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Semerci R, Samba VL, Diaz DRN, Punjwani R, Challinor J. Advanced Practice Pediatric Oncology Nursing as Imagined or In Place in Four Lower- and Upper-Middle-Income Countries. Semin Oncol Nurs 2024; 40:151631. [PMID: 38735785 DOI: 10.1016/j.soncn.2024.151631] [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: 12/30/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middle-income countries (LMICs) presents opportunities and challenges. The authors explore the implications of pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential benefits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered. METHODS Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized. RESULTS Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture. CONCLUSION The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to significantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation. IMPLICATIONS FOR NURSING PRACTICE The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations.
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Affiliation(s)
- Remziye Semerci
- Assistant Professor, Department of Pediatric Nursing, School of Nursing, Koç University, Health Sciences Campus, Topkapi, Istanbul
| | - Vera Larfi Samba
- Nurse practitioner/pediatric oncology nurse, Department of Childhood Cancer Program, Mboppi Baptist Hospital, Douala Cameroon Baptist Convention Health Services, Mboppi, Cameroon
| | - Dorian René Navarro Diaz
- Profesor de Asignatura de Licenciatura en Enfermería, Departamento de Clinicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, México
| | - Rehana Punjwani
- Additional Director Nursing, Department of Nursing, DOW University Hospital, W4VQ+CMW, Gulzar-e-Hijri Gulshan-e-Iqbal, Karachi, Pakistan
| | - Julia Challinor
- Associate Adjunct Professor, Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, California.
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Pergolizzi J, LeQuang JAK, Wagner M, Varrassi G. Challenges in Palliative Care in Latin America: A Narrative Review. Cureus 2024; 16:e60698. [PMID: 38899235 PMCID: PMC11186623 DOI: 10.7759/cureus.60698] [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: 03/19/2024] [Accepted: 05/14/2024] [Indexed: 06/21/2024] Open
Abstract
In "graying" populations with extended lifespans and survivable forms of cancer, palliative services become increasingly important but may be difficult to introduce into public discourse, public policy, and healthcare systems. Latin America (LATAM) faces many challenges as it introduces and, in some cases, develops its palliative care programs; though the challenges faced here are in many ways universal ones, LATAM approaches may be unique and based on the region's specific culture, politics, and economics. This narrative review based on a literature search identified 10 main themes that can be interpreted as challenges and opportunities for palliative care in LATAM. These challenges are integrating palliation into healthcare systems; public policy and funding; therapeutic obstinacy; changing demographics; access to services; analgesia; the role of religion, spirituality, and folk medicine; social determinants of palliative care; low health literacy; and limited clinician training. Some of the LATAM nations have palliative programs and palliative care training in place while others are developing these systems. Integrating this care into existing healthcare and reimbursement systems has been a challenge. A notable challenge in LATAM is also access to care since palliative programs tend to cluster in metropolitan areas and create hardships for rural citizens to access them. The better-defined role of familial caregivers and telehealth may be important factors in the expansion of palliative care in LATAM and beyond.
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Affiliation(s)
- Joseph Pergolizzi
- Anesthesiology - Pain Medicine and Critical Care Medicine, NEMA Research, Inc., Naples, USA
| | | | - Morgan Wagner
- Entrepreneur Program, NEMA Research, Inc., Naples, USA
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Scanlon A, Murphy M, Smolowitz J, Lewis V. Advanced Nursing Practice and Advanced Practice Nursing roles within low and lower-middle-income countries. J Nurs Scholarsh 2023; 55:484-493. [PMID: 36352540 DOI: 10.1111/jnu.12838] [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: 03/01/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Population health initiatives rely on the availability and skills of an appropriate workforce to meet required goals. One global workforce initiative with demonstrated ability to expand health care services and improve access to care is the development of Advanced Nursing Practice and Advanced Practice Nursing roles. Given the sparse published information about these roles in Low and Lower-Middle-Income countries, this study seeks to describe their development and application in these countries. DESIGN The researchers developed a descriptive cross-sectional multilingual survey for online distribution to nursing experts within the targeted countries. Survey questions addressed demographic information on the population served, Advanced Nursing Practice and Advanced Practice Nursing titles, the time frame and rationale for creating the title, and how the roles relate to the International Council of Nurses' Advanced Practice Nursing guidelines characteristics of education, practice, and regulation. RESULTS Of the 167 responses received, only 24 participants met the inclusion criteria. This represented five low-income countries and nineteen lower-middle-income countries from four World Bank regions. Seventy-one roles were identified. Roles emerged predominantly over the last 20 years, focusing on care for underserved populations, with an almost even spread across primary and acute care settings. There were differences in education, practice, and regulation amongst the roles. Roles that required a master's education or higher with practice-related characteristics had a broader scope of practice, which is consistent with international guidelines. CONCLUSION This paper describes how Advanced Nursing Practice and Advanced Practice Nursing roles from Low and Lower Middle-Income Countries have been implemented to address gaps in service and highlights disparities in education, practice and regulation compared to international guidelines. Maintaining and increasing support from organizations and universities internationally may be required to assist in developing and expanding educational programs for advanced nursing roles in these countries. CLINICAL RELEVANCE Understanding how these advanced nursing roles are operationalized in relation to education, practice, and regulation in Low and Lower-Middle-Income countries can provide baseline information that will inform workforce development policies to address healthcare needs in similar jurisdictions.
