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1.
J Nurs Adm ; 50(3): 120-121, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32068620

RESUMO

Innovations in patient care, nursing, and the practice environment are the hallmark of Magnet organizations. Establishing new ways of achieving high-quality care is the result of transformational leadership, empowering structures and processes, and exemplary professional practice in nursing. From coast to coast, clinical nurses take advantage of these opportunities to change care for the better, improve the patient experience, and drive the science of nursing forward. American Nurses Credentialing Center's National Magnet Nurse of the Year Awards recognize and reward this work. Five outstanding clinical nurses are honored, 1 in each of the Magnet Model components: transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovations, and improvements; and empirical outcomes. This month's Magnet Perspectives column spotlights the 2019 award winners and their achievements and examines how Magnet environments support and encourage their success.


Assuntos
Distinções e Prêmios , Liderança , Serviço Hospitalar de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital/normas , Padrões de Prática em Enfermagem/normas , Qualidade da Assistência à Saúde/normas , Humanos , Cultura Organizacional , Estados Unidos
2.
J Nurs Adm ; 50(1): 52-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31804408

RESUMO

OBJECTIVE: To describe the impact of the implementation of interprofessional shared governance and a caring professional practice model (Relationship-Based Care [RBC]) on the staff's self-report of caring, work engagement, and workplace empowerment over a 4-year time frame. BACKGROUND: Shared or interprofessional governance has moved mainstream within healthcare settings, particularly within agencies seeking to sustain high reliability in the offering of quality patient care services and/or interest in meeting Magnet standards or embarking upon the Pathway to Excellence. Nurse leaders report that organizations having implemented shared governance thrive, citing professional governance as key to workplace engagement and empowerment, particularly related to quality care initiatives. Transition to interprofessional shared governance structures typically takes 2 to 3 years. It is unknown whether related outcome variables are sustainable over time. METHODS: Utilizing Watson's theory of human caring and appreciative inquiry as underlying frameworks, a longitudinal, quantitative study design was employed. Interprofessional focus groups and introductory sessions were offered to inform and engage all personnel within the medical center. Motivated units were identified, professional shared governance council members elected, and unit-specific education provided. Quality improvement initiatives were facilitated within unit councils, and formal leadership programs to enhance project guidance and to support staff empowerment skills for the managers of the units that were up-and-running were provided. Preimplementation and postimplementation measurements of staff's caring, workplace engagement and work empowerment were assessed, compared, and trended across units over time. RESULTS: Only work empowerment scores among staff working within RBC units were sustainable and increased progressively and significantly over time. Work engagement levels initially rose and then stabilized over time. Caring levels remained stable despite the implementation of a caring professional practice model. Statistically significant correlations were noted between work engagement and empowerment, followed by the relationship between work engagement and caring, followed by the relationship between empowerment and caring. CONCLUSIONS: The sustainability of work empowerment is likely related to the periodic provision of education for leaders regarding leading within an empowered work environment. A stronger focus on staff caring, particularly within quality improvement initiatives, with leadership guidance, will be paramount moving forward.


Assuntos
Empatia , Padrões de Prática em Enfermagem/normas , Governança Compartilhada de Enfermagem , Local de Trabalho , Humanos , Melhoria de Qualidade , Inquéritos e Questionários , Estados Unidos
3.
J Nurs Adm ; 50(1): 22-27, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31809453

RESUMO

This article describes a practice improvement initiative (PII) demonstrating the impact of doctorate of nursing practice (DNP) skills beyond direct patient care. The Donna Wright Competency Assessment Model, AACN DNP Essentials, and National Organization of Nurse Practitioner Faculties nurse practitioner competencies framed the PII. The DNP graduates planned, implemented, and evaluated an assessment of 1,055 staff nurses on shift hand-off, physical assessment, and hand hygiene. Results indicated that 95% of the staff nurses scored 100% on competency assessment. The PII model was adopted for future competency evaluation.


