Interprofessional Ethics Simulations and Debriefing to Develop Collaborative Skills.

The Interprofessional Education Collaborative's (IPEC's) core competencies are accreditation standards of most, if not all, healthcare professions (Interprofessional Education Collaborative Expert Panel [2016, Core Competencies for Interprofessional Collaborative Practice: 2016 Update. Washington, DC: IPEC]). Limited literature exists on interprofessional (IP) learning outcomes in healthcare ethics; even fewer studies include debrief sessions. Interprofessional education (IPE) case discussion using web-based technology is a promising way to incorporate ethics content. This article summarizes a model for healthcare programs to create, conduct, and assess synchronous IPE ethics discussions and debrief sessions. Specifically, this article highlights debrief sessions that followed a standardized patient (SP) IP interaction with students from pharmacy and advanced practice nursing. Qualitative analysis of debrief comments identified four themes: the benefit of IP collaboration, the importance of patient-centered care, the need to adapt clinical recommendations with ethical challenges, and the importance of trust among team members. The findings indicate web-based, synchronous IP/SP ethics simulations and debrief sessions are an effective, albeit laborious, method for collaboration and reflection.

Role, education, policies and competencies for advanced practice in paediatric haematology-oncology nursing in Europe: A scoping review.

The aim of this scoping review is to describe the role, education, policies/regulation, skills and competencies required for advanced practice in paediatric haematology-oncology nursing in Europe, highlighting the differences in development between the different European countries. A scoping review was conducted following the methodological framework of guidelines by Arksey and O'Malley and the recommendations for advancing the methodology by Levac et al. We searched MEDLINE/PubMed, EMBASE, CINAHL, Cochrane Library, Scopus, grey literature, webpages, reference lists and performed a manual search, without any restrictions on language or time. The intersection between databases, grey literature and evidence documents traced from the sites of the most authoritative European organisations in the field made it possible to identify the regulatory and training differences between the various countries that were examined. This scoping review highlights how advanced knowledge and competences are used in the care of paediatric haematology-oncology patients, which are strictly necessary for implementing quality care. At present these competences are not recognised in policies and regulation in most of the countries that were examined. It is desirable that all EU member states work to implement a radical change and allow these more competent figures to assist patients in the best possible way.

Perception and Experience of Independent Consultations in Primary Healthcare among Registered Nurses in Kazakhstan: A Qualitative Study.

(1) Background: The nursing profession has undergone a significant transformation not only in a formal context but also in terms of the increased educational competencies required of nurses and their preparedness to adapt to evolving roles and statuses. The aim of our study was to examine the experience of advanced practice nurses who conduct independent consultations on patients and to identify the main challenges they face in their practice. (2) Methods: We carried out 22 semi-structured interviews with nurses responsible for conducting independent consultations across three urban polyclinics located in Aktobe, Almaty, and Astana. All interviews were audio-recorded, transcribed verbatim, and subjected to qualitative content analysis. (3) Results: The content analysis revealed three main themes: "People awareness of the role of an independent nursing appointment", "Adaptation of the work environment", and "Confidence of nurses to provide independent services". (4) Conclusions: Limited competency among nurses and the absence of quality metrics for autonomous nursing consultations present substantial obstacles to assessing and enhancing the quality of care delivered by nurses in their independent roles. Developing and implementing quality indicators for independent nursing appointment, as well as additional training within the framework of interprofessional continuous education for nurses, are important steps toward enhancing the effectiveness, safety, and accessibility of nursing care.

[Informing the clinical reasoning of advanced practice students with nursing theories]. / Éclairer le raisonnement clinique des étudiants en pratique avancée par les théories infirmières.

This article examines the integration of a Clinical Nurse Reasoning (CNR) model into advanced nursing practice training to develop the clinical reasoning skills of advanced practice nurses. The article explores the contribution of Callista Roy's conceptual model of adaptation and presents a global analysis of a complex care situation that justifies the introduction of an CNR model paired with nursing knowledge to ensure comprehensive, quality nursing care.

