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Internationally, there is limited evidence about the role and impact of nurse practitioners (NPs) in complex malignant hematology (CMH). In one Canadian CMH program, NPs have existed for 20 years but not been evaluated. This study aimed to understand stakeholder perceptions of CMH NP role structures, processes, and outcomes and the extent to which the role meets patient and health service needs. A qualitative descriptive study was conducted, guided by the PEPPA-Plus framework. Purposive sampling was used to recruit stakeholders who participated in focus groups and interviews. Content analysis was used to analyze the data. Participants included patients (n = 8) and healthcare professionals (n = 27). Themes about structures related to evolution of the CMH Program, model of care, and need for strategic vision. Process themes related to provision of accessible, comprehensive, and holistic care and NP workload. Positive and negative outcomes and lack of outcome measurement were identified. Structures related to patient and NP characteristics, organizational change, staffing, and how NP work is organized impacts on NP role implementation and outcomes. Organizational structures can be strengthened to improve the model of care and NP role implementation and workload. Value-added NP contributions related to providing comprehensive care with attention to safety and social determinants of health. Research is needed to evaluate NP role outcomes in CMH. The results can inform role design and organization policies and strategies to promote the recruitment, retention, and optimization of NP roles in CMH settings. Priorities for future research are also identified. [ABSTRACT FROM AUTHOR]

The labor markets for care professionals are a perennial topic of discussion. Advanced practice nurses (APN), as an advanced role in nursing, arose to solve the shortage of primary health care professionals. Prior research has advanced several areas of exploration for APNs’ training or employing methods in Chinese hospitals. However, this leaves a key imperative unexplored: the management strategy of APNs in hospitals. The present study seeks to explore the management strategy of APNs in Chinese hospitals. The resource orchestration theory served as the guide as the multi-case study method investigated 18 case hospitals, gathered information from a variety of case data sources, and summarized the management strategies for hospitals’ advanced practice nurses. Four types of APN management strategies—expert customized type, hierarchical linkage type, multidisciplinary benefit type, and professional penetration type—have been identified through resource orchestration. Hospitals can utilize the APN management strategy model as a guide to manage APNs in accordance with the unique characteristics of APN resources.

The scope of end-of-life communication is not well known among nephrology advanced practice nurses (APNs). Guided by the Theory of Planned Behavior, the study aimed to examine the independent effects of knowledge, attitude, and perceived behavioral control on the engagement of APNs in end-of-life communication and the mediating and moderating effects of attitude and perceived behavioral control on the relationships between knowledge and end-of-life communication. A theoretically derived 17-item survey measuring the concepts was administered to a convenience sample of 127 APNs. Descriptive statistics, Pearson's correlation, and multiple linear regression were employed. Attitudes and perceived behavioral control on end-of-life communication mediated and moderated the relationship between knowledge of end-of-life communication and engagement in end-of-life communication among nephrology APNs. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impact of the COVID‐19 pandemic on the emotional and spiritual well‐being and resilience of a global sample of Advanced Practice Nurses. Design A web‐based cross‐sectional mixed methods study. Survey data were collected from Advanced Practice Nurses globally over a 2‐month period ending on 31 August 2020. Methods: The Warwick‐Edinburgh Mental Well‐being Scale, FACIT‐12 Spiritual Well‐being Scale and Connor‐Davidson Resilience Scale 10 were used to quantify emotional and spiritual well‐being and resilience of Advanced Practice Nurses' globally. The survey was distributed internationally using snowball sampling via a secure platform (Qualtrics). Results were analysed using various bivariate tests for associations and group differences. Results: Nine hundred and twenty‐eight Advanced Practice Nurses from 53 countries participated in the study. Study participants reported meaningfully lower scores in resilience and emotional well‐being compared with non‐pandemic scores. Participants from countries with well‐developed Advanced Practice Nurses roles reported lower resilience and well‐being scores compared with those from countries where Advanced Practice Nurses roles are still being developed. Each scale revealed significant positive associations with the other scales. Conclusions: Emotional and spiritual well‐being and resilience of Advance Practice Nurses has been significantly impacted during the COVID‐19 pandemic. Regardless of their work location, work hours, credential or demographics, the APNs in our study reported lower levels of resilience and mental well‐being compared with typical scores on the instruments. [ABSTRACT FROM AUTHOR]

Genomic science is rapidly evolving, and ordering germline testing requires appropriate and comprehensive assessment of a patient's personal and family history, as well as the knowledge base to facilitate selection of the best test or panel of tests, provision of pretest counseling for informed consent, interpretation of test results, post-test recommendations, and coordination of care for other at-risk family members. Prior to ordering germline genetic testing, an advanced practice RN's scope of practice accountability includes consideration of competence in the provision of genomic care. This article provides a case study to illustrate the complexities of issues related to competence when ordering germline genetic testing. [ABSTRACT FROM AUTHOR]

