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Specialist stoma care nurses (SSCNs) are highly educated professionals who play a critical role in the care of people living with a stoma. However, they experience some unique challenges. Currently in the UK, stoma care has no national standards, targets or best practice pathway, resulting in significant variation and an undervalued service. As members of an evidence-based profession, SSCNs need to demonstrate their value. Specialist nurses in cancer care and inflammatory bowel disease are supported by nationally, with pathways, targets and standards of care, as well as career and education frameworks. This system could be used for SSCNs. A national approach is needed to develop an evidence-based best-practice pathway, commissioned and implemented across the UK for all stoma patients and with SSCNs at its heart. SSCNs need to demonstrate their value through data and evidence. Working with Getting it Right First Time, a taskforce aims to review the evidence and establish minimum standards of care for all stoma patients. SSCNs should be co-ordinators and drivers of change at the highest level of national innovation, policy and decision-making. The work of SSCNs should be is recognised and valued because what they do matters. [ABSTRACT FROM AUTHOR]

Design: A multi‐methods, single‐centre pilot comprising a quasi‐experimental pre‐/post‐test design and an exploratory qualitative study. Setting: A rural Australian hospital and health service. Participants: Men newly diagnosed with localised prostate cancer who were scheduled to undergo, or had undergone, radical or robotic prostatectomy surgery within the previous 3 months. Intervention: The intervention comprised a 12‐week virtual care program delivered via teleconference by a specialist nurse, using a pre‐existing connected care platform. The program was tailored to the post‐operative recovery journey targeting post‐operative care, psychoeducation, problem‐solving and goal setting. Main Outcome Measures: Primary outcome: program acceptability. Secondary outcomes: quality of life; prostate cancer‐related distress; insomnia severity; fatigue severity; measured at baseline (T1); immediately post‐intervention (T2); and 12 weeks post‐intervention (T3). Results: Seventeen participants completed the program. The program intervention showed very high levels (≥4/5) of acceptability, appropriateness and feasibility. At T1, 47% (n = 8) of men reported clinically significant psychological distress, which had significantly decreased by T3 (p = 0.020). There was a significant improvement in urinary irritative/obstructive symptoms (p = 0.030) and a corresponding decrease in urinary function burden (p = 0.005) from T1 to T3. Conclusions: This pilot has shown that a tailored nurse‐led virtual care program, incorporating post‐surgical follow‐up and integrated low‐intensity psychosocial care, is both acceptable to rural participants and feasible in terms of implementation and impact on patient outcomes. [ABSTRACT FROM AUTHOR]

Abstract Background Infectious diseases are becoming more widespread and re-emerging, causing psychological, social, economic, and health effects at both national and international levels. Specialist nurses can help prevent and control these infections. However, in Iran, there are currently no specialist infection prevention and control (IPC) nurses to manage and control infections. This study aims to explore clinical and academic nurses’ attitudes toward IPC nursing curriculum and duties. Methods The study used a qualitative content analysis approach. Thirty-six participants, including clinical and academic nurses, were selected using a purposeful sampling method. Data was collected through seven focused group discussions. The accuracy and validity of the research tools were measured using the Four-Dimension Criteria developed by Lincoln and Guba. Data analysis was conducted using directed content analysis. Results The data analysis of the discussions held in the seven focus groups extracted 628 codes. Three themes were developed from the qualitative analysis: “Core characteristics of the curriculum”, “Expected competencies and skills”, and “Evaluation.” These themes were derived from nine main categories and 25 subcategories. Conclusions Specialist IPC nurses can play important roles in various positions and environments. Therefore, educational policymakers in Iran should consider establishing IPC nursing courses. It is also recommended that policymakers and decision-makers in the nursing field of other less developed countries should prioritize this issue.

Aims: To explore Registered Nurses' motives to undergo specialist training and to choose a particular speciality. Design: A descriptive qualitative interview study. Methods: Semi‐structured interviews were conducted during 2021 with 20 Swedish specialist nurse students from different specialisation areas. Qualitative content analysis was used. The COREQ checklist was used to report the study. Results: Specialist nurse students' motivations for further training were divided into three main categories with two sub‐categories each. The main categories were 'toward new challenges and conditions in work life', 'contributions to the development and higher competencies in health care' and 'personal work and life experiences as ground for choice'. Conclusion: Our study demonstrates the importance of motivating factors in the career choices of Specialist nurse students, such as personal challenges, desirable working conditions, career growth opportunities and personal experiences in the career choices. Creating a supportive work environment that helps to prioritise work‐life balance and offers the development of new skills might help retain nurses. No Patient or Public Contribution: No patient or public contribution was used. However, if more nurses would choose to undergo specialist training, especially in areas facing significant shortages, it would most likely lead to improved health‐related outcomes for patients or populations. [ABSTRACT FROM AUTHOR]

Background: As the number of nursing home residents with multiple healthcare needs grows, the demand for nursing expertise increases. The implementation of new care models involving nurses with expanded roles is crucial for ensuring quality care in nursing homes. Objectives: To investigate the characteristics and activities of nurses employed in nursing homes in expanded roles and the factors associated with variation in the activities performed. Methods: This multicentre cross‐sectional survey in Switzerland collected data from a convenience sample of 118 nursing homes between September 2018 and October 2019. From a subsample of 62 nursing homes, we analysed the characteristics and activities of 104 nurses in expanded roles. Associations between the activities performed and the educational background of the nurses in expanded roles, their direct supervisors' positions and the presence of physicians in the nursing homes were examined. Results: Most Registered Nurses in expanded roles were diploma educated (48%), with fewer having a bachelor's (35%) or master's degree (17%). Overall, direct clinical practice and guidance and coaching activities were conducted monthly to weekly; consultation, evidence‐based practice, collaboration and ethical decision‐making activities were conducted monthly. We saw variations where a higher educational background was associated with more frequent evidence‐based practice activities (z = 3.47, p < 0.001), and if direct supervisors were ward managers, nurses in expanded roles worked more frequently below their scope of practice (z = 4.10, p < 0.001). Conclusion: This is the first study to use Hamric's integrative Advanced Practice Nursing model to examine the activities of nurses in expanded roles in nursing homes. We found considerable variation in their activities, where nursing homes seem to adapt their roles to their educational background and the local context. Implications for Practice: Our findings show the importance of clarifying role expectations for Registered Nurses in expanded roles, allowing them to practice at the top of the licence to meet residents' complex healthcare needs. [ABSTRACT FROM AUTHOR]

