International consensus-based policy recommendations to advance universal palliative care access from the American Academy of Nursing Expert Panels.

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.

Evidencias científicas y conocimiento disciplinar de enfermería / Evidências científicas e conhecimento disciplinar de enfermagem / Scientific evidence and nursing disciplinary knowledge

Objective: identify and analyze the origins and nature of nursing knowledge and theconcept of evidence in the nursing context. Method: free bibliographic research, critical reflectionand reflexive synthesis construction. Results: identification of nursing as a discipline ofknowledge and practical human science that exists as a function of an action, whose knowledgeoriginates in procedural sources, such as; research, tradition and experience. And yet, mentaloperations, such as; intuition, imagination, reflection and heuristics. Sources that feed the privateand public knowledge of nursing, synthesized in knowledge patterns, specific and diversifiedspecific knowledge. Conclusion: nursing knowledge is structured through specific processes inhermeneutical spiral and concrete operations, based on reflection, synthesize knowledge,originating in procedural sources, and in mental operations. Knowledge that benefits from theprocesses of translation, distinct concept and much beyond the schematic notion, application inthe practice of theories or scientific evidence. Explained within the scope of the epistemology ofpractice. Nursing as a disciplinary and scientific knowledge needs to determine the concept ofscientific evidence, accompanying the discussion about the limits and possibilities of science andits conjugation with other forms of knowledge, in a true ecology of knowledge.

Objetivo: identificar y analizar los orígenes y la naturaleza del conocimiento enenfermería y el concepto de evidencia en el contexto de enfermería.Método: investigación bibliográfica, reflexión crítica y construcción de síntesis reflexiva.Resultados: identificación de la enfermería como disciplina del conocimiento y ciencia humanapráctica que existe en función de una acción, cuyos conocimientos tienen su origen en fuentesprocesales; investigación, tradición y experiencia. Y, además, operaciones mentales; intuición,imaginación, reflexión y heurísticas. Fuentes que alimentan el conocimiento privado y público,sintetizado en patrones de conocimiento, saberes propios diversificados y específicos.Conclusión: el conocimiento en enfermería se estructura a través de procesos específicos enespiral hermenéutica y operaciones concretas, con base en la reflexión, sintetizan saberes, conorigen en fuentes procesales, y en operaciones mentales. Benefician de los procesos de traslación,concepto distinto de la noción esquemática, de aplicación en la práctica de teorías o de evidenciascientíficas. Explicado en el ámbito de la epistemología de la práctica. La enfermería comoconocimiento disciplinario y científico necesita apurar, el concepto de evidencia científica,acompañando la discusión acerca de los límites y posibilidades de la ciencia y de su conjugacióncon otras formas de saber, en una verdadera ecología de saberes.

Objetivo: identificar e analisar as origens e a natureza do conhecimento em enfermageme o conceito de evidência no contexto de enfermagem. Método: pesquisa bibliográfica livre,reflexão crítica e construção de síntese reflexiva. Resultados: identificação da enfermagem comodisciplina do conhecimento e ciência humana prática que existe em função de uma ação, cujosconhecimentos tem origem em fontes processuais, tais como; investigação, tradição e experiência.E ainda, operações mentais, como sejam; intuição, imaginação, reflexão e heurísticas. Fontes quealimentam o conhecimento privado e público de enfermagem, sintetizado em padrões deconhecimento, saberes próprios diversificados e específicos.Conclusão: o conhecimento em enfermagem estrutura-se através de processos específicos emespiral hermenêutica e operações concretas, com base na reflexão, sintetizam saberes, com origemem fontes processuais, e em operações mentais. Saberes que beneficiam dos processos detranslação, conceito distinto e muito para além da noção esquemática, de aplicação na prática deteorias ou de evidências científicas. Explicado no âmbito da epistemologia da prática. Aenfermagem como conhecimento disciplinar e científico necessita de apurar, o conceito deevidência científica, acompanhando a discussão acerca dos limites e possibilidades da ciência eda sua conjugação com outras formas de saber, numa verdadeira ecologia de saberes.

The ICN Global Nursing Leadership Institute: Integrating the SDGs into Leadership and Policy Development.

