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Nurses' Perceptions of the Clinical Nurse Specialist Role Implemented in a Highly Specialized University Hospital in Spain: A Qualitative Study. CLIN NURSE SPEC 2022; 36:317-326. [PMID: 36279493 DOI: 10.1097/nur.0000000000000703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/AIMS To explore nurses' perceptions of clinical nurse specialist practice as implemented in a highly specialized university hospital in Spain. DESIGN A descriptive qualitative study was carried out in 3 inpatient wards, with a clinical nurse specialist within the team, at a high specialized university hospital in Spain. METHOD Semistructured interviews were conducted by purposive sampling with 17 selected nurses with at least 2 years of professional experience who voluntarily agreed to participate and signed the informed consent form. Analysis of the qualitative data was conducted according to Burnard's method of content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used. RESULTS Four main categories emerged from the analysis of the data: "qualities of the role-holder," "role competencies in practice," "integration with the team," and "impact of the role" on nursing, the patient, and the organization. CONCLUSIONS The findings of this study have interesting implications for the development and implementation of clinical nurse specialist practice in healthcare organizations. They also provide evidence of the benefit of implementing clinical nurse specialist practice for improving the quality of care, patient outcomes, and healthcare efficiency.
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Intervention of Coordination by Liaison Nurse Where Ward Staff Struggled to Establish a Therapeutic Relationship with a Patient Because of Failure to Recognize Delirium: A Case Study. Healthcare (Basel) 2022; 10:healthcare10071335. [PMID: 35885860 PMCID: PMC9319112 DOI: 10.3390/healthcare10071335] [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: 06/17/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022] Open
Abstract
In this case study, ward staff found it difficult to establish a therapeutic relationship with a patient with advanced gastric cancer because they misdiagnosed delirium as a psychogenic reaction to the cancer diagnosis. This article reports on the process and effects of intervention by a liaison nurse. The liaison nurse recognized the misdiagnosis and approached the ward staff via a psychiatrist-led team. This enabled rapid revision of the treatment policy. The liaison nurse contributed to the continuation of treatment by enabling the ward staff and patient to understand each other better and to collaborate to build a relationship and control the patient’s mental health symptoms, including attention disorder and excessive demands. The patient and family had different views on discharge because of the patient’s mental health issues. The liaison nurse encouraged the ward staff to inform the family caregiver about the patient’s medical condition, the expected future course of the disease, and likely symptoms, and provide appropriate professional services. This enabled the patient to be discharged in line with their wishes. This case highlights the role of the liaison nurse in coordinating care and helping ward staff to recognize symptoms and provide appropriate care and support for patients and their families.
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Stewart A, Smith CH, Eaton S, De Coppi P, Wray J. COVID-19 pandemic experiences of parents caring for children with oesophageal atresia/tracheo-oesophageal fistula. BMJ Paediatr Open 2021; 5:e001077. [PMID: 34192203 PMCID: PMC8136802 DOI: 10.1136/bmjpo-2021-001077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has resulted in a global health crisis of unparalleled magnitude. The direct risk to the health of children is low. However, disease-containment measures have society-wide impacts. This study explored the pandemic experiences of parents of children with oesophageal atresia/tracheo-oesophageal fistula (OA/TOF) in the UK. DESIGN A phenomenological approach underpinned use of an asynchronous online forum method, in collaboration with a patient support group. Data were evaluated using thematic analysis. RESULTS The online forum ran between 7 November and 18 December 2020 with 109 participants.Pandemic experiences were divided into themes relating to healthcare and disease containment. Participants described positive experiences with remote healthcare but identified limitations. Delays and cancellations led to escalation of care to an emergency level, slower developmental progress and feelings of being abandoned by services. Inpatient care was perceived as safe but caring alone was emotionally and practically challenging. Disease containment themes revealed anxiety regarding health risks, 'collateral' damage to well-being because of isolation, and an impact on finances and employment. Parents described a transition from worry about direct health risks to concern about the impact of isolation on socialisation and development. A process of risk-benefit analysis led some to transition to a more 'normal life', while others continued to isolate. Benefits to their child's health from isolation were reported. CONCLUSIONS Parents' experiences of caring for a child with OA/TOF during the pandemic were varied. Rapid adoption of telehealth has demonstrated the enormous potential of remote healthcare delivery but requires refinement to meet the needs of the individual. Future pandemic planning should aim to retain community healthcare services to avoid escalation of care to an emergency, manage chronic and developmental concerns, and support parental well-being. Accurate and consistent disease-specific information is highly valued by parents. Third sector organisations are ideally positioned to support this.
