Key Factors to Consider When Implementing an Advanced Practice Registered Nurse-Led Heart Failure Clinic.

Advanced practice registered nurses (APRNs) such as clinical nurse specialists and nurse practitioners excel at chronic disease management. Development of an APRN-led heart failure (HF) clinic is an ideal way to manage complex HF patients. However, there are important factors to consider when implementing an APRN-led HF clinic. The purpose of this paper is to provide a consolidation of recommendations to consider when developing and implementing an APRN-led HF clinic. A review of applicable literature within the last 10 years was conducted to determine the key factors to be considered when developing organizational structures and processes for an APRN-led HF clinic. The increasing need for primary care and internal medicine providers supports using APRNs to fill the gap and provide disease management for HF patients. Also, APRNs can impact the overall costs of HF treatment by optimizing postdischarge care and preventing hospitalizations and readmissions. Multiple studies supported implementation of APRN-led HF clinics for disease management to provide complex treatment strategies and comprehensive care to these patients.

Perioperative Nurses' Perceptions of the QSEN Competencies.

Since the development of the Quality and Safety Education for Nurses (QSEN) competencies, most published studies related to the topic have focused on investigating the perceptions of nursing faculty members, prelicensure and graduate nursing students, and recently graduated nurses regarding the competencies. Few researchers have explored practicing nurses' perceptions. The purpose of this study was to describe practicing perioperative nurses' perceptions of their knowledge, skills, and attitudes associated with the QSEN competencies. Survey results from 654 perioperative nurses representing 49 states showed that participants reported they were very prepared for the patient-centered care and teamwork and collaboration competencies, but they were not prepared for the quality improvement competency. Similarly, perioperative nurses reported less participation in QSEN competency-related activities when they felt not at all prepared or somewhat prepared, despite perceiving these activities to be important. Hospital leaders should support perioperative nurses' efforts to apply the QSEN competencies in the practice setting.

A Study of Medical Surgical Nurses Leaders' Evidence-Based Practice Attributes: Critical Implications for Practice.

OBJECTIVE: The purpose of this study was to determine medical-surgical nurse leaders' evidence-based practice (EBP) attributes, perceived barriers to EBP, and whether there were differences in leaders' EBP competencies and EBP implementation by demographic and organizational factors. BACKGROUND: Leaders are crucial to the development of cultures that support EBP implementation, but little is known about medical-surgical nurse leaders' capacity to perform this aspect of their role. METHODS: A cross-sectional design using survey methodology was used. The survey contained demographic/work setting questions and 3 instruments to measure EBP beliefs, implementation, and competencies. RESULTS: Senior leaders self-reported higher EBP attributes compared with nurses in other roles; nurses with an MSN or higher reported greater frequency of EBP implementation. A regression revealed that EBP competencies, EBP beliefs, having a DNP degree, and working in an Academy of Medical-Surgical Nurses Premier Recognition In the Specialty of Med-surg unit or a Pathway to Excellence® organization had significant, positive effects on EBP implementation scores ( R2 = 0.37). CONCLUSIONS: Findings demonstrate there is a range of EBP beliefs and competencies, and barriers to EBP among medical-surgical nurse leaders. Because medical-surgical nursing is the largest acute care practice specialty in the United States and many other countries, leaders fully integrating EBP into their practice would be a substantial contribution to advancing EBP in healthcare.

Medical-surgical nurses' EBP beliefs and competencies.

BACKGROUND: The lack of evidence-based practice (EBP) knowledge and inability to implement EBP among nurses is a major barrier to quality nursing care. The literature shows that nurses highly value the use of EBP, however, they lack necessary EBP competencies. Although medical-surgical nurses were included in studies examining cross-sections of the nursing workforce, no studies exist specifically investigating their EBP beliefs and EBP competencies. AIMS: The purpose of this study was to describe medical-surgical nurses' self-reported EBP beliefs and competencies. METHOD: A descriptive, cross-sectional design employing survey methodology was used. RESULTS: A total of 1,709 medical-surgical nurses participated for a response rate of 13%. The findings revealed that medical-surgical nurses had positive beliefs about EBP. However, they rated themselves competent in only 2 EBP competencies of 24. Medical-surgical nurses working in units or organizations that had a special designation such as Academy of Medical-Surgical Nurses Premier Recognition in the Specialty of Med-Surg (AMSN PRISM; p = .001) or Pathway to Excellence (p = .006) reported greater EBP competency scores. Also, nurses educated at the master's level or higher had better EBP competency scores (p < .0001). LINKING EVIDENCE TO ACTION: Medical-surgical nurses need support at the personal and organizational levels to improve their EBP competence and increase uptake of EBP in their practice. Therefore, individual nurses must reflect on their EBP competence level and pursue opportunities to develop these essential attributes. Leaders must also create practice environments where EBP is valued, and barriers to EBP implementation are eliminated. Faculty in prelicensure and graduate programs should integrate EBP into their curricula and assess students' EBP competencies.

