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Aim: Identify and map international evidence regarding innovations led by or involving advanced practice nurses in response to COVID‐19. Background: COVID‐19 necessitated unprecedented innovation in the organization and delivery of healthcare. Although advanced practice nurses have played a pivotal role during the pandemic, evidence of their contributions to innovations has not been synthesized. Evidence is needed to inform policies, practices, and research about the optimal use of advanced practice nurses. Methods: A scoping review was conducted and reported using the PRISMA‐ScR checklist. Electronic databases were searched for peer‐reviewed articles published between January 2020 and December 2021. Papers were included that focused on innovations emerging in response to COVID‐19 and involved advanced practice nurses. Results: Fifty‐one articles were included. Four themes were identified including telehealth, supporting and transforming care, multifaceted approaches, and provider education. Half of the articles used brief and mostly noncomparative approaches to evaluate innovations. Conclusion: This is the first synthesis of international evidence examining the contributions of advanced practice nurses during the pandemic. Advanced practice nurses provided leadership for the innovation needed to rapidly respond to healthcare needs resulting from COVID‐19. Innovations challenged legislative restrictions on practice, enabled implementation of telehealth and new models of care, and promoted evidence‐informed and patient‐centered care. Implications for practice: Advanced practice nurses led, designed, implemented, and evaluated innovations in response to COVID‐19. They facilitated the use of telehealth, supported or transformed models of care, and enabled health providers through education, mentorship, and mental health support. Implication for policy: Advanced practice nurses are a critical resource for innovation and health system improvement. Permanent removal of legislative and regulatory barriers to their full scope of practice is needed. [ABSTRACT FROM AUTHOR]

Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper‐based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job‐demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job‐demand‐control‐support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. [ABSTRACT FROM AUTHOR]

Purpose: The COVID‐19 pandemic highlighted disparities in healthcare access and outcomes, particularly among individuals with chronic conditions. A positive outcome of the pandemic was an increased use of telehealth and the creation of innovative models of care. In many organizations, nurses became the leaders for these new models. Before this change, pediatric medicine had far fewer telehealth models than adult medicine due to limited Medicaid reimbursement and equipment that was not designed with children in mind. This article describes a new model of care for children with diabetes. We will review how a nurse‐led initiative with the incorporation of telehealth modalities can improve access and outcomes while reducing cost. Successful models of care will be reviewed, as well as programmatic planning, financial implications, and regulatory considerations. Conclusions: It is no longer necessary for families living in rural communities to drive long distances, missing school and work, to attend the frequent appointments needed for optimal management of pediatric diabetes. Telemedicine can bridge gaps in access to specialty care, and is feasible, reimbursable, and well‐accepted by families and providers. Practice Implications: Nurses in both primary care and pediatric specialty offices can initiate and support innovative telehealth models of care, such as this proposal. To win the backing of practice leadership, the availability of cost‐effective videoconferencing equipment and software, improvements in telehealth reimbursement prompted by the pandemic, and enhanced patient and parent satisfaction and outcomes should be emphasized. [ABSTRACT FROM AUTHOR]

Objectives To examine the evidence base for telemonitoring designed for patients who have chronic obstructive pulmonary disease and heart failure, and to assess whether telemonitoring fulfils the principles of monitoring and is ready for implementation into routine settings. Design Qualitative data collection using interviews and participation in a multi-path mapping process. Participants Twenty-six purposively selected informants completed semi-structured interviews and 24 individuals with expertise in the relevant clinical and informatics domains from academia, industry, policy and provider organizations and participated in a multi-path mapping workshop. Results The evidence base for the effectiveness of telemonitoring is weak and inconsistent, with insufficient cost-effectiveness studies. When considered against an accepted definition of monitoring, telemonitoring is found wanting. Telemonitoring has not been able so far to ensure that the technologies fit into the life world of the patient and into the clinical and organizational milieu of health service delivery systems. Conclusions To develop effective telemonitoring for patients with chronic disease, more attention needs to be given to agreeing the central aim of early detection and, to ensure potential implementation, engaging a wide range of stakeholders in the design process, especially patients and clinicians. [ABSTRACT FROM AUTHOR]

o'cathain a., sampson f.c., munro j.f., thomas k.j. & nicholl j.p. (2004) Journal of Advanced Nursing 45(3), 280–286 Nurses’ views of using computerized decision support software in NHS Direct Nurses working in NHS Direct, the 24-hour telephone advice line in England, use computerized decision support software to recommend to callers the most appropriate service to contact, or to advise on self-care. To explore nurses’ views of their roles and the computerized decision support software in NHS Direct. Qualitative analysis of semi-structured interviews with 24 NHS Direct nurses in 12 sites. Nurses described both the software and themselves as essential to the clinical decision-making process. The software acted as safety net, provider of consistency, and provider of script, and was relied upon more when nurses did not have clinical knowledge relevant to the call. The nurse handled problems not covered by the software, probed patients for the appropriate information to enter into the software, and interpreted software recommendations in the light of contextual information which the software was unable to use. Nurses described a dual process of decision-making, with the nurse as active decision maker looking for consensus with the software recommendation and ready to override recommendations made by the software if necessary. However, nurses’ accounts of the software as a guide, prompt or support did not fully acknowledge the power of the software, which they are required to use, and the recommendation of which they are required to follow under some management policies. Over time, the influence of nurse and software merges as nurses internalize the software script as their own knowledge, and navigate the software to produce recommendations that they feel are most appropriate. The nurse and the software have distinct roles in NHS Direct, although the effect of each on the clinical decision-making process may be difficult to determine in practice. [ABSTRACT FROM AUTHOR]