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ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To provide an overview of clinical supervision models and frameworks used in nursing and map them to their areas of use in nursing.A scoping review guided by JBI methodology for scoping reviews.A systematic search using CINAHL, Medline, PsycINFO, ERIC, and Emcare databases for English‐language papers published at any time and ProQuest and Google Scholar databases for unpublished guidelines was conducted in June 2023 and repeated in June 2024.Thirty‐nine papers covering thirty‐three clinical supervision models and frameworks highlighted conceptual confusion, lack of evidence for informed choices, and a need for balanced clinical supervision to enhance the reflective, critical thinking, and support of nurses transitioning to advanced practice.Further development is needed for clinical supervision models to support nurses transitioning to advanced practice.A clearer understanding of clinical supervision within contemporary nursing practice to support nurses' critical reflective thinking for advanced practice. A clearer understanding of clinical supervision within contemporary nursing practice. Importance of meta‐communication skills training for nurses and supervisors. Structured clinical supervision content should be based on nurses' clinical specialty and experience. Reporting was guided by The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews.No patient or public contributions were included as secondary data was used. [ABSTRACT FROM AUTHOR]

Aim: This article appraises models and theories related to advanced nursing practice. It argues that while the role of the advanced nurse practitioner builds on and extends beyond traditional nursing, it remains firmly grounded in 'caring'. Background: The stereotype that nurses 'care' and doctors 'cure' is fading. Increasingly, nurses have crossed boundaries and conducted independent assessment, diagnosis, prescribing and consultation, which used to be the doctor's role. Confusion and argument have arisen due to the higher‐level practice of the advanced nurse practitioner, as many questions where these 'doctor nurses' stand. Design: A literature review. Data Sources: Databases, including CINAHL, Medline and Google Scholar, were searched. Method: Databases were searched, and relevant studies and review articles from 1970 to 2023 were identified using the following keywords: 'advanced nurse practitioner', 'nurse practitioner', 'advanced nursing', 'advance practice', 'nurse practitioner', 'nursing theory' and 'nursing model'. Results: Although advanced nurse practitioners identify themselves as nurses, there is limited use of nursing theory to conceptualize this new level of practice and to define their contribution to the multi‐disciplinary team. It is noted that a holistic approach to personalized patient care, based on therapeutic relationships and effective communication, may help us identify the unique contribution of the advanced nurse practitioner. Conclusions: The development of advanced nursing theory needs to capture this holistic approach and its caring element to recognize the value and strengthen the identity allegiance of this hybrid role. Implications for the Profession and/or Patient Care: Holistic approach and patient‐centred care, effective communication and the therapeutic relationship are strong characteristics relating to ANP practice, the latter of which is yet to be clearly defined and captured in nursing theories. Conceptualizing ANP practice and capturing their valuable nursing care will enable better understanding and clarity for the role to realize its full potential. [ABSTRACT FROM AUTHOR]

Background: Master's degrees for nurses have various foci including clinical practice, leadership and education, with some programs consisting of coursework, while others offer hybrid study that combines coursework and research. Multiple formats are associated with offering the research component. The research component is often termed the minor thesis. Limited knowledge exists regarding the supervision of the research component. Aim(s): To capture the practices and perspectives of experienced nurse academics regarding effective supervision of the masters‐level minor thesis in nursing coursework master degrees. The Study: Design: Qualitative descriptive. Methods: Semi‐structured interviews with 28 experienced nurse academics recruited from 15 Australian and three New Zealand universities linked to the Council of Deans in Australia and New Zealand. Inclusion criteria were having experience of supervising masters‐level minor theses and higher degrees. Interviews were face‐to‐face using the internet platform Zoom©. Thematic analysis was undertaken. Findings: The analysis revealed three themes and associated sub‐themes: (i) establishing the framework (setting up the student's research; building the student–supervisor relationship; setting clear expectations), (ii) supervisors' knowledge and actions: driving for success (supervisors' knowledge for a satisfactory and timely outcome; supervisors' actions to develop students' capabilities; supervisors' actions of drawing in other expertise) and (iii) supervisor savviness: Attending to the finer points of supervision for student success (using your attributes as a supervisor; being savvy to teach and engage students; creatively seeking a smooth process for student success). Conclusion: The findings highlight three themes crucial to effective supervision of masters‐level minor theses in nursing: Establishing a strong research framework, emphasizing supervisors' knowledge and proactive engagement and attending to nuanced aspects of supervision for student success. These insights contribute to deeper understanding of the multifaceted nature of supervising minor theses, providing a valuable foundation for refining supervisory practices and enhancing the educational experience within coursework nursing master degree programs. Implications for the Profession and/or Patient Care: The findings highlight the supervisors' pivotal practices in guiding students through the minor thesis. These insights will be useful for inexperienced and experienced supervisors and for degree program directors. The findings should inform supervision training and supervision practices in the future. Impact: The study addressed a gap in knowledge about what experienced supervisors do to be effective and achieve success in the research component in a hybrid master degree for registered nurses.Effective supervision for student success in the minor thesis requires supervisors to establish and maintain a project and supervisory framework with appropriate boundaries and that is attuned to both the supervisor and student capabilities and preferences.Supervisors have an active role in directing the focus, scale and scope of a minor theses in keeping with university requirements and the short timeframe.Supervisors pay attention to the development of multiple student literacies (research, academic, professional, feedback and cultural) as core aspects of the masters research journey.Supervisors use their savviness and customize supervision to student contexts and capabilities as they guide development to achieve student success.The research findings have implications for targeted supervisor training and enhancing educational strategies for research supervision of minor thesis students. Reporting Method: COREQ reporting was adhered to as the relevant EQUATOR guideline. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

