Examining liminality in professional practice, relational identities, and career prospects in resource-constrained health systems: Findings from an empirical study of medical and nurse interns in Kenya.

We examine new doctors' and nurses' experiences of transitioning from training to practising as health professionals, drawing on the concept of liminality. Liminality is a stage of 'in-betweenness', involving uncertainty and ambiguity as people leave one social context and reintegrate into a new one. Surprisingly little research has explored new health professionals' experiences of liminality during role and career transitions, particularly in precarious and resource-constrained settings. Drawing on 146 qualitative interviews and seven focus groups, involving 121 new graduate medical doctors and nurses transitioning through internship training in Kenya, we describe three aspects of liminality. First, liminal professional practice, where interns realise that best practices learned during medical and nursing schools are often impossible to implement in resource constrained health care settings; instead they learn workarounds and practical norms. Second, liminal relational identities, where interns leave behind being students and adopt the identities and responsibilities of qualified professionals within pre-existing professional hierarchies of status and expertise. We explain how these new doctors and graduate nurses negotiate their liminal status, including in relation to more experienced but less qualified professional colleagues. We also discuss how interns cope with liminality due to disappointing and inadequate supervision and role modelling from senior colleagues but then find peer support and their place within their own professions. Finally, we discuss how new doctors and nurses come to terms with the precarity of working in resource constrained health systems, abandon expectations of secure, permanent employment and careers, and accept the realities of liminal professional careers. We explain how all three forms of liminality influence professionals' developing practices, identities, and careers. We call for further studies with a specific liminality lens to explore this critical period in health workers' careers, to inform policy and practice responding to global transformations in healthcare professions and practice.

Review of the Australian nurse teacher professional practice standards: An e-Delphi study.

AIM: The aim of the study was to review the 2010 Australian nurse teacher professional practice standards ('the Standards') to see if they were still relevant to current nursing educator practice in any practice setting, such as academia or clinical settings. BACKGROUND: It has been over 10 years since 'the Standards have been reviewed. Nurse education practice has met many challenges in the past decade, so it is timely to evaluate whether the Standards are still relevant to nursing educators today. DESIGN: A modified Delphi technique was used for this study. METHODS: Delphi surveys were used to obtain consensus on the relevance of the Standards' statements to any nursing educator. Links to two electronic surveys were sent to an expert panel of nursing educator leaders. Also, two online focus groups of nursing educators from any practice setting or level of experience were held. Results from the first survey and focus groups led to word changes and additional statements, which were included in the second Delphi survey. RESULTS: Forty participants responded to the first survey and 38 to the second. Fifteen nursing educators attended the focus groups. There was ≥85 % agreement on all statements in the first survey. with similar high agreement responses in the second survey. Changes in the Standards included language used around culture, inclusion of 'sustainability of the program' and 'demonstrates knowledge and expertise in teaching and educational practice'. CONCLUSIONS: The Australian nurse teacher professional practice standards remain highly relevant to nursing educators across all practice settings. In response to feedback from nursing educators some changes to language and additional standard statements were included in the revised standards.

Nurses' perceptions about management practices of nurse managers during pandemics: a descriptive and cross-sectional study

INTRODUCTION: Hospitals may not be able to manage the chaotic environment during pandemics through classical management principles. Management can only be achieved with the help of effective leadership, appropriate flow of crisis management systems, teamwork, and collaboration. Nurse managers should have effective management skills. OBJECTIVE: To evaluate the perception of the nurse managers' practices by nurses such as resource management, organization, communication, psychosocial, care-training, and decision-making practices in the management of the pandemic based on the COVID-19 pandemic. METHODS: A quantitative, cross-sectional method was used, and a web-based online questionnaire was applied to collect data. This study included 182 nurses working in a public and private hospital in Istanbul. RESULTS: The nurses perceived the management practices of their managers at a moderate level. The leaders' resource management practices as low (16.5%), and medium (78.6%) perceive. There was a statistically significant difference (p<0.01) between the communication and team relations (p<0.05), resource management (p<0.01), care-training (p<0.05), and decision-making scores (p<0.01) of the nurses working in the private hospitals compared to those working in the public hospital. CONCLUSION: To effectively manage a complex and chaotic environment, nurse managers should trust their team, have speed and adaptation skills, be based on human factor principles, and provide a safe working environment. Education should be emphasized so that nurses can work in specialized areas and nurse managers can improve their management skills.

