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Hulse AL. A multidisciplinary learning approach: training, preparation and role transition. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:430-440. [PMID: 35439072 DOI: 10.12968/bjon.2022.31.8.430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM To explore trainee and qualified advanced practitioner learning experiences, how training has prepared learners for clinical practice and role transition. Evaluation of a multidisciplinary learning approach was sought, identifying its impact on developing collaborative learning and working partnerships. DESIGN AND METHODS A small-scale, mixed-methods cross-sectional study was used to gather descriptive data. Convenience sampling was used with two groups: trainees and qualified advanced (paediatric) nurse practitioners/advanced clinical practitioners (ANPs/ACPs). All participants had completed or were undertaking master's level training. An anonymous, voluntary online survey was used to gather quantitative and qualitative data reflecting participant learning experiences. Evaluation research methodologies and their application were examined through exploration of three advanced practice frameworks and a well-established framework for evaluation of training. FINDINGS Overall, responses indicate positive learning experiences, and that current and previous ANP/ACP training in the UK does adequately prepare trainees for practice. However, further improvements in curriculum content are suggested. Consistent with the literature, collaborative multidisciplinary teaching, learning and mentorship were identified as key elements in the learning process and role transition.
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Affiliation(s)
- Anna Louise Hulse
- Advanced Paediatric Nurse Practitioner, Alder Hey Children's NHS Foundation Trust, Liverpool
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2
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Kleinke F, Michalowsky B, Rädke A, Platen M, Mühlichen F, Scharf A, Mohr W, Penndorf P, Bahls T, van den Berg N, Hoffmann W. Advanced nursing practice and interprofessional dementia care (InDePendent): study protocol for a multi-center, cluster-randomized, controlled, interventional trial. Trials 2022; 23:290. [PMID: 35410437 PMCID: PMC8996202 DOI: 10.1186/s13063-022-06249-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background A redistribution of tasks between specialized nurses and primary care physicians, i.e., models of advanced nursing practice, has the potential to improve the treatment and care of the growing number of people with dementia (PwD). Especially in rural areas with limited access to primary care physicians and specialists, these models might improve PwD’s quality of life and well-being. However, such care models are not available in Germany in regular healthcare. This study examines the acceptance, safety, efficacy, and health economic efficiency of an advanced nursing practice model for PwD in the primary care setting in Germany. Methods InDePendent is a two-arm, multi-center, cluster-randomized controlled intervention study. Inclusion criteria are age ≥70 years, cognitively impaired (DemTect ≤8) or formally diagnosed with dementia, and living in the own home. Patients will be recruited by general practitioners or specialists. Randomization is carried out at the physicians’ level in a ratio of 1:2 (intervention vs. waiting-control group). After study inclusion, all participants will receive a baseline assessment and a follow-up assessment after 6 months. Patients of the intervention group will receive advanced dementia care management for 6 months, carried out by specialized nurses, who will conduct certain tasks, usually carried out by primary care physicians. This includes a standardized assessment of the patients’ unmet needs, the generation and implementation of an individualized care plan to address the patients’ needs in close coordination with the GP. PwD in the waiting-control group will receive routine care for 6 months and subsequently become part of the intervention group. The primary outcome is the number of unmet needs after 6 months measured by the Camberwell Assessment of Need for the Elderly (CANE). The primary analysis after 6 months is carried out using multilevel models and will be based on the intention-to-treat principle. Secondary outcomes are quality of life, caregiver burden, acceptance, and cost-effectiveness. In total, n=465 participants are needed to assess significant differences in the number of unmet needs between the intervention and control groups. Discussion The study will provide evidence about the acceptance, efficacy, and cost-effectiveness of an innovative interprofessional concept based on advanced nursing care. Results will contribute to the implementation of such models in the German healthcare system. The goal is to improve the current treatment and care situation for PwD and their caregivers and to expand nursing roles. Trial registration ClinicalTrials.gov NCT04741932. Registered on 2 February 2021.
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Hulse AL. A multidisciplinary learning approach: a narrative review. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:364-370. [PMID: 35404652 DOI: 10.12968/bjon.2022.31.7.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Advanced nursing/clinical practice has emerged worldwide in response to the demands of changing complex healthcare needs and ageing populations, and the need to improve services and outcomes, decrease waiting times and reduce overall healthcare cost. A reduction in medical practitioners' working hours has meant other healthcare disciplines have to develop medical skills. Evidence suggests there are global differences in the advanced nursing/clinical practice role definition, expectations and scope of practice. Education and training for role development varies around the world. Part 1 of this review, which explores international approaches to advanced practice, examines literature findings that look at learner experiences of training and preparation and highlights a gap in educational research in this field. A small-scale cross-sectional mixed methods study that was subsequently undertaken will be discussed in part 2.