There is a growing number of non-medical prescribers in the UK. Practitioners working in advanced and specialist roles access university-based non-medical prescribing programmes to enhance their clinical practice. Despite this clinical and cultural shift, there is a paucity of literature and evidence on this issue. Using a mixed-methods approach of a focus group and the Likert survey, this study explored the experiences of specialist practice district nursing students undertaking non-medical prescribing. The findings of the study suggested that while the students felt supported by their teams, university and peers, there were limitations to the supervisors available and supervised prescribing opportunities, with a variance in the experiences of prescribing supervision. Further exploration into the experiences of prescribing supervision is warranted, as is the experience of prescribing students across multiple care settings. [ABSTRACT FROM AUTHOR]

In 2022, the radiation therapist committee of the Association française du personnel paramédical d'electroradiologie médicale (AFPPE, French association of paramedical electroradiology technicians), the Société française de radiothérapie oncologique (SFRO, French society of radiation oncology) and the Syndicat national des radiothérapeutes oncologue (SNRO, national syndicate of radiation oncologists) have been committed to working on the development of advanced practice roles. The objective of this article is to report the activities that should be in the scope of radiation therapists advanced practice and describe the competences required for these activities. This work was carried out by six radiation therapists, six radiation oncologists and one medical physicist representatives of the French national societies for each professional group. First, a basic list of activities was established and then competences were identified for groups of activities. In total, the list includes five core competences, nine competences and nine groups of activities that can be divided into the four pillars of advanced practice. The nine groups of activities can be presented in seven different dimensions including patient care and support, treatment planning, treatment imaging and delivery, management and consultancy, quality and risk management, research and innovation, education and training. The French advanced practice competences framework was developed with a multidisciplinary group to move forward the project of a master degree in advanced practice in radiation therapy in France. [ABSTRACT FROM AUTHOR]

Aim: To explore the feasibility of development and implementation of an educational intervention addressing sexual and gender minority healthcare issues; examine recruitment processes and instrument appropriateness. Design: Non‐randomized feasibility study. Methods: The educational intervention was developed and implemented in family nurse practitioner courses with data collection from August through December 2022. Clinical preparedness, attitudinal awareness and basic knowledge were measured using the lesbian, gay, bisexual and transgender Development of Clinical Skills Scale. Results: Development and implementation of the intervention was feasible but will require amendment before progressing to the pilot study. Clinical preparedness and basic knowledge increased post‐intervention, but attitudinal awareness did not improve. Recruitment did not achieve the desired sample size. Instrument internal consistency reliability was confirmed. Conclusion: Feasibility was established but will require amendment prior to the pilot study. Implications for the Profession and/or Patient Care: To prepare nurses and nurse practitioners to care for sexual and gender minority patients. Impact: This study addressed the feasibility of developing and implementing a sexual and gender minority healthcare education using an e‐Learning platform. Findings confirm that the intervention was feasible but will require amendment. The intervention increased knowledge and clinical preparedness in caring for this population, but recruitment was challenging. This research will impact nurses, nurse practitioners and nurse educators. Reporting Method: The authors adhered to the relevant EQUATOR guidelines. The Consolidated Standards of Reporting Trials guideline extension for reporting randomized and feasibility guidelines were used. Public Contribution: Sexual and gender minority community members contributed to the intervention development. What Does this Paper Contribute to the Wider Global Clinical Community?: The feasibility of using interactive e‐learning educational resources to provide sexual and gender minority healthcare curriculum.Evidence to support the use of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale to measure learning outcomes. Trial Registration: This study was not prospectively registered because it was an educational intervention involving graduate student nurses and did not assess clinical outcomes of patients. [ABSTRACT FROM AUTHOR]