Teaching Evidence-Based Practice Competencies to Meet Professional Practice Needs.

BACKGROUND: Evidence-based practice (EBP) is a major concept threaded throughout nursing education, yet competencies are not clearly identified in The Essentials. PURPOSE: Nurse leaders'EBP competency expectations for professional practice were explored to inform competency-based education for students and practicing nurses. A secondary aim explored potential effects of misinformation on EBP. METHODS: Descriptive qualitative inquiry was performed with a focus group of 6 clinical nurse leaders. RESULTS: EBP expectations were identified, discriminating between novice entry level and advanced-level nurses. Participants emphasized asking questions, linking evidence to practice, and acknowledging that evidence changes over time. All advanced-level nurses were expected to apply, lead, and teach EBP. Post pandemic, nurses need to reclaim evidence-based practices, critically appraise evidence, and educate patients and families to address misinformation. CONCLUSIONS: Information learned will inform competency-based EBP education for students and nurses in academic and clinical settings.

Survey of occupational hygiene professional practice in Spanish-speaking countries.

Professional credentialing schemes based on experience and examination are used to clarify the scope and required competencies associated with the practice of a profession. National occupational hygiene (OH) credentials developed in 17 nations have been recognized by the International Occupational Hygiene Association (IOHA) to meet or exceed the requirements of a model certification program. To date, there is no credentialing or certification scheme for occupational hygienists in Spanish-speaking regions. To fill this void, a new credentialing body has been created named the Iberoamerican Board of Occupational Hygiene (JIHO). As a first step to the development of a certification exam for a profession, it is necessary to determine the interest in an occupational hygiene certification exam in Spanish and to clarify the most common work practices for those practicing the profession. To determine the proper exam weightings for occupational hygiene competencies needed to practice in Spanish-speaking regions JIHO conducted a comprehensive survey of professional practice of occupational hygiene in nations where Spanish is spoken as the primary language. Surveys were sent to 456 practicing occupational hygienists in nine different countries on a variety of topics. Results indicated that 79% of respondents felt the need for an OH certification exam in Spanish was very or extremely important. The most frequent and important technical competencies utilized in practice were (1) awareness about the health effects of hazardous agents to make decisions about workplace activities and exposures, (2) application of the hierarchy of controls, control banding, hazard communication, training of employees and other methods to reduce worker exposure and workplace risks, and (3) application of principles to recognize and control biohazards in the workplace. The study results have been used to guide the weighting and importance of various technical topics and rubrics on the JIHO exam. Data from this study can be used in the development of certification examinations, to improve international coherence in the profession, and the development of educational programs in OH.

La integración de la inteligencia artificial en la educación médica y su impacto en la práctica clínica / The integration of artificial intelligence in medical education and its impact on clinical practice

Introducción: La integración de la inteligencia artificial (IA) en la educación médica redefine paradigmas, optimiza méto-dos y forja una simbiosis tecnológica. Desarrollo: La IA potencia simulaciones clínicas, mejora evaluaciones y desarrolla habilidades blandas, redefiniendo lainteracción médico-paciente. Conclusiones: Aunque persisten desafíos éticos, la colaboración interdisciplinaria y la adaptabilidad son cruciales. La IA marca un hito en la evolución médica al elevar la calidad asistencial y establecer estándares para una colaboración armoniosa entre tecnología y compasión.(AU)

Introduction: The incorporation of artificial intelligence (AI) into medical education redefines paradigms, optimisesmethods and forges a technological symbiosis. Development: AI enhances clinical simulations, improves assessments and develops soft skills, thereby redefining doctor-patient interaction. Conclusions: Although ethical challenges remain, interdisciplinary collaboration and adaptability are crucial. AI marks a milestone in the evolution of medicine by raising the quality of care and setting standards for harmonious collaboration between technology and compassion.(AU)

