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1.
Esc. Anna Nery Rev. Enferm ; 26(spe): e20210234, 2022. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1342933

RESUMO

Objetivo: Descrever a experiência de planejamento, execução e avaliação de um serviço de suporte ético-emocional para profissionais de enfermagem frente à pandemia de COVID-19. Método: Relato de experiência no âmbito da Comissão de Suporte Ético-Emocional do Conselho Regional de Minas Gerais, Brasil, desenvolvido entre os meses de abril e dezembro de 2020 e operacionalizado através de ligações telefônicas e mensagens via aplicativo de comunicação. Resultados: Foram atendidos 241 profissionais. Foram revelados e declarados sentimentos, emoções, vivências e problemas oriundos do cotidiano de trabalho da enfermagem diante do contexto pandêmico. Tais problemas reforçam a eminência, a urgência e o valor que o suporte teve para a vida, trabalho e saúde dos profissionais atendidos, configurando-se como uma estratégia de saúde e de intervenção indispensável à promoção, prevenção, segurança e proteção da saúde mental frente à pandemia. Os atendimentos culminaram na redução de sentimentos negativos; na percepção aumentada (identificação de potenciais ameaças e contextos de "gatilhos"); na valorização pessoal; no autoconhecimento e autocuidado. Considerações finais e implicações para a prática: O suporte fez-se inovador para área da saúde e da enfermagem ao constituir-se como uma estratégia multidisciplinar promotora, aconselhadora e facilitadora do cuidado em tempos de COVID-19. Encoraja-se a manutenção desta estratégia após a pandemia


Objective: To describe the experience of planning, implementing and evaluating an ethical-emotional support service for Nursing professionals facing the COVID-19 pandemic. Method: An experience report in the scope of the Ethical-Emotional Support Commission of the Regional Council of Minas Gerais, Brazil, developed between April and December 2020 and operationalized through phone calls and messages via a communication application. Results: A total of 241 professionals were assisted. Feelings, emotions, experiences and problems arising from the daily Nursing work in the pandemic context were revealed and stated. Such problems reinforce the prominence, urgency and value that the support service had for the life, work and health of the professionals assisted, configuring itself as a health and intervention strategy, indispensable for mental health promotion, prevention, safety and protection in the face of the pandemic. The consultations culminated in the reduction of negative feelings; in increased perception (identification of potential threats and "trigger" contexts); in personal appreciation; and in self-knowledge and self-care. Final considerations and implications for the practice: The support service was innovative for the Health and Nursing areas by constituting a multidisciplinary strategy that promotes, counsels, and facilitates care in times of COVID-19. We encourage the maintenance of this strategy after the pandemic


Objetivo: Describir la experiencia de planificación, implementación y evaluación de un servicio de soporte ético-emocional para los profesionales de enfermería ante la pandemia de COVID-19. Método: Relato de experiencia en el ámbito de la Comisión de Soporte Ético-Emocional del Consejo Regional de Minas Gerais, Brasil, desarrollado entre los meses de abril y diciembre de 2020 y operacionalizado a través de enlaces telefónicos y mensajes vía la aplicación de comunicación. Resultados: Se atendió a 241 profesionales. Se revelaron y declararon los sentimientos, las emociones, las experiencias y los problemas derivados del trabajo diario de las enfermeras ante el contexto de la pandemia. Estos problemas refuerzan la eminencia, la urgencia y el valor que el soporte tiene para la vida, el trabajo y la salud de los profesionales atendidos, configurándose como una estrategia de salud y de intervención indispensable para la promoción, prevención, seguridad y protección de la salud mental frente a la pandemia. Las consultas culminaron en la reducción de los sentimientos negativos; en el aumento de la percepción (identificación de posibles amenazas y contextos "desencadenantes"); en la valoración personal; en el autoconocimiento y el autocuidado. Consideraciones finales e implicaciones para la práctica: El soporte fue innovador en el ámbito de la salud y la enfermería como estrategia multidisciplinaria para promover, asesorar y facilitar la asistencia en tiempos de COVID-19. Se fomenta el mantenimiento de esta estrategia después de la pandemia