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Affiliation(s)
- Andrew Scanlon
- Department of Nursing, School of Nursing and Midwifery, University of Melbourne, La Trobe University, Melbourne, Victoria, Australia.,School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Maria Murphy
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Janice Smolowitz
- School of Nursing, Montclair State University, Montclair, New Jersey, USA
| | - Virginia Lewis
- La Trobe University, Research Chair in Community Health, Melbourne, Victoria, Australia
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Sullivan CE, Weber LS, Lamas PV, Diaz DN, Lu Z, Zhao X, Salinas-Avila SJ, Ramos RJ, Belderson KM, Challinor J. Expanding APHON's Pediatric Chemotherapy/Biotherapy Provider and Instructor Program to Spanish-Speaking Countries: Pilot Series Development and Evaluation. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:119-132. [PMID: 36285475 PMCID: PMC10073235 DOI: 10.1177/27527530221121729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Background: To address the need for standardized, comprehensive chemotherapy/biotherapy education in Latin American and Caribbean (LAC) countries, the Association of Pediatric Hematology/Oncology Nurses (APHON) Pediatric Chemotherapy/Biotherapy Provider and Instructor program courses were culturally adapted, translated to Spanish, and piloted. The process of course adaptation and implementation are described. A Context, Input, Process, Product model outcomes evaluation determined: (a) differences in pass rates by test version and pilot location, (b) predictors of pass rates, (c) course appropriateness for nurses' education and practice levels, and (d) strategies for course improvements. Methods: The Spanish APHON Pediatric Chemotherapy/Biotherapy Provider program was piloted four times and the Instructor program twice with nurses from Mexico, Central America, the Caribbean, South America, and Spain. Statistical analysis identified factors associated with pass rates. Results: Of the 203 students in four Spanish APHON Provider program courses, data from 108 students (three pilots) were analyzed (one unplanned pilot excluded for missing data). Significant predictors of pass rates included: pediatric oncology frontline nurses (OR = 9.86; 95% CI [2.56, 65.23]; p = .004), nurses dedicated to an inpatient or outpatient unit (non-rotating) (OR = 6.79 [1.29, 51.98]; p = .033), and graduation from a 5-year nursing program (OR = 5.92; 95% CI [1.30, 33.15]; p = .028). Discussion: The Spanish APHON Pediatric Chemotherapy/Biotherapy program was determined appropriate for nurses' education and practice levels in LAC countries. Through the APHON Spanish language instructor network, pediatric oncology nurses in LAC countries have increased access to standardized, comprehensive chemotherapy/biotherapy education.