Advanced clinical practitioners (ACPs) are experienced health professionals educated to master's level. They are accountable for the assessment, diagnosis and treatment of individuals, and are responsible for making complex decisions. The case study presented in this article critically analyses the consultation involving a male patient in his sixties with a 2-day history of abdominal pain, who was referred by his GP to a surgical assessment unit. Analysis was carried out using the Calgary-Cambridge Model. The article discusses history-taking, abdominal examination and differential diagnoses, and presents the process of how the trainee ACP arrived at the diagnosis of appendicitis. [ABSTRACT FROM AUTHOR]

Over the past two decades, the emergency nurse practitioner (ENP) role has significantly enhanced emergency care in the United States. With the increasing complexity of emergency care, ENPs have expanded into nontraditional settings, necessitating regulatory updates to maintain patient safety. The Consensus Model for Advanced Practice Registered Nurse Regulation has influenced ENP practice, yet consistent regulatory recognition is still needed due to the marked evolution in ENP practice. Despite collaborative efforts to prepare the ENP workforce and ensure competency through standardized education, certification, and licensure, recent unethical publications and skewed statistics have threatened the specialty's progress. Addressing these challenges is crucial for advancing the ENP role and ensuring high-quality emergency care delivery. [ABSTRACT FROM AUTHOR]

Aim: This study explores the experiences of interprofessional collaboration of Canadian midwives and obstetricians from midwives' perspective. Design: A concurrent mixed‐methods approach that combined a small validation study and qualitative thematic analysis was used to provide evidence of the nature and importance of collaboration between Registered Midwives (RMs) and obstetricians. Method: Eighteen RMs across Canada completed a demographic survey and the Midwifery‐Obstetrician Collaboration (MOC) scale in 2023. The quantitative analyses were conducted to assess the reliability of the Midwifery‐Obstetrician Collaboration (MOC) and accumulate preliminary evidence to support its validity. Semi‐structured interviews were conducted with 13 participants. After completing the interviews, themes were identified using thematic analysis. Results: The primary themes identified were knowledge of midwifery scope affects collaboration, collaboration is necessary for effective patient care, midwife‐physician collaboration is impacted by power differentials and hierarchies, and proposed methods to improve physician‐midwife collaboration. Although a small sample size did not permit extensive statistical testing, the quantitative results supported the reliability of the MOC scale. In addition, a strong correlation between the MOC and the communication subscale of the Inter‐Professional Collaboration (IPC) scale provided evidence of the MOC's concurrent validity as a measure of collaboration between midwives and physicians. Conclusion: This study provides support for the Midwifery‐Obstetrics Collaboration (MOC) Scale as an assessment tool to evaluate collaboration between midwives and OB/GYNs in obstetrics care. While the 18 RMs recruited for this study provided a fulsome analysis for the qualitative portion, a larger study is necessary to provide more extensive quantitative analysis to validate the MOC scale for continued use among RMs and OBs. Implications: The implications of this study are to foster strong interprofessional relationships between midwives and OBs and to improve the health outcomes of pregnant women and newborns. Reporting Method: The authors adhered to Consolidated criteria for reporting qualitative research (COREQ). [ABSTRACT FROM AUTHOR]

Aim: To explore healthcare workers' experiences of the changed caring reality during the COVID‐19 pandemic in Sweden. Design: An online fully mixed‐methods design. Methods: A web‐based self‐reported questionnaire with fixed and open‐ended answers collected data from March to April 2021, analysed in three steps. First, free‐text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta‐inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. Results: Meta‐inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post‐traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. Conclusions: Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID‐19 pandemic and to prevent mental health illness in future crisis. Patient or Public Contribution: No patient or public contribution. Summary: The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta‐analyses and systematic reviews. In‐depth understanding on experiences and how symptoms of post‐traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post‐traumatic stress disorder. Implications for Practice/Policy: This study might guide how to prepare for resilience in future emergencies. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim(s) Design Methods Results Conclusion Impact Patient and Public Contribution This study reports on the implementation of a registered advanced nurse practitioner intervention. Aims include improving access, service user outcomes and integration between primary and secondary care.This paper reports the quantitative results of a mixed methods implementation study. Qualitative data are reported separately. The PARiHS framework informs the implementation process itself, with considerations for nurses and other healthcare professionals explored.The CORE‐OM 34 item rating scale was administered both pre‐ and post‐intervention. Service user attendances in secondary care was monitored.Findings suggest that the intervention was associated with clinically significant improvements in global or generic distress, reported by service users, as evidenced by changes in the CORE‐OM scores. Access to care was recorded at an average of 3.6 days. Implementation science supported effective and safe implementation with clear governance structures.Registered advanced nurse practice in mental health clinics which provide full episodes of care results in improved integration and may be associated with positive patient outcomes. Implementation science is taught on Irish nursing programmes and this is important if innovative services are to be embedded in the healthcare system.The development of a model of care for mental health Registered Advanced Nurse Practitioners at the interface of primary and secondary care settings may be merited. Positive Advanced Recovery Connections may be associated with improving mental health outcomes and bolstering integration of primary and secondary care services. The utilisation of implementation science highlights the need for collaboration with all stakeholders to overcome barriers and recognise facilitators to attain the necessary model of integrated care.Peer recovery input was provided by members of the service Recovery College, with participation evident in all stages of the project. The psychosocial assessment template was also co‐designed. [ABSTRACT FROM AUTHOR]