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Affiliation(s)
- Anna Louise Hulse
- Advanced Paediatric Nurse Practitioner, Alder Hey Children's NHS Foundation Trust, Liverpool
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Reynolds J, Mortimore G. The ascent to advanced practice: challenges, support and opportunities. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:106-108. [PMID: 33529099 DOI: 10.12968/bjon.2021.30.2.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Julie Reynolds
- Senior Lecturer in Advanced Clinical Practice, University of Derby
| | - Gerri Mortimore
- Senior Lecturer in Advanced Clinical Practice, University of Derby
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Michalowsky B, Henning E, Rädke A, Dreier-Wolfgramm A, Altiner A, Wollny A, Drewelow E, Kohlmann T, Biedenweg B, Buchholz M, Oppermann RF, Zorn D, Hoffmann W. Attitudes towards advanced nursing roles in primary dementia care - Results of an observational study in Germany. J Adv Nurs 2020; 77:1800-1812. [PMID: 33305488 DOI: 10.1111/jan.14705] [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: 12/12/2019] [Revised: 10/05/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022]
Abstract
AIMS To demonstrate the attitudes of general practitioners (GPs), nurses, persons with dementia, and caregiver towards suitable tasks and qualification needs for and the acceptance and impact of advanced nursing roles in German dementia primary care. DESIGN Observational study using a questionnaire survey with 225 GPs, 232 nurses, 211 persons with dementia, and 197 caregivers, conducted between December 2017-August 2018. METHODS A questionnaire was generated that includes specific assessment, prescription, and monitoring tasks of advanced nursing roles in dementia primary care as well as qualification requirements for and the acceptance and the impact of advanced nursing roles. Data were analysed using descriptive statistics. Group differences were assessed using the Fisher's exact test. RESULTS Advanced nursing roles were highly appreciated across all groups. Assessment and monitoring tasks were rated as highly suitable, and prescription authorities as moderately suitable. Nurses felt less confident in assessment and monitoring, but more confident in prescribing as practitioners expected. Patients and caregivers would appreciate a takeover of tasks by nurses; nurses and practitioners preferred a delegation. A dementia-specific qualification was rated as best suitable for advanced nursing roles, followed by 'no specific qualification' if medical tasks that only can be carried out by practitioners were delegated and an academic degree if tasks were substituted. Advanced nursing roles were rated as beneficial, strengthening the confidence in nursing care and improving the cooperation between professionals and the treatment. Practitioners assumed that advanced nursing roles would improve job satisfaction of nurses, which was not confirmed by nurses. CONCLUSION There is an extended consensus towards the enlargement of advanced nursing roles, represented by high endorsement, acceptance, and willingness to reorganize tasks. IMPACT Results debunk the common notion that German practitioners would be reluctant towards advanced nursing roles and a takeover of current practitioner tasks, supporting the implementation of advanced nursing roles in Germany.
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Affiliation(s)
- Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE) e.V. Site Rostock/Greifswald, Translational Health Care Research, Greifswald, Germany
| | - Esther Henning
- Section Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases (DZNE) e.V. Site Rostock/Greifswald, Translational Health Care Research, Greifswald, Germany
| | - Adina Dreier-Wolfgramm
- Department of Nursing and Management, Faculty of Business & Social Science, University of Applied Science Hamburg (HAW), Hamburg, Germany
| | - Attila Altiner
- Institute for General Practice, University Medical Center Rostock, Rostock, Germany
| | - Anja Wollny
- Institute for General Practice, University Medical Center Rostock, Rostock, Germany
| | - Eva Drewelow
- Institute for General Practice, University Medical Center Rostock, Rostock, Germany
| | - Thomas Kohlmann
- Section Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Bianca Biedenweg
- Section Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Maresa Buchholz
- Section Methods in Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Roman F Oppermann
- Department of Health, Nursing and Management, University of Applied Science Neubrandenburg, Neubrandenburg, Germany
| | - Daniela Zorn
- Department of Health, Nursing and Management, University of Applied Science Neubrandenburg, Neubrandenburg, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE) e.V. Site Rostock/Greifswald, Translational Health Care Research, Greifswald, Germany.,Section Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Cherak SJ, Rosgen BK, Amarbayan M, Plotnikoff K, Wollny K, Stelfox HT, Fiest KM. Impact of social media interventions and tools among informal caregivers of critically ill patients after patient admission to the intensive care unit: A scoping review. PLoS One 2020; 15:e0238803. [PMID: 32915848 PMCID: PMC7485758 DOI: 10.1371/journal.pone.0238803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022] Open
Abstract