Nurses have become integral members of multidisciplinary teams in managing rheumatic diseases, departing from their traditional patient care roles. This article provides a comprehensive review of nurses' roles, interventions, and impacts in several rheumatic diseases, including rheumatoid arthritis, osteoarthritis, spondyloarthritis, gout, systemic lupus erythematosus, and polymyalgia rheumatica. It has been demonstrated that care under nursing supervision is effective and safe, with benefits including disease management, quality of life, and treatment adherence. In addition, nurses play a crucial role in promoting health, educating patients, and administering biological disease-modifying anti-rheumatic drugs. The COVID-19 pandemic has highlighted the significance of telehealth services and nurses' role in delivering remote care. However, nursing education and training challenges persist, particularly in standardization and access to postgraduate education. Efforts to enhance the role of nurses in rheumatology care are necessary to optimize patient outcomes and meet the evolving needs of individuals with rheumatic diseases. Collaboration across healthcare institutions, professional groups, and educational facilities is necessary for promoting the continual growth and advancement of rheumatology nurse practice. By equipping nurses with the requisite knowledge, expertise, and resources to deliver top-notch care, we can enhance the well-being of individuals with rheumatic diseases and foster improved overall health outcomes. [ABSTRACT FROM AUTHOR]

Background Child mental health services are under major pressure worldwide. In the Netherlands, Youth Mental Health Practice Nurses (YMHPNs) have been introduced in general practice to improve access to care. In this study, we evaluated care delivered by YMHPNs. Methods We used medical records of a population-based cohort (21 717 children, 0–17 years). Characteristics of children consulting a YMHPN, type of problem, care delivered by YMHPNs and referrals were assessed using quantitative content analysis. Results Records of 375 children (mean age 12.9 years, 59.2% girl) were analysed. These children were often in their adolescence (57.3% was between 13 and 17 years), and more often female than male (59.2% vs 40.8%). YMHPNs had a median of four consultations (IQR 2–7) with the child. YMHPNs managed a variety of psychosocial problems. YMHPNs managed 22.4% of children without need of referral, 52.0% were eventually referred for additional care. 13.3% of children dropped out during the treatment trajectory. In the remaining 12.3% of children, the treatment trajectory was stopped because the child was already attending specialized services, the treatment trajectory was still ongoing or the medical record was inconclusive. Conclusions YMHPNs successfully managed one in four children with psychosocial problems without need for referral. Nevertheless, most children were eventually referred for additional care. [ABSTRACT FROM AUTHOR]

Background Methods/Aims Design Data Sources Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or public contribution What does this article contribute to the wider global clinical community? Optimal selection of vascular access devices is based on multiple factors and is the first strategy to reduce vascular access device‐related complications. This process is dependent on behavioural and human factors. The COM‐B (Capability, Opportunity, Motivation, Behaviour) model was used as a theoretical framework to organize the findings of this systematic review.To synthesize the evidence on determinants shaping the optimal selection of vascular access devices, using the COM‐B behavioural model as the theoretical framework.Systematic review of studies which explore decision‐making at the time of selecting vascular access devices.The Medline, Web of Science, Scopus and EbscoHost databases were interrogated to extract manuscripts published up to 31 December 2021, in English or Spanish.Among 16 studies included in the review, 8/16 (50%) focused on physical capability, 8/16 (50%) psychological capability, 15/16 (94%) physical opportunity, 12/16 (75%) social opportunity, 1/16 (6%) reflective motivation and 0/16 (0%) automatic motivation. This distribution represents a large gap in terms of interpersonal and motivational influences and cultural and social environments. Specialist teams (teams created for the insertion or maintenance of vascular access devices) are core for the optimal selection of vascular access devices (75% physical capability, 62% psychological capability, 80% physical opportunity and 100% social opportunity).Specialist teams predominantly lead all actions undertaken towards the optimal selection of vascular access devices. These actions primarily centre on assessing opportunity and capability, often overlooking motivational influences and social environments.A more implementation‐focused professional approach could decrease inequity among patients and complications associated with vascular access devices. Optimal selection of vascular access devices is the primary strategy in mitigating complications associated with these devices. There is a significant disparity between interpersonal and motivational influences and the cultural and social environments. Furthermore, specialized teams play a pivotal role in facilitating the optimal selection of vascular access devices. The study can benefit institutions concerned about vascular access devices and their complications. This review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.No Patient or Public Contribution. Optimal selection of vascular devices remains a growing yet unresolved issue with costly clinical and patient experience impact. Interventions to improve the optimal selection of vascular devices have focused on training, education, algorithms and implementation of specialist vascular teams; alas, these approaches do not seem to have substantially addressed the problem. Specialist vascular teams should evolve and pivot towards leading the implementation of quality improvement interventions, optimizing resource use and enhancing their role. [ABSTRACT FROM AUTHOR]

Background: Clinical elective courses provide additional specialty knowledge for prelicensure nursing students; however, it is unknown how these courses impact nurses' clinical practice after graduation. Purpose: To describe how clinical nursing electives impact graduates' clinical practice. Methods: A mixed-methods descriptive design was used. Students who graduated from a prelicensure nursing program were sent an electronic survey and participated in qualitative interviews. Results: Thirty-three graduates completed the survey, with 9 participating in interviews. Sixteen graduates worked in the clinical practice areas that were the same, or related to, the clinical elective they took. Many graduates felt that taking the elective course improved their confidence in the clinical setting and provided increased knowledge that put them at an advantage over their peers. Conclusion: Clinical electives may offer a means to meet health care system needs by preparing a more confident, knowledgeable new graduate in specialty areas in which nurses are needed most. [ABSTRACT FROM AUTHOR]

Background: Nurses improve themselves with various trainings according to the developing era and patient needs. Determining the effects of postgraduate education in the clinical field opens new horizons for improving the quality of patient care. Aim: To determine the opinions of the participants about the effects of postgraduate education in nursing and the reflection of these effects on the clinic field and patient care by the nurse specialist. Methods: This is a phenomenological descriptive qualitative study which was data gathered through in-depth interviews with nurses, physicians, and patients. For content analysis, the data were subjected to thematic analysis. Results: The data obtained from the views of the participants about the effects of postgraduate education in nursing and its reflections on the clinic were combined under 4 main themes and 20 sub-codes. Conclusions: It was concluded that postgraduate education has effects on nursing roles, individual development, other professional development, increasing its professional value and scientific power, and these effects are reflected positively in clinical field. [ABSTRACT FROM AUTHOR]