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Affiliation(s)
- Alexandra Stewart
- Department of Speech and Language Therapy, Great Ormond Street Hospital For Children NHS Trust, London, UK.,Department of Language and Cognition, University College London, London, UK
| | - Christina H Smith
- Department of Language and Cognition, University College London, London, UK
| | - Simon Eaton
- Stem Cells and Regenerative Medicine Section, University College London Institute of Child Health, London, UK
| | - Paolo De Coppi
- Stem Cells and Regenerative Medicine Section, University College London Institute of Child Health, London, UK.,Specialist Paediatric and Neonatal Surgery, Great Ormond Street Hospital For Children NHS Trust, London, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital For Children NHS Trust, London, UK
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Vázquez-Calatayud M, Oroviogoicoechea C, Pittiglio L, Pumar-Méndez MJ. Nurses' protocol-based care decision-making: a multiple case study. J Clin Nurs 2020; 29:4806-4817. [PMID: 33007122 DOI: 10.1111/jocn.15524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 01/20/2023]
Abstract
AIM To describe and explain nurses' protocol-based care decision-making. BACKGROUND Protocol-based care is a strategy to reduce variability in clinical practice. There are no studies looking at protocol-based care decision-making. Understand this process is key to successful implementation. METHOD A multiple embedded case study was carried out. Nurses' protocol-based care decision-making was studied in three inpatient wards (medical, surgical and medical-surgical) of a university hospital in northern Spain. Data collection was performed between 2015 and 2016 including documentary analysis, non-participant observations, participant observations and interviews. Analysis of quantitative data involved descriptive statistics and qualitative data was submitted to Burnard's method of content analysis (1996). The data integration comprised the integration of the data set of each case separately and the integration of the findings resulting from the comparison of the cases. The following the thread method of data integration was used for this purpose. The SRQR guideline was used for reporting. RESULTS The multiple embedded case study revealed protocol-based care decision-making as a linear and variable process that depends on the context and consists of multiple interrelated elements, among which the risk perception is foremost. CONCLUSION This study has allowed progress in protocol-based care decision-making characterisation. This knowledge is crucial to support the design of educational and management strategies aimed at implementing protocol-based care. RELEVANCE TO CLINICAL PRACTICE Strategies to promote protocol-based care should address the contexts of practice and the ability of professionals' to accurately assess the degree of risk of clinical activity. Hence, it will promote quality of care, patient safety and efficiency in healthcare cost.