The perioperative environment has seen the implementation of the perioperative nurse surgical assistant as an advanced practice nursing role for the instrument nurse; however, there is currently no recognised equivalent role for the anaesthesia nurse. Anaesthesia nurses complete post-graduate qualifications and learn advanced clinical skills, and yet the authoritative body for perioperative nurses, the Australian College of Perioperative Nurses, does not define a specific role for advanced practice nursing in anaesthesia. Career advancement for the anaesthesia nurse focuses on education and management roles which are a distinct deviation from advanced clinical practice. A new role should be developed to allow the advanced practice nurse in anaesthesia to be recognised and their skills used in Australian operating rooms. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The shortage of general practitioners in Switzerland requires new ways to ensure primary outpatient health care. The group practice Medbase Winterthur Neuwiesen has been testing the use of Advanced Practice Nurses (APN) and Clinical Nurses (CN) for the treatment of clearly defined cases with minor illnesses for the past two years. In the context of quality assurance, this study examines the quality of treatment and outcome in 60 patients with symptoms of an acute upper respiratory tract infection, half of whom were assigned to a physician and half to an APN/CN

Abstract Background Considering shortages of general practitioners (GP) and strategies for improving the quality of health care provision, many countries have implemented interprofessional care models with advanced practice nurses (APN). International evidence suggests that APN care results in high patient satisfaction. In Switzerland, the role is still new, and the patient perspective has not yet been researched. Our aim was therefore to explore patients’ experiences with the APN role in Swiss family practices. Methods We conducted 22 semi-structured interviews in four different family practices with patients aged 18 to 97 suffering from minor acute to multiple chronic diseases, and who had at least one consultation with an APN. All interviews were audiotaped, transcribed verbatim, and analysed using qualitative content analysis. Results The analysis resulted in five themes: Despite the unfamiliarity, all patients were willing to be consulted by an APN because it was recommended by their GP (1); after several encounters, most participants perceived differences between the APN and the GP consultation in terms of the length and style of the consultations as well as the complexity of their tasks (2); the interviewees emphasised coaching, guidance, care coordination, and GP-assisting tasks as APN core competencies and attributed the characteristics empathetic, trustworthy, and competent to the APN role (3); most patients especially valued home visits and the holistic approach of the APNs, but they also noticed that in certain cases GP supervision was required (4); and due to the close collaboration between the APN and the GP, patients felt safe, well cared for and experienced improvements in physical and psychological well-being as well as in daily activities (5). Conclusion Our results suggested that patients value the APNs’ competencies, despite their initial lack of role knowledge. Trust in the GP seemed to be the most important factor for patients’ receptiveness toward the APN role. Overall, patients perceived an added value due to the enlargement of the scope of practice offered by APNs. The patient perspective might provide valuable insights for further APN role implementation in Swiss family practices.

Abstract Background Primary care systems around the world have implemented nurse practitioners (NPs) to ensure access to high quality care in times of general practitioner (GP) shortages and changing health care needs of a multimorbid, ageing population. In Switzerland, NPs are currently being introduced, and their exact role is yet to be determined. The aim of this study was to get insight into patient characteristics and services provided in NP consultations compared to GP consultations in Swiss primary care. Methods This case study used retrospective observational data from electronic medical records of a family practice with one NP and two GPs. Data on patient-provider encounters were collected between August 2017 and December 2018. We used logistic regression to assess associations between the assignment of the patients to the NP or GP and patient characteristics and delivered services respectively. Results Data from 5210 patients participating in 27,811 consultations were analyzed. The average patient age was 44.3 years (SD 22.6), 47.1% of the patients were female and 19.4% multimorbid. 1613 (5.8%) consultations were with the NP, and 26,198 (94.2%) with the two GPs. Patients in NP consultations were more often aged 85+ (OR 3.43; 95%-CI 2.70–4.36), multimorbid (OR 1.37; 95%-CI 1.24–1.51; p

Suicide prevention is a major public health issue, both nationally and internationally. The management of suicidal patients leaving emergency departments is crucial to preventing the risk of suicidal recurrence. Advanced practice nurses in psychiatry and mental health can provide real added value thanks to their specialist training, their ability to carry out a comprehensive and detailed clinical assessment, their mastery of medicinal and non-medicinal therapeutic interventions, their skills in coordinating the various players involved in the care pathway, their commitment to prevention and their skills in supporting the development of the skills of care and research teams., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Medication iatrogenia is a real public health problem. Elderly people are particularly at risk, due to their multiple pathologies, including heart failure; residents of residential care facilities for the dependent elderly (Ehpad) are no exception. Studies show that this risk is avoidable in 60% of cases, and that advanced practice nurses (APNs) can play a pivotal role in preventive measures. How would the role of the APN be perceived by other healthcare professionals working with these heart failure patients institutionalized in Ehpad?, (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Introduction: The number of Advanced Practice Nurses (APNs) has significantly increased in France since 2019, with the number of graduates expected to reach 1700 by the end of 2023, up from approximately 60. Fifteen percent of them specialize in oncology-hematology (APN-OH). Data on their activities, access to continuing education, and expectations are limited., Methods: We conducted an observational study among practicing APN-OHs in France. A questionnaire was distributed from June to September 2023., Results: Of the 55 responding APN-OHs, 78.3% worked in Cancer Centers or within University Hospital Centers. Their primary motivation for becoming APN-OH was to enhance their nursing practice and deepen their medical knowledge, with teaching and research interests remaining marginal. Their level of responsibility generally aligned with their expectations and the medical staff was perceived as supportive. The main challenges were of logistical and material nature. The heterogeneity in APN-OH training was seen as a limiting factor in the attractiveness of the profession. The most significant gaps in their education revolved around the lack of practical cases., Conclusion: This study highlights that the primary concern of APN-OHs is to strengthen their practical training. Medical personnel are perceived as supportive, but challenges related to working conditions and education persist. It is essential to consider these factors to support the deployment of APN-OHs across the country and improve ongoing education., (Copyright © 2024 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Background: In the United States health care system, nurse practitioners (NPs) and physicians work very closely in the delivery of high-quality patient care across lifespans and acuities. In fact, advanced practice nurses work closer with physicians in their day-to-day care delivery than with any other group of professionals. This remains true even in states with independent practice for NPs. Because of the significant relationships between physicians and NPs, assessment of how these professionals resolve conflict is essential. Purpose: The purpose of this study was to determine the style of conflict resolution employed by NPs and physicians. Methods: Nurse practitioners (n = 57) and physicians (n = 58) were randomly sampled from the Florida Department of Health—Health Care Practitioner Data Portal (N = 115). Participants completed a demographic questionnaire assessing experience in conflict resolution training and the Rahim Organizational Conflict Inventory—II, Form C , which defined the style of conflict resolution they most used and preferred. Results: Results showed that 29.8% of physicians and 40.4% of NPs received formal conflict resolution/management education/training (p =.24). The dominant style of conflict resolution used for 78% of physicians and 74% of NPs was the integrating style, with no statistical difference between the two professions (p =.87). Implications for practice: Physicians and NPs lack formal education on conflict resolution in their graduate studies. In addition, both professionals tend to use similar styles of conflict resolution among one another in clinical practice, which affects their collaboration and ultimately how optimal care is delivered to patients. [ABSTRACT FROM AUTHOR]