Enhancing triage accuracy: The influence of nursing education on risk prediction.

AIM: This study aimed to compare the performance in risk prediction of various outcomes between specially trained triage nurses and the Manchester Triage System (MTS). DESIGN: Prospective observational study. METHODS: The study was conducted from June 1st to December 31st, 2023, at the Emergency Department of Merano Hospital. Triage nurses underwent continuous training through dedicated courses and daily audits. We compared the risk stratification performed by expert nurses with that of MTS on various outcomes such as mortality, hospitalisation, and urgency defined by the physicians. Comparisons were made using the Areas Under the Receiver Operating Characteristic curve (AUROC). RESULTS: The agreement in code classification between the MTS and the expert nurse was very low. The AUROC curve analysis showed that the expert nurse outperformed the MTS in all outcomes. The triage nurse's experience led to statistically significant better stratification in admission rates, ICU admissions, and all outcomes based on the physician's assessment. CONCLUSIONS: The continuous training of nurses enables them to achieve better risk prediction compared to standardized triage systems like MTS, emphasizing the utility and necessity of implementing continuous training pathways for these highly specialised personnel.

[IPAs mentioning PCS mobilize a care model based on patient partnership]. / Mobilisation par des IPA d'un modèle de soin portant sur le partenariat patient.

The Impact program aims to structure the care provided by advanced practice nurses (APNs) for people with chronic illnesses, based on the humanistic health partnership model. This model, based on patient partnership, is enriched by measurement tools that take into account four determinants of adaptation to chronic illness. Impact aims to improve patient partnership, individualize care and integrate IPAs into a research dynamic.

Career Considerations in Nurse-Led Traditional Chinese Medicine Clinics: a Two-Center Qualitative Study.

Background: Growing demand exists for high-quality Traditional Chinese Medicine (TCM) care, particularly through Nurse-led TCM clinics (TCM-NLCs). Nurses with extensive experience in TCM departments represent a potential workforce for this healthcare model. This qualitative study aims to investigate the willingness of these candidates to engage in TCM-NLCs, with a specific focus on their main concerns and apprehensions when facing new challenges. Methods: Individual semi-structured face to face interviews were conducted with senior nurses from two TCM hospitals in Shanghai. Each participant had a minimum of three years of work experience in a TCM related department. Conventional qualitative content analysis was utilized. Results: Fourteen participants were interviewed and data saturation was achieved. Nurses exhibited strong interest in practicing in TCM-NLCs. They believed that such innovative TCM nursing service model not only extends nursing role, provides greater empowerment and opportunities for professional development but also meets patients' diverse healthcare needs, reduces reliance on other healthcare providers such as doctors, and increases hospital revenue. However, challenges such as deficiencies in evidence-based TCM nursing education, the absence of standardized practice guidelines, and limited prescriptive privileges were identified as primary obstacles to engaging in TCM-NLCs practice, potentially undermining the specialization of this advanced nursing practice model. Conclusion: Although the nurses interviewed were highly motivated, they generally lacked confidence to practice independently in TCM-NLCs. A pressing priority is to address their concerns by providing appropriate resources as well as education and policy support to enhance their competency and ensure their practice autonomy, therefore building a more qualified pool of professionals for advanced TCM nursing practice.

What Are the Best Practices for Nursing Care during an Earthquake? A Scoping Review.

Among natural disasters, earthquakes have a considerable impact and are among the ten deadliest, with an extreme impact on the healthcare sector. This study aimed to analyze the best practices in nursing care for earthquake victims. An in-depth analysis was carried out by using a scoping review, a method used in accordance with the PRISMA-ScR recommendations, to identify best nursing practice in these circumstances based on searches of eight databases: MEDLINE via PubMed; Cochrane Library; Embase; VHL; PDQ-Evidence; Scopus; ProQuest; and Google Scholar. Twenty-one studies were selected. The nursing practices identified were grouped into two distinct dimensions, each subdivided into four subcategories: (i) care practices: (a) immediate care, (b) intermediate care, (c) psychosocial care, and (d) ethical care; (ii) care management and coordination practices, which cover (a) care coordination, (b) victim care network organization, (c) teamwork, and (d) training. By analyzing these nursing practices during care and relief operations for earthquake victims, this study identified the various actions carried out, the nursing skills to be developed, and the reinforcement of these advanced practices through the systematization of nurses' skills, in order to promote victims' rehabilitation, minimize their suffering, and improve their quality of life during and after an earthquake.