Aims Design Methods Data Sources Results Conclusion Implications for the Profession and/or Patient Care Impact To understand specialized nurses' role in the culture of patient safety and their ability to promote and enforce it within healthcare.A systematic integrative review using the approach of Whittemore and Knafl.Systematic literature search for qualitative, quantitative and mixed‐methods studies, followed by data evaluation, quality assessment, analysis and research synthesis with a narrative perspective. Findings were contextualized within a ‘framework for understanding the development of patient safety culture’.Searches were conducted in PubMed [including MEDLINE], Scopus, CINAHL, Web of Science and EMBASE from Jan 2013 until Sep 2023.Sixteen studies published in English from six different countries were selected and used for research synthesis. Diverse enabling factors and enacting behaviours influencing specialized nurses' roles to promote patient safety culture were identified, mainly focusing on nurses' workload, professional experiences and organizational commitment. Patient safety outcomes focused on medication management, infection prevention, surveillance process in critical care, oversight on quality and safety of nurses' practice, patient care management, continuity of care, adherence to the treatment plan and implementation of a specialized therapeutic procedure.Specialized nurses can make a significant contribution to promote patient safety culture and support organizational initiatives to prevent adverse events.Stronger participation and leadership of specialized nurses in initiatives to improve patient safety culture requires appropriate investments and support by policy makers and managers in terms of resources and training.There is a gap in existing literature on the contribution that specialized nurses can make in promoting patient safety culture. Review results highlight the importance of interprofessional collaboration and teamwork by involving specialized nurses. They inform healthcare policy makers about recognizing their roles and competencies in patient safety culture.Preferred reporting items for systematic reviews and meta‐analysis.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Abstract Aims To explore Registered Nurses' motives to undergo specialist training and to choose a particular speciality. Design A descriptive qualitative interview study. Methods Semi‐structured interviews were conducted during 2021 with 20 Swedish specialist nurse students from different specialisation areas. Qualitative content analysis was used. The COREQ checklist was used to report the study. Results Specialist nurse students' motivations for further training were divided into three main categories with two sub‐categories each. The main categories were ‘toward new challenges and conditions in work life’, ‘contributions to the development and higher competencies in health care’ and ‘personal work and life experiences as ground for choice’. Conclusion Our study demonstrates the importance of motivating factors in the career choices of Specialist nurse students, such as personal challenges, desirable working conditions, career growth opportunities and personal experiences in the career choices. Creating a supportive work environment that helps to prioritise work‐life balance and offers the development of new skills might help retain nurses. No Patient or Public Contribution No patient or public contribution was used. However, if more nurses would choose to undergo specialist training, especially in areas facing significant shortages, it would most likely lead to improved health‐related outcomes for patients or populations.

Aim: To identify attitudes and barriers to evidence-based practice from the perspective of Portuguese nurses specialized in medical-surgical nursing. Design: Descriptive cross-sectional study. Methods: Data collection in 2022, via a digital form comprising a questionnaire on socio-professional characterization and the Portuguese version of the "Barriers to Evidence-Based Practice in Primary Care". Non-probability convenience sampling. Data analysis performed using the Statistical Package for the Social Sciences, version 24. The checklist used was "Strengthening the Reporting of Observational Studies in Epidemiology". Results: The final sample consisted of 218 specialist medical-surgical nurses working in clinical practice settings in Portugal, who showed a generally positive attitude towards evidence-based practice. The barriers to evidence-based practice highlighted were lack of incentives, support from expert colleagues, training, financing, and time. Conclusion: Specialist medical-surgical nurses value evidence-based practice and recognized its benefits, but also identified barriers that make its practical implementation a challenge. The identification of the attitudes and barriers allows for the identification of shortcomings and the making of tailored training plans, thereby increasing the integration of evidence into the practice of these renowned professionals.

This paper analyzed the needs, status quo and shortcomings of training Traditional Chinese Medicine (TCM) encephalopathy nurse specialists in China. Conception and prospect of talent training were discussed to improve the continuous development of TCM treatment for encephalopathy, strengthen the construction of TCM nursing and promote the implementation of Healthy China Initiative (分析我国中医脑病专科护士培养需求, 结合我国中医专科护士及脑病专科护士培养现状及不足, 对中医脑病专科护士培养提出了初步的构思与展望, 旨在推进中医脑病学科的持续发展, 加强中医护理学科建设, 促进健康中国。)

Abstract Background The context of end-of-life care for older heart failure patients with a complex clinical course provided by certified nurse specialists in gerontology (GCNSs) and Certified nurses in chronic heart failure (CNCHFs) is unclear; therefore, this study aims to describe comprehensive nursing practice for older patients with heart failure at their end of life. Methods This study adopts a qualitative descriptive design using content analysis. Five GCNSs, and five CNCHFs were interviewed using a web app from January to March 2022. Results Thirteen categories of nursing practices for older patients with heart failure were generated: (1) Provide thorough acute care by a multidisciplinary team to alleviate dyspnea, (2) Assess psychiatric symptoms and use a suitable environment to perform treatment, (3) Explain the progression of heart failure with the doctor, (4) Build a trusting relationship with the patient and family and implement advance care planning (ACP) early during the patient's recovery, (5) Involve multiple professions to help patients to achieve their desired life, (6) Perform ACP always in collaboration with multiple professionals, (7) Provide lifestyle guidance according to patients' feelings so that they can continue living at home after discharge from the hospital, (8) Provide palliative and acute care in parallel with multiple professions, (9) Achieve end-of-life care at home through multidisciplinary cooperation, (10) Provide basic nursing care to the patient and family until the moment of death, (11) Provide concurrent acute and palliative care as well as psychological support to alleviate physical and mental symptoms, (12) Share the patient's prognosis and future wishes with multiple professionals, and (13) Engage in ACP from early stages, through several conversations with patients and their families. Conclusions Specialized nurses provide acute care, palliative care, and psychological support to alleviate physical and mental symptoms throughout the different stages of chronic heart failure. In addition to nursing care by specialized nurses at each stage shown in this study, it is important to initiate ACP early in the end-of-life stage and to provide care for patients with multiple professionals.

Purpose: Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform--a modified Six-Sigma-based training program--against a conventional educational program on rehabilitation specialist nurses' core competencies, post-training performance, and satisfaction. Methods: A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 train- ing course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base's 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented. Results: Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program ( p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform ( p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly ( p < .05). Conclusion: The modified training program strengthens rehabilitation nurses' base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore the work conditions that influence the opportunities for professional development of specialist nurses in surgical care. Design: A qualitative descriptive design was used. Methods: With a purposeful sampling procedure, 14 specialist nurses in surgical care were included. Four focus‐group interviews were conducted during November to December 2021 and deductively analysed using the Job Demand‐Resource theory as a guiding framework. Reporting adheres to COREQ guidelines. Findings: Work conditions that were identified as job demands and that inhibited nurses' opportunities for professional development were mainly found at an organizational and leadership level. Primarily, those conditions included role ambiguity and time constraints caused by uncompensated nursing shortages that restricted the nurses from exercising their role. Such conditions could also discourage other nurses from further education. Job demands were seen as largely compensated for by work conditions identified as job resources and located mainly at an individual level, for example finding the work interesting and multifaceted. Most prominent was the participants' inner motivation to work with surgical patients and to continue to develop themselves and other nurses professionally. Conclusions: A prerequisite for professional development is that the specialist role is clearly defined in collaboration with representatives from the nursing profession and universities. Hence, hospital organizations need to reflect on how to utilize the competence. Also, it is important that nurse leaders promote the specialist nurses' motivation by supporting them in the exercise of their role. Impact: Findings from this study revealed work conditions that need to be acknowledged during hospital organizations' endeavours to maintain and enhance nursing competence. Patient or Public Contribution: Patient or public contribution was not applicable since the study focused on specialist nurses' working conditions. [ABSTRACT FROM AUTHOR]