Assuntos
Humanos , Masculino , Feminino , Consulta Remota , Ética em Enfermagem , Telessaúde Mental , COVID-19/psicologia , Profissionais de Enfermagem/psicologia , Esgotamento Profissional , Saúde do Trabalhador , Carga de Trabalho
2.
J Nurs Care Qual ; 37(1): 6-13, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34483310

RESUMO

BACKGROUND: The American Geriatrics Society regularly updates the Beers Criteria for Potentially Inappropriate Medication (PIM) to improve prescribing safety. PURPOSE: This study assessed the impact of nurse practitioner (NP) practices on PIM prescribing across states in the United States and compared the change in PIM prescribing rates between 2016 and 2018. METHODS: We used data from a random selection of 20% of Medicare beneficiaries (66 years or older) from 2015 to 2018 to perform multilevel logistic regression. A PIM prescription was classified as initial or refill on the basis of medication history 1 year before a visit. PIM use after an outpatient visit was the primary study outcome. RESULTS: We included 9 000 224 visits in 2016 and 9 310 261 in 2018. The PIM prescription rate was lower in states with full NP practice and lower among NPs than among physicians; these rates for both physicians and NPs decreased from 2016 to 2018. CONCLUSIONS: Changes could be due to individual state practices.


Assuntos
Profissionais de Enfermagem , Médicos , Idoso , Humanos , Prescrição Inadequada , Medicare , Lista de Medicamentos Potencialmente Inapropriados , Estados Unidos
4.
J Prof Nurs ; 37(5): 962-970, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34742529

RESUMO

BACKGROUND: In the past decade, numerous nurse residency models have been created and implemented nationwide; however, validated specialty-specific competency standards have not been established to evaluate Nurse Practitioner (NP) resident core competencies. PURPOSE: To report the specialty-specific competency assessment tool devised to assess Department of Veterans Affairs (VA) NP residents' competencies and discuss the VA NP residency program's effectiveness in expanding new graduate NP knowledge and skills in the veteran-centric care setting. METHODS: The VA Nursing Academic Partnership NP residency faculty established and piloted a web-based Nurse Practitioner Resident Competency Assessment (NPRCA) instrument for the comprehensive, specialty-specific assessment of individual NP resident's skill competencies across 24 areas. RESULTS: The VA specialty-specific competency assessment instrument demonstrates strong internal consistency. The robust VA NP residency program enhances new graduate NP competencies. CONCLUSIONS: The VA NP residency model can further the goal of standardizing clinical competencies in NP residency programs.


Assuntos
Internato e Residência , Profissionais de Enfermagem , Veteranos , Competência Clínica , Humanos
5.
Trials ; 22(1): 785, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749784

RESUMO

BACKGROUND: Canada has one of the highest rates of multiple sclerosis (MS) in the world. Treatments and supports for people with MS (PwMS) have become increasingly complex, requiring individualized and adaptive care. Specialized NPs provide advanced skills to those with complex medical conditions, with potential to enhance the health, functioning, and quality of life for PwMS. This study aims to determine the effect of a Nurse Practitioner (NP) on depression and anxiety levels in PwMS. METHODS: We will perform a parallel randomized controlled trial. PwMS who are followed by general private-practice neurologists will be randomly assigned to the intervention group (NP-led care) or the 'usual care' control group (general neurologist or family physician and registered nurse support). In the intervention group, the NP will assess and provide care to the MS patient and their caregiver at a baseline visit, with 3-month and 6-month follow-up visits. PwMS in the control group will receive usual care provided by their community neurologists or family physicians with the standard assistance provided by registered nurses experienced in MS care. The primary outcome will be the difference in change in the patient's anxiety and depression scores as measured by the validated Hospital Anxiety and Depression Scale (HADS) questionnaire at 3 months. Secondary outcomes will include difference in change in HADS at 6 months; Modified Fatigue Impact Scale scores (MSIF) at 3 and 6 months; EQ-5D scores at 3 and 6 months; caregiver health-related quality of life in MS measures (CAREQOL-MS) at 3 and 6 months; number of visits and phone calls to healthcare professionals recorded by patient, and satisfaction with NP-led care vs usual care measured by the validated Consultant Satisfaction Questionnaire. DISCUSSION: Findings from this study will contribute to exploring benefits of advanced nursing practitioner interventions for PwMS followed by general neurologists and family physicians in a community setting. It will provide evidence of the benefits of NP-led care for PwMS and offer an alternative healthcare resource for management of MS. TRIAL REGISTRATION: ClinicalTrials.gov Pro00069595 . Retrospectively registered on June 26, 2020. Protocol version: January 2017, version 1.