Background The use of social media in healthcare continues to evolve. The purpose of this scoping review was to summarize existing research on the impact of social media interventions and tools among informal caregivers of critically ill patients after patient admission to the intensive care unit (ICU). Methods This review followed established scoping review methods, including an extensive a priori-defined search strategy implemented in the MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane CENTRAL Register of Controlled Trials databases to July 10, 2020. Primary research studies reporting on the use of social media by informal caregivers for critically ill patients were included. Results We identified 400 unique citations and thirty-one studies met the inclusion criteria. Nine were interventional trials–four randomized controlled trials (RCTs)–and a majority (n = 14) were conducted (i.e., data collected) between 2013 to 2015. Communication platforms (e.g., Text Messaging, Web Camera) were the most commonly used social media tool (n = 17), followed by social networking sites (e.g., Facebook, Instagram) (n = 6), and content communities (e.g., YouTube, SlideShare) (n = 5). Nine studies’ primary objective was caregiver satisfaction, followed by self-care (n = 6), and health literacy (n = 5). Nearly every study reported an outcome on usage feasibility (e.g., user attitudes, preferences, demographics) (n = 30), and twenty-three studies reported an outcome related to patient and caregiver satisfaction. Among the studies that assessed statistical significance (n = 18), 12 reported statistically significant positive effects of social media use. Overall, 16 of the 31 studies reported positive conclusions (e.g., increased knowledge, satisfaction, involvement) regarding the use of social media among informal caregivers for critically ill patients. Conclusions Social media has potential benefits for caregivers of the critically ill. More robust and clinically relevant studies are required to identify effective social media strategies used among caregivers for the critically ill.
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Affiliation(s)
- Stephana J. Cherak
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Brianna K. Rosgen
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mungunzul Amarbayan
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
| | - Kara Plotnikoff
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
| | - Krista Wollny
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Henry T. Stelfox
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Kirsten M. Fiest
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Critical Care Medicine, Alberta Health Services, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
- * E-mail:
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Hyde R, MacVicar S, Humphrey T. Advanced practice for children and young people: A systematic review with narrative summary. J Adv Nurs 2019; 76:135-146. [DOI: 10.1111/jan.14243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 10/07/2019] [Accepted: 10/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Robin Hyde
- School of Health & Social Care Edinburgh Napier University Edinburgh UK
| | - Sonya MacVicar
- School of Health & Social Care Edinburgh Napier University Edinburgh UK
| | - Tracy Humphrey
- School of Health & Social Care Edinburgh Napier University Edinburgh UK
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Hakim N, Mummadi SM, Jolly K, Dawson J, Darr A. Nurse-led epistaxis management within the emergency department. ACTA ACUST UNITED AC 2019; 27:41-46. [PMID: 29323978 DOI: 10.12968/bjon.2018.27.1.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND the incidence of epistaxis has increased secondary to increased life expectancy and morbidities. This study sought to assess the knowledge, practice and opinion relating to adequacy of training of advanced nurse practitioners (ANPs) and staff nurses (SNs) in the emergency department. METHODS a national survey was distributed over an 8-week period; this included a 3-point scoring system based on the National Institute for Health and Care Excellence Clinical Knowledge Summaries guidance on epistaxis management to assess overall performance. RESULTS analysis included 109 ANPs and 101 SNs; 12% of ANPs achieved the maximum score, 40% scored 2, 25% scored 1, and 23% scored 0, while 14% of SNs achieved the maximum score, 24% scored 2, 29% scored 1, and 32% scored 0. Overall 88% of respondents advocated further training. CONCLUSION significant deficits in knowledge regarding epistaxis management were highlighted. Further training could help to empower patients in basic first aid measures, subsequently reducing admissions rates.
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Affiliation(s)
- Navid Hakim
- General Practice Trainee, Princess Royal University Hospital, London
| | - Sangha Mitra Mummadi
- Core Surgical Trainee, Department of Otolaryngology, University Hospitals North Midlands, Stoke-on-Trent
| | - Karan Jolly
- ENT Registrar, Department of Otolaryngology, University Hospitals North Midlands, Stoke-on-Trent
| | - Julian Dawson
- Advanced Nurse Practitioner, Department of General Surgery, University Hospitals North Midlands, Stoke-on-Trent
| | - Adnan Darr
- ENT Registrar, Department of Otolaryngology, University Hospitals North Midlands, Stoke-on-Trent
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