• Advanced practice nurses are well-positioned to engage in clinical research • Barriers to engagement in research persist for practicing advanced practice nurses • Mentored research opportunities can foster engagement and lead to benefits • Increased capacity for research can advance nursing science Advanced practice nurses (APNs) are well-positioned to function in research settings, however barriers to their engagement persist. Capacity-building through multisite research opportunities is an important strategy to overcome these barriers. To describe the benefits and challenges of incorporating APNs in research and discuss opportunities for building capacity for nursing research. Grounded in the experience of a nurse-led multisite longitudinal observational descriptive symptom study, field notes representing the research continuum were reviewed and categorized into themes reflecting benefits and challenges. Uniform benefits of acquiring research knowledge and skills, participating in research activities, and engaging in professional development were experienced among APNs. Limited support for regulatory and research activities, inadequate financial infrastructure, and a perceived lack of value for APNs' professional growth were commonly encountered challenges. Establishment of an infrastructure that elevates benefits and mitigates challenges is necessary to effectively incorporate APNs in a research environment, build capacity, and advance nursing science. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study explores physicians' perceptions of the advanced practice nurse (APN) role in the primary care setting in Singapore. Methods and Design: A descriptive qualitative design utilizing face‐to‐face semistructured interviews was conducted on a purposive sample of 16 primary care physicians from six primary care clinics. Thematic analysis and constant comparative analysis were used. Findings: Three themes were identified: a collaborative partner in primary care, a conduit for specialist care and information, and a leader in community care. Physicians generally reported positivity about the clinical role of APNs and their potential in leading community care. However, they verbalized role ambiguity beyond clinical practice. Conclusions: Physicians viewed primary care APNs as competent healthcare professionals. They viewed APNs as specialists in their fields, with the potential for expanding their services into the community. However, there remains gaps in physicians' understanding of the primary care APNs' nonclinical roles. The findings from this study indicate a need for nursing schools and nurse leaders to increase awareness of the complete APN role among physicians. APNs' roles in educating healthcare professionals and delivering care to the community can be further developed. Clinical Relevance: APNs are at the forefront in leading nursing care. There is a need to develop greater collaborative partnerships while delineating their respective roles in patient care. [ABSTRACT FROM AUTHOR]

Aim: To conduct a construct validity test on a clinical nurse specialist core competency scale. Background: Clinical nurse specialists' competency development dates back to the late 20th century; however, there is scarcity of competency descriptions from outside of North America. Furthermore, little knowledge is available on the previous research‐driven efforts to develop and validate clinical nurse specialist core competencies. Design: A descriptive study, using an online self‐report questionnaire, was conducted from May to September 2019 in three Nordic countries. Methods: An exploratory factor analysis using principal axis factoring and rotation method oblimin with Kaiser normalisation was undertaken to examine factors in the 50‐item scale. Parallel analysis with eigenvalue Monte Carlo simulation and scree plot was used to determine the number of factors to extract. Psychometric properties of the scale were evaluated, and subjective interpretation was used to modify the tool in line with the statistical analysis. The STROBE checklist was used as the reporting guideline for this study. Results: One hundred and eighty‐four responses were obtained (Finland n = 52, Denmark n = 95, Iceland n = 37) with an overall response rate of 45%. The results provided construct validity evidence of the underlying theoretical structures of the four competency spheres of patient, nursing, organisation and scholarship. Cronbach's alpha coefficient for the original overall scale was 0.94, thus indicating adequate reliability of the scale. Conclusions: Based on the analysis and subjective interpretation, we suggest a 47‐item clinical nurse specialist core competency scale. Further study should be conducted to validate the core competency content and construct in other contexts beyond the present study. Relevance to clinical practice: The scale may be used to guide clinical nurse specialist practice and identify areas for professional development, develop graduate‐level programme curricula and inform future competency research. [ABSTRACT FROM AUTHOR]