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Affiliation(s)
- Courtney E. Sullivan
- Global Nursing Project Coordinator; St. Jude Children’s Research Hospital; Memphis, Tennessee, USA
| | - Lorena Segovia Weber
- St Jude Global Nursing Contractor; Nurse Educator, Luis Calvo Mackenna Hospital, Santiago, Chile
| | - Paola Viveros Lamas
- St Jude Global Nursing Contractor; Nurse Educator, Luis Calvo Mackenna Hospital, Santiago, Chile
| | - Dorian Navarro Diaz
- Nurse Educator; Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”; Universidad de Guadalajara, Jalisco, México
| | - Zhaohua Lu
- Biostatistician; St. Jude Children’s Research Hospital; Memphis, Tennessee, USA
| | - Xiwen Zhao
- Biostatistician; Yale Center for Analytical Sciences; Yale University; New Haven, Connecticut, USA
| | | | - Richard J. Ramos
- Pediatric Oncology Nurse; Lucile Packard Children’s Hospital at Stanford; Palo Alto, California, USA
| | - Kristin M. Belderson
- Manager Professional Development; Children’s Hospital Colorado; Aurora, Colorado, USA
| | - Julia Challinor
- Associate Adjunct Professor; University of California at San Francisco; San Francisco, California, USA
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O'Reilly-Jacob M, Perloff J, Sherafat-Kazemzadeh R, Flanagan J. Nurse practitioners' perception of temporary full practice authority during a COVID-19 surge: A qualitative study. Int J Nurs Stud 2022; 126:104141. [PMID: 34923317 PMCID: PMC8609748 DOI: 10.1016/j.ijnurstu.2021.104141] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND At the beginning of the COVID-19 pandemic in the United States, 22 state governors temporarily waived physician supervision of nurse practitioners to expand access to health care during the state of emergency. OBJECTIVE We examined the nurse practitioner perception of the simultaneous scope of practice changes and the exigent pandemic demands during the initial COVID-19 surge in Massachusetts. METHODS Qualitative descriptive design using content analysis of open-ended responses to a web-based survey of Massachusetts nurse practitioners conducted in May & June 2020. RESULTS Survey response rate was 40.6 percent (N = 389). Content analysis identified four themes including: 1) State waivers enabled more control over practice and more expedited care, 2) State waiver did not change practice either because of pre-established independence or employers not changing policy, 3) Perception of nurse practitioner role as both versatile and disposable and 4) Telehealth increased access to care and created an autonomous setting. CONCLUSIONS Although findings suggest fewer barriers in some areas, the temporary removal of state-level restrictions alone is not sufficient to achieve immediate full scope of practice for nurse practitioners. There is a need for regulatory frameworks that optimize the capacity of the advanced practice nursing workforce to respond to global health emergencies. US-based policymakers and healthcare organizations should revise outdated scope of practice policies and capitalize on telehealth technology to utilize the full extent of nurse practitioners. Likewise, nursing leaders should be a voice for nurse practitioners to more effectively and safely maximize the nurse practitioner contribution during emergency responses. In countries where the role is under development, regulators can leverage these findings to establish modernized nurse practitioner scope of practice policies from the outset.
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Affiliation(s)
- Monica O'Reilly-Jacob
- Boston College, Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA,Corresponding author
| | - Jennifer Perloff
- Brandeis University, The Heller School for Social Policy and Management, 415 South Street, Waltham, MA, 02454, USA
| | - Roya Sherafat-Kazemzadeh
- Brandeis University, The Heller School for Social Policy and Management, 415 South Street, Waltham, MA, 02454, USA
| | - Jane Flanagan
- Boston College, Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA
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Busca E, Savatteri A, Calafato TL, Mazzoleni B, Barisone M, Dal Molin A. Barriers and facilitators to the implementation of nurse's role in primary care settings: an integrative review. BMC Nurs 2021; 20:171. [PMID: 34530813 PMCID: PMC8444166 DOI: 10.1186/s12912-021-00696-y] [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: 02/12/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background The rapid evolution of the epidemiological picture and the recent SARS-COV-2 pandemic has expressed the vulnerabilities of health systems and focuses attention on the population’s needs. The nurse’s figure in the care teams is universally identified; however, the implementation of the role within some care settings turns out to be complex and challenging. This integrative review aims to identify the barriers and facilitators in implementing the role of the nurse in primary care settings. Methods An integrative review was conducted on the Medline and Cinahl databases until 9 June 2020. Qualitative, quantitative, and Mixed-method research studies were selected to identify studies related to the barriers and facilitators of the nurse’s role in nursing facilities’ primary care. For the extraction of the results, the Consolidating Framework for Research Implementation (CFIR) was used to identify the factors that influence implementation in health care. Results Following the duplicates’ removal, the search identified 18,257 articles, of which 56 were relevant to the inclusion criteria; therefore, they were included in the summary. The selected studies were conducted in thirteen countries, most from Oceania, Europe, North America, Latin America, and the Caribbean. The barriers reported most frequently concern the nursing profession’s regulatory and regulatory aspects within the contexts of care, cultural and organizational aspects, training, and the transfer of specific skills, which were previously designated to doctors. The facilitators are mainly linked to the nurse’s adaptability to the various contexts of care, recognizing the patient’s role, and the desire to develop multidisciplinary and effective working groups to respond to the health needs of the population in primary care contexts. Conclusion This review highlighted the main barriers and facilitators in implementing the nurse’s role in primary care settings. These results offer useful elements for stakeholders to identify effective strategies in preparing programs and activities for implementing the nurse’s role, acting on the elements identified as barriers and favouring the aspects that emerge as facilitators. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00696-y.