Tecnologias relacionais e atuação psicológica em HIV/Aids: contribuições da psicologia socioconstrucionista / Relational technologies and psychological action in HIV/AIDS: contributions from socioconstructionist psychology / Tecnologías relacionales y acción psicológica en VIH/SIDA: aportes desde la psicología socioconstruccionista

OBJETIVO: Discutir como se estabelece a indicação de tecnologias relacionais off-line e on-line como recurso de cuidado a Pessoas Vivendo com HIV/Aids (PVHA) por psicólogas/os atuantes em serviços especializados. MÉTODO: Trata-se de uma pesquisa de abordagem qualitativa e exploratória. Utilizamos a perspectiva da psicologia social construcionista, além das noções de tecnologias dura, leve-dura e leve e seu encontro com a perspectiva de tecnologias (materiais e não materiais) como mediadoras inventivas. Realizamos entrevistas semiestruturadas e submetemos os dados à análise categorial temática. RESULTADOS: Foram elaboradas duas categorias: tecnologias relacionais off-line e on-line. Tratam-se dos sentidos construídos em torno de estratégias para o cuidado de PVHA, que não são típicas da clínica psicológica clássica. CONCLUSÃO: Concluímos que o uso de tecnologias relacionais off-line e on-line no acompanhamento de PVHA sugere uma ampliação do repertório profissional das/dos psicólogas/os que trabalham em serviços especializados em HIV/Aids, porém, isso não demonstrou ocorrer de forma tão articulada no campo de atuação psicológica, em comparação às práticas psicológicas clássicas.

OBJECTIVE: To discuss how offline and online relational technologies are recommended as a care resource for People Living with HIV/Aids (PLWHA) by psychologists working in specialized services. METHOD: This is research with a qualitative and exploratory approach. We use the perspective of constructionist social psychology, in addition to the notions of hard, soft-hard and soft technologies and their encounter with the perspective of technologies (material and non-material) as inventive mediators. We carried out semi-structured interviews and submitted the data to thematic categorical analysis. RESULTS: Two categories were created: offline and online relational technologies. These are the meanings constructed around strategies for caring for PLWHA, which are not typical of classical psychological clinics. CONCLUSION: We conclude that the use of offline and online relational technologies in monitoring PLWHA suggests an expansion of the professional repertoire of psychologists working in specialized HIV/AIDS services, however, this has not been demonstrated to occur in a so articulated, in the field of psychological action, in comparison to classical psychological practices.

OBJETIVO: Discutir cómo las tecnologías relacionales offline y online son recomendadas como recurso de atención a las Personas que Viven con VIH/SIDA (PVVS) por parte de psicólogos que trabajan en servicios especializados. MÉTODO: Se trata de una investigación con un enfoque cualitativo y exploratorio. Utilizamos la perspectiva de la psicología social construccionista, además de las nociones de tecnologías duras, blandas-duras y blandas y su encuentro con la perspectiva de las tecnologías (materiales y no materiales) como mediadoras inventivas. Realizamos entrevistas semiestructuradas y sometimos los datos a análisis temático categórico. RESULTADOS: Se crearon dos categorías: tecnologías relacionales en línea y fuera de línea. Estos son los significados construidos en torno a estrategias de atención a las PVVS, que no son propias de las clínicas psicológicas clásicas. CONCLUSIÓN: Concluimos que el uso de tecnologías relacionales en línea y fuera de línea en el seguimiento de las PVVS sugiere una expansión del repertorio profesional de los psicólogos que trabajan en servicios especializados en VIH/SIDA, sin embargo, no se ha demostrado que esto ocurra de manera tan articulada en el campo de acción psicológica, en comparación con las prácticas psicológicas clásicas.

Still a long way to go on patient safety.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, looks at the findings of a parliamentary review into progress on safety proposals and encourages nurses to be part of the culture change.

Professional practices of dentists and unscheduled dental care in Nouvelle-Aquitaine (France) / Pratiques professionnelles et soins dentaires non programmés en Nouvelle-Aquitaine.