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Affiliation(s)
- Mónica Vázquez-Calatayud
- Area of Nursing Professional Development, Clínica Universidad de Navarra, Pamplona, Spain.,Faculty of Nursing, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Cristina Oroviogoicoechea
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Area of Research and Innovation, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - María Jesús Pumar-Méndez
- Faculty of Nursing, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,ImPuLs Research Group, University of Navarra, Pamplona, Spain
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Hökkä M, Martins Pereira S, Pölkki T, Kyngäs H, Hernández-Marrero P. Nursing competencies across different levels of palliative care provision: A systematic integrative review with thematic synthesis. Palliat Med 2020; 34:851-870. [PMID: 32452294 DOI: 10.1177/0269216320918798] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Palliative care exists in diverse healthcare settings. Nurses play a crucial role in its provision. Different levels of palliative care provision and education have been recognized in the literature. Therefore, nurses need a set of various competencies to provide high-quality palliative care. AIMS To systematically synthesize the empirical evidence of (1) nursing competencies needed in palliative care and (2) whether these competencies differ across the level of palliative care. DESIGN Systematic integrative review with thematic synthesis. Prospero: CRD42018114869. DATA SOURCES CINAHL, PubMed, Academic Search Premier, Scopus and Medic databases. Studies on nursing competencies linked to palliative care reported in English, Swedish, Finnish, Spanish, Portuguese or German were considered. Search terms: 'palliative care or hospice care or end-of-life care', 'competency or professional competence or skills' and 'nursing'. Articles were independently screened and reviewed by two researchers. Quality appraisal was conducted following Hawker's criteria. RESULTS A total of 7454 articles were retrieved, 21 articles were included in the analysis. Six diverse nursing competencies dimensions, namely leadership, communication, collaboration, clinical, ethico-legal and psycho-social and spiritual were identified. The reports rarely defined the level of palliative care and covered a wide array of healthcare settings. CONCLUSION Nurses need a wide range of competencies to provide quality palliative care. Few studies focused on which competencies are relevant to a specific level of palliative care. Further research is needed to systematize the nursing competencies and define which nursing competencies are central for different levels of palliative care to enhance palliative care development, education and practice.
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Affiliation(s)
- Minna Hökkä
- Research Unit of Nursing Science and Health Management, Medical Department, Oulu University, Oulu, Finland.,School of Health, Kajaani University of Applied Sciences, Kajaani, Finland
| | - Sandra Martins Pereira
- CEGE - Research Center in Management and Economics, Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal.,Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal.,UNESCO Chair in Bioethics, Institute of Bioethics, Universidade Católica Portuguesa, Porto, Portugal
| | - Tarja Pölkki
- Department of Children and Women, Oulu University Hospital, Oulu, Finland
| | - Helvi Kyngäs
- Research Unit of Nursing Science and Health Management, Medical Department, Oulu University, Oulu, Finland
| | - Pablo Hernández-Marrero
- CEGE - Research Center in Management and Economics, Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal.,Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal.,UNESCO Chair in Bioethics, Institute of Bioethics, Universidade Católica Portuguesa, Porto, Portugal
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6
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Cosentino C, Artioli G, Cervantes Camacho V, Pedroni E, D'Apice C, Sarli L. The VaRP Project: qualitative evaluation of the training effectiveness of Post Graduate Specializations for health professionals. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:106-117. [PMID: 32573513 PMCID: PMC7975833 DOI: 10.23750/abm.v91i6-s.10027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The healthcare professionals' specialized training has a positive impact on professional values, patient's outcome, and promotion of evidence-based practices. To raise the educational standard, the University of Parma has created Post Graduate Specializations which, in addition to learning sector-specific techniques and skills, include the acquisition of soft skills. Aim of the study is investigating the perception of the tutors dedicated to the organization, management, and teaching of the Post Graduate Specializations on the skills gained and the changes achieved in clinical practice, training, and research. MATERIALS AND METHODS Qualitative research was carried out through a semi-structured interview to 11 tutors who have been coordinating the Post Graduate Specializations. RESULTS The Qualitative analysis developed "thick" descriptions characterized by analytical density and interpretative richness. The emerging thematic nuclei were: General/unpredicted aspects, Professional empowerment, Satisfaction, Professional outcomes, Limits of the Post Graduate Specializations, and Development areas. CONCLUSIONS We identified the most effective areas of the Post Graduate Specializations that emerged consistently from the interviews. We hypothesized that the values and mission the Scientific Board, are effectively lived and championed in the everyday activities of the Post Graduate Specializations. Some domains still need to be furtherly developed, as the professional record, the absence of a "follow up" relationship with former students, and the effective management of workload both for students and tutors. The rise of these limits, can be particularly fruitful, as it gives the chance to identify the development trajectory the post-graduate trainings should pursue to raise the standard of excellence.