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Affiliation(s)
- Erica Busca
- Department of Translational Medicine, University of Piemonte Orientale, Via P. Solaroli, 17, 28100, Novara, Italy
| | - Alessia Savatteri
- Functional Oncology Department - Gastroenterology, Hospital "San Vincenzo" of Taormina, Contrada Sirina, 98039, Taormina, Italy
| | - Tania Lorenza Calafato
- Emergency-Urgency Department, Hospital "Sant'Elia" of Caltanissetta, Via Cusmano,1, 93100, Caltanissetta, Italy
| | - Beatrice Mazzoleni
- Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
| | - Michela Barisone
- Department of Translational Medicine, University of Piemonte Orientale, Via P. Solaroli, 17, 28100, Novara, Italy.
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Direzione delle Professioni Sanitarie - A.O.U. Maggiore della Carità di Novara, Via P. Solaroli, 17, 28100, Novara, Italy
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Nigenda G, Lee G, Aristizabal P, Walters G, Zárate-Grajales RA. Progress and challenges for advanced practice nursing in Mexico and the United Kingdom. J Nurs Manag 2021; 29:2461-2469. [PMID: 34251714 DOI: 10.1111/jonm.13413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/03/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study is to compare the advanced practice nursing development in Mexico with the United Kingdom. BACKGROUND In spite of the involvement of global and local bodies to establish and develop advanced practice nursing worldwide, progress remains variable due to the lack of homogeneity in health care systems and policies. EVALUATION Using thematic analysis from interviews of 29 health care professionals in Mexico, we identified four major issues that impact on the development of advanced practice nursing: (a) workforce, (b) organizational and institutional, (c) regulatory and legal and (d) academic and educational. KEY ISSUES Learning from the UK experience in relation to overcoming some of these issues has been insightful in terms of how advanced practice nursing skills in Mexican nurses can be developed. CONCLUSIONS Mexico is still in early stages of the development of APN. Based on the UK experience, the government may have to move forward to support higher level training, create labour market positions, establish new nursing functions, promote task-shifting and particularly implement solid regulation. IMPLICATIONS FOR NURSING MANAGEMENT The development of advanced practice nursing represents important challenges for training and practice of nursing in Mexico and the United Kingdom; therefore, interested actors will have to reach key agreements that could work as the foundations of an assertive planning process.
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Affiliation(s)
- Gustavo Nigenda
- Iztacala Faculty of Higher Studies, National school of nursing and obstetrics, National Autonomous University of Mexico, Mexico, Mexico
| | - Geraldine Lee
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Patricia Aristizabal
- Iztacala Faculty of Higher Studies, National school of nursing and obstetrics, National Autonomous University of Mexico, Mexico, Mexico
| | | | - Rosa A Zárate-Grajales
- Iztacala Faculty of Higher Studies, National school of nursing and obstetrics, National Autonomous University of Mexico, Mexico, Mexico
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Zuniga-Villanueva G, Ramos-Guerrero JA, Osio-Saldaña M, Casas JA, Marston J, Okhuysen-Cawley R. Quality Indicators in Pediatric Palliative Care: Considerations for Latin America. CHILDREN (BASEL, SWITZERLAND) 2021; 8:250. [PMID: 33806896 PMCID: PMC8004984 DOI: 10.3390/children8030250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022]
Abstract
Pediatric palliative care is a growing field in which the currently available resources are still insufficient to meet the palliative care needs of children worldwide. Specifically, in Latin America, pediatric palliative care services have emerged unevenly and are still considered underdeveloped when compared to other regions of the world. A crucial step in developing pediatric palliative care (PPC) programs is delineating quality indicators; however, no consensus has been reached on the outcomes or how to measure the impact of PPC. Additionally, Latin America has unique sociocultural characteristics that impact the perception, acceptance, enrollment and implementation of palliative care services. To date, no defined set of quality indicators has been proposed for the region. This article explores the limitations of current available quality indicators and describes the Latin American context and how it affects PPC development. This information can help guide the creation of standards of care and quality indicators that meet local PPC needs while considering the sociocultural landscape of Latin America and its population.