Background: Internationally, there is increasing demand for nurse practitioner (NP) and advanced practice nursing (APN) roles; however, high variability exists in how NP/APN roles are defined and understood. Purpose: The aim of this research was to improve our understanding of how the NP/APN is defined globally by: 1) examining role definitions, competencies, and standards of practice for advanced practice nurses internationally; 2) describing from a global perspective the core concepts and common features of NP/APN associated with practice domains; and 3) exploring the utility of text mining and visual analytics in identifying the clustered core concepts common to NP/APN roles organized around the five advanced practice domains of the Strong Advanced Practice Model. Methods: This article describes the findings of a secondary analysis of an international NP/APN competency mapping project, using innovative text mining and visual analysis techniques to reexamine and summarize the NP/APN role in 19 countries from Africa, Australia, Asia, Europe, and North America. Results: Although weak aggrupation/associations suggest that further work is needed to define the domains of advanced practice with associatedmodel development, visual analysis points to the identification of common concepts and linkages between concepts for each practice domain of advanced practice outlined in the Strong Model. Implications for practice: The secondary text mining and visual analysis presented in this article allows for comparison of core elements between advanced practice role descriptions, standards, and competencies globally to ultimately provide a global perspective on the common features of NP/APN roles and areas where further delineation is required. [ABSTRACT FROM AUTHOR]

Copyright of SCENARIO: Official Italian Journal of ANIARTI is the property of ANIARTI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: To systematically explore the structures, functions, outcomes, roles and nursing credentials of memory clinics where nurses autonomously lead diagnosis and postdiagnostic care. Design: A systematic rapid review was conducted. Data sources: MEDLINE (Ovid), CINAHL Full‐Text (EBSCO) and EMBASE were systematically searched in December 2019 with no timeframe limitations imposed. Review Methods: The modified PRISMA checklist was used as a guide to facilitate the review. Articles identified were screened and assessed for inclusion criteria, and screening of reference lists of included studies was also completed. Results: Six articles, published between 2011–2019, including two case studies, two descriptive reports, one qualitative study and one programme evaluation were included in the review. Nurse‐led memory clinics were situated in community centres, on university campuses, hospitals and in general practitioners' offices. The services offered included assessment, diagnosis and treatment/postdiagnostic care. Nurse credentials included advanced practice nurses and a community psychiatric nurse who was a non‐medical prescriber. Overall, there was low quantity and quality of evidence to evaluate outcomes. [ABSTRACT FROM AUTHOR]

Sedative‐use disorder can occur in elderly individuals, but remains a taboo subject. France is the second top‐consuming country of benzodiazepines (BZDs) and Z drugs in Europe, with 38% of women >80 years old using these drugs. Despite the recommendations of the French National Authority for Health (HAS) to general practitioners, deprescription remains rare. The aim of this study was to understand the perception of healthcare providers towards BZD or Z drug withdrawal within a psychogeriatric unit and to provide insights from advanced practice nurses (APRNs) on this topic. Eight healthcare providers from different professions in a psychogeriatric unit were interviewed. The interviews were recorded and transcribed verbatim, and the data were analysed following the interpretive phenomenological approach. The COREQ statement was used as a guide in the reporting of the study. Four themes were identified in the interview transcripts: (i) problems specific to the elderly; (ii) problems specific to BZD or Z drug consumption; (iii) present care; and (iv) envisioned practice. While the healthcare providers interviewed appeared to have knowledge on the adverse effects of BZDs, it appears difficult to taper the use of BZDs outside crisis periods of behaviour disorders in elderly patients. Caregivers recommend an evolution of practices, such as introducing BDZ and Z drug withdrawal programs that could involve the emerging profession of APRNs in general practice in France. APRNs could be a valuable resource to screen for BZD‐related disorders and to manage withdrawal strategies in complex cases. [ABSTRACT FROM AUTHOR]

The development of medical science creates new challenges for nurses to acquire new skills. Thanks to legal changes in Poland, nurses have gained the opportunity to independently provide health services in many areas, including consultations for patients. The aim of the survey is to analyze nurses' opinions on the expansion of competences in their profession. This is a cross-sectional, descriptive study conducted among 798 nurses using the survey technique. The majority (65.48%) of the respondents believed that they were adequately prepared to take up new competences. Most of the respondents believed that the new competence would improve the efficiency of the healthcare system in Poland (71.06%) and facilitate patients' access to health services (65.29%). According to the nurses, the scope of nursing advice will mainly concern the promotion of health education, wound treatment and prescribing medications. Age, seniority and education level significantly influenced the nurses' opinions on the scope of nursing advice. The Mann–Whitney test and the Kruskal–Wallis test were used. A correlation between two quantitative variables was assessed with the Spearman's rho coefficient. The significance level of p < 0.05 was assumed. The extension of the professional competences of nurses will increase the prestige of the profession and is another step toward introducing the role of Advanced Practice Nurse in Poland. [ABSTRACT FROM AUTHOR]

