTS

The units of analysis "Organizational Obstacles for Educational Praxis in the Family Health Strategy" and "Operational Obstacles for Educational Praxis in the Family Health Strategy" reveal difficulties, tensions, resistances and the impossibilities to adhere to emerging models of work organization, in general, and in particular, in educational work.

CONCLUSION

What presents itself in reality as an obstacle is, at the same time, indicative of the possibility of overcoming and potentiality for co-creation of educational work as a strategy to rescue professional motivation, and an alternative on the agenda for the permanent qualification of workers and institutions.

Nurses' work at Family Health Strategy: possibilities to operate health needs

OBJECTIVES

to identify and analyze possibilities for recognizing health needs in the nurses' work at Family Health Strategy.

METHODS

a qualitative study with interviews and observation of the nurses' work in the countryside of São Paulo. The empirical material was subjected to thematic content analysis and interpreted in the light of the health work process.

RESULTS

two themes emerged: Possibilities utilized and Possibilities neglected to recognize health needs. Careful observation, welcoming, attention, listening, bonding and dialogue developed by nurses, in live work in action with users, touched on the possibilities, which, taken advantage of, were evidenced in care in spontaneous demand, scheduled consultation, examination gynecological and group activities.

FINAL CONSIDERATIONS

nurses are able to recognize health needs, which can expand their clinical practice and interprofessionality in Family Health.