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Affiliation(s)
| | | | | | | | - Clelia D'Apice
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Italy.
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8
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LeBaron VT, Palat G, Sinha S, Chinta SK, Jamima BJB, Pilla UL, Podduturi N, Shapuram Y, Vennela P, Rapelli V, Lalani Z, Beck SL. Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India. Indian J Palliat Care 2017; 23:188-198. [PMID: 28503040 PMCID: PMC5412128 DOI: 10.4103/ijpc.ijpc_153_16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. AIM The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. METHODS Qualitative ethnography. SETTING The study was conducted at a government cancer hospital in urban South India. SAMPLE Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study. DATA COLLECTION Data were collected over 9 months (September 2011- June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews. ANALYSIS Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns. RESULTS Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training. CONCLUSIONS Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.
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Affiliation(s)
- Virginia T LeBaron
- Department of Acute and Specialty Care, University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Gayatri Palat
- Palliative Access Programme, Two Worlds Cancer Collaboration-INCTR, Canada.,Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Sudha Sinha
- Department of Medical Oncology, South Indian Cancer Hospital, India.,Department of Pediatrics, South Indian Cancer Hospital, India
| | | | | | | | | | - Yadamma Shapuram
- Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Padma Vennela
- Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Vineela Rapelli
- Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Zahra Lalani
- Palliative Access Programme, Two Worlds Cancer Collaboration-INCTR, Canada.,Vancouver Hospice Society, British Columbia Cancer Agency, Canada
| | - Susan L Beck
- Division of Acute and Chronic Care, University of Utah College of Nursing, Salt Lake City, Utah, USA
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9
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Ebadi A, Tabanejad Z, Pazokian M, Yasser S. Designing and Psychometric Evaluation of the Competency Inventory for Postgraduate Students of Intensive Care Nursing. Nurs Midwifery Stud 2016. [DOI: 10.17795/nmsjournal32677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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del Barrio-Linares M, Pumar-Méndez MJ. [Differences and similarities between the competencies of a nursing supervisor and an advanced clinical nurse specialist]. ENFERMERIA INTENSIVA 2015; 26:112-9. [PMID: 26187518 DOI: 10.1016/j.enfi.2015.03.001] [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: 07/01/2014] [Revised: 11/21/2014] [Accepted: 03/14/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION With the aim of contributing to the development of a more specific professional regulation, the present study was to identify differences and similarities between the competencies of the nursing supervisor and clinical nurse specialist in an intensive care unit. MATERIAL AND METHODS A critical analysis of the literature published between 2003 and 2013 was conducted, identified through systematic searches in electronic databases, health management and practitioner journals and reference lists of the 17 items included. RESULTS «Management and administration» and «direct clinical practice» were identified as specific competencies of nursing supervisor and clinical nurse specialist respectively. «Collaboration», «leadership» and «research» emerged as competencies shared by both profiles, but with different a operationalization way of conducting it. CONCLUSIONS These findings imply that regulation, education and implementation of these profiles must address their specific skills as the distinctive approach taken in operationalizing shared.
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Affiliation(s)
| | - M J Pumar-Méndez
- Facultad de Enfermería, Universidad de Navarra, Pamplona, España.
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11
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The Perioperative Nurse Surgeon's Assistant: Issues and challenges associated with this emerging advanced practice nursing role in Australia. Collegian 2015; 22:109-15. [DOI: 10.1016/j.colegn.2013.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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12
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Zhang L, Hawley CM, Johnson DW. Focus on peritoneal dialysis training: working to decrease peritonitis rates. Nephrol Dial Transplant 2015; 31:214-22. [PMID: 26908816 DOI: 10.1093/ndt/gfu403] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 12/02/2014] [Indexed: 11/12/2022] Open
Abstract
Patient training has widely been considered to be one of the most critical factors for achieving optimal peritoneal dialysis clinical outcomes, including avoidance of peritonitis. However, research in this important area has been remarkably scant to date. This article will critically review the clinical evidence underpinning PD patient training and will specifically focus on four key areas: who should provide training and how, when and where should it be performed to obtain the best results. Evidence gaps and future research directions will also be discussed.