Development and impact of a tailored eHealth resource on fibromyalgia patient's self-management and self-efficacy: A mixed methods approach.

Aim: To develop an eHealth resource to support fibromyalgia patients and explore it for usability and impact on their self-management and self-efficacy. Background: Fibromyalgia is a complex, non-progressive chronic condition characterised by a bewildering array of symptoms for patients to self-manage. International guidelines recommend patients receive illness-specific information once diagnosed to promote self-management and improve health-related quality of life. Design: A 3-phase mixed methods exploratory sequential design. Methods: Qualitative interviews explored the information and self-management needs of fibromyalgia patients attending a large tertiary hospital in Dublin. Identified themes together with an extensive review of the literature of interventions proven to be impactful by patients with fibromyalgia were utilised in the design and development of the eHealth resource. The resource was tested for usability and impact using pre and post-intervention outcomes measures. Results: Patient interviews highlighted a lack of easy accessible evidenced information to support self-management implicating the urgent need for a practical solution through development of a tailored eHealth resource. Six themes emerged for inclusion; illness knowledge, primary symptoms, treatment options, self-management strategies, practical support and reliable resources. Forty-five patients who tested the site for usability and impact demonstrated a statistically significant improvement in self-efficacy after 4 weeks access with a medium positive effect size. Patients with the most severe fibromyalgia impact scores pre-intervention demonstrated the most improvement after 4 weeks. Patients gave the resource a System Usability Score A rating, highly recommending it for fellow patients diagnosed with fibromyalgia. Conclusions: The study demonstrated how the development of a novel eHealth resource positively impacted fibromyalgia patients' self-efficacy to cope with this debilitating condition. Impact: This study suggests that access to eHealth can positively impact patients self-efficacy, has the potential to be a template for eHealth development in other chronic conditions, supporting advanced nurse practitioners working in chronic disease management.

What is nursing in advanced nursing practice? Applying theories and models to advanced nursing practice-A discursive review.

AIM: This article appraises models and theories related to advanced nursing practice. It argues that while the role of the advanced nurse practitioner builds on and extends beyond traditional nursing, it remains firmly grounded in 'caring'. BACKGROUND: The stereotype that nurses 'care' and doctors 'cure' is fading. Increasingly, nurses have crossed boundaries and conducted independent assessment, diagnosis, prescribing and consultation, which used to be the doctor's role. Confusion and argument have arisen due to the higher-level practice of the advanced nurse practitioner, as many questions where these 'doctor nurses' stand. DESIGN: A literature review. DATA SOURCES: Databases, including CINAHL, Medline and Google Scholar, were searched. METHOD: Databases were searched, and relevant studies and review articles from 1970 to 2023 were identified using the following keywords: 'advanced nurse practitioner', 'nurse practitioner', 'advanced nursing', 'advance practice', 'nurse practitioner', 'nursing theory' and 'nursing model'. RESULTS: Although advanced nurse practitioners identify themselves as nurses, there is limited use of nursing theory to conceptualize this new level of practice and to define their contribution to the multi-disciplinary team. It is noted that a holistic approach to personalized patient care, based on therapeutic relationships and effective communication, may help us identify the unique contribution of the advanced nurse practitioner. CONCLUSIONS: The development of advanced nursing theory needs to capture this holistic approach and its caring element to recognize the value and strengthen the identity allegiance of this hybrid role. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Holistic approach and patient-centred care, effective communication and the therapeutic relationship are strong characteristics relating to ANP practice, the latter of which is yet to be clearly defined and captured in nursing theories. Conceptualizing ANP practice and capturing their valuable nursing care will enable better understanding and clarity for the role to realize its full potential.