Abstract Background Primary care is facing a multimorbid, ageing population and a lack of general practitioners (GPs), especially in rural areas. In many countries, advanced practice nurses (APNs) may be a potential solution for these challenges. Switzerland, however, is in the early stages of APN role development with a handful of pilot projects that are unresearched. Our aim was to explore the experiences of APNs and GPs involved in introducing the APN role to Swiss primary care. Methods We organised two focus group discussions with APNs (n = 9) engaged in primary care across German-speaking Switzerland and individual interviews with APNs (n = 2) and GPs (n = 4) from two pilot projects in remote areas. Data analysis followed an exploratory hybrid approach of thematic analysis and was guided by the PEPPA Plus framework. Results The analysis resulted in five main themes: The participants considered themselves pioneers developing a new model in primary care, seeking to shape and improve future health care ((1) pioneering spirit). Both nurses and doctors agreed on the additional value of the APN role, a role seen as having more time for and a different approach to patient care, bringing higher quality of care and flexibility to the practice ((2) added value from the APN role). Participants also emphasized the importance of asking for advice when unsure about diagnostic steps or appropriate treatment ((3) awareness of limited knowledge and skills). The main barriers identified included the impression that Swiss doctors have little knowledge about nurses in advanced roles ((4) GP’s lack of knowledge regarding the APN role), and that further regulations will be important to foster role clarity and accountability ((5) political and legal obstacles in introducing the APN role). Conclusions The early phase of introducing APNs to Swiss primary care is characterised by heterogeneous, small-scale projects of pioneering GPs and APNs recognising the added value and limits of APNs despite a lack of governance and knowledge regarding the APN role among GPs. Experiences gained from ongoing projects provide elements of good practice for political discussions and regulations.

Aim: This study aimed to explore the role and impact of advanced practice nurses (APNs) in care of patients following fragility hip fracture by systematically reviewing the available evidence. Review Design: Systematic review. Data sources: A search of the databases Ovid Medline, CINAHL, Embase, Emcare, Cochrane Library, and Google Scholar was conducted from January–February 2019. Method: This systematic review adhered to The PRISMA Statement. Study selection was managed using the Covidence software platform and quality was assessed using JBI Critical appraisal tools. Studies included adults >18 years and described the role and impact of APNs in care of patients following fragility hip fracture on clinical and non‐clinical outcomes. Results: There were 19 papers identified that met the inclusion/exclusion criteria. Quality was graded as moderate to low risk of bias. Six characteristics of APNs were identified: (1) coordination; (2) collaboration; (3) education; (4) assessment, investigation and treatment recommendations; (5) discharge planning, support and follow up; and (6) documentation. Overall mortality and LOS improved when characteristics of the APN role were present. Conclusion: Key findings from this systematic review showed: (1) The APN title and role are not clearly defined, but characteristics of the APN role are evident; (2) characteristics of APNs promote the delivery of best practice hip fracture care and have a positive impact on mortality and LOS; and (3) innovative service delivery models involving APNs should be considered to address future projections of hip fracture rates and improve outcomes. Impact: This systematic review provides evidence of the role characteristics of APNs in fragility hip fracture and the impact of the role on outcomes. Findings from this research could be used to develop service delivery models using APNs to care for patients following fragility hip fracture and to inform practice where APN roles may improve outcomes for other patient cohorts. [ABSTRACT FROM AUTHOR]

Aims: This study was to determine if there is a greater difference in Advanced Practice student nurse self‐reported transition towards practice and professional identity for an experimental group compared with a control group. The information gathered is expected to: (a) provide a curriculum baseline for focused clinical objectives as well as preceptor training, and (b) to meet these objectives in alignment with the expectations for graduation and subsequent post‐graduation transition into practice. Design: Pilot exploration using quasi‐experimental, mixed methods included a quantitative five‐point Likert Scale and a self‐reported qualitative phenomenological analysis. Methods: This study evaluated responses from all participants through a series of three self‐report periods during a 14‐week clinical semester. Results: Based on the self‐reported data, the experimental group made minor additional progress with respect to their growth and professional identity transition compared with the control group. Conclusion: This study fostered the need for further studies to support residency programs that aid newly graduated nurse practitioners as they transition into the advanced practice role. Impact: The cost to replace these practitioners can be as high as twice their annual salary. The adjustment to an advanced practice role is difficult as postgraduate training is currently optional in many States. According to Brown, et al. (Nurse Educator, 2015, 40:148), novice Advanced Practice Nurses report being underprepared for this new role, particularly diagnostic interpretation skills. Supporting the advanced practitioner with a structured curriculum is imperative to achieve successful skills development, transition to practice, and professional identity. [ABSTRACT FROM AUTHOR]

Background: Families with preterm infants find life after hospital discharge challenging and need tailored support to thrive. The "Transition to Home (TtH)"-model offers structured, individual support for families with preterm infants before and after hospital discharge. TtH improves parental mental health and competence, promotes child development and fosters interprofessional collaboration (IPC). Aim: Evaluate the TtH-models' structure and implementation process and its associated interprofessional collaboration from the healthcare professional's (HCP) perspective. Methods: This qualitative explorative study thematically analyzed four focus group interviews (n=28 HCP) and an open-ended questionnaire with general pediatricians (n=8). Results: The main themes of the thematic analysis were the benefits of the TtH-model, tailored parental support, the challenges of changing interprofessional collaboration, facilitators and barriers to successfully implementing the model, and feasibility and health economic limits. HCP acknowledge that continuous family-centered care led by an advanced practice nurse (APN) supports, strengthens, and relieves families with preterm infants in the transition from hospital to home. Families in complex situations benefit most. The TtH-model incorporates key aspects of integrated care like shared decision-making, considering family preferences, and defining the APN as the family's main contact. HCP want network collaboration but found communication, cooperation, and reorganization challenging in the new IPC process. IPC challenges and involving many HCP in family care can create parental oversupply, negatively affect treatment outcomes, and raise health care costs. Conclusion: These challenges need to be addressed to ensure sustainable implementation of the model. The roles and tasks of HCP should be clearly distinguished from each other, and HCP must have time to learn this new form of IPC. Learning requires time, effective communication strategies, and leadership support. Political action is also required to implement new models of care, including regulating advanced practice roles and developing new financing models. [ABSTRACT FROM AUTHOR]

