Assessing the fulfillment of nurses' full potential in diverse geriatric settings-moving towards change.

BACKGROUND: In response to the aging population, the Department for Professional Development in the Nursing Division at the Israeli Ministry of Health has invested significant resources in training registered nurses for post-basic certification in the field of geriatrics. However, little is known about how the nurses implement the scope of practice in the field and how they maximize their full potential following the training. AIMS AND OBJECTIVES: To assess whether nurses' full potential is maximized in geriatric acute and long-term geriatric care, and community settings in Israel. DESIGN: A quantitative, cross-sectional study. METHODS: The study population is a convenience sample of registered nurses who completed post-basic certification in geriatric care (n = 287). The participants completed a self-administered questionnaire addressing socio-demographic and occupational characteristics, implementation of the scope of practice, and a professional satisfaction questionnaire. Baseline demographic variables were summarized using means and counts, with frequency counts and percentages used for the scope of practice. A one-way ANOVA was utilized to examine the differences between the workplace and the scope of practice. Chi-square was used to examine practice types and the workplace. RESULTS: Nurses in all surveyed geriatric settings reported average to high overall performance in independent decision-making activities and delegated duties. The majority (66%) reported very high satisfaction with the completion of the post basic certification education However overall performance differed significantly between the different geriatric settings. CONCLUSION: Most of the nurses with a post-basic geriatric certification are satisfied with their scope of practice, feel valued by colleagues and managers, and are able to practice independently within their professional scope. This can have a positive impact on the care of the older adult population. CLINICAL RELEVANCE: Administrators should ensure that nurses with a post-basic geriatric certification are able to maximize their scope of practice. Specifically, we recommend nurse managers to leverage the results of this study and advocate for nurses to fulfill their full potential in their scope of practice.

Recommendations From the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients.

BACKGROUND: By July 2020, the Extracorporeal Life Support Organization had documented more than 133 000 extracorporeal membrane oxygenation (ECMO) implementations, with more than 61 000 implementations in adult patients. No clear policies regarding the authority and responsibility of nursing staff in the treatment of ECMO-supported patients are currently available. OBJECTIVE: To formulate evidence-based recommendations for nursing care of ECMO-supported patients. METHODS: The National Head Nurse's office and the Professional Guidelines Department in the Nursing Division of Israel's Ministry of Health formed the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients to address concerns regarding the current state of professional nursing practice in the care of these patients. The Professional Advisory Committee brought together 15 senior Israeli ECMO nursing experts who explored the potential of registered nurses in caring for ECMO-supported patients, considered the competencies of nurses treating ECMO-supported patients, discussed training programs and health care policy, and examined nursing outcomes for quality assurance. RESULTS: The Professional Advisory Committee formulated recommendations regarding the following priority issues: (1) determining boundaries of professional authority and nurses' responsibilities, including designated activities for different professional ranks of registered nurses; (2) providing appropriate content for the training programs offered, such as generic/basic, above-basic, and clinical specialization nursing programs; and (3) defining relevant quality measures for nursing treatment of ECMO-supported patients. CONCLUSIONS: Introducing international standards would ensure the safety and effectiveness of nursing care for ECMO-supported patients through quality and risk management and establishment of new evidence-based nursing practices.