Search

Objective: To explore advanced practice nurses' experiences and perceptions of running nurse-led clinics in the Australian context. Background: Advanced practice nurses consult with patients through nurse-led clinics to address ever-growing clinical demands and healthcare workforce shortages. Their experiences and perceptions of running nurse-led clinics are vital, but studies offering insights into this area are scarce. Study design and methods: This study adopted a qualitative descriptive design. Using purposive and snowball sampling methods, ten semi-structured individual virtual interviews were conducted with advanced practice nurses who run nurse-led clinics in Australia. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Reporting of this study adhered to Consolidated Criteria for Reporting Qualitative Research guidelines. Results: Three themes were constructed: 1) the genesis of nurse-led clinics; 2) perceived positive outcomes of nurse-led clinics; and 3) contextual determinants influencing nurse-led clinics. Findings show that nurses establish, manage, and expand nurse-led clinics to fulfil health service demands and patients' care needs. Though advanced practice nurses reported positive outcomes, there were several barriers that need to be addressed at all levels. Discussion: Advanced practice nurses are required to have wide-ranging knowledge and skills across the validated domains of patient care, support of systems, education, research, and professional leadership to be able to provide evidence-based holistic care. Advanced practice nurses face obstacles in running nurse-led clinics with overwhelming workloads and insufficient support. Regular communication with healthcare organisational leadership and collaboration with other healthcare workers is crucial to gain recognition and support. Conclusion: Nurse-led clinics are a valuable service that should be promoted and recognised. It is the responsibility of healthcare organisations to review current policies and provide necessary support to advanced practice nurses to enable effective and efficient nurse-led services. It is also incumbent upon governments to support funding that enables nurse-led care models across policy, funding, and healthcare levels, spanning macro-, meso-, and micro-levels. Implications for research, policy, and practice: Advanced practice nurses as participants shared experiences in establishing, running, and expanding nurse-led clinics, that can provide a framework to other nurses wanting to start nurse-led services. Advanced practice nurses are encouraged to promote their work to gain recognition and create awareness of the role of nurses in the provision of nurse-led services. More studies are needed at the global level to understand advanced practice nurses' experiences and the challenges they encounter which will assist in developing the strategies to address these barriers. What is already known about the topic? * Nurse-led clinics were introduced to mitigate the shortage of healthcare resources, accommodate increasing clinical demands, and enhance patients' experiences. * Nurse-led clinics achieve positive outcomes, however, advanced practice nurses face barriers in running nurse-led clinics. * Studies offering insights into Australian advanced practice nurses' experiences and perceptions of running nurse-led clinics are lacking. What this paper adds? * Advanced practice nurses shared experiences in establishing, running, and expanding nurse-led services which can be adopted to guide nurses new to nurse-led services. * Advanced practice nurses strived to overcome obstacles encountered in running nurse-led clinics. They need support at all levels to implement nurseled services successfully. * As this is the first study of its kind in Australia, more research is needed to promote and improve the awareness of nurse-led clinics both in Australia and globally. [ABSTRACT FROM AUTHOR]

Background: Airway clearance impairment has a significant impact on self-care and quality of life. Identifying clinical data, nursing diagnoses, and nursing interventions is essential to clinical reasoning and enhancing nursing care. This study aims to map the existing evidence on clinical data, nursing diagnoses, and nursing interventions addressing the nursing focus on "airway clearance". Methods: Research was conducted based on Joanna Briggs's Scoping Review Methodology. We searched four databases for published studies until December 2023. Results: From the initial 1854 studies identified, 123 were included in the review. The findings highlighted two areas of nursing attention: one related to signs and symptom management, and the other related to education and coping strategies. The data that led to nursing diagnoses were divided into cognitive and clinical data. The nursing diagnoses were mostly related to secretion retention, excessive mucus production, and airway obstruction. The most commonly identified nursing interventions were educational interventions assembled into predesigned education programs rather than patient-tailored programs. Conclusions: Findings can add substantial value for systematizing the nursing process related to "airway clearance", improving nursing decision-making and care quality. This study was prospectively registered with the Open Science Framework (OSF) on 02 December 2022, with the registration number wx5ze. [ABSTRACT FROM AUTHOR]

Aim: Patients living with chronic obstructive pulmonary disease (COPD) are challenged with managing the medical, social, and emotional consequences of the disease. Self-management of the disease plays a major role in actively preventing a deterioration such as an acute exacerbation (AECOPD). The aim of this study was to explore patients’ perspectives on self-management, for both participants who received a complex multicomponent behavior-focused intervention (e.g., physical activity) after hospitalization (intervention group) and participants who did not (control group). Design: A qualitative descriptive study design was used. Methods: Semi-structured one-to-one interviews were conducted (n = 10). A newly implemented counselling program conducted by an Advanced Nursing Practice (ANP) care team was introduced as part of the study. Participants in the control group received standard treatment for hospitalized AECOPD, while the intervention group received counselling focused on patient self-management from the ANP care team over a 13-week period. Control and intervention group narratives were compared using framework analysis. Results: The predominant four topics in both groups were deducted from Lorig’s conceptualization of self-management. These were: the management of burdensome emotions, the management of life roles, the management of medical regimen and recommendations, and the perception of self-management needs. The participants in the intervention group reported that counselling by the ANP team helped motivate them to sustain physical activity. They also found it reassuring to have a contact person they could easily reach out to in case of any queries or uncertainties, which provided them with a sense of security. Conclusion: There is a need for support in several areas of self-management after hospitalization for AECOPD. The newly introduced nurse-led self-management support was immediately well-received. Indeed, all participants appreciated the contact with their respective health professionals. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice, in conjunction with optimum care quality, improves patients' clinical outcomes. However, its implementation in daily clinical practice continues to present difficulties. The aim of this study was to identify the strategies applied by Advanced Practice Nurses (APNs) to foster adherence to clinical practice guideline recommendations. Methods: An exploratory qualitative study was conducted with six focus groups at three public hospitals belonging to the Balearic Islands Health Care Service (Spain). The study participants were 32 ward nurses and 5 advanced practice nurses working routinely with inpatients at these hospitals. The study was conducted from November 2020 to January 2021, using thematic analysis, based on the COREQ checklist. Results: Four major themes related to the facilitation process were identified either by RNs and APNs: the context of the project, APN contribution to nursing team management, healthcare provision on the ward, and the acquisition and application of knowledge. Conclusions: The APNs adapted their actions to the characteristics and needs of the local context, employing strategies aimed at improving teamwork, healthcare, and knowledge management. Each of these contributions enhanced the sustainability of the changes made. [ABSTRACT FROM AUTHOR]

(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing's role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of this study was to review the scope of the existing scientific literature on creating safe and inclusive healthcare environments for transgender people and provide an overview of the resources and nursing skills required to do so. (2) Methods: With the research question in mind, an exploratory search of six databases was conducted to identify all relevant primary studies. After screening and selection of articles based on the inclusion and exclusion criteria, a total of 41 articles were included and reviewed. (3) Results: The results were classified under four headings: the training of health professionals, the creation of safe spaces, the nurse as facilitator, and best care practice. Most of the evidence indicates that it is essential for nurses and other healthcare staff to be trained in specific skills to provide comprehensive, high-quality care to transgender people; however, there is a lack of material and human resources to do so. (4) Conclusions: The trans-inclusive care competent nurse should use neutral language that respects the person's preferred name and pronouns in a safe healthcare environment that offers and ensures warmth, respect, and inclusivity in the care provided. This study was registered with the Open Science Framework (OSF) on 9 January 2024 (osf.io/rpj6a). [ABSTRACT FROM AUTHOR]