Development and evaluation of an intravascular link nurse network to sustain improvements in practice.

Link nurses have been used to support many areas of specialist nursing practice since the 1980s. They add value as they provide a practical and timely way of sharing information and knowledge and raising awareness with the wider multidisciplinary team. One strategy to improve standards and sustain improvements in the care of vascular access devices was to develop an intravascular link nurse network: 'Finding the missing link'. The link nurses are supported to attend quarterly masterclasses underpinned by the current evidence base. The masterclasses provide forums and workshops for learning, sharing initiatives, processes, progress and feedback. Results from the 2018/2019 sessions evaluation showed that 80% of the link nurses scored the workshops as excellent, 14% good, less than 1% fair and poor, and 4% did not provide an answer. Overall, 87% of link nurses were extremely likely to recommend the programme, 13% were likely to recommend it, and 93% found it helpful in their personal and professional growth. The network with supporting masterclasses has proven to be an effective strategy within the Trust.

Employers' duty of care to district nursing team members: health and safety concerns with lone domiciliary visits.

District nurses and their teams often work in isolation during domiciliary visits. As employers, providers of district nursing services have responsibility to ensure that appropriate policies and procedures are in place to keep district nursing teams safe. If the employer fails to do everything that was reasonable in the circumstances to keep the employee safe, the employer can be deemed to have breached their duty of care. Employees also have responsibility for their own health and wellbeing at work, and they are entitled by law to refuse to undertake work that is not safe, without fear of disciplinary action. Staff training in risk management, personal safety, handling aggressive behaviour, using safety devices such as mobile phone trackers, incident reporting and debriefing are essential for district nurses and their teams, as they face a steeply increased demand for their services and a severely compromised skill mix within their teams.

From staff nurse to nurse consultant Continuing professional development part 11: using reflection.

John Fowler, Educational Consultant, explores CPD for clinically based nurses.

District nursing renascent as Wales adopts safe staffing levels.

This article reflects on the history of the NHS in Wales and how this has led to its current structure. How this structure supports integrated working across primary, community and secondary care and how further integration with social care is moving forward and its direct effects on district nursing are explored. This article describes how district nursing is meeting these challenges. Support for district nurses as part of integrated multiprofessional teams is being developed to promote appropriately staffed teams centred on meeting the requirements of people within a designated area and ensuring that home is the best and first place of care.

Reflections on nurse education: past, present and future.

Janet Scammell, Associate Professor (Nursing), Bournemouth University, reflects on the changes in nursing that she has seen since beginning her nursing career 40 years ago.

[Differences and similarities between the competencies of a nursing supervisor and an advanced clinical nurse specialist]. / Diferencias y similitudes entre las competencias de una supervisora de enfermería y una enfermera clínica especialista.

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 administration¼ and «direct clinical practice¼ were identified as specific competencies of nursing supervisor and clinical nurse specialist respectively. «Collaboration¼, «leadership¼ and «research¼ 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.

Current nursing practice by hospital-based stoma specialist nurses.

INTRODUCTION: Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). AIMS AND OBJECTIVES: The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. METHODS: A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). RESULTS: The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). CONCLUSIONS: The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.

Advanced practice registered nurse certification.

Advanced practice registered nurses (APRNs) in nephrology began to be certified through the Nephrology Nursing Certification Commission (NNCC) in 2006. Since that time, the APRN Consensus Model has been developed, which addresses licensure, accreditation, certification, and education and which strongly recommends specialty certification for advanced practice nurses. This article discusses NNCC certification for advanced practice in nephrology nursing and describes the major components of the APRN Consensus Model.

Strategies to Increase Nursing Certification: A Progressive Care Certification for Nurses-Pathway for Success.

Nursing specialty certification is essential for delivering competent patient care based on evidence and improving outcomes. Certification enhances nurses' professional growth, promotes satisfaction, and creates stability in an organization. Nurses value certification, but certain barriers hinder them from taking the certification examination. This article describes strategies incorporated by a nursing professional development specialist to increase nurses' participation in the Progressive Care Certification for Nurses review course, certification success, and retention in the organization.

An integrative review of expert nursing practice.

PURPOSE: To review relevant literature on expert practice in nursing to assess common characteristics across the breadth of nursing specialties and work settings. ORGANIZING CONSTRUCT: An integrative literature search was conducted with inclusion criteria: (a) primary studies of how clinical staff nurses develop and demonstrate expert practice; (b) subjects from variety of specialties, employment settings, and countries of origin; and (c) studies of clinical staff nurses and not nurses in advanced practice roles. METHODS: Literature published between 1996 and 2009 was reviewed using MEDLINE and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the key words "nursing,""expert," and "practice." FINDINGS: The characteristics of expert practice as explicated across a variety of specialty areas of practice and international settings included the following: knowing the patient, intuitive knowledge, reflective practice, risk taking, and skilled know-how. Involvement and engagement of the expert nurse with her or his patients underpin these characteristics. Themes were illustrated in a star model of nursing expert practice surrounded by support and grounded in emotional involvement. CONCLUSIONS: Expert practice develops as nurses gain experience in a specialized practice setting, reflect on and learn from their experience, and develop meaningful relationships with their patients, families, and colleagues. CLINICAL RELEVANCE: The findings provide an understanding of expert nursing practice that can serve as a foundation for efforts to transfer knowledge from expert nurses to less expert nurses in all practice settings to reduce the expertise gap that is now widening.

Nurses with special interests.

High Quality Care for All (Department of Health (DH), 2008) emphasised the centrality of quality within NHS provision based upon a service that is 'fair, personalized, effective and safe'. The challenge of meeting this aspiration is even greater today amid resource constraints and the imperative of transferring more complex care out of hospitals and into primary care and community settings. The quality of care delivered to older people in particular has attracted much negative comment (Ombudsman, 2011), with the values of care and compassion appearing to have evaporated in some services.