Aim: To identify attitudes and barriers to evidence-based practice from the perspective of Portuguese nurses specialized in medical-surgical nursing. Design: Descriptive cross-sectional study. Methods: Data collection in 2022, via a digital form comprising a questionnaire on socio-professional characterization and the Portuguese version of the “Barriers to Evidence-Based Practice in Primary Care”. Non-probability convenience sampling. Data analysis performed using the Statistical Package for the Social Sciences, version 24. The checklist used was “Strengthening the Reporting of Observational Studies in Epidemiology”. Results: The final sample consisted of 218 specialist medical-surgical nurses working in clinical practice settings in Portugal, who showed a generally positive attitude towards evidence-based practice. The barriers to evidence-based practice highlighted were lack of incentives, support from expert colleagues, training, financing, and time. Conclusion: Specialist medical-surgical nurses value evidence-based practice and recognized its benefits, but also identified barriers that make its practical implementation a challenge. The identification of the attitudes and barriers allows for the identification of shortcomings and the making of tailored training plans, thereby increasing the integration of evidence into the practice of these renowned professionals. [ABSTRACT FROM AUTHOR]

Background: The context of end-of-life care for older heart failure patients with a complex clinical course provided by certified nurse specialists in gerontology (GCNSs) and Certified nurses in chronic heart failure (CNCHFs) is unclear; therefore, this study aims to describe comprehensive nursing practice for older patients with heart failure at their end of life. Methods: This study adopts a qualitative descriptive design using content analysis. Five GCNSs, and five CNCHFs were interviewed using a web app from January to March 2022. Results: Thirteen categories of nursing practices for older patients with heart failure were generated: (1) Provide thorough acute care by a multidisciplinary team to alleviate dyspnea, (2) Assess psychiatric symptoms and use a suitable environment to perform treatment, (3) Explain the progression of heart failure with the doctor, (4) Build a trusting relationship with the patient and family and implement advance care planning (ACP) early during the patient's recovery, (5) Involve multiple professions to help patients to achieve their desired life, (6) Perform ACP always in collaboration with multiple professionals, (7) Provide lifestyle guidance according to patients' feelings so that they can continue living at home after discharge from the hospital, (8) Provide palliative and acute care in parallel with multiple professions, (9) Achieve end-of-life care at home through multidisciplinary cooperation, (10) Provide basic nursing care to the patient and family until the moment of death, (11) Provide concurrent acute and palliative care as well as psychological support to alleviate physical and mental symptoms, (12) Share the patient's prognosis and future wishes with multiple professionals, and (13) Engage in ACP from early stages, through several conversations with patients and their families. Conclusions: Specialized nurses provide acute care, palliative care, and psychological support to alleviate physical and mental symptoms throughout the different stages of chronic heart failure. In addition to nursing care by specialized nurses at each stage shown in this study, it is important to initiate ACP early in the end-of-life stage and to provide care for patients with multiple professionals. [ABSTRACT FROM AUTHOR]

In 2005, the Korea Disease Control and Prevention Agency (KDCA) launched “Health Care Facility Counseling Project on People Living with human immunodeficiency virus (HIV)” funded by the private-subsidy project for the prevention of acquired immune deficiency syndrome (AIDS) and sexually transmitted diseases to provide people living with HIV (PLWH) psychological support and counsel them about the disease and antiretroviral therapy (ART). Currently, 38 counseling nurse specialists work at 28 healthcare facilities for patient care. Of all PLWH in Korea, 71.9% received benefits from the Counseling Project. Adherence to ART medication (>95.0%), level of depression or anxiety, counseling coverage, and viral load status were monitored as common project indicators. Various specialized programs have been implemented in diverse facilities. This project has played a pivotal role in HIV care continuum and viral suppression policies, resulting in 95.9% of PLWH maintaining undetectable status (<40 copies/ml) in 2021. In this review, we present the chronology and fulfillment of this project, which will be an essential step for future planning in the context of aging and the chronic comorbid nature of HIV/AIDS. [ABSTRACT FROM AUTHOR]

Alcohol and other drug (AOD) nurse practitioners have an advanced scope of practice that allows them to diagnose, prescribe pharmacological treatments for alcohol and other substance use disorders, and monitor physical and mental health. The Behaviour Change Wheel (BCW) is used to understand barriers and facilitators to implementation by applying three conditions of behaviour change (capability, opportunity, and motivation—the COM‐B framework). The aim of this paper is to describe the current AOD nurse practitioner workforce, and to explore barriers and facilitators to AOD nurse practitioner uptake in Australia. A mixed method approach was used in this study: a survey to determine the current state of the AOD nurse practitioner workforce (n = 41) and qualitative interviews with 14 participants to determine barriers to endorsement and ongoing work as a nurse practitioner. Interview transcripts were analysed using thematic analysis and mapped to the COM‐B framework. The AOD nurse practitioner is a highly specialized provider of holistic care to people who use alcohol and other drugs, with AOD nurse practitioners performing advanced roles such as prescribing and medication management. However, there are several barriers to the further uptake of AOD nurse practitioners in Australia, including varied organizational support, a lack of support for the higher study required to become a nurse practitioner and a lack of available positions. Arguably, nurse practitioners are key to addressing prescriber shortages inherent in AOD treatment settings. In addition, they are equipped to provide true holistic care. We recommend that barriers are addressed to expand the AOD nurse practitioner workforce in Australia. [ABSTRACT FROM AUTHOR]

Abstract Aims The aims of the study were to identify factors affecting nurses' decision to undergo specialist education and choose a specialty and to describe differences between specialization areas with different types of care. Design A descriptive cross‐sectional design. Methods A survey was conducted among specialist nurse students in three nursing colleges in Sweden (n = 227). Instruments such as Big Five Inventory and RAND‐36 and items earlier used by Bexelius and Olsson were included. Survey data were analysed by using descriptive and analytical statistics, and for open‐ended question qualitative content analysis was used. Results Wage benefit during the education was regarded by 47% as an incentive to start studies. Most of the specialist nurse students considered an opportunity for new tasks (75%), new areas of responsibility (75%), intellectual challenges (72%) and higher wages (71%) to be of high importance when choosing a specialty. However, the students in specialization areas with transitory care‐rated challenges regarding the practical skills (84%) and the occurrence of acute events (82%) higher. Conclusion Although higher wages were important to make nurses feel that they will get value from the education, there were also other important aspects, such as opportunity for new tasks, new areas of responsibility and intellectual challenges that influenced nurses' willingness to undergo a specialist education. Our findings provide employers with the useful information to guide and influence nurses' decisions to enter specialist education and their choice of specialist area.