This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article discusses the International Council of Nurses Global Nursing Leadership Institute and its integration of the SDGs into a global leadership and policy development program.

Current status and future directions of U.S. genomic nursing health care policy.

BACKGROUND: As genomic science moves beyond government-academic collaborations into routine healthcare operations, nursing's holistic philosophy and evidence-based practice approach positions nurses as leaders to advance genomics and precision health care in routine patient care. PURPOSE: To examine the status of and identify gaps for U.S. genomic nursing health care policy and precision health clinical practice implementation. METHODS: We conducted a scoping review and policy priorities analysis to clarify key genomic policy concepts and definitions, and to examine trends and utilization of health care quality benchmarking used in precision health. FINDINGS: Genomic nursing health care policy is an emerging area. Educating and training the nursing workforce to achieve full dissemination and integration of precision health into clinical practice remains an ongoing challenge. Use of health care quality measurement principles and federal benchmarking performance evaluation criteria for precision health implementation are not developed. DISCUSSION: Nine recommendations were formed with calls to action across nursing practice workforce and education, nursing research, and health care policy arenas. CONCLUSIONS: To advance genomic nursing health care policy, it is imperative to develop genomic performance measurement tools for clinicians, purchasers, regulators and policymakers and to adequately prepare the nursing workforce.

Cómo elaborar una Guía PRAXIS de Buena Práctica para ser publicada / How to prepare a PRAXIS Guideline of good practice to be published

OBJETIVO: Diseñar un formato estandarizado de la guía PRAXIS de buena práctica que facilite su publicación como artículo en una revista científica. METODOLOGÍA: A partir de una guía piloto elaborada con fines académicos, se utilizó una técnica Delphi mediante cuestionario para consensuar con expertos los componentes que deberían reflejarse en el formato de artículo y la adecuación de sus contenidos. RESULTADOS: Se obtuvieron doce elementos básicos agrupados en tres bloques: partes preliminares, cuerpo del artículo y partes finales. Se propone un tamaño de 5.500 palabras, con mayor dedicación a los contenidos aplicados a la práctica. UTILIDAD ESPERADA: La tecnología de síntesis de conocimiento propuesta en el modelo PRAXIS es sencilla y asumible desde la práctica clínica, empoderando así a los profesionales. La singularidad y ejemplaridad de los casos garantiza la creación de conocimiento y hará posible la realización de metasíntesis cualitativas sobre problemas complejos de salud en entornos de cuidado compartido

AIM: To design a standardized format of the PRAXIS good practice guideline that facilitates its publication as a article in a scientific journal. METHODOLOGY: Based on a pilot guide prepared for academic purposes, Delphi technique was used in conjunction with a questionnaire to support experts' agreement of the components that should be included in the article format and of the adequacy of its contents. RESULTS: Twelve basics elements were obtained and grouped into three blocks: preliminary part, body of the article and final part. The extension of 5,500 words is proposed, with greater dedication on the practical contents. EXPECTED UTILITY: Knowledge synthesis technology achieved by the PRAXIS model is simple and acceptable for clinical practice, empowering health professionals. The uniqueness and illustrative nature of the cases guarantees the generation of knowledge and will make it possible to carry out qualitative meta-synthesis on complex health problems in shared-care settings

Enfermería y práctica basada en la evidencia / No disponible

No disponible

The barriers to evidence-based nursing implementation in mainland China: A qualitative content analysis.

It has been widely recognized that healthcare practices should be based on up-to-date high-quality evidence; however, the implementation of evidence has been a slow process in nursing practice. It is crucial for clinical practitioners to be aware of the barriers to implementing evidence-based nursing. The aim of this study was to describe participants' experiences and thoughts on barriers to implementing evidence-based nursing in mainland China. Forty-five participants came from 45 evidence-based nursing implementation projects carried out in 16 hospitals in mainland China. Data were collected through observation and semi-structured interviews, after which qualitative content analysis was undertaken. Then, the five themes and subthemes were extracted from the data. The five themes were evidence-based, nurse-related, patient-related, setting barriers, and lack of support. In this study, a variety of barriers influencing evidence implementation in the Chinese nursing context were identified and further explored from the perspective of clarifying misunderstandings about evidence-based nursing, the profound influence of Chinese culture on patients' preferences and attitudes, and the lack of professional knowledge of nurses.