In a context of saturation of private dental practices and medical demography issues, responses to requests for emergency dental care are a poorly documented problem. In partnership with the Observatoire Regional de la Santé, the URPS Chirurgiens-Dentistes Nouvelle-Aquitaine, a union, conducted a survey of private dentists in May and June 2022. The objective was to estimate the volume of requests for unscheduled dental care and to describe the responses provided by professionals. More than eight out of ten professionals said they were often called upon for unscheduled care and more than four out of ten set aside specific time slots to provide it. More than a quarter of them said they provided care in 90 percent of cases, in response to requests of this type, and 40 percent provided care in at least half of the cases. For most professionals, the average waiting time for patients requesting unscheduled care was less than 24 hours. Respondents cited patient education as a general avenue for improvement, in addition to the creation of a specific pricing structure for unscheduled care. This survey provides a better understanding of the difficulties faced by professionals on a subject not yet investigated by the dental profession. It documents the acceptability of possible responses in terms of improving professional practices and institutional organizations.

Dans un contexte de saturation des cabinets dentaires libéraux et de démographie médicale tendue, l'apport de réponses aux demandes de soins dentaires non programmés constitue une réelle problématique assez peu documentée. En partenariat avec l'Observatoire régional de la santé, l'URPS Chirurgiens-dentistes Nouvelle-Aquitaine a mené en mai-juin 2022 une enquête auprès de chirurgiens-dentistes libéraux. L'objectif était d'estimer le volume des demandes de soins non programmés en soins dentaires et de décrire les réponses apportées par les professionnels. Plus de huit professionnels sur dix ont déclaré être souvent sollicités pour des soins non programmés, et plus de quatre sur dix prévoyaient des créneaux spécifiques pour les assurer. Plus d'un quart d'entre eux ont déclaré répondre à 90 % des sollicitations pour ce type de soins et 40 % répondre à moins de la moitié des demandes. Les soins non programmés étaient pris en charge dans les 24 heures en moyenne pour la majorité des professionnels. L'éducation des patients a été citée comme une piste d'amélioration générale ou institutionnelle, devant la création d'une cotation spécifique pour les soins non programmés. Cette enquête permet de mieux connaître les difficultés des professionnels sur un sujet non encore investigué auprès de la profession dentaire. Elle documente l'acceptabilité de pistes de réponses pouvant être apportées pour améliorer les pratiques professionnelles et les organisations institutionnelles.

Implementation of a COVID-19 Closed/Open POD Partnership: A Creative Professional Practice Exemplar for Occupational and Environmental Health Nurses.

BACKGROUND: For more than 15 years, the U.S. Centers for Disease Control and Prevention has recommended that all community agencies and workplace environments create structured communication and collaborative plans for emergency or disaster events (2008). This recommendation is aligned with the U.S. Department of Homeland Security's (2022) National Infrastructure Protection Plan. The Coronavirus Disease 2019 (COVID-19) pandemic ultimately demonstrated the importance of having organized plans and processes in place for the effective and rapid dispensing of medical countermeasures (MCMs) to the general populace. Occupational and environmental health nurses (OHNs) can utilize examples of successful MCM dispensing programs and adjust details to fit individual organizational needs. METHODS: This report examines a closed point of dispensing (Closed POD) mass vaccination program as a guide for designing successful workplace partnerships. FINDINGS: Closed PODs are public or private sites that have set up a memorandum of understanding (MOU) with local health authorities to dispense MCMs to their populations during a public health emergency. The desired outcome of a closed POD agreement is the facilitation of employee health and safety, as well as enabling workplace continuity of operations. CONCLUSIONS/APPLICATIONS TO PRACTICE: OHNs will play a pivotal role in any future disaster or emergency event. Because OHNs understand the critical need for anticipatory planning, they are in a prime position to drive the creation and implementation of a closed POD partnership between their workplace and their local health department.

[Assessment of professional practices on the use of computerized medicine cabinets by registered nurses]. / Évaluation des pratiques professionnelles sur l'utilisation des armoires informatisées de stockage des médicaments par les infirmiers diplômés d'état.