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Affiliation(s)
- Gregorio Zuniga-Villanueva
- Department of Pediatrics, Tecnologico de Monterrey, Monterrey 64849, Mexico
- Division of Pediatric Palliative Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada
| | | | - Monica Osio-Saldaña
- Department of Global Studies, Universidad Nacional Autonoma de Mexico, Mexico City 04510, Mexico;
| | - Jessica A. Casas
- Department of Pediatric Palliative Care, Texas Children’s Hospital, Houston, TX 77030, USA; (J.A.C.); (R.O.-C.)
| | - Joan Marston
- Global Ambassador, International Children’s Palliative Care Network, Assagay 3624, South Africa;
| | - Regina Okhuysen-Cawley
- Department of Pediatric Palliative Care, Texas Children’s Hospital, Houston, TX 77030, USA; (J.A.C.); (R.O.-C.)
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Nigenda López GH, Aristizábal Hoyos GP. El liderazgo silencioso de la enfermería en México: reflexiones sobre su transformación. REVISTA CUIDARTE 2020. [DOI: 10.22201/fesi.23958979e.2020.9.18.1.77574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
<p><strong>Introducción. </strong>El objetivo del documento es argumentar que el liderazgo de enfermería en México tiene un enorme potencial por desarrollar y que en gran medida es silencioso. Se exponen casos para mostrar el liderazgo de la enfermería en el sistema de salud de México que no son reconocidos debidamente por los actores sociales y el Estado. <strong>Desarrollo. </strong>Se discuten un conjunto de características del liderazgo que la enfermería podría incorporar en su desarrollo y lograr avanzar hacia nuevas etapas de su estatus profesional, sus niveles de entrenamiento y su papel en la producción de servicios de salud. Particularmente, se hace énfasis en el desarrollo de un liderazgo colectivo que permita a la enfermería apoyar el alcance de objetivos sistémicos por encima objetivos grupales o individuales. A diferencia de otros grupos profesionales, la enfermería es entrenada sobre bases humanistas las cuáles han sido obliteradas por los cambios que las reformas de los sistemas de salud han traído consigo en las últimas dos décadas. <strong>Conclusión. </strong>Un liderazgo conspicuo de la enfermería debe basarse en preservar su formación humanista, en la capacidad de establecerse como par en las decisiones clínicas y gerenciales, en articular un plan consistente para el desarrollo de la enfermería en práctica avanzada y, finalmente, para fungir como un motor del cambio del sistema hacia el modelo de atención primaria a la salud.<strong></strong></p>
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Andriola IC, Sonenberg A, Lira ALBDC. [Understanding advanced practice nursing as a step towards its implementation in BrazilComprender la enfermería de práctica avanzada como un paso hacia su aplicación en Brasil]. Rev Panam Salud Publica 2020; 44:e115. [PMID: 33005186 PMCID: PMC7521614 DOI: 10.26633/rpsp.2020.115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 08/21/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To describe the elements of the practice of certified nurse-midwives and women's health nurse practitioners in the context of the United States of America in order to facilitate the implementation of advanced practice nursing in Brazil. METHOD Exploratory case study describing elements of advanced practice nursing in one of the largest hospitals in New York City, United States of America. The practice of certified nurse-midwives and women's health nurse practitioners was observed between April and May 2019. The data were analyzed inductively and a category scheme was developed from the analysis of field notes. RESULTS The results were organized into the following categories: activities that are commonly performed; foundations that support practice; differential function of these professionals; interaction with other health professionals; barriers to practice; facilitating elements; and results of the practice. CONCLUSIONS The observation of advanced practice nursing in another context, such as the United States, is a relevant step in the process of its implementation in Brazil. Nursing professionals and other stakeholders need to understand this practice in order to truly support the implementation process.