Assuntos
Benchmarking , Modelos de Enfermagem , Profissionais de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Padrões de Prática em Enfermagem/normas , Humanos , Estados Unidos
4.
Support Care Cancer ; 28(1): 201-210, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30997595

RESUMO

INTRODUCTION: Fear of cancer recurrence (FCR) in people with breast cancer affects treatment recovery, quality of life, service utilisation and relationships. Our aim was to investigate how specialist breast cancer nurses (SBCN) respond to their patients' fears of cancer recurrence and analyse SBCN's views about embedding a new psychological intervention, the Mini-AFTERc, into their consultations. METHOD: A mixed methods sequential design was used, informed by normalisation process theory. Phase 1: UK SBCNs were emailed a web-based survey to investigate how breast cancer survivors' FCR is currently identified and managed, and their willingness to utilise the Mini-AFTERc. Phase 2: a purposive sample of respondents (n = 20) were interviewed to augment phase 1 responses, and explore views on the importance of addressing FCR, interest in the Mini-AFTERc intervention, its content, skills required and challenges to delivering the intervention. RESULTS: Ninety nurses responded to the survey. When SBCN's were asked to identify the proportion of patients experiencing FCR in their caseload, there was no consensus on the size of the problem or unmet need. They estimated that 20-100% people experience moderate FCR and 10-70% severe FCR. The interviews identified that clinical conversations are focused primarily on giving information about signs and symptoms of recurrence rather than addressing the psychological aspects of fear. CONCLUSION: Findings indicate wide variability in how FCR was identified, assessed and supported by a sample of UK SBCNs. The introduction of a structured intervention into practice was viewed favourably and has implications for nursing and health professional ways of working in all cancer services.


Assuntos
Neoplasias da Mama/enfermagem , Medo , Recidiva Local de Neoplasia/psicologia , Enfermeiras e Enfermeiros/psicologia , Percepção , Transtornos Fóbicos/enfermagem , Adulto , Idoso , Atitude do Pessoal de Saúde , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Medo/psicologia , Feminino , Implementação de Plano de Saúde/normas , Humanos , Oncologia/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/enfermagem , Recidiva Local de Neoplasia/prevenção & controle , Transtornos Fóbicos/etiologia , Padrões de Prática em Enfermagem/normas , Qualidade de Vida , Especialidades de Enfermagem , Inquéritos e Questionários
5.
Enferm. clín. (Ed. impr.) ; 29(5): 271-279, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184151

RESUMO

Objetivo: Conocer las opiniones de los tutores y de los estudiantes del Grado en Enfermería sobre las prácticas clínicas e identificar estrategias y propuestas de mejora para el desempeño de la labor docente. Método: Estudio cualitativo con perspectiva fenomenológica mediante grupos focales con enfermeros tutores de prácticas clínicas y estudiantes de Enfermería. Los participantes se segmentaron en 3 grupos: estudiantes, tutores del área médica y tutores del área quirúrgica. El número de grupos lo determinó la saturación de la información. Se transcribieron los discursos y se realizó un análisis manual sintáctico y semántico de los discursos para extraer las variables de análisis. Se obtuvieron los permisos del Comité de Ética de la Investigación Provincial y del centro correspondiente. Resultados: Tanto los tutores como los estudiantes destacan la necesidad de capacitar a los tutores en las habilidades formativas y proporcionarles herramientas que faciliten su labor, así como el reconocimiento formal de su función docente. En sus discursos, ambos colectivos proponen un cambio de visión y, sobre todo, de actitudes en el desarrollo de la enseñanza-aprendizaje. Y, por último, se manifiesta la necesidad de un cambio en el modelo de relaciones entre la Universidad y los servicios sanitarios. Conclusiones: Con base en lo anteriormente expuesto, se identifica la necesidad de incentivar y formar a los profesionales clínicos para la función tutorial y de plantear un cambio de modelo que propicie un acercamiento entre la Universidad y el sistema sanitario