Self-reported competence among advanced practice nursing students in Denmark, Finland and Norway: a cross-sectional multicentre study.

BACKGROUND: The health care systems in the Nordic countries and worldwide are under pressure due to increased longevity and a shortage of nurses. Providing nurses with a high level of education, such as advanced practice nursing, is of great importance to ensure effective, safe and high-quality care. AIM: The aim of this study was to investigate self-reported competence using the Nurse Professional Competence Scale Short-Form for the first time among master's students of advanced practice nursing in the Nordic countries and to relate the findings to age, work obligations, child-rearing responsibilities, level of education and clinical nursing experience. METHODS: A multicentre, cross-sectional design was used in this study conducted at five universities in Denmark, Finland and Norway. The Nurse Professional Competence Scale Short-Form consisting of six competence areas was used with a maximum score of 7 per item for the analysis of single items and a transformed scale from 14.3 to 100 for analysing the competence areas (higher score equals higher self-reported competence). Descriptive and comparative statistics were used to analyse the data. RESULTS: The highest mean score was found for the competence area 'Value-based nursing care'. Students living with home-dwelling children (≤ 18 years) reported significantly higher competence in 'Nursing care', while students ≥33 years reported significantly higher competence in 'Nursing care' and 'Value-based nursing care'. No significant differences were found between students working and those not working alongside their studies, between students with and without further nursing-related education, or between students with long and short experience as nurses. CONCLUSIONS: The findings from this study might help to further develop curricula in advanced practice nursing master's programmes to ensure high-quality nursing and sustainable health care in the future. Future high-quality master's programmes might benefit from systematic collaboration between Nordic higher education institutions as also Sweden is planning master's programme. Higher age, having children at home and working while studying should not be considered causes for concern.

[The new nursing professions in psychiatry: One man's dream, another man's nightmare?] / Les nouvelles professions infirmières en psychiatrie, rêve des uns, cauchemar des autres ?

The deployment of case management and advanced nursing practice is shaking up the roles of the various professionals on mental health teams, and the usual organization of care in psychiatry. These changes can be perceived as either positive or worrying, depending on each individual's role and position. For the past 3 years, the mobile teams of the Centre rive gauche cluster at Le Vinatier hospital have been organized according to the principles of Flexible Assertive Community Treatment, and include an advanced practice nurse (APN) on their staff. The roles of the case manager and the APN have been rethought. A number of measures have facilitated the implementation of these new functions.

Evaluation of patient satisfaction of receiving Systemic Anti-Cancer Therapy prescribed by nurse Non-Medical Prescribers.

PURPOSE: To evaluate patient satisfaction of patients receiving Systemic Anti-Cancer Treatment prescribed by nurse Non-Medical Prescribers as a new model of care at a Cancer Unit in Northern Ireland, United Kingdom. METHODS: A cross-sectional survey design, with a convenience sample of patients from five tumour groups who received Systemic Anti-Cancer Therapy by nurse Non-Medical Prescribers, across a 3-month period in 2022 was employed. Anonymised data were collected via postal survey, which incorporated a minimally modified version of the 45-item Leeds Satisfaction Questionnaire (LSQ). RESULTS: One-hundred and sixteen surveys were returned, yielding a 36% response rate. Overall patients' satisfaction levels with nurse non-medical prescribing of systemic anti-cancer therapy were high across all six subscales of the modified LSQ corroborated by qualitative free-text comments. Eighty-five percent of participants indicated they were happy to continue being prescribed systemic anti-cancer therapy by the nurse non-medical prescribers. CONCLUSION: Overall patient satisfaction of Systemic Anti-Cancer Treatment prescribed by nurse Non-Medical Prescribers was positively rated; with high standards of compassionate, person-centred care reported, demonstrating an acceptable transformation in care delivery from a consultant-led model. Nonetheless, there was scope for improved health literacy to enhance patients' understanding and compliance with treatment.