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Affiliation(s)
- Lei Zhang
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Carmel M Hawley
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Australia
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Capture of Knowledge Work of Clinical Nurse Specialists Using a Role Tracking Tool. CLIN NURSE SPEC 2014; 28:323-31. [DOI: 10.1097/nur.0000000000000078] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Dutton M, Chiarella M, Curtis K. The role of the wound care nurse: an integrative review. Br J Community Nurs 2014; Suppl Wound Care:S39. [PMID: 24642739 DOI: 10.12968/bjcn.2014.19.sup3.s39] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The role of the wound care nurse has developed to meet the need for expert wound care advice. Internationally, the role has developed with a variety of different titles. Although all positions have some common tasks and obligations, there remain gaps in knowledge around the role of the wound care nurse. This article aims to determine the state of knowledge in relation to the context of practice, scope of practice and impact of the wound care nurse. An integrative review design was used to allow a broad search strategy and to gather papers from a variety of sources. A multi-method search strategy of the literature published between 1980-2011 was undertaken. This included 5 electronic databases, a thesis search and manual search. It was found that the characteristics of the patients wound care nurses care for reflect an ageing population and disease processes, including diabetes and obesity. Internationally, there is little consensus on the level of competence, educational requirements and qualifications required to practise as a wound care nurse. There was some evidence that the wound care nurse improved healing times and decreased pressure injury prevalence.
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Affiliation(s)
- Matthew Dutton
- Sydney Nursing School, University of Sydney, Australia, St George Hospital, NSW Australia
| | | | - Kate Curtis
- Sydney Nursing School, University of Sydney, Australia, St George Hospital, NSW Australia, The George Institute for Global Health, St George Clinical School, Faculty of Medicine, University of NSW, Australia
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del Barrio-Linares M. Competencias y perfil profesional de la enfermera de práctica avanzada. ENFERMERIA INTENSIVA 2014; 25:52-7. [DOI: 10.1016/j.enfi.2013.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 11/08/2013] [Accepted: 11/10/2013] [Indexed: 11/15/2022]
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Wickham S. Impact of formal educational level on clinical specialist role activity. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2014; 23:167-8, 170-3. [PMID: 24526024 DOI: 10.12968/bjon.2014.23.3.167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS This study, set in Ireland, aimed to explore demographics of the clinical nurse specialist and clinical midwife specialist population and their role activity, particularly in the educational role. BACKGROUND The clinical nurse/midwife specialist is recognised as an important part of nursing today. In Ireland, formal recognition of the specialist role occurred as recently as 2001. METHODS Following ethical approval, a questionnaire was circulated to the total population of specialist nurses and midwives in Ireland. The questionnaire captured the formal educational level held and individual educational role activity. RESULTS The study articulates the individual educational role elements (e.g. patient education, peer education) and captures the level of activity but the level varies between different educational role elements. Formal education level held has an impact on role activity, with higher education levels resulting in greater activity levels. CONCLUSIONS The clinical specialist has tremendous potential for a positive impact on patient care in his or her education role. The majority are active in this role but the analysis shows there is room for growth. Combined with the finding that the level of activity rises with the level of formal education, this gives a strong reason why there should be continuing focus on further education and life-long learning.