Objective: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. Method: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. Results: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. Conclusions: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together


Assuntos
Humanos , Estágio Clínico/organização & administração , Padrões de Prática em Enfermagem/organização & administração , Padrões de Prática em Enfermagem/normas , Melhoria de Qualidade , Mentores , Análise Qualitativa , Estudantes de Enfermagem/estatística & dados numéricos , Educação em Enfermagem/organização & administração
6.
J Infus Nurs ; 42(5): 228-236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31464830

RESUMO

Nursing practice and institutional policies regarding short peripheral catheter (SPC) flushing vary. These variations result in a lack of understanding about the factors that influence nurses' SPC flushing practices and leave their effect on outcomes unexplored-information that could potentially enhance nurses' clinical education, institutional policy efforts, and patient care. Using a mixed-methods design, this study examined SPC flushing practices and outcomes among a cohort of medical-surgical nurses and explored their rationale for flushing. Trends were noted in the timing of flushes, and the factors that influenced nurses' SPC flushing practices included patient acuity, experience, and workload.


Assuntos
Cateterismo Periférico/enfermagem , Educação em Enfermagem , Assistência ao Paciente/normas , Padrões de Prática em Enfermagem/normas , Competência Clínica/normas , Grupos Focais , Humanos , Enfermagem Médico-Cirúrgica , Gravidade do Paciente , Inquéritos e Questionários , Fatores de Tempo
7.
J Clin Nurs ; 28(21-22): 4053-4061, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31287603

RESUMO

AIMS AND OBJECTIVES: To evaluate the opinion of hospital nurses on a group of recommendations aimed at reducing low-value nursing care and, based on these results, to detect low-value practices probably existing in the hospital. BACKGROUND: Low-value nursing care refers to clinical practices with poor or no benefit for patients that may be harmful and a waste of resources. Detecting these practices and understanding nurses' perceptions are essential to developing effective interventions to reduce them. METHODS: We conducted a survey in a tertiary hospital. STROBE guidelines were followed. The questionnaire appraised nurses' agreement, subjective adherence and perception of usefulness of a group of recommendations to reduce low-value nursing care from Choosing Wisely and other initiatives. Practices described in recommendations with an agreement over 70% and a subjective adherence under 70% were categorised as low-value practices probably existing in the hospital. RESULTS: A total of 265 nurses from eight areas of care participated in the survey. The response rate by area ranged between 2%-55%. From the 38 recommendations evaluated, agreement was 96% (95% confidence interval [95%CI], 95%-97%), median subjective adherence was 80% (95%CI, 80%-85%), and usefulness was 90% (95%CI, 89%-92%). Based on these results, we detected seven (0-15) low-value practices probably existing in our hospital, mostly on general practice, pregnancy care and wound care. CONCLUSIONS: We found a great understanding of low-value care between nurses, given the high agreement to recommendations and perception of usefulness. However, several low-value practices may be present in nursing care, requiring actions to reduce them, for instance, reviewing institutional protocols and involving patients in de-implementation. RELEVANCE TO CLINICAL PRACTICE: Hospitals and other settings should be aware of low-value practices and take actions to identify and reduce them. A survey may be a simple and helpful way to start this process.


Assuntos
Recursos Humanos de Enfermagem no Hospital/normas , Estudos Transversais , Assistência à Saúde/normas , Humanos , Processo de Enfermagem/normas , Padrões de Prática em Enfermagem/normas , Inquéritos e Questionários
8.
Midwifery ; 77: 144-154, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31330402

