[Development trends and future challenges in community nurse practitioner].

Community health nursing is an innovative aspect of healthcare that has grown in response to changing environmental and social structure changes into a worldwide movement. Taiwan's fast growing elderly population, improving health technologies and rising healthcare costs impact significantly upon the development and definition of the scope of practice for community health nurse nurses. This paper explores the innovative community care model development experiences of several countries and reviews the scope of practice of community health nurse practitioners in each. We further explore the current situation of nurse practitioners in Taiwan and suggest a future path for Taiwan community health nurse practitioners development and policymaking.

[Community health care trends for the coming decade: advantages and opportunities for nurses].

Health policies in many advanced countries have been revised and reformed to address increasing public healthcare demands and increasingly limited resources. Upgrading the quality and quantity of community healthcare is the most effective solution. Implementation of the National Health Insurance system in Taiwan has introduced instability into the medical system, as insurance premiums no longer correspond to healthcare demand, Taiwanese live inadequately healthy lifestyles, and expectations of the healthcare system continue to grow. Community nursing now faces many challenges at this historic crossroads. This paper tries to analyze factors in the domestic and international environment that affect Taiwan's national community healthcare. These include changes in population structure, adjustment of governmental policies, the implementation of nursing and medical regulations, and consensus among nursing professional groups. The authors hope to anticipate the trends and prospects and advantages and opportunities in community healthcare in the coming decade in order to help our community healthcare partners prepare a good foundation and establish a model for the national healthcare system and nursing profession.

Family and community nursing, chronology of a specialty. / Enfermería familiar y comunitaria, cronología de una especialidad.

More the 30 years have passed since the first Royal Decree that regulated nursing specialties was published in 1987. It is the Royal Decree published in 2005 that really allowed the training development of part of the specialties recognized in it (family and community nursing, paediatric nursing, geriatric nursing and occupational health nursing) since the obstetric-gynaecological specialist nurses (midwives) and mental health specialists had long since already started their training processes through the resident internal nurse model, today, training in the specialty of family and community nursing has been implemented in all the autonomous communities, but has not had the same development in terms of the incorporation of specialists in the health institutions of the respective health services of the autonomous communities This circumstance is generating a great lack of motivation among community nurses, both specialists and those who hope to obtain the qualification through a specialty exam. Many of the objectives achieved to date have been made possible thanks to the work of the scientific societies of community nursing (Association of Community Nursing [AEC] and Federation of Associations of Community Nursing and Primary Care [FAECAP]), which have allowed progress to be made and the process not to be halted, although there are still many achievements to be made on which the aforementioned scientific societies continue to work. In a society in which nursing care is increasingly necessary and demanded, it must have greater consideration and position in health policies, since it has demonstrated its effectiveness and can be the model that allows the health system to be sustainable. Therefore, nurses who specialize in family and community nursing must cease constituting an opportunity and become a reality.

Community and family nurse: Present keys, future challenges. / Enfermería Familiar y Comunitaria: claves de presente, retos de futuro.

It is the mission of the Community and Family Nurse through an integral and holistic approach to accompany people from cradle to death in developing their health potential, and promote different family, work and social environments to facilitate this development. Throughout history, various international, European and national organizations have regulated the figure of the Community and Family Nurse, and now their functions, powers and professional performance are fully regulated. The Community and Family Nurse can respond to the needs of a changing population and take on new responsibilities in management and research. Their extensive basic and advanced skills gathered under a rigorous training programme, benefit the health system, the nursing profession, citizenry and its communities. Many challenges remain for the Health Departments of each Autonomous Region to make it possible for this specialty to develop its full potential for improving care.

Voices - Like nurses, education must adapt to changes in care, says Janet Finch.

Nurses and midwives will play a vital role in meeting the health challenges of the future. While it is impossible to foresee all the ways in which practice will change over the next decade, we do know that nurses and midwives will be working with an ageing population, with more community-based services and growing public expectations.

The 1990s and beyond: determining the need for community health and primary care nurses for rural populations.

Increased numbers of primary care and advanced practice nurses with unique generalist skills will be required to meet the accelerating physiologic and sociocultural health care needs of rural populations. Several factors have been identified that will influence the demands and position of community-based nurses in rural practice settings during the next decade. A back-to-basics type of health care offered out of a growing elderly population; technological breakthroughs that make it possible for more chronically ill patients to live at home; serious substance abuse and other adolescent problems; AIDS; and high infant morbidity and mortality statistics are only some of the concerns that will demand nursing intervention. These changes speak to the need for improved nursing coordination, stronger collegial relationships, and better communication between physicians and nurses. Health care is moving in new directions to offer more efficient and technologically sophisticated care. These changes enhance the need for clinically expert educators who teach and jointly practice in programs with a rural focus. Telecommunications, and heightened computer literacy, will play a major role both in nursing education and clinical practice. The goals of kindergarten through 12th grade health promotion and disease prevention strategies in school health will be the norm and will require better prepared, and positions for, school nurses. More midwives and public health nurses will be needed to care for the growing population of sexually active adolescents who are in need of family planning and prenatal care. Underinsured and indigent populations will continue to fall within the purview of midlevel practitioners, as will providing anesthesia services in small rural hospitals. The transition of some rural hospitals into expanded primary care units (e.g., EACHs and RPCHs), and new models of case management will greatly influence nursing demands. This paper will further identify critical areas of advanced practice nursing within community settings, including new relationships with other health care providers, and will introduce strategies upon which rural health policy recommendations for the 1990s can be addressed.