Introduction. Advanced Nursing Practice (ANP) is a relatively new concept in Poland. In order to be introduced, it needs a legal basis. There are specific regulations in Europe, yet they are only a framework for more detailed legislation in every member state of the European Union. Aim. To discuss Advanced Nursing Practice principles and the benefits for the national healthcare system resulting from implementing ANP in Poland. Discussion. Advanced Nursing Practice was defined in the 1950s in the United States of America. Presently in Europe and in Poland a definition by the International Council of Nurses (ICN) is applied. ICN has also defined the scope of competences for nurses of Advanced Practice. In Poland there already exist some regulations which substantially cover this scope. ANP implementation can naturally start in hospital settings. In ambulatory field ANP gives hope for effective transformation, namely increasing the efficiency and effectiveness of Primary Healthcare (pol. POZ) centers (comparable to General Practice in other countries). Conclusions. Effective implementation of ANP in Poland requires a slight modification of existing legal acts, a properly developed educational system and proven solutions or concepts derived from other European countries' experience. [ABSTRACT FROM AUTHOR]

In France, the supply of healthcare services remains insufficient to meet the growing needs of the population, which has prompted the legislator to authorize direct access to certain professionals, in particular advanced practice nurses (APNs) working in coordinated practice structures. This article details an innovative multi-professional pathway in a nursing home, where the APN takes direct charge of people without a general practitioner, with the aim of improving their access to care and reintegrating them into the healthcare system., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The institutionalization of the nursing discipline within French universities can take a number of different paths, but must not ignore a fundamentally diverse practical reality. Heterogeneity is also evident in the abundance of theories available and mobilized to address objects of nursing interest. This text emphasizes this mobilization and presents a rhizomic nursing discipline that departs from a classical, vertical and hierarchical academic discipline. It draws on multiple theoretical contributions to address the encounter with cared-for bodies, and on critical perspectives to question the future of advanced practice nurses as a caring corps., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Introduction Colorectal stomas are prevalent in surgical wards and demand careful medical attention, particularly in stoma management. Junior doctors play a vital role in this care, but their limited exposure and training may hinder their ability, impacting patient care. Given the dearth of literature, we aimed to assess junior doctors' stoma care knowledge and the efficacy of a specialized teaching course in boosting their confidence and skills. Methods The research, conducted at the West Suffolk Hospital NHS Trust in the UK, engaged 60 junior doctors, predominantly from Foundation Year 1 and Year 2, from August 2021 to December 2022. To ensure effective management and assessment, participants were divided into four groups, each comprising 15 doctors. A pivotal aspect of the study was implementing a structured stoma teaching series delivered by a panel of seasoned surgical experts. This series, conducted every Friday for three weeks, comprehensively covered all facets of stoma care. Both before and after the teaching series, assessments were administered to measure the impact of this educational intervention on the participants' understanding of stomas. The study meticulously adhered to ethical guidelines, with all participants providing informed consent, and measures were implemented to guarantee anonymity, thus safeguarding the privacy and confidentiality of all individuals involved. The primary objective of this investigation was to evaluate the efficacy of the stoma teaching series in augmenting the knowledge and comprehension of stomas among junior doctors. The findings of this study hold significant potential in guiding healthcare professionals toward developing more efficacious stoma education programs, ultimately leading to improved patient care outcomes. Results The study involved 60 junior doctors categorized into four groups from August 2021 to December 2022. It aimed to assess their understanding of colorectal stomas, focusing on complications and their knowledge about stoma appliances and care nurses. A questionnaire was used to evaluate their knowledge in these areas at the start of their surgical rotation, which showed significant knowledge gaps among participants. Of the 60 participants, 48 (80%) expressed slight or no confidence in basic stoma care, while 54 (90%) admitted unfamiliar with managing stoma complications. Astonishingly, all 60 (100%) participants lacked awareness of fundamental stoma care concepts. Significant improvements were observed following a comprehensive stoma teaching series covering basic stoma knowledge, its complications and management, and practical stoma care. Feedback from the course revealed positive outcomes, with 54 (87%) doctors feeling confident or very confident in basic stoma knowledge and 48 (80%) reporting increased familiarity with managing stoma complications. Remarkably, all 60 (100%) doctors indicated comfort with stoma care concepts after the sessions. Participants emphasized the course's value in medical education and professional development, citing enhanced practical skills such as communication and teamwork. Conclusion Our study revealed junior doctors' limited stoma knowledge, emphasizing the need for a dedicated teaching program that significantly improves their understanding. Focused stoma education is vital for junior doctors to deliver optimal patient care, necessitating hospitals to promote awareness for improved patient outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bavikatte et al.)