RESUMO

OBJECTIVES: To compare neonatal and maternal outcomes, and the relative risk of interventions between mothers attended to by midwives, general practitioners, and obstetricians, and to assess the cost-effectiveness of the employee-model of midwifery-led care in Nova Scotia, Canada, when compared with general practitioners. DESIGN, SETTING, AND PARTICIPANTS: The study was a retrospective cohort study involving routinely collected clinical and administrative data from all low-risk births from January 1st, 2013 to December 31st, 2017. There were 24,662 observations. MEASUREMENTS: Descriptive statistics were used to summarise the mother's socio-demographic characteristics. We used a nearest-neighbour matching estimator in assessing differences in outcomes, and generalized linear models in the estimation of the risks of interventions, adjusting for potential confounders. An analytic decision tree served as the vehicle for the cost-effectiveness analysis, assessed using the net monetary benefit approach. All health care resources utilized were measured and valued. Neonatal intensive care admissions avoided was the measure of outcome. We performed probabilistic sensitivity and subgroup analyses. FINDINGS: Mothers attended to by midwives spent less time at the hospital during birth admissions, were less likely to have interventions, instrumental births, and more likely to have exclusive breastfeeding at discharge from birth admission. There were no differences in Apgar scores and neonatal intensive care unit admissions. The employee-model of midwifery-led care was found to be cost-effective. KEY CONCLUSIONS: The midwifery program is both effective and cost-effective for low-risk pregnancies IMPLICATIONS FOR PRACTICE: Increasing the number of midwives will increase access and represents value for money.


Assuntos
Análise Custo-Benefício/normas , Tocologia/métodos , Padrões de Prática em Enfermagem/normas , Qualidade da Assistência à Saúde/normas , Adulto , Estudos de Coortes , Análise Custo-Benefício/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Tocologia/organização & administração , Tocologia/estatística & dados numéricos , Nova Escócia , Padrões de Prática em Enfermagem/organização & administração , Padrões de Prática em Enfermagem/estatística & dados numéricos , Gravidez , Qualidade da Assistência à Saúde/estatística & dados numéricos , Estudos Retrospectivos
9.
Rev Lat Am Enfermagem ; 27: e3132, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340339

RESUMO

OBJECTIVE: this paper aims to describe the first phase of a project whose general goal was to develop a consensus-based set of advanced practice nurse competencies applicable to Latin American countries and, based on these competencies, produce an advanced practice nurse curricular prototype adapted to Latin American countries. The project was framed in a competency-based approach to advanced practice nursing education. The specific aims of the first phase of the project described in this paper were: 1) to identify a set of potential advanced practice nurse competencies that would serve as the template for Core Advanced Practice Nurse Competencies in Latin American countries and 2) to establish consensus for Core Advanced Practice Nurse Competencies in Latin American countries. METHOD: advanced practice nurse competencies were derived from a comprehensive review of published competencies and informed the development of a survey designed to assess the relevance of advanced practice nurse competencies in Latin American countries. The survey was distributed to nurse leaders and nurse educators. Data were analyzed using descriptive statistics. RESULTS: consensus for Core Competencies was established. CONCLUSION: the Core Advanced Practice Nurse Competencies presented can provide a structured framework to build educational programs aligned to the needs of the regional environment.


Assuntos
Prática Avançada de Enfermagem/normas , Competência Clínica/normas , Acesso aos Serviços de Saúde , Prática Avançada de Enfermagem/educação , Educação em Enfermagem/métodos , Humanos , América Latina , Padrões de Prática em Enfermagem/normas , Inquéritos e Questionários
10.
Int Nurs Rev ; 66(2): 151-153, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31124133

RESUMO

Integration of advanced practice nurses into the healthcare workforce is an increasing trend worldwide. An important step forward for supporting this trend was the development of a definition of advanced practice nursing by the International Council of Nurses in 2002, for the presence of such nurses internationally has increased significantly. Although initially beneficial, the generic nature of the definition has contributed to disagreement and confusion regarding the role. In response to this critique and to facilitate improved role clarity for advanced practice nurses, the International Council of Nurses is reviewing and revising its original position. The intent is to provide a clearer understanding of the components of the specialty to key stakeholders, the public and other healthcare professionals. This article describes the process for updating and clarifying the International Council of Nurses' description of advanced practice nursing, specifically the clinical nurse specialist and nurse practitioner. Key elements for best practice, policy and a professional standard are identified to facilitate role development and implementation.