Assuntos
Esclerose Múltipla , Profissionais de Enfermagem , Ansiedade/diagnóstico , Ansiedade/terapia , Depressão/diagnóstico , Depressão/terapia , Humanos , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/terapia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Home Healthc Now ; 39(6): 327-335, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34738968

RESUMO

Access to healthcare is challenging for both Veterans and the nation's general population. To keep up with national primary healthcare needs, the Department of Veteran Affairs (VA) implemented Home Based Primary Care (HBPC). After a structure remodel at a Texas VA medical center, 40% of nurse practitioners (NPs) left the HBPC department in one year. The Anticipated Turnover Scale and the Misener NP Job Satisfaction Scale were administered online (n = 7), and results were used to complete a program evaluation. Forty-three percent of participants indicated intent to leave, and 56% of answers indicated job dissatisfaction. Seven categories were identified to mitigate voluntary turnover: Recognition; Shared governance; Orientation; Full practice authority; Collaboration; Organizational workflow maps; and Mentoring. Implementation of recommendations resulting from this project may help retain NPs in both VA and non-VA organizations, reduce organizational costs, support optimal patient outcomes, and increase access to healthcare.


Assuntos
Serviços de Assistência Domiciliar , Profissionais de Enfermagem , Veteranos , Humanos , Atenção Primária à Saúde , Melhoria de Qualidade , Estados Unidos
8.
JAAPA ; 34(12): 35-41, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34772854

RESUMO

OBJECTIVES: Physician assistants (PAs) and NPs are essential to quality care delivery. The need to demonstrate value and optimize PA and NP roles in neurology subspecialty clinics is unmet. We outline the development of a PA- and NP-led neuro-oncology procedural clinic and provide metrics to support the institutional and clinician value added. METHODS: We designed a PA- and NP-led Geisinger Ommaya Clinic (GOC) to manage leptomeningeal carcinomatosis (LMC) with defined clinician roles and the GOC treatment protocol. A retrospective review of 135 patients (2012-2019) compared survival outcomes for patients treated on the protocol compared with those treated off the protocol. RESULTS: Centralized care in the GOCs minimized shared physician encounters and improved PA and NP autonomy and utility. LMC therapy as part of the GOC protocol improved care continuity and survival outcomes. CONCLUSIONS: PA- and NP-led procedural clinics optimize use of these clinicians and open physician availability for nonprocedural duties. This research highlights the institutional patient and financial benefit while demonstrating the operational and leadership growth potential for PAs and NPs.