Conforto ao adulto em fim de vida hospitalizado / Comfort to the adult at the end of life hospitalized

Introduction: This review article arises from the need to make a broader contribution to the issue of comfort in the practice of nursing care for the adult and elderly person at the end of life during hospitalization. Objective: To systematize the scientific evidence about comfort care of the adult and elderly person at the end of life hospitalized. Methodology: Integrative literature review using the MeSH descriptors of each EBSCOhost database (CINAHL Plus With Full Text, MEDLINE with Full text and Scientific Electronic Library Online - SciELO. Results: The sample consisted of 15 articles whose findings were analyzed and synthesized. Conclusions: Comfort is a preponderant factor for the well-being of the adult and elderly person who is hospitalized, especially in the context of end-of-life. It is noted that there is great fragility on the part of health teams, especially nurses, in dealing with end-of-life situations still strongly mobilized by feelings of sadness, grief and impotence due to the impending death process, which may condition care of comfort that are provided by the teams to these patients. On the other hand, the reduced number of studies with these characteristics, as well as the need to understand comfort in hospitalization, encourages the development of new investigations

No disponible

Knowledge translation: A concept analysis.

AIM: The aim of this article is to clarify the concept of knowledge translation (KT) to close the gap that exists between research knowledge and actionable nursing practice. BACKGROUND: KT addresses the research to practice gap that exists in healthcare. KT is often confused with other terms and needs to be defined further as a concept for clarification and application in nursing practice. DESIGN: Concept analysis using the Walker and Avant method. DATA SOURCES: Databases searched were OVID, CINAHL, ProQuest, Mendeley, Western Libraries, and Google Scholar. Keywords used were "knowledge translation", "knowledge", "translation", "evidence-based practice", "research dissemination". Abstracts were reviewed for relevance, and 27 articles available in full-text and in English from 2000 to 2018 were retained. Online dictionaries included Merriam-Webster. The ancestry method was also used to retrieve relevant articles. RESULTS: KT is one of many terms used to describe the concept of moving research to actionable practice in healthcare. Six attributes of KT were identified: collaboration, action, receptivity, process, translation, and improved healthcare outcomes. CONCLUSIONS: Nurses are responsible to provide the best care to their patients, and effectively using KT in nursing practice can ensure better outcomes for patients.

Implementation of a MEWS-Sepsis screening tool: Transformational outcomes of a nurse-led evidence-based practice project.

BACKGROUND: One in three patients who die in the hospital has sepsis. Alerting clinicians to early detection of high-risk patients before deterioration is a top health care priority. Modified Early Warning Scoring (MEWS) tools have assisted organizations in identifying at-risk patients at the first sign of subtle deterioration. AIM AND SETTING: In conjunction with an academic-clinical partner, we evaluated, revised and implemented a modified MEWS-Sepsis screening tool in an acute care facility. PARTICIPANTS: One hundred and thirty-nine direct-care nurses participated in tool evaluation. METHODS: Using a plan-do-study-act cycle of quality improvement, critical care scenarios from septic patient data were created and tested in a simulated setting. RESULTS: Upon implementation of the MEWS-Sepsis tool, the monthly risk-adjusted sepsis mortality rate immediately declined by 24%. The decline in mortality has been sustained from implementation to the present, spanning a 5-year period. CONCLUSIONS: The implementation of a MEWS-Sepsis screening tool contributed to early identification and implementation of time-sensitive interventions aimed at preventing sepsis-associated deaths. MEWS-Sepsis tools hold potential for scale-up and spreading out of evidence-based practice nursing innovations to transform care, improve patient outcomes, and save lives.

Implementing Evidence-Based Care for Women Who Have Experienced Human Trafficking.