Assuntos
Prática Avançada de Enfermagem/normas , Enfermagem Baseada em Evidências/normas , Papel do Profissional de Enfermagem , Padrões de Prática em Enfermagem/normas , Humanos , Conselho Internacional de Enfermagem/organização & administração
11.
Ann Pharm Fr ; 77(4): 313-323, 2019 Jul.
Artigo em Francês | MEDLINE | ID: mdl-31027755

RESUMO

OBJECTIVES: Evaluate the compliance of practices of nursing professionals related to the preparation and administration of drugs in 2018. Discuss the evolution of compliance practices from 2014 to 2018. METHODS: Prospective transversal observational study. Based on an observation grid with 55 compliance criteria, we conducted direct observation of medication doses prepared and administered by nursing professionals. For each compliance criterion, the auditor could indicate whether the practice was compliant, non-compliant or not applicable. A convenience target of 250 observations has been set. RESULTS: A total of 252 doses of drugs were observed between March 1, 2018 and April 29, 2018. Drug doses were observed by day (52 %), evening (30 %) or night (18 %) mainly nurses (80 %) working on regular shifts (94 %). Just over half of the doses required preparation by a nurse (58 %) and almost half of the doses were administered parenterally (48 %). In 2018, the observed compliance rate of the drug circuit ranged from 25.0 % to 86.3 %. CONCLUSION: This descriptive study shows a compliance rate of practices of nursing professionals related to the preparation and administration of drugs, which varies from 25.0 % to 86.3 % by observed stage of the drug circuit. 2018. The study identified 15 action actions for continuous improvement.


Assuntos
Composição de Medicamentos/normas , Enfermeiras e Enfermeiros/normas , Preparações Farmacêuticas/administração & dosagem , Padrões de Prática em Enfermagem/normas , Adulto , Criança , Estudos Transversais , Fidelidade a Diretrizes , Humanos , Infusões Parenterais , Estudos Longitudinais , Auditoria Médica , Erros de Medicação , Estudos Prospectivos , Quebeque , Fatores de Tempo
12.
Rev Bras Enferm ; 72(2): 577-581, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017224

RESUMO

OBJECTIVE: To discuss the contribution of nursing theories in the conceptual expansion of good practices in the area for the construction of the unified health system (Sistema Único de Saúde - SUS). METHOD: Theoretical production of reflection, based on the neomodern framework of philosophy of science. RESULTS: The knowledge and political, social and epistemological commitments of nursing are discussed, highlighting the relationship of the theories with good practices for the construction and application of knowledge in the area in the context of the Brazilian health care system. Reflection on how middle-range theories can help in solving dichotomies between discipline, theory, practice, producers and consumers of knowledge is made. CONCLUSION: Original reflections on the contributions of disciplinary and professional knowledge of nursing theories to the creation of SUS are presented, defending a creation through the academy-service partnership, in which the theories start being incorporated into a new concept of nursing practices aligned to neomodern principles of science.


Assuntos
Teoria de Enfermagem , Padrões de Prática em Enfermagem/normas , Humanos , Guias de Prática Clínica como Assunto/normas , Padrões de Prática em Enfermagem/tendências
14.
Br J Nurs ; 28(5): 315-316, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30907657

RESUMO

Emeritus Professor Alan Glasper, University of Southampton, discusses a new initiative for additional training for health professionals in England. An open consultation is inviting nurses and others to comment on the proposals.