Objective: To assess the acceptability of a nurse‐led prostate cancer survivorship intervention adapted for virtual delivery and tailored to post‐surgical care, in a regional Australian hospital and health service. Methods: A qualitative exploratory study using the Theoretical Framework of Acceptability (TFA). Results: Twenty‐two participants took part in a semistructured interview comprising men who had completed the program (n = 16) and health professionals/service stakeholders involved in program delivery (n = 6). Acceptability of this virtual prostate cancer survivorship care program was very high across all constructs of the TFA, from the perspectives of both program recipients and those delivering the program. The quality of care received was seen as superior to what men had experienced previously (burden, opportunity costs). The time afforded by the regularly scheduled video‐consultations allowed men to come to terms with the recovery process in their own time (self‐efficacy), and provided an ongoing sense of support and access to care outside the consultation (ethicality). Clinically, the program improved care co‐ordination, expedited identification of survivorship care needs, and met service priorities of providing quality care close to home (burden, perceived effectiveness). Conclusions: Findings from this study suggest virtual post‐surgical care delivered via videoconferencing is highly acceptable to prostate cancer survivors in a regional setting. Future research exploring virtual program implementation at scale and long‐term patient and service outcomes is warranted. [ABSTRACT FROM AUTHOR]

Purpose: As the Australian population grows and ages, the demand for eye care services, and nurses to provide the services, is expected to increase. This will impact nurses, who are Australia's largest health-care provider group. Understanding and mapping the current role and use of nurses in eye care is an essential first step for future health workforce planning and development. To map their engagement, we undertook a scoping review to gain an understanding of the current Australian nurse eye care workforce landscape, to help guide and support future workforce development activities. Secondly, we evaluated if publications in this field incorporated or mentioned the Australian Ophthalmic Nursing Association's National Standards (Practice standards) in their publication. This review also offers other nations and eye care providers the opportunity to evaluate their own health workforce plan and nurse utility. Study Design and Methods: We conducted a review of academic and grey literature, via various search engines, and an inclusion and exclusion criteria. Results: We uncovered 11 publications. Of those, five were academic papers examining extended and advanced nursing practice, one was a letter to the editor, two were industry feature reviews, two were industry reports and the final was the Practice Standards. Key themes throughout indicated the benefit of nurse training and nurse involvement in eye care. Overall, there was insufficient information or data to describe nurse deployment, practice and utility. Finally, the Practice Standards were not referenced in any publication. Conclusion: There is insufficient published information to calculate the level and involvement of nurses, or describe their existing role, advancement or future deployment in eye care in Australia. Without clear information, Australia is unable to develop effective health workforce strategies to attract, train, retain, and appropriately deploy nurses to meet future eye care needs. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to identify factors affecting nurses' decision to undergo specialist education and choose a specialty and to describe differences between specialization areas with different types of care. Design: A descriptive cross‐sectional design. Methods: A survey was conducted among specialist nurse students in three nursing colleges in Sweden (n = 227). Instruments such as Big Five Inventory and RAND‐36 and items earlier used by Bexelius and Olsson were included. Survey data were analysed by using descriptive and analytical statistics, and for open‐ended question qualitative content analysis was used. Results: Wage benefit during the education was regarded by 47% as an incentive to start studies. Most of the specialist nurse students considered an opportunity for new tasks (75%), new areas of responsibility (75%), intellectual challenges (72%) and higher wages (71%) to be of high importance when choosing a specialty. However, the students in specialization areas with transitory care‐rated challenges regarding the practical skills (84%) and the occurrence of acute events (82%) higher. Conclusion: Although higher wages were important to make nurses feel that they will get value from the education, there were also other important aspects, such as opportunity for new tasks, new areas of responsibility and intellectual challenges that influenced nurses' willingness to undergo a specialist education. Our findings provide employers with the useful information to guide and influence nurses' decisions to enter specialist education and their choice of specialist area. [ABSTRACT FROM AUTHOR]

Aims: To investigate the knowledge sharing behaviour of critical care nurse specialists and identify potential influencing factors. Background: The specialist knowledge of critical care nurses is an important resource for the nursing team. It is necessary to investigate influencing factors of knowledge sharing behaviour of them. Methods: Convenience sampling was used to conduct an investigation involving critical care nurse specialists from three provinces in China between October 2018 and June 2019. Practice Environment Scale, Competency Inventory for Registered Nurses, Knowledge Self‐efficacy Scale, and knowledge sharing behaviour scale were utilized. Results: The knowledge sharing behaviour score of critical care nurse specialists was 64.84 ± 11.53. The results of the regression analysis showed that the level of education, position, involvement of nurses in hospital affairs, knowledge, self‐efficacy, sex, average number of night shifts per month, years engaged in nursing work, type of employment, leadership skills, critical thinking ability and manpower and material resources accounted for 45.9% of the variance. Conclusions: Critical care nurse specialists exhibited limited knowledge sharing behaviour. Therefore, interventions based on the dependent variables are necessary. Implications for Nursing Management: Knowledge sharing behaviour of critical care nurse specialists remains at a low level. Hence, it is necessary to encourage their greater participation according to associated factors. [ABSTRACT FROM AUTHOR]

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Ward nurse, ORN, dresser: there are many names for this nursing specialty. But what does it mean to be a scrub nurse? What are the specific aspects and characteristics of this nurse who cares for patients in the operating theatre, ensuring their safety and comfort? What does it mean in terms of posture to be the surgeon's close collaborator? What does the profession's scope of activity cover?, (Copyright © 2024. Publié par Elsevier Masson SAS.)

Abstract Aim To identify and evaluate the impact of Intellectual Disability Nurse Specialists person‐centred care for people with intellectual disability. Design An Integrative review of the literature was performed between January 2007–December 2017. Methods Searching the PubMed Library of Medicine, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline Ovid, PsychINFO, Health Source: Nursing/Academic edition. A total of eight articles were selected for the final study example, including four mixed methods studies and four qualitative studies. Results Three Intellectual Disability Nurse Specialist models were evaluated, and three main themes emerged: person‐centred care, organizational and practice development. Conclusion The Intellectual Disability Nurse Specialist expert knowledge and skills contribute to the development of effective systems and processes. The results highlighted the complex nature of the Intellectual Disability Nurse Specialist role and the importance of ongoing development, promotion and evaluation and their contribution to care in the healthcare setting.