Ensuring the safety of patient medication management is a public health priority. In hospitals, the medication circuit involves risks, especially in terms of storage. As part of an institutional project, the deployment of computerized medicine cabinets in our hospital's care units was initiated in 2015. By 2022, almost all care departments were equipped. Each drug picking is carried out by the registered nurse according to the patient's name, in accordance with the administration plan. In addition, local recommendations are to collect medication for a maximum of 24hours. In this context, our objective was to assess nursing professional practices in order to identify the steps requiring action plans. To meet this objective, we i) studied the compliance of computerized drug samplings with prescriptions on a given day throughout the establishment, ii) assessed picking practices with an observational audit, and iii) proposed questionnaires, including practical cases and satisfaction questions. Over 300 prescriptions were analyzed, including 2,511 drugs requiring at least one collect on the day of the assessment. The compliance rate for picking in relation to the drugs prescribed was 44.7%. According to the audit observation, the picking compliance rate was 74.5%. Non-compliances were mainly linked to the selection of the wrong patient at the computerized medicine cabinet and/or to a picking for longer than the recommended duration. Finally, the rate of correct answers to the proposed cases was 61.9%, and nurses were generally satisfied or very satisfied with the equipment.

Do we know where we are heading?

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the issue of long-term workforce planning, focusing on England.

Autonomia do enfermeiro no exercício das práticas de enfermagem na atenção primária à saúde / Nurses autonomy in the exercise of nursing practices in primary health care / Autonomía de las enfermeras en el ejercicio de las prácticas de enfermería en la atención primaria de salud

Objetivo: Compreender a autonomia do enfermeiro quanto as suas responsabilidades normativas legais no exercício das práticas de enfermagem na Atenção Primária à Saúde (APS) do Pará. Métodos: Estudo observacional, de delineamento transversal qualitativo, realizado em três municípios do estado do Pará. A coleta de dados foi realizada de outubro de 2020 a janeiro de 2021. Os participantes foram os enfermeiros da Atenção Primária à Saúde. Foi realizada entrevista, com roteiro semiestruturado. Foi realizada análise temática dos conteúdos, com auxílio da ferramenta IRaMuTeq Resultados: Emergiram cinco categorias temáticas: 1) Autonomia do enfermeiro no contexto da prescrição de outro profissional na APS; 2) Autonomia para prescrição nos programas e exames na APS; 3) Áreas de identificação da autonomia profissional na APS; 4) As práticas preventivas na APS e suas dificuldades; e 5) Limites da prática profissional do enfermeiro na APS. Conclusão: Os enfermeiros da APS do Pará têm práticas de enfermagem individuais com diferentes tipos de autonomia, cujos cuidados colocam em prática com o respaldo dos protocolos e regulamentos técnicos. Contudo, há necessidade de ampliar e fortalecer parcerias com outros atores sociais municipais. (AU)

Objective: To understand the autonomy of nurses regarding their legal regulatory responsibilities in the exercise of nursing practices in Primary Health Care (PHC) in Pará. Methods: Observational study with qualitative cross-sectional design, conducted in three municipalities of the state of Pará. Data collection was carried out from October 2020 to January 2021. The participants were Primary Health Care nurses. Interviews were conducted, with a semi-structured script. A thematic analysis of the contents was performed, with the help of the IRaMuTeq tool. Results: Five thematic categories emerged: 1) Nurses' autonomy in the context of another professional's prescription in PHC; 2) Autonomy for prescription in programs and exams in PHC; 3) Areas of identification of professional autonomy in PHC; 4) Preventive practices in PHC and their difficulties; and 5) Limits of nurses' professional practice in PHC. Conclusion: PHC nurses in Pará have individual nursing practices with different types of autonomy, whose care they put into practice with the support of protocols and technical regulations. However, there is a need to expand and strengthen partnerships with other municipal social actors. (AU)