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Affiliation(s)
- Sheelagh Wickham
- Associate Dean for Teaching and Learning, Faculty of Science and Health, Dublin City University, Dublin
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Affiliation(s)
- Owen Doody
- Department of Nursing and Midwifery, University of Limerick, Ireland
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18
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Abstract
Examining the meanings of the experiences of advanced practice nurses (APNs) who chose to work with older adults and why they continue to work with this population was the focus of this hermeneutic qualitative research study. Twelve geriatric APNs currently practicing in two South Central states were interviewed using an open-ended interview guide. Using Gadamerian hermeneutics, the researchers identified Gerontology Found Me as the significant expression that reflected the fundamental meaning of the experience as a whole. Four themes emerged that further described the meanings of the participants’ personal, educational, and professional experiences: Becoming a Gerontology Nurse, Being a Gerontology Nurse, Belonging to Gerontology, and Bringing Others to Gerontology. This study concluded that APNs’ personal and professional experiences were more influential than educational experiences to become geriatric nurses, and having these personal and professional experiences of being in relationship with older individuals further contributed to their choice of gerontology.
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Rooth C, Sidhu A. Implementing enhanced recovery in gynaecology oncology. ACTA ACUST UNITED AC 2012; 21:S4, S7-10, S12 passim. [DOI: 10.12968/bjon.2012.21.sup10.s4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Amar Sidhu
- Imperial College Healthcare NHS Trust, London
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Clinical Nurse Specialists Shaping Policies and Procedures Via an Evidence-Based Clinical Practice Council. CLIN NURSE SPEC 2012; 26:74-86. [DOI: 10.1097/nur.0b013e3182467292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Risk determination after an acute myocardial infarction: review of 3 clinical risk prediction tools. CLIN NURSE SPEC 2012; 26:35-41. [PMID: 22146272 DOI: 10.1097/nur.0b013e31823bfafc] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE The objective of the study was to provide comprehensive information for the clinical nurse specialist (CNS) on commonly used clinical prediction (risk assessment) tools used to estimate risk of a secondary cardiac or noncardiac event and mortality in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). BACKGROUND The evolution and widespread adoption of primary PCI represent major advances in the treatment of acute myocardial infarction, specifically STEMI. The American College of Cardiology and the American Heart Association have recommended early risk stratification for patients presenting with acute coronary syndromes using several clinical risk scores to identify patients' mortality and secondary event risk after PCI. Clinical nurse specialists are integral to any performance improvement strategy. Their knowledge and understandings of clinical prediction tools will be essential in carrying out important assessment, identifying and managing risk in patients who have sustained a STEMI, and enhancing discharge education including counseling on medications and lifestyle changes. DESCRIPTION Over the past 2 decades, risk scores have been developed from clinical trials to facilitate risk assessment. There are several risk scores that can be used to determine in-hospital and short-term survival. This article critiques the most common tools: the Thrombolytic in Myocardial Infarction risk score, the Global Registry of Acute Coronary Events risk score, and the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications risk score. OUTCOME The importance of incorporating risk screening assessment tools (that are important for clinical prediction models) to guide therapeutic management of patients cannot be underestimated. The ability to forecast secondary risk after a STEMI will assist in determining which patients would require the most aggressive level of treatment and monitoring postintervention including outpatient monitoring. With an increased awareness of specialist assessment tools, the CNS can play an important role in risk prevention and ongoing cardiovascular health promotion in patients diagnosed with STEMI. CONCLUSION/IMPLICATIONS FOR PRACTICE Knowledge of clinical prediction tools to estimate risk for mortality and risk of secondary events after PCI for acute coronary syndromes including STEMI is essential for the CNS in assisting with improving short- and long-term outcomes and for performance improvement strategies. The risk score assessment utilizing a collaborative approach with the multidisciplinary healthcare team provides for the development of a treatment plan including any invasive intervention strategy for the patient.
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Aspinal F, Gridley K, Bernard S, Parker G. Promoting continuity of care for people with long-term neurological conditions: the role of the neurology nurse specialist. J Adv Nurs 2012; 68:2309-19. [DOI: 10.1111/j.1365-2648.2011.05928.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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DeFlon S. The Role of the Clinical Nurse Specialist as Clinician and Advocate in a Primary Health Care Clinic. Creat Nurs 2012; 18:104-8. [DOI: 10.1891/1078-4535.18.3.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The clinical nurse specialist (CNS) functions as an expert clinician to disseminate knowledge and apply evidence-based practice in his or her role. The framework of CNS practice competencies (patient, nurse, and system) reflects an opportunity to advocate for disadvantaged and underserved populations when providing care. Strategies, techniques, and tools to advance CNS practice in the primary care setting are discussed.