This work is mainly aimed at the detection, visualization and description of the scientific collaboration patterns in the Nursing field in Latin America as a response to the lack of evidence on the implications of collaboration and its effects on the scientific influence in the Nursing field.For this purpose, a retrospective quantitative analysis was conducted by including all the publications classified under the code 2900 in All Science Journal Classification Codes of Scopus, corresponding to the field of General Nursing during 2005–2020. A total of 40 countries and 362,354 unique publications were analyzed, although the main subset herein consists of 18,371 unique publications authored by Latin-American institutions.World proportion of Latin-American publications in Nursing is higher than all the publications in the region. This increase is especially remarkable in the latest year of the studied period, which may result from the progressive increase in the numbers of nursing schools, the diversity in the graduate and specialization programs, the creation of scientific societies, and the many conferences carried out recently on Nursing.

Objective: to analyze the differences in the profile of attitudes of rehabilitation nurses towards death before and after the first critical period of the COVID-19 pandemic. Method: quantitative, comparative study, before and after the critical period. Data collection took place through a self-administered questionnaire, in two phases, a first with 102 participants and a second with 100, all specialists in rehabilitation nursing. Results: although with some changes in the scores, the profile of attitudes of rehabilitation nurses towards death before and after the critical period, remained the same. In addition to the slight increase in the fear score, acceptance as an approximation was the one that registered the greatest increase. Regarding avoidance, neutrality and escape, the scores were slightly lower. Conclusion: despite the feelings experienced by rehabilitation nurses, attitudes towards death continue to show concern in responding to the needs of the people they care for, particularly in the final phase of life.

Introdução: A equipa Enfermagem de ligação na área da saúde mental e psiquiátrica, consiste em elementos que prestam uma contribuição para o tratamento global do utente em outros serviços, permitindo fazer a ponte entre a psiquiatria e as restantes especialidades. A presença do enfermeiro de ligação da área da saúde mental e psiquiátria é incontestavelmente uma mais-valia para toda a equipa multidisciplinar, quer na prática dos cuidados especializados com o utente, quer na colaboração existente com a Equipa do Serviço de Internamento. A Enfermagem de Ligação na área da Saúde Mental e Psiquiátrica permite uma relação cooperativa contínua entre o enfermeiro especialista de saúde mental e equipas de outras especialidades, traduzindo-se assim como uma estratégia eficaz na promoção da saúde mental e contribuindo para a obtenção de ganhos em saúde não apenas nas diferentes áreas da especialidade. Objetivo: Avaliar o processo de enfermagem subjacente ao pedido de colaboração ao Enfermeiro de Saúde Mental e Psiquiátrica e a tomada de decisão realizada pela equipa de enfermagem dos internamentos; Executar uma avaliação global que descreva a história de saúde com ênfase na história de saúde mental do indivíduo internado e da sua família, se aplicável; Elaborar um plano de cuidados individualizado na área de saúde mental em colaboração com o cliente e família; Coordenar a transição do indivíduo internado e família entre os cenários de cuidados de saúde mental, cenários de cuidados de saúde gerais e os diferentes contextos pós alta de internamento hospitalar, para fornecer continuidade de cuidados e suporte ao cliente, família. Método: Este trabalho consiste num projeto de melhoria contínua, na área da Enfermagem de Psiquiatria de Ligação, idenficando e descrevendo o problema; percebendo o problema e dimensioná-lo; formulando objetivos iniciais; percebendo as causas; planeando e executando as tarefas/atividades. Resultados: Pretende-se que as equipas de enfermagem dos diferentes serviços ao avaliarem a necessidade de apoio especializado numa situação concreta da área da saúde mental e psiquiátrica, solicitem a colaboração do enfermeiro de ligação, através do SClinico; As equipas de enfermagem adiram a colaboração de um enfermeiro especialista externo ao serviço com o objetivo de proporcionar a melhoria de cuidados; A pessoa e/ou família seja alvo de um cuidado especializado e individualizado, independentemente do serviço; A pessoa e/ou família tenha a possibilidade de ser acompanhado por um enfermeiro especialista em saúde mental, após alta; Rentabilizar recursos especializados na área de saúde mental, garantindo um serviço de qualidade e de continuidade de cuidados à pessoa/família. Conclusões: Quando falamos em saúde não podemos segmentar as diferentes dimensões, devendo-se observar o utente na dimensão física, psicológica e social, sendo que a instabilidade em uma delas poderá influenciar de forma direta outra dimensão. Estudos indicam que pessoas com perturbações físicas têm associados mais problemas psiquiátricos do que outras pessoas sem qualquer perturbação física. A colaboração de Enfermagem de Psiquiatria de Ligação surge e visa integrar a prestação de cuidados ao nível da enfermagem de saúde mental e psiquiátrica durante o internamento geral ou nas diferentes especialidades, promovendo assim cuidados de excelência.

Objectives RA should be treated to target in a process of shared decision-making with patients. Person-centred care is essential to meeting specific patient needs. Nurse-led clinics, where a nurse is responsible for care, have demonstrated added value in some countries but are still not implemented widely. This study aimed to explore stakeholders' perceptions of advantages, disadvantages and conditions for the implementation of nurse-led clinics for RA in Belgium. Methods We performed a cross-sectional qualitative study consisting of five semi-structured focus group interviews. Rheumatology nurses, patients with RA and rheumatologists were interviewed as stakeholders. The analysis was carried out by three researchers according to the Qualitative Analysis Guide of Leuven (QUAGOL), formulating a conceptual framework of overarching themes and deconstructing this into perceived advantages, disadvantages and conditions. Results Two focus groups with nurses (total n  = 16), two with patients (n  = 17) and one with rheumatologists (n  = 9) were conducted. The interview synthesis resulted in five overarching themes across stakeholders: efficiency of care, disease management, legal and organizational requirements, the conventional role of the nurse and the extended role of the nurse. All stakeholders perceived additional education for nurses as essential, but rheumatologists debated nurses' abilities to lead a rheumatology clinic. Furthermore, patients preferred care protocols to guide nurses, and care providers approached this reluctantly. Generally, patients with a well-controlled disease were perceived as the ideal candidates for nurse-led care. Conclusion Nurse-led clinics could provide many benefits but require additional nurse education and a legal and organizational framework before being implemented widely and successfully. [ABSTRACT FROM AUTHOR]

Objective: to analyse the differences in the profile of attitudes towards death between specialist nurses in rehabilitation nursing and specialist nurses in other areas. Method: comparative, quantitative, cross-sectional study, with the participation of 223 specialist nurses from a hospital in northern Portugal. A questionnaire was applied as a data collection instrument. For data analysis, descriptive and analytical statistics were used. Results: as for attitudes towards death, in nurses who specialize in rehabilitation, those of approach, neutrality, fear, avoidance and escape predominated. In nurses with expertise in other areas, attitudes of approach, fear, neutrality, avoidance and escape prevailed. Conclusion: although the positive attitudes towards death, of nurses specializing in rehabilitation, acquired a higher percentage value, the difference was not significant. In addition, negative attitudes signal the need to rethink training strategies in the academic, but also in the professional context.