Beyond hospital walls: educating pediatric nurses for the next millennium.

As pediatric units in acute care hospitals close, as lengths of stay shorten, and as increasing numbers of procedures are completed on an outpatient basis, faculty must find different learning experiences for their prelicensure students. Some programs have discontinued pediatric rotations, others are seeking clinical experiences in community settings. These community experiences hopefully produce a more well-rounded, globally thinking nurse to practice in the 21st century, yet they also raise a number of concerns.

Community health CNSs and health care in the year 2000.

As our nation addresses health care reform and the need for programs at the community level that deal with preventable health problems, there is an increasing need for the community health clinical nurse specialist (CHCNS). In this article, the CHCNS's role, as defined by the profession, is discussed and ideas for implementing this role in the community, home health care and public health are proposed. Standards of Community Health Nursing Practice and Healthy People 2000 are resources the CHCNS can use to guide practice at the community level.

What's on the Agenda for Change?

With the imminent roll-out of "Agenda for Change", most nurses will be busy checking their job profiles and ensuring they get the most out of the process. In this article, Yvonne Savage provides a timely overview of what all this effort will mean in the longer term.

The role of the nurse in the millennium.

The paper emphasizes the changing role of the nurse in the millenium. The changes will be in three basic fields: 1. Education: In education, the criteria for acceptance to nursing school will become higher, so that the requirement for trained nurses will increase. The new nurse will be focused on the role of management and leadership. 2. Service: The nursing service will be the guider which will lead the discipline of nursing treatment via knowledge, new nursing technologies and new managing techniques. The service will change the professional independence of the nurse into full partner and collaborator with other professions. 3. Community: The new nurses role will be derived from a new concept of "health for all" which will lead to a wider view of the entire community. Management will be the major qualification needed by the community nurse, using judgement, advanced knowledge and the ability of decision making and determining priorities. The nurse will have to fit her abilities and qualifications to the changes needed, using authority, responsibility and advanced knowledge.

A force for the future. The changing role of the district nurse.

Current developments in community nursing mean the district nurse's role will inevitably be enhanced. To meet the challenge posed by greater responsibility, it is vital that training is expanded to meet new requirements.

Informing the future: 2. Developing the role of community IPCNs.

This paper is the second in a two-part series summarising the main findings and conclusions of a review of the roles and responsibilities of infection prevention and control nurses commissioned by the Department of Health. It describes the core work of IPCNs, discusses the strengths and constraints of the current role and makes suggestions for future development.

Consulta de enfermagem na estratégia saúde da família, ampliando o reconhecimento das distintas formas de ação: uma revisão integrativa / Consulta de enfermería en estrategia de salud de la familia, ampliando elreconocimiento de las diferentes formas de acción: una revisión integradora / Nursing consultation in family health strategy, increasing the recognition of the distinct forms of action: an integrative review

Objetivo: explorar as publicações na área da saúde nos últimos seis anos sobre consulta de enfermagem na Estratégia Saúde da Família (ESF), de modo a compor evidências bibliográficas sobre os processos de trabalho que se configuram hoje nesse cenário. Método: Trata-se de um estudo exploratório de abordagem qualitativa. O método escolhido foi a revisão integrativa. A seleção dos artigos foi realizada no portal Biblioteca Virtual em Saúde (BVS), sem filtro por bases de abril-julho 2014. Os dados foram analisados segundo a análise temática de Bardin. Resultados: Foram gerados 61 artigos nas bases Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Banco de Dados em Enfermagem (BDENF) e Coleção Nacional das Fontes de Informações do Sistema Único de Saúde (Coleciona SUS). Após exclusão dos semelhantes e avaliação da pertinência do conteúdo para este trabalho, foram analisados 30 artigos. Conclusão: A consulta de enfermagem, muitas vezes, configura um cenário de atenção à saúde de forma verticalizada e medicalizada.

Objective: to explore the publications in the field of health in the last six years concerning nursing consultation in Family Health Strategy in order to gather bibliographical evidences about the process of the works that are today in this setting. Method: It is an exploratory research of qualitative approach. The chosen method was integrative review. The articles selection was made on the BVS portal with no filter based between April and July 2014. The data were analyzed according to the thematic analysis of Bardin. Results: 61 articles were found in the LILACS, BDENF and ColecionaSUS data bases. After excluding the similar ones and evaluating the relevance of the content to this work there were 30 articles. Conclusion: The nursing consultation often sets a scenario of attention to health in a verticalized and medicalized way.

Objetivo: explorar las publicaciones en el área de la salud en los últimos seis años sobre la consulta de enfermería en la Estrategia de Salud de la Familia para componer evidencias bibliográficas sobre los procesos de trabajo que se configuran en este escenario de hoy. Método: Se trata de un estudio exploratorio de abordaje cualitativo. El método elegido fue la revisión integradora. La selección de los artículos se realizó en El portal BVS, sin filtro por bases de abril a julio de 2014. Los datos fueron analizados mediante el análisis temático de Bardin. Resultados: Fueron generados 61 artículos en las bases LILACS, BDENF y ColecionaSUS. Tras la exclusión de los similares y evaluación de la pertinencia del contenido para este trabajo, se analizaron 30 estudios. Conclusión: La consulta de enfermería, a menudo, configura un escenario de atención a la salud de manera vertical y medicalizado.