Assuntos
Transtorno Autístico , Capacitação em Serviço , Padrões de Prática em Enfermagem/normas , Pessoas com Deficiência , Humanos , Melhoria de Qualidade , Medicina Estatal , Reino Unido
15.
J Trauma Nurs ; 26(2): 99-103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845009

RESUMO

Grand Strand Medical Center is a 325-bed, Level I adult, Level II pediatric trauma center located in Myrtle Beach, SC. In September 2015, a Trauma Nurse Lead (TNL) program was developed and implemented to allow for consistent, expert clinical nursing care across the trauma continuum. This TNL program has led to measurable improvements in patient care and quality metrics. These improvements include decreases in hospital and intensive care unit length of stay, arrival to administration of massive transfusion and anticoagulation reversal, and arrival to final disposition time. The TNL program has ensured the presence of highly trained trauma nurses at all times within the hospital. With the consistent availability of these highly trained and specialized nurses, trauma patients are cared for more efficiently and in a timely manner.


Assuntos
Papel do Profissional de Enfermagem , Equipe de Assistência ao Paciente/normas , Padrões de Prática em Enfermagem/normas , Ferimentos e Lesões/enfermagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva/normas , Masculino , Pessoa de Meia-Idade , South Carolina , Centros de Traumatologia/normas , Adulto Jovem
16.
Int Nurs Rev ; 66(3): 404-415, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30768709

RESUMO

AIM: To investigate whether the CanMEDS-based International Federation of Nurse Anesthetists' Standards could adequately define the scope of practice and reliably be used to train and evaluate Swiss nurse anesthetists (NAs). BACKGROUND: Although nurse anesthetists represent a majority of the global workforce in anesthesia, policies that define the scope of practice are frequently non-existent. In low- and middle-income countries, the lack of anesthesia providers with adequate training is a major challenge. INTRODUCTION: Despite stringent training requirements, the scope of practice of Swiss nurse anesthetists is actually not defined. Therefore, we surveyed and assessed whether nurse anesthetists felt that the professional competencies outlined in this framework were aligned with their clinical practice. METHODS: A cross-sectional survey investigated Swiss nurse anesthetists' relevance ratings of 76 competencies of the International Federation of Nurse Anesthetists according to their professional practice. Cronbach's alpha coefficients were used to determine the internal consistency of the competencies, as well as factor analyses to assess construct validity of these competencies integrated into the CanMEDS roles model. RESULTS: Participants rated the Standards overall as very relevant with high reliability. Factor analyses provided evidence of construct validity of these. DISCUSSION: The International Federation of Nurse Anesthetists' Standards of Practice provide a highly relevant framework and a valuable set of competencies for the scope of practice of Swiss nurse anesthetists, which enabled translation from global guides to local national standards. CONCLUSION AND IMPLICATION FOR NURSING AND HEALTH POLICY: Adopted by low- and middle-income countries or countries where national standards are non-existent, this survey could introduce national and local policies at minimally acceptable standards of care for nurse anesthetists worldwide. The above standards have the potential to align education, outcomes and assessment of nurse anesthetists with the needs of national healthcare systems.


Assuntos
Enfermeiras Anestesistas/educação , Enfermeiras Anestesistas/normas , Padrões de Prática em Enfermagem/normas , Competência Profissional/normas , Estudos Transversais , Currículo/normas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Garantia da Qualidade dos Cuidados de Saúde , Sociedades de Enfermagem/normas , Suíça
17.
J Nurs Manag ; 27(5): 992-1004, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30776163

RESUMO

AIMS: To provide an overview of the practice patterns of advanced practice nurses and to explore their perceptions of their role in Singapore. BACKGROUND: Role expansion of advanced practice nurses is increasingly popular in healthcare systems. However, their practice patterns remain variable, thereby introducing role ambiguity. Uncertainty revolves around how advanced practice nurses perceive their practice, competency and readiness for role expansion. METHODS: A nationwide survey of advanced practice nurses was conducted in Singapore. Statistical analyses of closed-ended responses and content analysis of open-ended responses were undertaken. RESULTS: A total of 87 participants were surveyed (42.8% response rate). Significant discrepancies existed between current practices and their expectations. Readiness for and acceptance of role expansion were discerned but multiple barriers to practice have remained. CONCLUSION: This pioneering study in Asia provides important evidence to support the call for greater clarity in the role of APNs and for review of existing institutional practice restrictions. It provides insights into healthcare systems in similar developmental stages of advanced practice nursing. IMPLICATIONS FOR NURSING MANAGEMENT: When outlining the goals and role priorities of advanced practice nurses APNs, nurse administrators can consider their best contributions in practice. This allows for long-term sustainability of their role.