Assuntos
Carcinomatose Meníngea , Profissionais de Enfermagem , Assistentes Médicos , Atenção à Saúde , Humanos , Carcinomatose Meníngea/tratamento farmacológico , Estudos Retrospectivos
9.
J Nurs Educ ; 60(11): 651-654, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34723744

RESUMO

BACKGROUND: This educational innovation describes the implementation of a telehealth supportive counseling center for psychiatric/mental health nurse practitioner (PMHNP) students at a small graduate school. The free, nurse-run, health care center was at risk due to the coronavirus disease 2019 (COVID-19) in-person care restrictions. METHOD: Due to COVID-19, PMHNP faculty and students pivoted to offer services via telehealth for the summer 2020 semester. Planning and implementation strategies regarding this pivot are presented. RESULTS: PMHNP students conducted a total of 82 visits, recording a 150% increase in clients served during the telehealth implementation. On average, students accrued between 39 and 73 supervised clinical hours. CONCLUSION: Given the COVID-19 pandemic, clinical placements as well as access to health care services were jeopardized. Through innovation and flexibility, PMHNP students were able to continue accruing supervised clinical hours, and an identified need in the community was continued to be met. [J Nurs Educ. 2021;60(11):651-654.].


Assuntos
COVID-19 , Profissionais de Enfermagem , Telemedicina , Aconselhamento , Humanos , Pandemias , SARS-CoV-2 , Estudantes
10.
J Nurses Prof Dev ; 37(6): 353-357, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723839

RESUMO

This article describes the development and psychometric testing of a 43-item nurse residency program stakeholder evaluation. The valid and reliable survey provides nursing professional development practitioners with insight into opportunities to improve nurse residency program design and educational content. Survey results may also substantiate human and capital resources required for effective programs.


Assuntos
Internato e Residência , Profissionais de Enfermagem , Humanos , Avaliação de Programas e Projetos de Saúde , Psicometria , Inquéritos e Questionários
11.
J Nurses Prof Dev ; 37(6): 365-367, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723843

RESUMO

The unexpected challenges of COVID-19 forced our nation to "rework" normal practices and routines. Kathy Chappell states that nurse professional development practitioners must be problem focused and solution oriented. Led by a nurse professional development specialist, planners employed innovation and creativity to address the problems found in one professional development program. This article assures readers that remote day-long conferences are well accepted and useful in today's fast-paced learning environment.


Assuntos
COVID-19 , Profissionais de Enfermagem , Criatividade , Humanos , Aprendizagem , SARS-CoV-2
12.
Br J Nurs ; 30(20): 1212, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34761983

RESUMO

Ediscyll Lorusso, Senior Thrombosis Specialist Nurse Practitioner, St George's University Hospitals NHS Foundation Trust, was awarded third place in the Nurse of the Year category in the BJN Awards 2021.


Assuntos
Distinções e Prêmios , Profissionais de Enfermagem , Tromboembolia , Feminino , Hospitais Universitários , Humanos , Gravidez , Gestantes , Tromboembolia/prevenção & controle
13.
Br J Nurs ; 30(21): 1232-1236, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34839692

RESUMO

Advanced clinical practitioner (ACP) roles require a broad range of knowledge of both medical and surgical areas and the ability to work autonomously in a variety of settings. Despite around half of the UK adult population presenting with a skin condition requiring attention at some point, this is an area many ACPs feel unprepared to manage. However, due to the complexity and large number of potential diagnoses, it is imperative that ACPs develop their knowledge of skin conditions so that they can confidently conduct consultations with patients. This clinical review presents the key elements of patient consultation, history taking and assessment of the skin. This is designed to support novice ACPs, whether working in acute hospital settings or primary care, to develop an understanding of the key points that should be included when consulting with and assessing the skin of patients outwith the dermatology setting.


Assuntos
Profissionais de Enfermagem , Dermatopatias , Adulto , Humanos , Atenção Primária à Saúde , Encaminhamento e Consulta , Dermatopatias/diagnóstico , Dermatopatias/terapia
14.
Enferm. foco (Brasília) ; 12(7, supl 1): 93-98, out. 2021. ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1337770