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Affiliation(s)
- Isadora Costa Andriola
- Universidade Federal do Rio Grande do NorteNatalBrasilUniversidade Federal do Rio Grande do Norte, Natal, Brasil
| | - Andréa Sonenberg
- PACE UniversityNew York CityUnited States of AmericaPACE University, New York City, United States of America
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Grešš Halász B, Majerníková L, Obročníková A, Hudáková A, Vojteková M. Developing the advanced practice nursing role in Slovakia: Perception, education, and practice. J Am Assoc Nurse Pract 2020; 33:916-923. [PMID: 32740339 PMCID: PMC8565510 DOI: 10.1097/jxx.0000000000000460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Advanced practice nursing (APN) is a modern and effective nursing role that has a positive impact on health care systems around the world. Guiding principles are advanced education, expanded scope of practice, and policies supportive of the role. PURPOSE The aim of this study was to find out the perception of APNs of their own practice in the context of the current legislative conditions in Slovakia and to identify related factors. METHODS A quantitative exploratory design was selected. From 5,067 APN, 584 were conveniently selected. The adapted and modified SCAPE study questionnaire was used for data collection. Data were processed using SPSS 25. RESULTS There were differences between newly introduced competencies for the APN role in Slovakia and the general concept of the role that could influence practice. The level of APNs' perception of their own practice is low. Years of practice was significantly and positively related to the perception. The results in each region were significantly different. Community nurses/outpatient nurses assessed their practice at a significantly higher level. The educational curriculum lacks the subject of APN. Competencies, remuneration, and satisfaction with the status are insufficient. IMPLICATIONS FOR PRACTICE To understand, implement, and practice the concept of APN, it is essential to change policies related to competencies, education, remuneration, and status. Creation of an educational model that includes the subject area of advanced practice nursing in the postgraduate curriculum is essential. Education and practice conditions for advanced practice nurses should be uniform in all regions of the country.
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Affiliation(s)
- Beáta Grešš Halász
- Department of Nursing, Faculty of Health Care, University of Prešov, Prešov, Slovakia
| | - L'udmila Majerníková
- Department of Nursing, Faculty of Health Care, University of Prešov, Prešov, Slovakia
| | - Andrea Obročníková
- Department of Nursing, Faculty of Health Care, University of Prešov, Prešov, Slovakia
| | - Anna Hudáková
- Department of Nursing, Faculty of Health Care, University of Prešov, Prešov, Slovakia
| | - Marta Vojteková
- Faculty of Arts, Institute of Ukrainian and Central European Studies, University of Prešov, Prešov, Slovakia
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Torrens C, Campbell P, Hoskins G, Strachan H, Wells M, Cunningham M, Bottone H, Polson R, Maxwell M. Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. Int J Nurs Stud 2020; 104:103443. [DOI: 10.1016/j.ijnurstu.2019.103443] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 11/27/2022]
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Scanlon A, Murphy M, Smolowitz J, Lewis V. Low- and lower middle-income countries advanced practice nurses: an integrative review. Int Nurs Rev 2019; 67:19-34. [PMID: 31364775 DOI: 10.1111/inr.12536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIM To review published literature descriptions of advanced practice nurses' roles in low- and lower middle-income countries. BACKGROUND Advanced practice nurse roles have the potential to address insufficient healthcare resources in low- and lower middle-income countries. INTRODUCTION This integrative review highlights advanced practice nurses' roles in the delivery of healthcare services in low- and lower middle-income countries. METHODS Three electronic databases PubMed, CINAHL complete and ProQuest Health & Medicine were searched. No limits by year or language were set. The names for low- and lower middle-income countries and combinations 'related to advanced practice nurses' titles were used to identify papers. In addition, a review of publication type was performed. Themes found within the publications were assessed against the advanced practice nurses' International Council of Nurses' characteristics. An integrative review facilitated an appraisal of the papers identified. RESULTS The initial search identified 5778 publications in 16 languages. This number was reduced to 23, from 18 low- and lower middle-income once exclusion criteria were applied. Six publications were from 1977 to 1999, and six between 2000 and 2010, with the remaining 11 from 2011 to 2018. Zambia had the most publications. Notably, 63 countries were not represented. Of those meeting inclusion criteria, the majority addressed education with a lesser extent focusing on practice and regulation of advanced practice nurse's roles. The majority were published during the last decade. DISCUSSION This review of the published literature identified advanced practice nurses' roles and function within some healthcare systems. However, not all components were reported. Examination of the grey literature could provide additional information about the actual and potential benefits of advanced practice nurses' in low- and lower middle-income countries. CONCLUSION The published literature that referred to advanced practice nurses' identified their contribution to positive impacts on health care over the last 40 years. However, with only 11 publications identified in the last 7 years, further review is required to understand the advanced practice nurses' roles in these countries. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY Further development of advanced practice nurses' in low- and lower middle-income countries is supported by the lack of published literature.