Aims: Same-day discharge (SDD) after atrial fibrillation (AF) ablation is an effective means to spare healthcare resources. However, safety remains a concern, and besides structural adaptations, SDD requires more efficient logistics and coordination. Therefore, in this study, we implement a streamlined, nurse-coordinated SDD programme following a standardized protocol., Methods and Results: As a dedicated SDD coordinator, a nurse specialized in ambulatory cardiac interventions was in charge of the full SDD protocol, including eligibility, patient flow, in-hospital logistics, patient education, and discharge as well as early post-discharge follow-up by smartphone-based virtual visits. Patients planned for AF ablation were considered eligible if they had a left ventricular ejection fraction (LVEF) ≥35%, with basic support at home and accessibility of the hospital within 60 min also forming a part of the eligibility criteria. A total of 420 consecutive patients were screened by the SDD coordinator, of whom 331 were eligible for SDD. The reasons for exclusion were living remotely (29, 6.9%), lack of support at home (19, 4.5%), or LVEF <35% (17, 4.0%). Of the eligible patients, 300 (91%) were successfully discharged the same day. There were no major post-SDD complications. Rates of unplanned medical attention (19, 6.3%) and 30-day readmission (5, 1.6%) were extremely low and driven by femoral access-site complications. These were significantly reduced upon the introduction of compulsory ultrasound-guided punctures after the initial 150 SDD patients (P = 0.0145). Standardized SDD coordination resulted in efficient workflows and reduced the total workload of the medical staff., Conclusion: Same-day discharge after AF ablation following a nurse-coordinated standardized protocol is safe and efficient. The concept of ambulatory cardiac intervention nurses functioning as dedicated coordinators may be key in the future transition of hospitals to SDD. Ultrasound-guided femoral puncture virtually eliminated relevant femoral access-site complications in our cohort and should therefore be a prerequisite for SDD., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

The rapid increase in the number of Parkinson's patients in the population is raising questions about the organization of expert resources. The creation of advanced practice nurses is likely to have an impact on this public health issue, as is the implementation of multi-level care gradation and the prospects for paramedical development., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Many elderly people live well and at home, but some require somatic and psychiatric care. Mobile psychiatric teams for the elderly are called upon to intervene with people aged 65-70 and over who are experiencing psychological distress. Among senior citizens, addictive disorders are very common, and are associated with psychiatric and geriatric co-morbidities. Alcohol, tobacco and benzodiazepine use disorders require holistic, individualized care, based on identification, prevention and referral, as well as training and coordination of professionals and caregivers., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

In a medical-social setting, the work of addiction care providers is somewhat unusual. Drawing on the teachings of Carl Rogers and his person-centred approach, and Hildegard Peplau and her theory of care based on the interpersonal relationship, this article explores the possibilities of welcoming a user to an addictology care, support and prevention center that is trying to rethink its operations at a time when advanced practice nurses are being deployed., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Demographic change and the resulting increase in chronic diseases, rapid developments in medicine and digitization, and the increasing shortage of skilled workers pose challenges for the German healthcare system. A rethink in patient care is required. This means that new structures, areas of action, and responsibilities must be implemented for professional nursing. The advancing academicization in nursing is leading to new role developments for professional nursing personnel in healthcare. Using the example of Klinikum Oldenburg (Oldenburg Hospital) as a maximum care provider in the region, many patients are treated in highly complex care situations that require a qualitative and evidence-based nursing practice. In order to ensure this, the concept of practice development according to McCormack, Manley, and Garbett has been implemented as a theoretical framework. Through direct evidence-based practice, complications can be reduced, which has a positive impact on mortality rate, length of stay, and readmission. Another positive factor is interprofessional collaboration and the skill-grade mix with diverse competencies. Taken together, these factors increase team satisfaction and lead to a positive outcome for patients. A prerequisite for implementing academically trained nursing professionals is good planning and preparation of the units and their stakeholders. Scientific support is also necessary to evaluate and potentially adapt the concept., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

This review aimed to examine the effectiveness of clinical nurse specialist (CNS) interventions in patients with chronic obstructive pulmonary disease (COPD). COPD significantly affects people’s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.

The aim of this study was to explore the experience of Spanish people living with rheumatoid arthritis (RA) and the support these people received from health professionals, particularly nurses. Nineteen patients with >1 year diagnosis, disease activity moderate or severe (DAS28 > 3.2), and already treated with disease-modifying antirheumatic drugs (DMARDs) were interviewed. A thematic analysis was performed to interpret the discourses. The difficulties of symptom management; the need for home-adaptations, the difficulties of living with a deteriorating self-image; and the reluctant reliance on medication to control their disease were the main themes that emerged from the discourse analysis of this study. Nurses appeared to have a limited role in RA patients care, and focused primarily on giving information and training for biological therapies. RA patients in Spain would benefit from having contact with specialist nurses who could empower them to self-manage their disease, as happens in other countries. [ABSTRACT FROM AUTHOR]

Background: Given the global shortage of the health workforce and the nature of diseases, strengthening and improving health care systems become a necessity. One of the solutions that is recommended by the literature is to utilize advanced practice nurses (APNs) to accelerate the progress toward the Sustainable Development Goals and universal health coverage (UHC). Purpose: To delineate APN practice and competencies in relation to UHC and primary care in Jordan from the perspective of nurse administrators, clinical nurse specialist, academics, and policymakers. Procedure: A descriptive exploratory survey design was utilized to identify APN competencies that are important in achieving UHC. The survey developed by one of the authors (JH) at a PAHO Collaborating Center to delineate APN practice and APN competencies was adapted and utilized. A convenience sample of 94 nurse leaders was recruited from the education sector, nursing associations, councils, and hospitals. Results: The results showed that all four competencies (clinical care; interdisciplinary and patient‐centered communication; systems of care; and using evidence for best practice) were rated as agree/strongly agree across all four domains. There was a consensus of participates on dimensions of all competency domains. Conclusion: The current study confirms that the role of APNs is still in its infancy in Jordan. The current study provides nurse educators with baseline information that can be utilized as a framework for APN education programs. The faculty readiness to start new competency‐based APN programs or revise the current graduate programs needs to be assessed. [ABSTRACT FROM AUTHOR]