Purpose This study investigated the relationship of the partnership between nurses and parents of hospitalized children with the quality of pediatric nursing care as perceived by pediatric nurses. Methods A cross-sectional descriptive study was conducted among 90 nurses. The data collected were analyzed using the independent t-test and the Pearson correlation coefficient. Results The level of partnership between nurses and parents showed significant differences by nurses’ age (t=2.22, p=.029) and marital status (t=2.54, p=.013). The quality of pediatric nursing care was found to significantly differ by the nurses’ age (t=2.62, p=.013), marital status (t=4.17, p

Background: There is increasing use of extracorporeal membrane oxygenation (ECMO) in intensive care, where nurses provide the majority of the required ongoing care of cannulas, circuit, and console. Limited evidence currently exists that details nursing perspectives, experiences, and challenges with workload in the provision of ECMO care., Objective: The objective of this study was to investigate intensive care nurses' perceptions of workload in providing specialist ECMO therapy and care in a high-volume ECMO centre., Methods: The study used a qualitative descriptive methodology through semistructured interviews. Data were analysed using an inductive thematic analysis approach following Braun and Clarke's iterative process. This study was conducted in an intensive care unit within an Australian public, quaternary, university-affiliated hospital, which provides specialist state-wide service for ECMO., Findings: Thirty ECMO-specialist trained intensive care nurses were interviewed. This study identified three key themes: (i) opportunity; (ii) knowledge and responsibilities; and (iii) systems and structures impacting on intensive care nurses' workload in providing ECMO supportive therapy., Conclusions: Intensive care nurses require advanced clinical and critical thinking skills. Intensive care nurses are motivated and engaged to learn and acquire ECMO skills and competency as part of their ongoing professional development. Providing bedside ECMO management requires constant monitoring and surveillance from nurses to care for the one of the most critically unwell patient populations in the intensive care unit setting. As such, ECMO nursing services require a suitably trained and educated workforce of intensive care trained nurses. ECMO services provide clinical development opportunities for nurses, increase their scope of practice, and create advanced practice-specialist roles., (Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Competing Interests: Competing interests: None declared.

Competing Interests: Competing interests: None declared.

Competing Interests: Competing interests: None.

Background: Infectious diseases are becoming more widespread and re-emerging, causing psychological, social, economic, and health effects at both national and international levels. Specialist nurses can help prevent and control these infections. However, in Iran, there are currently no specialist infection prevention and control (IPC) nurses to manage and control infections. This study aims to explore clinical and academic nurses' attitudes toward IPC nursing curriculum and duties., Methods: The study used a qualitative content analysis approach. Thirty-six participants, including clinical and academic nurses, were selected using a purposeful sampling method. Data was collected through seven focused group discussions. The accuracy and validity of the research tools were measured using the Four-Dimension Criteria developed by Lincoln and Guba. Data analysis was conducted using directed content analysis., Results: The data analysis of the discussions held in the seven focus groups extracted 628 codes. Three themes were developed from the qualitative analysis: "Core characteristics of the curriculum", "Expected competencies and skills", and "Evaluation." These themes were derived from nine main categories and 25 subcategories., Conclusions: Specialist IPC nurses can play important roles in various positions and environments. Therefore, educational policymakers in Iran should consider establishing IPC nursing courses. It is also recommended that policymakers and decision-makers in the nursing field of other less developed countries should prioritize this issue., (© 2024. The Author(s).)

Aim: To explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland., Background: Clinical decision-making in an emergency department environment is a complex process often occurring in times of crisis. It is an important aspect contributing to the quality of care. However, empirical research is limited regarding the decision-making process in different nursing roles., Methods: In accordance with the consolidated criteria for reporting qualitative research, a qualitative and observational study was conducted to explore clinical decision-making by comparing the processes used by three groups of nurses in the emergency departments of three hospitals: in Norway, Finland and Ireland. Six Registered Nurses, six Nurse Specialists and six Nurse Practitioners were observed. A total of 40 hours of observation was made at each setting according to a structured observation guideline, followed by clarifying questions. The data material was analysed by means of a qualitative manifest and latent content analysis., Results: Three themes arose: acting in accordance with routines, previous experience and intuition; considering patient experience; and facilitating new alternatives based on critical thinking. The Registered Nurses mainly used the first approach, the Nurse Specialists used the first and the second approaches, and the Nurse Practitioners used all three approaches., Conclusions: The results highlight the differences in decision-making processes between these groups. Nurse Practitioners were the only group that facilitated and evaluated new alternatives using their clinical autonomy, such as stepping up and making independent and collaborative decision-making., Implication: The results can be used in countries developing advanced practice nursing education and defining their scope of practice to inform stakeholders., (© 2024 The Authors. International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.)

Introduction: Managing bleeding disorders (BDs) is complex, requiring a comprehensive approach coordinated by a multidisciplinary team (MDT). Haemophilia nurses (HNs) play a central role in the MDT, frequently coordinating care. As novel treatments bring change to the treatment landscape, ongoing education and development is key. However, understanding of the roles and tasks of HNs is lacking., Aim: The EAHAD Nurses Committee sought to identify and describe the roles and tasks of the European HN., Methods: A five-step integrative review was undertaken, including problem identification, literature search, data evaluation, data synthesis and presentation. Relevant literature published from 2000 to 2022 was identified through database, hand and ancestry searching. Data were captured using extraction forms and thematically analysed., Results: Seven hundred and seventy-seven articles were identified; 43 were included. Five main roles were identified, with varied and overlapping associated tasks: Educator, Coordinator, Supporter, Treater and Researcher. Tasks related to education, coordination and support were most frequently described. Patient education was often 'nurse-led', though education and coordination roles concerned both patients and health care practitioners (HCPs), within and beyond the MDT. The HN coordinates care and facilitates communication. Long-term patient care relationships place HNs in a unique position to provide support. Guidelines for HN core competencies have been developed in some countries, but autonomy and practice vary., Conclusion: As the treatment landscape changes, all five main HN roles will be impacted. Despite national variations, this review provides a baseline to anticipate educational needs to enable HNs to continue to fulfil their role., (© 2024 The Authors. Haemophilia published by John Wiley & Sons Ltd.)