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Affiliation(s)
- A Scanlon
- School of Nursing and Midwifery, La Trobe University, Bundoora, Vic., Australia.,School of Nursing, Montclair State University, Montclair, NJ, USA
| | - M Murphy
- School of Nursing and Midwifery, La Trobe University, Bundoora, Vic., Australia
| | - J Smolowitz
- School of Nursing, Montclair State University, Montclair, NJ, USA
| | - V Lewis
- Australian Institute for Primary Care & Ageing, Bundoora, Vic., Australia
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Honig J, Doyle-Lindrud S, Dohrn J. Moving towards universal health coverage: advanced practice nurse competencies. Rev Lat Am Enfermagem 2019; 27:e3132. [PMID: 31340339 PMCID: PMC6687366 DOI: 10.1590/1518-8345.2901.3132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/27/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE this paper aims to describe the first phase of a project whose general goal was to develop a consensus-based set of advanced practice nurse competencies applicable to Latin American countries and, based on these competencies, produce an advanced practice nurse curricular prototype adapted to Latin American countries. The project was framed in a competency-based approach to advanced practice nursing education. The specific aims of the first phase of the project described in this paper were: 1) to identify a set of potential advanced practice nurse competencies that would serve as the template for Core Advanced Practice Nurse Competencies in Latin American countries and 2) to establish consensus for Core Advanced Practice Nurse Competencies in Latin American countries. METHOD advanced practice nurse competencies were derived from a comprehensive review of published competencies and informed the development of a survey designed to assess the relevance of advanced practice nurse competencies in Latin American countries. The survey was distributed to nurse leaders and nurse educators. Data were analyzed using descriptive statistics. RESULTS consensus for Core Competencies was established. CONCLUSION the Core Advanced Practice Nurse Competencies presented can provide a structured framework to build educational programs aligned to the needs of the regional environment.
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Affiliation(s)
- Judy Honig
- Columbia University, School of Nursing, New York, NY, EUA
| | | | - Jennifer Dohrn
- Columbia University, School of Nursing, New York, NY, EUA
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Ortega J, Hooshmand M, Foronda C, Padron M, Simon D, Waters M, Cassiani S, Montano NP. Developing nurse leaders across the Americas: evaluation of an online nursing leadership course. Rev Panam Salud Publica 2018; 42:e152. [PMID: 31093180 PMCID: PMC6386060 DOI: 10.26633/rpsp.2018.152] [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] [Received: 08/08/2017] [Accepted: 06/04/2018] [Indexed: 11/24/2022] Open
Abstract
Development of leadership capacities in the nursing workforce is essential to achieving universal health in the Region of the Americas. This evaluation considered the effectiveness of an online leadership course offered in English and Spanish to nurses throughout Latin America and the Caribbean. The online course was an asynchronous eight-module leadership nursing course created and offered by the Pan American Health Organization (PAHO) Virtual Campus. A retrospective, descriptive design was used to evaluate learner performance data from the modules. Learner performance on the course was analyzed. Electronic surveys were distributed to individuals who withdrew prior to course completion to obtain information regarding the reason for withdrawal. In all, 289 individuals from 41 countries participated in the online course. Learner performance demonstrated improvement from pre- to post-test. The most frequent reason for not completing the course was being too busy with other obligations. The Spanish-language course version received more enrollment applications than any other course in the virtual campus' 12-year history. The evaluation concluded that continuing education that develops nursing leadership is desired across Latin America and the Caribbean. Online education through the PAHO Virtual Campus may be a low-cost yet powerful means of disseminating knowledge to the nursing workforce throughout the Americas.
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Affiliation(s)
- Johis Ortega
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, United States of America
| | - Mary Hooshmand
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, United States of America
| | - Cynthia Foronda
- Pan American Health Organization (PAHO) / World Health Organization (WHO) Collaborating Center, University of Miami School of Nursing and Health Studies, Coral Gables, Florida, United States
| | - Maria Padron
- Pan American Health Organization (PAHO) / World Health Organization (WHO) Collaborating Center, University of Miami School of Nursing and Health Studies, Coral Gables, Florida, United States
| | - Desiree Simon
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, United States of America
| | - Michelle Waters
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, United States of America
| | - Silvia Cassiani
- Health Systems and Services, PAHO/WHO, Washington, D.C., United States
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