Human trafficking is a significant women's health issue in the United States. Clinicians who provide care to women are often unaware of the signs and symptoms of human trafficking and are unprepared to provide appropriate care. Nurses represent one of the few agents of change who women may encounter while they are in captivity; this places nurses at the forefront of their care. To provide safe and effective care, nurses can use the ABCD treatment model, which stands for assessment, buy-in, case management, and diversion programming. Any gaps between recognition of women's health care needs and the provision of appropriate care must be closed. Integrating evidence-based human trafficking education and skill building into nursing curricula, standard nursing orientation, and continuing education is an essential step to help nurses transform care and advocate on behalf of those who have been trafficked.

Cuidados de Enfermería en el tratamiento con hipotermia en la encefalopatía hipóxico-isquémica del recién nacido / Nursing care in hypothermia treatment for newborns with hypoxic-ischemic encephalopathy

Objetivo: analizar la evidencia científica disponible sobre el tratamiento con hipotermia y los cuidados de Enfermería en la encefalopatía hipóxico-isquémica del recién nacido. Método: revisión narrativa de la literatura. Se realizó una búsqueda bibliográfica en diferentes bases de datos, plataformas, bibliotecas y repositorios, que incluían entre otras PubMed, Cochrane, Lilacs, Enfispo, Cuiden, Scielo, etc. Se usaron los términos combinados "hipoxia- isquemia encefálica", "hipotermia inducida", "recién nacido" y "atención de Enfermería". La búsqueda se limitó a artículos científicos de neonatología y pediatría, publicados entre 2006 y 2017, en castellano o inglés. Resultados: se identificaron 29 estudios que hacían referencia al tratamiento con hipotermia en la encefalopatía hipóxico-isquémica (EHI) del recién nacido, así como de los cuidados de Enfermería. Diversos estudios han demostrado que la hipotermia aplicada antes de las seis horas de vida y mantenida durante 72 horas, reduce la mortalidad y lesiones cerebrales. Existe controversia en su aplicación en la encefalopatía hipóxico-isquémica severa o moderada, pero en las dos se obtienen resultados favorables. No hay ninguna terapia que combinada con la hipotermia mejore su eficacia. El éxito de este tratamiento requiere del esfuerzo de un equipo multidisciplinar. La profesión enfermera tiene un papel fundamental en su aplicación y ha de incluir también la atención a los padres durante todo el proceso. Conclusiones: la evidencia disponible apoya que la hipotermia inducida reduce la mortalidad y las secuelas neurológicas en recién nacidos afectados. Queda pendiente un mayor control a lo largo de los años de estos neonatos. Son necesarias otras estrategias que combinadas con la hipotermia inducida reduzcan el impacto de la encefalopatía hipóxico-isquémica

Objective: to analyze the scientific evidence available about hypothermia treatment and Nursing care for newborns with hypoxic-ischemic encephalopathy. Method: a narrative review of literature. A bibliographic search was conducted in different databases, platforms, libraries and repositories, including PubMed, Cochrane, Lilacs, Enfispo, Cuiden, Scielo, etc. The following combined terms were used: "hipoxia- isquemia encefálica" (hypoxic-ischemic encephalopathy), "hipotermia inducida" (induced hypothermia), "recién nacido" (newborn) and "atención de Enfermería" (Nursing care). The search was limited to scientific articles on Neonatology and Paediatrics published between 2006 and 2017, in Spanish and English. Results: twenty-nine (29) studies were identified regarding hypothermia treatment for newborns with hypoxic-ischemic encephalopathy (HIE) as well as Nursing care. Different studies have demonstrated that applying hypothermia before the first 6 hours of life, and maintaining it for 72 hours, will reduce mortality and brain damage. There is some controversy regarding its application in severe or moderate hypoxic-ischemic encephalopathy, but favourable results are obtained in both. No therapy will improve the efficacy of hypothermia when used in combination. The success of this treatment requires the effort of a multidisciplinary team. Nurses as professionals will play an essential role in its application, with must also include care for parents during the entire process. Conclusions: the evidence available supports that induced hypothermia will reduce mortality and neurological consequences in newborns. Further follow-up over the years should be conducted in these newborns. Other strategies are required, to be used in combination with induced hypothermia, for a reduction in the impact of hypoxic-ischemic encephalopathy