RESUMO

Objetivo: Relatar a experiência de um Círculo de Cultura virtual para promover a saúde de enfermeiras, diante dos desdobramentos da Coronavirus Disease 2019. Método: Realizou-se um Círculo de Cultura virtual em abril de 2020, com a participação de 15 enfermeiras, residentes em Santa Catarina, Brasil. Para tanto, percorreu-se as três etapas do Itinerário de Paulo Freire por meio de uma analogia com as partes de um estetoscópio: o diafragma (Investigação Temática); o tubo de condução (Codificação e Descodificação); e as hastes e olivas (Desvelamento Crítico). Resultados: A dialogicidade do Círculo de Cultura resultou em um tem gerador "lugar de fala" no enfrentamento da COVID-19. As enfermeiras refletiram sobre o seu papel durante a pandemia, destacando sua influência sobre usuários e outros profissionais, por seus conhecimentos científicos e protagonismo no cuidado em saúde. Considerações finais: Estimulou-se a compreensão sobre o "lugar de fala" da Enfermagem durante a pandemia e a importância de seu fortalecimento. O Círculo de Cultura virtual destacou-se como uma possibilidade de promoção da saúde em situações de restrição social. (AU)


Objective: To report the experience of a virtual Culture Circle to promote the health of nurses, in view of the consequences of Coronavirus Disease 2019. Methods: A virtual Culture Circle was held in April 2020, with the participation of 15 nurses, residing in Santa Catarina Brazil. Therefore, the three stages of Paulo Freire's Itinerary were covered through an analogy with the parts of a stethoscope: the diaphragm (Thematic Research); the conduction tube (Encoding and Decoding); and the stems and olives (Critical Unveiling). Results: The dialogicity of the Culture Circle resulted in a "place of speech" generator in the confrontation of COVID-19. The nurses reflected on their role during the pandemic, highlighting their influence on users and other professionals, due to their scientific knowledge and leading role in health care. Conclusion: The understanding of the "place of speech" in Nursing during the pandemic and the importance of strengthening it was stimulated. The virtual Culture Circle stood out as a possibility for health promotion in situations of social restriction. (AU)


Objetivo: Informar la experiencia de un Círculo de Cultura virtual para promover la salud de enfermeras, ante las consecuencias de la Enfermedad del Coronavirus 2019. Métodos: Se realizó un Círculo de Cultura virtual en abril de 2020, con la participación de 15 enfermeras, residentes en Santa Catarina Brasil. Por tanto, las tres etapas del Itinerario de Paulo Freire fueron cubiertas a través de una analogía con las partes de un estetoscopio: el diafragma (Investigación Temática); el tubo de conducción (codificación y decodificación); y los tallos y aceitunas (Desvelamiento Crítico). Resultados: La dialogicidad del Círculo Cultural resultó en un generador de "lugar de habla" en el enfrentamiento del COVID-19. Los enfermeros reflexionaron sobre su papel durante la pandemia, destacando su influencia en los usuarios y otros profesionales, por su conocimiento científico y protagonismo sanitario. Conclusión: Se incentivó la comprensión del "lugar del habla" en Enfermería durante la pandemia y la importancia de fortalecerlo. El Círculo de Cultura virtual se destacó como una posibilidad de promoción de la salud en situaciones de restricción social. (AU)


Assuntos
Quarentena , Adaptação Psicológica , Doenças Transmissíveis , Enfermagem , Profissionais de Enfermagem
15.
Rev Bras Enferm ; 75(suppl 1): e20201382, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34669786

RESUMO

OBJECTIVE: to assess the quality of life of nurse practitioners during the COVID-19 pandemic and analyze related factors. METHODS: cross-sectional and analytical study carried out with nurse practitioners. A questionnaire on sociodemographic characterization, work activities and changes perceived with the pandemic and WHOQOL-bref were used. To compare the groups of interest, analysis of covariance was used. RESULTS: 572 professionals participated, who had a mean total quality of life score of 56.79 (SD=13.56). In the relationship of variables with WHOQOL-bref, having two or more jobs and being a nurse were associated with better quality of life, but being a woman and working more than 50 hours a week was associated with a worse perception of the construct. CONCLUSIONS: the factors analyzed indicate a lower perception of quality of life associated with the social domain, requiring interventions that reduce the damage to professionals' health and contribute to quality of care provided.