Autonomia profissional do enfermeiro na atenção primária à saúde: perspectivas para a prática avançada / Professional autonomy of nurses in primary health care: perspectives for advanced practice / Autonomía profesional de los enfermeros en la atención primaria de salud: perspectivas para la práctica avanzada

Objetivo: Descrever como os enfermeiros atuantes na Atenção Primária identificam sua autonomia profissional no desenvolvimento das práticas de Enfermagem. Métodos: Trata-se de uma pesquisa exploratória, descritiva, de abordagem qualitativa. Participaram de entrevistas online 28 enfermeiros que atuam na Atenção Primária de um município do Sul do Brasil, entre o período de outubro de 2020 até fevereiro de 2021. Para tratamento dos dados, foi utilizada a análise de conteúdo temática. Resultados: Emergiram duas categorias: 1) Resolutividade das práticas da Enfermagem; 2) Respaldo nas regulamentações profissionais e evidências científicas. A Enfermagem dispõe de maior autonomia frente à atenção à saúde da mulher, Infecções Sexualmente Transmissíveis e no cuidado à pessoa com feridas, pois no momento da consulta do enfermeiro, despontam habilidades e competências para a tomada de decisão na prática clínica. Em relação à regulamentação para exercício profissional, os profissionais enfatizaram a importância dos protocolos para respaldar as ações. Conclusão: O protagonismo do enfermeiro e sucesso nas experiências indicam um caminho promissor para a discussão e implementação da Enfermagem de Prática Avançada no Brasil. (AU)

Objective: To describe how nurses working in Primary Care identify their professional autonomy in the development of Nursing practices. Methods: This is an exploratory, descriptive research with a qualitative approach. Twenty-eight nurses who work in Primary Care in a municipality in southern Brazil participated in online interviews, between October 2020 and February 2021. For data processing, thematic content analysis was used. Results: Two categories emerged: 1) Resolving nursing practices; 2) Support in professional regulations and scientific evidence. Nursing has greater autonomy in the care of women's health, Sexually Transmitted Infections and in the care of the person with wounds, because at the time of the nurse's consultation, skills and competences for decision-making in clinical practice emerge. Regarding regulation for professional practice, professionals emphasized the importance of protocols to support actions. Conclusion: The role of nurses and success in the experiences indicate a promising path for the discussion and implementation of Advanced Practice Nursing in Brazil. (AU)

Objetivo: Describir cómo los enfermeros que actúan en la Atención Primaria identifican su autonomía profesional en el desarrollo de las prácticas de Enfermería. Métodos: Se trata de una investigación exploratoria, descriptiva, con abordaje cualitativo. Veintiocho enfermeros que actúan en la Atención Primaria de un municipio del sur de Brasil participaron de entrevistas en línea, entre octubre de 2020 y febrero de 2021. Para el procesamiento de datos, se utilizó el análisis de contenido temático. Resultados: Emergieron dos categorías: 1) Prácticas resolutivas de enfermería; 2) Apoyo en normativa profesional y evidencia científica. La enfermería tiene mayor autonomía en el cuidado de la salud de la mujer, Infecciones de Transmisión Sexual y en el cuidado de la persona con heridas, porque en el momento de la consulta del enfermero emergen habilidades y competencias para la toma de decisiones en la práctica clínica. En cuanto a la regulación para la práctica profesional, los profesionales destacaron la importancia de los protocolos para apoyar las acciones. Conclusión: El papel de los enfermeros y el éxito de las experiencias indican un camino promisorio para la discusión e implementación de la Enfermería de Práctica Avanzada en Brasil. (AU)

Enfermagem de práticas avançadas no atendimento pré-hospitalar: desafios e estratégias de implementação / Advanced practice nursing in pre-hospital care: challenges and implementation strategies / Enfermería de práctica avanzada en la atención prehospitalaria: desafíos y estrategias de implementación