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Foster J, Clark AP, Heye ML, Rosenow DJ, Baldwin K, Villagomez ET, Wilkinson S, Gilliland I, Ward S. Differentiating the CNS and CNL roles. Nurs Manag (Harrow) 2011; 42:51-54. [PMID: 21178750 DOI: 10.1097/01.numa.0000390985.30592.6d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Jan Foster
- Texas Woman's University in Houston, Tex, USA
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Alexandrov AWW, Brethour M, Cudlip F, Swatzell V, Biby S, Reiner D, Kiernan TE, Handler D, Tocco S, Yang J. Postgraduate fellowship education and training for nurses: the NET SMART experience. Crit Care Nurs Clin North Am 2010; 21:435-49. [PMID: 19951762 DOI: 10.1016/j.ccell.2009.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The Neurovascular Education and Training in Stroke Management and Acute Reperfusion Therapy (NET SMART) program for advanced practice nursing (APN) offers a first-of-its-kind, academic, postgraduate, fellowship program for APNs that is modeled after physician academic fellowship programs but supported by a flexible Internet-based platform. This article details the rationale, methods, and preliminary results of the NET SMART APN experience, which serves as a unique template for the development of academic postgraduate nursing fellowship programs across a variety of specialty practices.
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Affiliation(s)
- Anne W Wojner Alexandrov
- University of Alabama at Birmingham, Comprehensive Stroke Center, 1813 6th Avenue South, UAB Hospital Russell Wing, Suite 226, Birmingham, AL 35249, USA.
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Profetto-McGrath J, Negrin KA, Hugo K, Smith KB. Clinical Nurse Specialists' Approaches in Selecting and Using Evidence to Improve Practice. Worldviews Evid Based Nurs 2010; 7:36-50. [DOI: 10.1111/j.1741-6787.2009.00164.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Walker JA, Urden LD, Moody R. The Role of the CNS in Achieving and Maintaining Magnet® Status. J Nurs Adm 2009; 39:515-23. [DOI: 10.1097/nna.0b013e3181c1803a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Providing care and sharing expertise: Reflections of nurse-specialists in palliative home care. Palliat Support Care 2009; 7:357-64. [DOI: 10.1017/s1478951509990290] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:This study explored the experiences, perspectives, and reflections of five nurse-specialists in palliative home care, whose dual role includes caring for patients in their daily practice as well as sharing their knowledge, skills, expertise, and experiences with other home care nurses in the community.Methods:A qualitative research design, incorporating face-to-face semistructured interviews, was used. Interviews were based on open-ended questions such as: “What is your experience in providing palliative home care to patients and their families? How do you feel about sharing your expertise and experiences with home care nurses?” Data were content analyzed using the constant comparative method.Results:Three major themes and a number of subthemes emerged: (1) acknowledging one's own limitations and humanness: (a) calling for backup, (b) learning as we go along, (c) coping with emotional demands, and (d) interacting with family members; (2) building a collaborative partnership: (a) working collaboratively, (b) sharing information, (c) guiding home care nurses, and (d) being nonjudgmental; and (3) teamwork and implementing palliative home care teams.Significance of results:Nurse-specialists play a key role in palliative home care as both carers and as resources of expert knowledge for other home care nurses caring for palliative patients. As the population ages, the health care system will be faced with increasing requests for high-quality palliative home care. The results of this study demonstrate that, from the perspective of the nurse-specialists of NOVA-Montréal (a nonprofit social and health service organization), nurse-specialists can work collaboratively with home care nurses to improve patients' quality of care and their quality of life. Moreover, patients and their families would benefit from the more widespread establishment of palliative care teams within community health organizations.
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