Assuntos
COVID-19 , Profissionais de Enfermagem , Estudos Transversais , Feminino , Humanos , Pandemias , Qualidade de Vida , SARS-CoV-2 , Inquéritos e Questionários
17.
Br J Nurs ; 30(18): S4-S6, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34645340
18.
Int J Nurs Educ Scholarsh ; 18(1)2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34668359

RESUMO

OBJECTIVES: To explore the outcomes of threading the Patient-Centered Integrated Behavioral Health Care Principles and Tasks Checklist (AIMS Checklist) into the curricula and experiential setting. METHODS: A qualitative exploratory descriptive method with a constructivist epistemology was used to obtain in-depth student perspectives about their understanding, experiences, and process of applying Integrated Collaborative Care within the clinical setting. RESULTS: 24 Psychiatric Mental Health Nurse Practitioner Students (PMHNP) were divided into focus groups that yielded seven main themes and seven subthemes. Three of the identified themes emerged as opportunities for curriculum enhancement. CONCLUSIONS: The checklist was found to be a valuable tool in not only evaluating collaborative care but in closing the gap between didactic and clinical education in fostering student-preceptor discussion.


Assuntos
Saúde Mental , Profissionais de Enfermagem , Competência Clínica , Currículo , Humanos , Percepção , Estudantes
19.
Nurs Leadersh (Tor Ont) ; 34(3): 63-73, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34698015

RESUMO

OBJECTIVE: The objective of this paper is to describe the day-to-day activities, known as practice patterns, of nurse practitioners (NPs) across a four-site academic healthcare network in Ontario, which comprises acute, primary, rehabilitation and complex continuing care. BACKGROUND: Information regarding NP practice patterns is available from other jurisdictions and practice settings, but information specific to large, urban and multi-site organizations is available to a lesser extent. This information can inform and support leaders' decisions about NP roles and responsibilities. METHOD: A cross-sectional online survey was sent to the 125 NPs employed in this healthcare network. RESULTS: Respondents (n = 45) were primarily experienced, graduate-prepared NPs, who work with specialized populations and support the education of healthcare professional trainees. The majority of these NPs' activities focused on direct and indirect care, with fewer activities centred on leadership/administration, education, research and personal breaks. Clinical care activities varied among NPs and were contextual to the population and program. CONCLUSION: While direct and indirect care are vital components of NP practice, the overwhelming emphasis on these components indicates that the organization and the healthcare system are losing opportunities to capitalize on advanced nursing practice knowledge and skills in the domains of leadership, research and education.


Assuntos
Prática Avançada de Enfermagem , Profissionais de Enfermagem , Estudos Transversais , Atenção à Saúde , Humanos , Liderança
20.
J Nurs Educ ; 60(10): 586-589, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605684

RESUMO

BACKGROUND: The coronavirus disease 2019 pandemic prevented in-person activities at colleges and universities in the spring/summer 2020 semester. Therefore, adult-geriatric acute care nurse practitioner students were unable to have on-campus clinical experiences. METHOD: An innovative virtual experience was developed, using synchronous platforms for lectures and a virtual patient (VP) encounter. RESULTS: Eight students participated in the experience, composed of three interactive lectures and a VP encounter. Students spent an average of 24.88 minutes (range = 20.88 to 35.48) with the VP, followed by debriefing. Students who became frustrated with the technology were identified as those who did not perform the practice session within the virtual platform. CONCLUSION: Faculty determined that the virtual experience was a success. They were able to evaluate students' critical thinking and clinical decision-making. Next steps include refinement of the avatar platform as well as forcing completion of a practice session prior to the actual synchronous graded activity. [J Nurs Educ. 2021;60(10):586-589.].


Assuntos
COVID-19 , Profissionais de Enfermagem , Estudantes de Enfermagem , Adulto , Idoso , Humanos , Pandemias , SARS-CoV-2 , Estudantes
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