Objetivo: Mapear e analisar os potenciais desafios e estratégias na implementação da Enfermagem de Práticas Avançadas, no modelo de atendimento pré-hospitalar móvel brasileiro, a partir da experiência de outros países. Métodos: Revisão narrativa, a partir da análise da literatura sobre o tema, realizada em duas etapas: Revisão de documentos de entidades internacionais e busca de artigos nas bases nas bases Pubmed, LILACS, Scielo e no Google Scholar. Ao final, foi realizada a análise de cada desafio elencado e suas respectivas estratégias, quando aplicados ao modelo pré-hospitalar móvel brasileiro. Resultados: Os principais desafios analisados foram: compreensão do papel dos enfermeiros de práticas avançadas; a definição do escopo de práticas e das políticas de formação e qualificação; a regulamentação da atuação; a redução da resistência médica; os custos de implementação e a definição de mecanismos de remuneração. As estratégias de enfrentamento incluem: a sensibilização do público, definição do conjunto de prerrogativas e dos mecanismos de credenciamento e formação, associados a constituição de currículos potentes. Conclusão: Foram mapeados e analisados desafios e estratégias, que permitiram antecipar o cenário de aplicação da proposta da Enfermagem de Práticas Avançadas no modelo pré-hospitalar brasileiro, viabilizando proposição de ações fundamentais para a implementação e o sucesso da estratégia no país. (AU)

Objective: To map and analyze the potential challenges and strategies in the implementation of Advanced Practice Nursing in the Brazilian mobile pre-hospital care model, based on the experience of other countries. Methods: Narrative review, based on the literature on the subject, carried out in two stages: Review of documents from international organizations and search for articles in the databases Pubmed, LILACS, Scielo and Google Scholar. At the end, the analysis of each challenge listed and their respective strategies was carried out, when applied to the Brazilian mobile prehospital model. Results: The main challenges analyzed were: understanding the role of advanced practice nurses; definition of the scope of training and qualification practices and policies; the regulation of performance; the reduction of medical resistance; implementation costs and definition of remuneration mechanisms. Coping strategies include: raising public awareness, defining the set of prerogatives and mechanisms for accreditation and training, associated with building powerful curricula. Conclusion: Challenges and strategies were mapped and analyzed, which made it possible to anticipate the scenario of application of the Advanced Practice Nursing proposal in the brazilian prehospital model, enabling the proposition of fundamental actions for the implementation and success of the strategy in the country. (AU)

Objetivos: Objetivos: Mapear y analizar los potenciales desafíos y estrategias en la implementación de la Enfermería de Práctica Avanzada en el modelo de atención prehospitalaria móvil brasileña, a partir de la experiencia de otros países. Métodos: Revisión narrativa, basada en la literatura sobre el tema, realizada en dos etapas: Revisión de documentos de organismos internacionales y búsqueda de artículos en las bases de datos Pubmed, LILACS, Scielo y Google Scholar. Al final, se realizó el análisis de cada desafío listado y sus respectivas estrategias, cuando se aplicó al modelo prehospitalario móvil brasileño. Resultados: Los principales desafíos analizados fueron: comprender el papel de las enfermeras de práctica avanzada; definición del alcance de las prácticas y políticas de formación y cualificación; la regulación del desempeño; la reducción de la resistencia médica; costos de implementación y definición de mecanismos de retribución. Las estrategias de afrontamiento incluyen: sensibilizar al público, definir el conjunto de prerrogativas y mecanismos de acreditación y formación, asociados con la construcción de planes de estudio potentes. Conclusión: Se mapearon y analizaron desafíos y estrategias que permitieron anticipar el escenario de aplicación de la propuesta de Enfermería de Práctica Avanzada en el modelo prehospitalario brasileño, posibilitando la proposición de acciones fundamentales para la implementación y éxito de la estrategia en el país. (AU)

Advanced Practice Nursing and CAR-T Cell Therapy: Opportunities, Challenges and Future Directions.