Objetivo: Comprender la autonomía de los enfermeros en cuanto a sus responsabilidades normativas legales en el ejercicio de las prácticas de enfermería en la Atención Básica a la Salud (APS) en Pará. Métodos: Estudio observacional, con diseño transversal cualitativo, realizado en tres municipios del estado de Pará. La recolección de datos se realizó de octubre de 2020 a enero de 2021. Los participantes fueron enfermeros de la Atención Primaria de Salud. Se realizó una entrevista, con un guión semiestructurado. Se realizó un análisis temático de dos contenidos, con la ayuda de la herramienta IRaMuTeq. Resultados: Emergieron cinco categorías temáticas: 1) Autonomía del enfermero en el contexto de la prescripción de otro profesional en la APS; 2) Autonomía para prescribir programas y exámenes en la APS; 3) Áreas de identificación de la autonomía profesional en APS; 4) Prácticas preventivas en APS y sus dificultades; y 5) Límites del ejercicio profesional de enfermería en la APS. Conclusión: Los enfermeros de la APS de Pará tienen prácticas de enfermería individuales con diferentes tipos de autonomía, cuyo cuidado está sustentado por dos protocolos y normas técnicas. Sin embargo, existe la necesidad de ampliar y fortalecer las alianzas con otros socios municipales. (AU)

Trabalho interdisciplinar e condições de trabalho de enfermeiros que atuam na atenção primária à saúde / Interdisciplinary work and working conditions of nurses working in primary health care / Trabajo interdisciplinario y condiciones de trabajo de los enfermeros que actúan en la atención primaria de salud

Objetivo: Discutir acerca do trabalho interdisciplinar na prática do enfermeiro na Atenção Primária à Saúde e as suas condições de trabalho. Métodos: Pesquisa descritiva, qualitativa, realizada com 45 profissionais Enfermeiros, que atuam na Atenção Primária à Saúde do estado da Paraíba, de dezembro de 2020 a abril de 2021. A coleta de dados foi guiada por um roteiro semiestruturado. Os dados foram interpretados com base na Análise de Conteúdo e discutidos a partir da literatura existente. Resultados: Evidenciou-se que, apesar de os enfermeiros conseguirem firmar parceria com os outros trabalhadores da unidade, usuários e gestão, e sentirem autonomia para realizar procedimentos, existem condições que dificultam suas práticas, como o pouco reconhecimento profissional, os problemas com a gestão, a falta de insumos e a sobrecarga de função. Conclusão: Os enfermeiros na Atenção Primária vêm buscando seu espaço e melhores condições de trabalho que facilitem suas práticas e favoreçam o cuidado ao usuário. Dessa forma, tais profissionais necessitam de visibilidade e reconhecimento social de suas competências técnicas. (AU)

Objective: Discuss about the interdisciplinary work in the practice of nurses in Primary Health Care and their working conditions. Methods: Descriptive, qualitative research, carried out with 45 professional nurses, who work in Primary Health Care in the state of Paraíba, from December 2020 to April 2021. Data collection was guided by a semi-structured script. Data were interpreted based on Content Analysis and discussed from the existing literature. Results: It was evidenced that, although the nurses manage to establish a partnership with the other workers of the unit, users and management, and feel autonomy to carry out procedures, there are conditions that hinder their practices, such as little professional recognition, problems with management, the lack of inputs and the function overload. Conclusion: Nurses in Primary Care have been seeking their space and better working conditions that facilitate their practices and favor user care. Thus, such professionals need visibility and social recognition of their technical skills. (AU)

Objetivo: Discutir sobre el trabajo interdisciplinario en la práctica de los enfermeros en la Atención Primaria de Salud y sus condiciones de trabajo. Métodos: Investigación descriptiva, cualitativa, realizada con 45 enfermeros profesionales, que actúan en la Atención Primaria de Salud en el estado de Paraíba, de diciembre de 2020 a abril de 2021. La recolección de datos fue guiada por un guión semiestructurado. Los datos fueron interpretados con base en el Análisis de Contenido y discutidos a partir de la literatura existente. Resultados: Se evidenció que, aunque los enfermeros logran establecer una sociedad con los demás trabajadores de la unidad, usuarios y gerencia, y sienten autonomía para realizar los procedimientos, existen condiciones que dificultan sus prácticas, como poco reconocimiento profesional, problemas con la gestión, la falta de insumos y la sobrecarga de funciones. Conclusión: Los enfermeros en Atención Básica vienen buscando su espacio y mejores condiciones de trabajo que faciliten sus prácticas y favorezcan la atención al usuario. Por lo tanto, estos profesionales necesitan visibilidad y reconocimiento social de sus habilidades técnicas. (AU)