Evaluation of comparing urban area land use change with Urban Atlas and CORINE data.

Urban Atlas (UA) data covering the large urban areas have been produced by the European Environment Agency for a variety of European countries including Turkey since 2006. The use of the UA data for the determination of spatiotemporal land use and density changes in urban areas. UA data of Eskisehir, Turkey, were used in order to detect the spatiotemporal changes between 2012 and 2018. CORINE data-based change detection and NDVI analysis were also made and compared with the results obtained from the UA data. The results based on the UA data revealed that the artificial surfaces in the study area increased by 17.65% and there was a 18.32% increase in the total amount of agricultural lands, natural lands, forests, and vegetation. Although CORINE data-based analyses showed a similar trend in land use/land cover changes, the amount of changes between 2012 and 2018 in CORINE and UA data-based analyses were found to be 4.99% and 17.55%, respectively. A 9.30% mismatch between the UA changes and NDVI difference data was also calculated. Research findings revealed that the utilization of the UA data in the urban territories would be advantageous especially in planning processes to detect and compare the changes in the artificial and non-artificial surfaces and NDVI analysis would be very supportive to control and compare the results. It is also concluded that this study may be a useful model to monitor the cities in accordance with the 2030 and 2050 policies of European Council on Land Use, Land Use Change and Forestry.

A concept analysis of role ambiguity experienced by hospital nurses providing bedside nursing care.

The concept of role ambiguity, despite its wide application in nursing research, lacks a clear definition and conceptualization, resulting in inconsistencies about how it is defined, operationalized, and applied in research. The purpose of this paper was to analyze and define the concept of role ambiguity among hospital nurses providing nursing care, using the concept analysis method developed by Walker and Avant. The three defining attributes of role ambiguity were lack of information (information deficiency), lack of clarity, and unpredictability. Antecedents included lack of clear role definitions, lack of education/training, communication problems, supervisory behaviors and support, organizational culture, practice environment conditions, experience, group cohesiveness, and preferred work setting. The consequences of role ambiguity included increased stress, lack of organizational commitment, job dissatisfaction, burnout, and increased intent to leave. This concept analysis provides a clear conceptual definition to better understand role ambiguity among hospital nurses along with implications for nurse leaders, educators, clinicians, and researchers to support nurses and guide future research. This paper further emphasizes the importance of nurse-manager relationships in reducing the experience of role ambiguity among hospital nurses.

Assessing Nursing Students' Perceptions of the QSEN Competencies: A Systematic Review of the Literature With Implications for Academic Programs.

BACKGROUND: Nurses are in key positions in the healthcare system to provide, monitor, and manage the care delivered to their patients. In 2005, the Quality and Safety Education for Nurses (QSEN) initiative was launched to redefine quality and safety competencies for pre-licensure nursing education. It is imperative that nurses are graduating with the full spectrum of the QSEN competencies to practice in today's healthcare environments. AIMS: The purpose of this systematic review was to evaluate the research about student nurses' perceptions of their abilities to perform the six QSEN competencies and to determine the effect of integrating the QSEN content in their courses, clinical placements, or simulation experiences. METHOD: A systematic review of the literature was conducted to retrieve published studies from CINAHL, PubMed, Web of Science, and ERIC using the search terms of Quality and Safety Education for Nurses, QSEN, QSEN competencies, nursing student, and student nurse. The studies that were included in this review were assessed by both authors independently using standardized critical appraisal tools. RESULTS: Seven studies met the inclusion criteria: four descriptive, one quasi-experimental, and two mixed-methods designs. Overall, pre-licensure nursing students perceived patient-centered care as the most discussed and quality improvement as the competency least reviewed in their curricula. Students reported to be most prepared to perform patient-centered care skills and least prepared to perform quality improvement skills. LINKING EVIDENCE TO ACTION: Revisiting the integration of the quality improvement competency into nursing curricula can increase nursing students' understanding of this QSEN competency. More research with sufficiently powered sample sizes, valid and reliable tools measuring outcomes of interventional studies, and attention to quality and rigor is needed to assess graduating students' understanding of the QSEN competencies.

Application of project management tools and techniques to support nursing intervention research.

Nursing research involves much planning and attention to details, yet novice and seasoned nurse researchers often overlook the day-to-day operations required to conduct research studies. Project management is a set of iterative steps that can facilitate the process of conducting nursing research. In this paper we aim to provide an overview of project management and identify ways in which its specific principles and strategies may be applied to facilitate nursing research. Here we give an overview of our current longitudinal study using a Solomon four-group design and illustrate how we applied strategies and tools from the project management literature. In addition, we offer descriptions and illustrations of several other project management tools that could have been used in specific phases of this research project. We encourage nurse educators and researchers to familiarize themselves with the principles of project management and consider using them in future studies.