OBJECTIVES: Chimeric antigen receptor (CAR)-T cell therapy is a new treatment for patients with myeloma and other B cell malignancies where advanced practice nurses (APN) can make a great contribution. The aim of this review is to identify key aspects of current literature relevant to APNs working with this population. METHODS: Discussion of selected peer-reviewed literature and best practice guidelines found through electronic database searches (CINAHL, MEDLINE). RESULTS: Although few APN roles in CAR-T cell therapy have been published to date, recent research suggests that the APN is central to the care of these patients. They are essential for continuity of care and navigation through the treatment process, providing an important and consistent point of contact for patients' and carers' anxieties and uncertainties. APNs play a central role in symptom management, as they constantly incorporate new experience and scientific findings into the refinement of existing protocols. The continuum of care extends far beyond the inpatient stay and addresses symptoms that may persist long after cytokine release syndrome and neurotoxicity have resolved. The APN may therefore make a relevant contribution to patients' health-related quality of life, given its likely correlation with the dynamics and intensity of treatment-related symptoms. The APN also takes on a leadership role in the treatment team. CONCLUSIONS: APNs use all core competencies to sustainably support and empower patients and caregivers. This is achieved through counseling and education, in addition to identifying, developing, and implementing evidence-based symptom management. They play pivotal roles in introducing new CAR-T cell products, educating teams, and advancing their role through APN networks. Finally, APNs are integral members of multiprofessional teams, supporting colleagues in ethically challenging patient situations. IMPLICATIONS FOR NURSING PRACTICE: APNs in the field of CAR-T cell therapy make an important contribution to the continuous care of patients, caregivers, and treatment teams.

Mapeamento das ações do enfermeiro de prática avançada em uma instituição de ensino superior / Mapping the actions of advanced practice nurses in a higher education institution

Mapear as ações do Enfermeiro de Prática Avançada nos campos de ensino clínico e estágio curricular supervisionado de um curso de graduação em enfermagem. Métodos: estudo transversal, descritivo, incluindo 21 enfermeiros. A coleta de dados deu-se por questionário sócio-profissiográfico, alinhado às competências do Conselho Internacional de Enfermeiros no tocante à Prática Avançada de Enfermagem. Resultados: Os enfermeiros demonstraram médio conhecimento em Prática Avançada de Enfermagem, e ações de prática avançada mapeadas como prescrição de agentes terapêuticos para lesões, procedimento de catéter central de inserção periférica, solicitação de exames de imagem e swab peri-anal, pareceres em lesão, manejo e consulta de enfermagem no pré-parto, assistência no parto. Competências no domínio do cuidado e no domínio da gestão/educação foram evidenciadas. Conclusão: evidenciou-se potenciais de ação de Prática Avançada na Instituição de Ensino.(AU)

To map the actions of Advanced Practice Nurses in the clinical teaching and supervised curricular internship fields of an undergraduate nursing course. Methods: A cross-sectional, descriptive study including 21 nurses. Data was collected using a socio-professional questionnaire, aligned with the International Council of Nurses' competencies regarding Advanced Nursing Practice. Results: The nurses demonstrated medium knowledge of Advanced Nursing Practice, and mapped advanced practice actions such as prescribing therapeutic agents for injuries, peripherally inserted central catheter procedures, requesting imaging tests and peri-anal swabs, injury opinions, management and nursing consultation in the prepartum period, and assistance in childbirth. Skills in the care domain and the management/education domain were highlighted. Conclusion: There was potential for action in Advanced Practice at the Teaching Institution.(AU)

Mapear las acciones de las Enfermeras de Práctica Avanzada en los campos de la enseñanza clínica y de las prácticas curriculares supervisadas de un curso de enfermería de pregrado. Métodos: Se trató de un estudio transversal, descriptivo, en el que participaron 21 enfermeras. Los datos fueron recogidos a través de un cuestionario socio-profesional, alineado con las competencias del Consejo Internacional de Enfermería en relación a la Práctica Avanzada de Enfermería. Resultados: Las enfermeras demostraron conocimiento medio de la Práctica Avanzada de Enfermería, y mapearon acciones de práctica avanzada como prescripción de agentes terapéuticos para lesiones, procedimientos de catéter central de inserción periférica, solicitud de pruebas de imagen e hisopos perianales, emisión de dictámenes sobre lesiones, manejo y consulta de enfermería en el período preparto, asistencia al parto. Se destacaron las competencias en el ámbito de los cuidados y en el de la gestión/educación. Conclusión: Hubo potencial de actuación en la Práctica Avanzada en la Institución de Enseñanza.(AU)

