Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean.

SYNOPSIS Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.

COVID-19 Issues in Long-Term Care in Ontario: A Document Analysis.

The COVID-19 crisis in long-term care in Canada has been characterized as a crisis upon a crisis. This study examines recent documents on the crisis in long-term care in Ontario, using document and thematic analysis to synthesize issues and recommendations from the perspectives of different groups and organizations. Thirty-three documents from 20 organizations were analysed and six thematic areas were identified: resident care; human resources; governance, leadership and management; financing; physical infrastructure and supplies; and training and preparation. The six common themes, as perceived by different perspectives, can inform policy makers on long-term care issues.

Using Experiential Simulation-Based Learning to Increase Engagement in Global Health Education: an Evaluation of Self-reported Participant Experience.

BACKGROUND: Simulations aim to supplement historic teacher-centric methods by facilitating experiential, self-guided learning and the application of students' knowledge in a controlled environment. The objective of our study is to describe the methodology of developing and facilitating simulations, and to assess their effectiveness as an educational tool for global health training. METHODS: We describe the methodology used by Global Health Sim between October 2016 and March 2019 to design and facilitate simulations for participants at the high school through graduate school levels, and at conferences and online. Using a mixed-methods evaluation design, we assessed self-reported quantitative measures of content knowledge before and after participating in the simulation and different aspects of the simulation experience. We also conducted a qualitative thematic analysis of the experience and lessons learned as reported by evaluation respondents. RESULTS: We conducted a total of 20 simulations on six unique topics for 213 evaluation respondents. Self-reported knowledge of the topic increased an average of 3.3 points on a 10-point scale (4.1-7.4) and the seven aspects of the experience were rated highly (3-5 points on a 5-point Likert scale). Thematic analysis revealed an increased understanding of the complexity of global health problems and strategies for effectively responding to issues in a multidisciplinary manner. CONCLUSIONS: Respondents valued the opportunity to learn about the complexities of responding to global health events, which confirmed that simulations can be utilized as teaching tools for students and professionals. Further research is required to assess the long-term educational impact of simulations in global health.

Characteristics of Medical Teams in Disaster.

Disasters present unique challenges for teams providing medical assistance to those populations impacted by the event. This scoping review focused on the characteristics of medical teams in disaster and how these characteristics are developed. The scoping review methods of Arksey and O'Malley were followed. An inductive thematic analysis of selected articles was used to identify recurrent themes. A total of 6,521 articles were reviewed from eight databases, yielding 33 articles. Four recurrent theme groups were identified: (1) adaptability, flexibility, and improvisation; (2) creativity and innovation; (3) experience and training; and (4) leadership and command structure. The study highlighted key characteristics identified by responders for effective team functioning and interdependence between the characteristics. It also identified the paucity of literature on the subject. Results from the study can help to guide future research and training development for medical teams in disaster. Oldenburger D , Baumann A , Banfield L . Characteristics of medical teams in disaster. Prehosp Disaster Med. 2017;32(2):195-200.