Assuntos
Prática Avançada de Enfermagem/métodos , Papel do Profissional de Enfermagem/psicologia , Padrões de Prática em Enfermagem/normas , Adulto , Prática Avançada de Enfermagem/normas , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática em Enfermagem/tendências , Singapura , Inquéritos e Questionários
18.
Comput Inform Nurs ; 37(3): 161-170, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30762611

RESUMO

The use of nursing big data sets for value-based measurement is novel. Nursing value measurement depends on the availability of essential data attributes in the electronic health record related to nursing care delivered (what happened, when, and the result seen). Key in measuring value is a standardized structure and format of these attributes for enabling uniform consistent analysis, along with data sets that are sharable and comparable across individuals and groups, time, organization, and practice focus. The foundation of such sharable and comparable data sets would represent at a minimum individual essential nurse care actions and the resulting patient outcome(s). While nurses generate an extraordinary amount of health-related data, healthcare information systems are not designed to collect structured data that reflect the unique attributes of nursing care or support nursing analytic activities that would measure value. More important, the multidimensional features of the nursing process are difficult to untangle and differentiate from other healthcare workers and nonnursing care activities. The complexity of nursing knowledge work has limited the development of nursing data science methods like value measurement and discouraged value versus cost discussions. This article sets out to describe nursing value measurement and an approach that nurse scientists are maximizing through methods adapted from agile project management, including user stories, and business analysis processes to recognize nurses as primary contributors to patient outcomes and value generation. Nursing Value User Story methods deconstruct complex nursing scenarios into user stories that capture nursing actions as standardized data that can be mapped to a common nursing data model. Methods described here are being used in pilot research at Los Angeles Children's Hospital, and results will be available in 2019.


Assuntos
Benchmarking , Registros Eletrônicos de Saúde , Modelos de Enfermagem , Padrões de Prática em Enfermagem/normas , Humanos , Padrões de Prática em Enfermagem/estatística & dados numéricos
19.
Rev Neurol (Paris) ; 175(3): 189-193, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30683450

RESUMO

Epilepsy, often considered as a stigmatizing disease, affects 65 million people worldwide and is frequently associated with comorbidities that increase both direct and indirect costs. The degree of impact on quality of life and the cost of care differs depending on the social and health care organizations in place, political, medico-economic and/or socio-cultural contexts. Across the globe, healthcare is provided by nurses in primary care, urgent or emergency care, and within specialized domains of practice. In Epilepsy the global care could be enhanced by developing standardized nursing education in close collaboration with other caregivers. The impact of epilepsy nursing care has been documented in some developed countries, but the diversity of nursing practices and professional education of nurses raise difficulties in generalizing these findings. Specialized education in epilepsy will improve access, treatment and ultimately the quality of life of patients.


Assuntos
Educação em Enfermagem/normas , Epilepsia/enfermagem , Neurocirurgia/enfermagem , Enfermeiras Especialistas , Papel do Profissional de Enfermagem , Padrões de Prática em Enfermagem/normas , Educação em Enfermagem/estatística & dados numéricos , Epilepsia/epidemiologia , Geografia , Humanos , Neurocirurgia/educação , Neurocirurgia/estatística & dados numéricos , Enfermeiras Especialistas/educação , Enfermeiras Especialistas/normas , Enfermeiras Especialistas/estatística & dados numéricos , Padrões de Prática em Enfermagem/estatística & dados numéricos
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