Partnership-based nursing practice framework for patients with advanced chronic obstructive pulmonary disease and their families-A discursive paper.

AIM: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a 'Dialogue' with the patients, which has four components: 'Establishing family involvement', 'Assisting living with symptoms' and 'Facilitating access to healthcare', with the primary goal being 'Enhancement of the health experience'. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. DESIGN: Discursive paper. METHODS: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. RESULTS: The nursing practice framework highlights capacities and possibilities that lie in the nurse-patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component 'Assisting living with the disease' was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: 'Assisting living with symptoms' and 'Facilitating access to healthcare'. The primary goal remains unchanged: enhancing the 'Health experience'. CONCLUSION: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. PATIENT OR PUBLIC CONTRIBUTION: There is no direct patient- or public contribution.

Education pathways for graduate entry registered nurses to transition to advanced practice roles: A realist review.

OBJECTIVE: Explore potential education and clinical pathways for nurses entering the profession through a Graduate Entry Nursing programme to transition to advanced practice roles. DESIGN: Realist review. REVIEW METHODS: A two stage process included 1) a systematic search of the following electronic databases EMCARE, MEDLINE, CINAHL, ERIC, and Scopus for published peer reviewed literature reporting academic pathways for graduates of graduate entry nursing programmes to progress to advanced nursing roles, and 2) consultation with key education programme stakeholders of graduate entry nursing programmes across Australasia, who undertook an inductive interpretive approach using realist logic to determine what works, for whom, and in what circumstances. RESULTS: Twelve published articles that explored advanced practice academic pathways for graduate entry nursing graduates were synthesised in terms of context, mechanisms, and outcomes. Data were then interpreted as to what works, for whom, in what context, and why, to develop new understandings of opportunities for advanced practice pathways for these students. No specific tailored academic pathway for graduate entry nursing graduates to progress to advanced practice was identified. Important relationships were identified between financial imperatives, political drivers, and registration requirements. CONCLUSIONS: Transformative strategies for new education pathways were identified as necessary to inspire innovation in nurturing graduate entry nurse graduates to progress to advanced practice roles. Effective collaboration and consultation within and across agencies and organisations are needed to both develop and implement accessible, expedient, and equitable programmes to enable this capable cohort to contribute to the health workforce.

[Academised nursing in direct patient care-but how?] / Akademisierte Pflege in der direkten Patienten/-innenversorgung ­ aber wie?

Demographic change and the resulting increase in chronic diseases, rapid developments in medicine and digitization, and the increasing shortage of skilled workers pose challenges for the German healthcare system. A rethink in patient care is required. This means that new structures, areas of action, and responsibilities must be implemented for professional nursing. The advancing academicization in nursing is leading to new role developments for professional nursing personnel in healthcare. Using the example of Klinikum Oldenburg (Oldenburg Hospital) as a maximum care provider in the region, many patients are treated in highly complex care situations that require a qualitative and evidence-based nursing practice. In order to ensure this, the concept of practice development according to McCormack, Manley, and Garbett has been implemented as a theoretical framework. Through direct evidence-based practice, complications can be reduced, which has a positive impact on mortality rate, length of stay, and readmission. Another positive factor is interprofessional collaboration and the skill-grade mix with diverse competencies. Taken together, these factors increase team satisfaction and lead to a positive outcome for patients. A prerequisite for implementing academically trained nursing professionals is good planning and preparation of the units and their stakeholders. Scientific support is also necessary to evaluate and potentially adapt the concept.