Aims: To investigate the attitudes and beliefs towards the implementation of nurse prescribing among general nurses and nurse specialists. Design: A cross‐sectional survey among general nurses and nurse specialists was conducted in seven provinces and one autonomous region in mainland China using convenience sampling method. Methods: The attitudes and beliefs towards nurse prescribing were assessed using the Nurse Attitudes and Beliefs towards Nurse prescribing scale, of which Cronbach's coefficient was 0.902, retest reliability was 0.808. Respondents from eight hospitals across the country were employed to complete an online questionnaire. Results: Nurse specialists (n = 399) had statistically significantly more favourable intentions towards nurse prescribing than general nurses (n = 415; 105.64 ± 12.83 vs. 96.39 ± 13.16; p <.001). The years of clinical work experience, professional title, education degree were positively correlated with general nurses' and nurse specialists' attitudes and beliefs towards nurse prescribing (p <.05). Among nurse specialists, the variety of specialties and whether they work in nurse‐led clinics on an outpatient basis have positively influence on their intentions towards nurse prescribing (p <.05). [ABSTRACT FROM AUTHOR]

Aim: To identify and evaluate the impact of Intellectual Disability Nurse Specialists person‐centred care for people with intellectual disability. Design: An Integrative review of the literature was performed between January 2007–December 2017. Methods: Searching the PubMed Library of Medicine, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline Ovid, PsychINFO, Health Source: Nursing/Academic edition. A total of eight articles were selected for the final study example, including four mixed methods studies and four qualitative studies. Results: Three Intellectual Disability Nurse Specialist models were evaluated, and three main themes emerged: person‐centred care, organizational and practice development. Conclusion: The Intellectual Disability Nurse Specialist expert knowledge and skills contribute to the development of effective systems and processes. The results highlighted the complex nature of the Intellectual Disability Nurse Specialist role and the importance of ongoing development, promotion and evaluation and their contribution to care in the healthcare setting. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess healthcare utilization costs of a dedicated outpatient clinic for patients with atrial fibrillation (AF). Methods: We conducted a registry-based retrospective study in patients with a first-time AF diagnosis from 2009 to 2011 (control group) and 2013 to 2015 (intervention group). The control group had physician-led usual care, and the intervention group received multidisciplinary care. The primary outcome was total costs of AF-related resource utilization. Exploratory outcomes were ischemic stroke, intracranial hemorrhage, and all-cause mortality. Multiple regression methods were used to control for confounders in the assessment of effects on outcomes. Results: A total of 1552 patients were included, hereof 850 in the intervention group. Total AF-related costs were €2746 for the control group and €3154 for the intervention group, which was not statistically significant. Average outpatient costs were significantly higher in the control group than in the intervention group (€522 vs €344, respectively; P = .003). There was no difference in the number of AF-related hospital admissions and outpatient visits between the control group and the intervention group (incidence risk ratio, 1.03 vs 0.85; and 95%confidence interval, 0.92--1.16 vs 0.69--1.05, respectively). There was a trend toward reduced all-cause mortality (hazard ratio, 0.86; 95% confidence interval, 0.63--1.16) in the intervention group, which was not statistically significant. Conclusion: Total expenses for AF-related hospital resource utilization in the intervention group were higher, but the expenses for AF-related outpatient visits were significantly lower. There was a trend toward lower all-cause mortality in the intervention group, although the differences were not statistically significant. More research is needed investigating whether a multidisciplinary AF clinic is cost-effective. [ABSTRACT FROM AUTHOR]

Background: Wound care nurses are recognised as a key element for improving health outcomes. However, there is still fragmented knowledge of the outcomes associated with their practice in individuals with pressure ulcers. Aims and objectives: To identify, summarise and map all available evidence related to the outcomes of wound care nurses' practice in individuals with pressure ulcers. Design: Integrative literature review. Review method: To report the review, we followed the modified version of Cooper's five‐step methodology, and the PRISMA guidelines. Methods: The search was carried out on CINAHL, PubMed, the Cochrane Library and Scopus, with a time frame ranging from each database inception to December 21, 2019. We included observational or experimental studies of adult individuals affected by (or at risk of) developing pressure ulcers who were also cared for by wound care nurses. Results: Of the 439 peer‐reviewed publications, 13 studies met the inclusion criteria. The most frequent outcomes were pressure ulcer incidence, healing rate and time taken for complete healing. Less frequent outcomes were changes in pressure ulcers' stage, number of completely healed wounds, treatment costs and physical discomfort. No patient‐reported outcomes were assessed. Conclusion: This review indicates that clinical‐related outcomes were by far the most reported. Future studies should broaden the spectrum of outcomes to include more subjective parameters (e.g. pain, quality of life, stress, etc.), in order to gain a better understanding of the global impact of wound care practice on patients with pressure ulcers. Relevance to clinical practice: There is promising evidence of a positive impact of wound care nurses' practice on health and economic outcomes. Nonetheless, more robust and rigorous research is needed to provide stronger evidence in the field and support investment in these practitioners. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the work activities of nurse-led rapid response teams (RRT). Methods: For this study a methodological approach was used to identify work activities for nurse-led RRT. The study was conducted in two stages. The first step was to analyze the work activities of domestic nurse-led RRTs using the interview method, and then develop a questionnaire based on the results of the interviews. As a second step, field surveys were conducted by nurse-led RRT nurses to investigate importance and performance based on the developed questionnaire. Results: Fifty-eight work activities were identified for nurse-led RRTs in the following nine core areas: advanced nursing practice, education, counseling, consultation, collaboration, ethical decision-making, research, evidence-based practice, and leadership. Conclusion: The identified work activities for nurse-led RRTs will be used as basic data in nurse-led RRTs job description, developing job standards and can also serve as basic data for developing a nurse-led RRT educational curriculum. The results of this study suggest that follow-up research is needed to develop job standards based on the identified nurse-led RRT's work activities. [ABSTRACT FROM AUTHOR]

Purpose: To highlight the utility of Colorectal Nurse Specialist (CNS) supervised parental administration of rectal washouts in the management of Hirschsprung's disease (HD)., Methods: Retrospective case note review of HD patients treated at a tertiary children's hospital in United Kingdom from January 2011 to December 2022. Data collected included demographics, complications, enterocolitis, obstructive symptoms and stomas. Primary pull-through (PT) is done 8-12 weeks after birth. Parental expertise in performing rectal washouts at home is ensured by our CNS team before and after PT., Results: PT was completed in 69 of 74 HD patients. Rectal washouts were attempted on 63 patients before PT. Failure of rectal washout efficacy necessitated a stoma in four patients (6.4%). Of the 65 patients who had PT and stoma closed, three (4.5%) required a further stoma over a mean follow-up period of 57 months (Range 7-144 months). Two of these had intractable diarrhoea due to Total Colonic Aganglionosis (TCA). One patient (1.5%) had unmanageable obstructive symptoms requiring re-diversion. Hirschsprung-associated enterocolitis (HAEC) requiring hospital admission occurred in 14 patients (21%)., Conclusion: Our stoma rates are lower compared to recent UK data. This could potentially be due to emphasis on parental ability to perform effective rectal washouts at home under CNS supervision., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)