Aim: To determine the construct validity and test–retest reliability of the Patient Satisfaction Survey Questionnaire (PSSQ). Background: Advanced practice nurses (APNs) co‐manage patients with non‐communicable diseases (NCDs) with public primary care physicians in Singapore. The original Nurse Practitioner Satisfaction Survey (NPSS) instrument was adapted (renamed as PSSQ) to assess satisfaction with APN service. Method: A total of 209 patients self‐administered the PSSQ at first visit and repeated it in a retest through phone within the next 2 weeks in 2018. Cronbach's alpha and intra‐class correlation (ICC) coefficients were performed to evaluate the internal consistency and test–retest reliability. Construct validity was determined by confirmatory factor analysis (CFA). Results: The overall Cronbach's alpha (>0.7) and ICC scores (0.697–0.729) indicated excellent test–retest reliability and good internal consistency, respectively. The CFA results of three‐factor model showed poor fit. Additional exploratory factor analysis (EFA) and principal component analysis (PCA) with varimax rotation revealed that adding another factor (communication with physician) resulted in a better model (eigenvalue > 1). The ICC for the four‐factor model ranged from 0.664 to 0.825, indicating fair to excellent reliability. Conclusion: The PSSQ shows good internal consistency and test–retest reliability. The four‐factor model is a better instrument to assess APN service in local populations. Implications for Nursing Management: The validated PSSQ can be used as instrument to assess the quality of services provided by various categories of nurses, including registered nurses, nurse clinicians and APNs. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Exploring new roles and responsibilities available to clinicians offers a path to renovate a nurse practitioner's career. The role of academician and nurse faculty broadens career horizons, presents a sense of autonomy, and offers unique opportunities to teach, participate in research, build leadership skills, and contribute to the health care delivery system at a higher level. Advance practice nurses often consider a shift to academia but are concerned about the unfamiliarity of the entire process. This article offers elements a clinician will likely encounter throughout the transition to a faculty role. These include expectations for the application and interview, negotiating for a position, and orientation to the role of an academic. [ABSTRACT FROM AUTHOR]

Background: Primary care systems around the world have implemented nurse practitioners (NPs) to ensure access to high quality care in times of general practitioner (GP) shortages and changing health care needs of a multimorbid, ageing population. In Switzerland, NPs are currently being introduced, and their exact role is yet to be determined. The aim of this study was to get insight into patient characteristics and services provided in NP consultations compared to GP consultations in Swiss primary care. Methods: This case study used retrospective observational data from electronic medical records of a family practice with one NP and two GPs. Data on patient-provider encounters were collected between August 2017 and December 2018. We used logistic regression to assess associations between the assignment of the patients to the NP or GP and patient characteristics and delivered services respectively. Results: Data from 5210 patients participating in 27,811 consultations were analyzed. The average patient age was 44.3 years (SD 22.6), 47.1% of the patients were female and 19.4% multimorbid. 1613 (5.8%) consultations were with the NP, and 26,198 (94.2%) with the two GPs. Patients in NP consultations were more often aged 85+ (OR 3.43; 95%-CI 2.70–4.36), multimorbid (OR 1.37; 95%-CI 1.24–1.51; p < 0.001) and polypharmaceutical (OR 1.28; 95%-CI 1.15–1.42; p < 0.001) in comparison to GP consultations. In NP consultations, vital signs (OR 3.05; 95%-CI 2.72–3.42; p < 0.001) and anthropometric data (OR 1.33; 95%-CI 1.09–1.63; p 0.005) were measured more frequently, and lab tests (OR 1.16; 95%-CI 1.04–1.30; p 0.008) were ordered more often compared to GP consultations, independent of patient characteristics. By contrast, medications (OR 0.35; 95%-CI 0.30–0.41; p < 0.001) were prescribed or changed less frequently in NP consultations. Conclusions: Quantitative data from pilot projects provide valuable insights into NP tasks and activities in Swiss primary care. Our results provide first indications that NPs might have a focus on and could offer care to the growing number of multimorbid, polypharmaceutical elderly in Swiss primary care. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The advanced nurse practitioner (ANP) role was established in Ireland in 2001 and represents an important nursing role development within Irish healthcare. Currently there are 336 ANPs registered with the Nursing and Midwifery Board of Ireland, working across 40 specialties. This number is increasing exponentially in response to emerging and anticipated future service needs and population demand projecting to a critical mass of 750 by 2021. Health service provision is enhanced by advanced practice performance outcomes. This article explores nurse to advanced nurse practitioner transitional journeys, a concept that has not previously been researched in depth from an Irish perspective. The theories of Benner, Woods, and Bourdieu are reviewed to explore whether an advance practice career trajectory results in unique nurse-to-ANP role transitioning. Contextualising possible personal, professional and educational transitions may enable the promotion of effective career 'scaffolding' to enhance a smooth transition for aspiring ANPs into advanced nursing practice roles. [ABSTRACT FROM AUTHOR]