Evaluación del conocimiento y manejo de la violencia basada en género desde la perspectiva de los ginecotocólogos y posgrados en la práctica clínica en Uruguay / Evaluation of knowledge and management of gender-based violence from the perspective of gynecologists and postgraduates in clinical practice in Uruguay / Avaliação do conhecimento e do gerenciamento da violência baseada em gênero sob a perspectiva de ginecologistas e pós-graduandos na prática clínica no Uruguai

Introducción: la violencia basada en género (VBG) es un grave problema de salud con cifras alarmantes. Las mujeres víctimas de VBG acuden a los centros de salud para ser atendidas por este y otros motivos, siendo en muchos casos el primer y único contacto de las mujeres con el sistema sanitario. El objetivo de este estudio es investigar acerca del nivel de formación, conocimientos, actuación y percepciones sobre la atención por parte de los ginecotocólogos y posgrados de Ginecotocología en casos de VBG en la práctica clínica diaria en nuestro medio. Método: se realizó un estudio descriptivo observacional de corte transversal de una muestra por conveniencia. Se encuestaron 143 profesionales, comprendiendo ginecotocólogos y posgrados de Ginecotocología en el período comprendido entre el 1 y el 30 de septiembre de 2019. Resultados: 9 de cada 10 de los profesionales refirieron no realizar o realizar pocas preguntas sobre VBG en la práctica clínica, y 80% no tiene claro sobre cuál es su rol en la detección de una víctima de VBG, siendo profesionales que asisten a un promedio de 20 a 60 mujeres semanalmente. Un tercio de los encuestados manifestaron tener menos de una hora de formación académica en VBG. Conclusión: existe escasa formación académica en esta temática. Se mostró que entender el papel del profesional en la detección de casos de VBG y la capacidad para responder apropiadamente están íntimamente relacionados con la capacidad de identificar la VBG en la práctica clínica diaria.

Introduction: Gender-based violence (GBV) is a serious health problem that accounts for alarming figures. Women victims of GBV come to health centers to be treated for this and other reasons, in many cases being this the first and only contact they have with the health system. The objective of this study is to find out the level of training, knowledge, actions, and perceptions regarding care by gynecologists and gynecology postgraduates in cases of gender-based violence seen during daily clinical practice in our setting. Method: A descriptive observational study was conducted, with a cross-sectional design and convenience sample. A total of 143 professionals were surveyed, including gynecologists and gynecology postgraduates, between September 1st and September 30th, 2019. Results: Nine out of ten professionals reported not asking or asking few questions about GBV in their clinical practice, and 80% were unclear about their role in detecting GBV victims, despite assisting an average of 20 to 60 women weekly. One-third of respondents reported having less than an hour of academic training in GBV. Conclusion: There is limited academic training in this area. The study showed that understanding the professionals' role in detecting GBV cases and their ability to respond appropriately to it are closely related to the ability to identify GBV in daily clinical practice.

Introdução: a violência baseada em gênero (VBG) é um grave problema de saúde com números alarmantes. As mulheres vítimas de VBG procuram os centros de saúde para tratamento por esse e outros motivos e, em muitos casos, esse é o primeiro e único contato que as mulheres têm com o sistema de saúde. O objetivo deste estudo é pesquisar o nível de formação, conhecimento, desempenho e percepções do atendimento por tocoginecologistas e pós-graduandos em Tocoginecologia nos casos de VBG na prática clínica diária. Métodos: foi realizado um estudo observacional descritivo de corte transversal com uma amostra de conveniência. Foram incluídos 143 profissionais, incluindo tocoginecologistas e pós-graduandos em Tocoginecologia no período entre 1º e 30 de setembro de 2019. Resultados: 9 em cada 10 profissionais relataram não fazer nenhuma ou poucas perguntas sobre a VBG na prática clínica, e 80% não tinham clareza sobre seu papel na identificação de uma vítima de VBG em sua prática, sendo profissionais que atendem uma média de 20 a 60 mulheres por semana. Um terço dos entrevistados relatou ter menos de uma hora de formação acadêmica em VBG. Conclusão: Há pouca formação acadêmica nessa área. A compreensão do papel do profissional na detecção de casos de VBG e a capacidade de responder adequadamente estão intimamente relacionadas à capacidade de identificar VBG na prática clínica diária.

Healthy work environment: A systematic review informing a nursing professional practice model in the US Military Health System.

AIM: The aim of the study was to develop recommendations for creating a healthy work environment based on current literature for nurses working within the US Military Health System (MHS). However, our findings would likely benefit other nursing populations and environments as well. DESIGN: Systematic literature review. DATA SOURCES: We conducted a systematic literature search for articles published between January 2010 until January 2024 from five databases: PubMed, Joanna Briggs, Embase, CINAHL and Scopus. METHODS: Articles were screened, selected and extracted using Covidence software. Article findings were synthesized to create recommendations for the development, implementation and measurement of healthy work environments. RESULTS: Ultimately, a total of 110 articles met the criteria for inclusion in this review. The articles informed 13 recommendations for creating a healthy work environment. The recommendations included ensuring teamwork, mentorship, job satisfaction, supportive leadership, nurse recognition and adequate staffing and resources. Additionally, we identified strategies for implementing and measuring these recommendations. CONCLUSIONS: This thorough systematic review created actionable recommendations for the creation of a healthy work environment. Based on available evidence, implementation of these recommendations could improve nursing work environments. IMPACT: This study identifies methods for implementing and measuring aspects of a healthy work environment. Nurse leaders or others can implement the recommendations provided here to develop healthy work environments in their hospitals, clinics or other facilities where nurses practice. REPORTING METHOD: PRISMA 2020 guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

AONN+ Navigation Metrics That Support the Oncology Navigation Standards of Professional Practice.

OBJECTIVES: To offer a comprehensive overview of the critical elements contributing to the achievements of oncology navigation, address challenges in standardized implementation, and examine recent advancements influencing the acknowledgment and reimbursement of navigation services. Lastly, the AONN+ 35 evidence-based navigation metrics will be shared, emphasizing the five core metrics that should be utilized by all navigation models in all settings. METHODS: Employed in this review involves synthesizing information from established oncology organizations, documenting the development of navigator professional standards of practice and navigation metrics that measure patient experience, clinical outcomes, and return on investment, and analyzing outcomes from national studies and collaborations to present a summary of advancements in oncology navigation. RESULTS: The key components vital for ensuring the enduring success of programs encompass the core competencies of navigators, adherence to standards of navigation practice set by the Professional Oncology Navigation Taskforce, and the establishment of well-defined metrics specific to oncology navigation. CONCLUSIONS: Despite these advancements, challenges persist in implementing and recognizing the newly defined standards and metrics. Effective solutions involve aligning navigation programs with leadership, integrating standards into daily practice, defining navigator roles, measuring navigation program outcomes through defined metrics, and leveraging certifications. Standardized measurement and practice are imperative for national policy development and reimbursement models, aligning with the Cancer Moonshot's goal of high-quality, patient-centered, and cost-effective cancer care. IMPLICATIONS FOR NURSING PRACTICE: To contribute to standardizing measurement and practice in oncology navigation for national policy development and reimbursement models.

Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice on telerehabilitation. The European PRM position (UEMS PRM Section).

INTRODUCTION: The evidence on the utility and effectiveness of rehabilitation interventions delivered via telerehabilitation is growing rapidly. Telerehabilitation is expected to have a key role in rehabilitation in the future. AIM: The aim of this evidence-based position paper (EBPP) is to improve PRM physicians' professional practice in telerehabilitation to be delivered to improve functioning and to reduce activity limitations and/or participation restrictions in individuals with a variety of disabling health conditions. METHODS: To produce recommendations for PRM physicians on telerehabilitation, a systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. RESULTS: The systematic literature review is reported together with the 32 recommendations resulting from the Delphi procedure. CONCLUSIONS: It is recommended that PRM physicians deliver rehabilitation services remotely, via digital means or using communication technologies to eligible individuals, whenever required and feasible in a variety of health conditions in favor of the patient and his/her family, based on evidence of effectiveness and in compliance with relevant regulations. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians in telerehabilitation.

The needs of newly qualified nurses.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the importance of providing the right support to nurses who are new to the register.