In the United Kingdom, radiographers with a qualification in image interpretation have interpreted mammograms since 1995. These radiographers work under the title of radiography advanced practitioners (RAP) or Consultant Radiographer. This study extends upon what has been very recently published by exploring further clinical, non-clinical and experiential factors that may impact the reporting performance of RAPs. Fifteen RAPs interpreted an image test set of 60 2D mammograms of known truth using the Detected-X software platform. Unknown to the reader, twenty cases contained a malignancy. Sensitivity, specificity, lesion sensitivity, receiver operating characteristic (ROC) and jack-knife free response operating characteristic (AFROC) values were established for each RAP. Specific features that had significant impact on accuracy were identified using Student's-T and Mann Whitney tests. RAPs with more than 10 years' experience in image interpretation, compared to those with less than 10 years' experience, demonstrated lower specificity (51.3% vs 84.8%, p = 0.0264), ROC (0.83 vs 0.91, p = 0.0264) and AFROC (0.75 vs 0.87, p = 0.0037) values. Further, higher sensitivity values of 90.7% were seen in those RAPs who had an eye test in the last year compared to those who had not, 82% (p = 0.021). Other changes are presented in the paper. These data reveal previously unidentified factors that impact the diagnostic efficacy of RAPs when interpreting mammographic images. Highlighting such findings will empower screening authorities to better examine ways of standardising performance and offer a baseline for performance benchmarks. This study for the first time performs an initial exploration of the factors that may be associated with RAP performance when interpreting screening mammograms. [ABSTRACT FROM AUTHOR]

* OBJECTIVE: To assess the effectiveness of a single session of education and exercise compared with multiple sessions of a multimodal physiotherapy intervention for adults with spinal disorders in an advanced practice physiotherapy specialized spine model of care. * DESIGN: Pragmatic randomized controlled trial. * METHODS: We randomized patients with spinal disorders, who were referred for a spinal surgery consultation and triaged as nonsurgical cases by an advanced practice physiotherapist, to a single session of education and prescription of an exercise program (n = 52) or multiple sessions (6 in total) of a multimodal physiotherapy intervention (n = 54). The primary outcomes were the short form Brief Pain Inventory pain severity scale (BPI-S) and the Brief Pain Inventory pain interference scale (BPI-I), and secondary outcomes included disability, quality of life, catastrophization, and satisfaction. Linear mixed models were used to assess differences between groups across time points at 6, 12, and 26 weeks. * RESULTS: There were no significant between-group differences on the BPI-S and only a significant improvement at 6 weeks on the BPI-I in the multiple-session group (mean difference: -0.96/10; 95% CI, -1.87 to -0.05). There were no other statistically significant differences between groups, except for satisfaction where participants in the multiple-session group reported statistically significantly greater satisfaction on the 9-item Visit-Specific Satisfaction Questionnaire and the MedRisk questionnaire. Both groups saw significant improvements over time on all outcomes except for the BPI-S. * CONCLUSION: Adding supervised multimodal physiotherapy sessions did not result in better clinical outcomes when compared to a single session of education and exercise. Patients were more satisfied with the multiple-session approach. J Orthop Sports Phys [ABSTRACT FROM AUTHOR]

The aim of this article is to identify challenges for advanced practitioners within the district nursing services in remote and rural areas and the impact of the new Scottish GP contract. Advanced nurse practitioners (ANPs) working within the community providing care in patients' homes have a wide skill base to draw upon. However, community care is often not reviewed or studied to identify the impact it makes to patients and the wider community. This article looks at a review of the qualitative research provided by a search on CINAHL, Medline, PsychINFO and Google scholar between 2019 to 2023. Studies needed to be about advanced practice in remote and rural areas with a focus on district or community nursing. A separate search was conducted for reviews on the new Scottish GP contract and the impact on services this has had, using the same search engines and between the same dates. Articles that were based on ANPs working in GP practices were excluded. [ABSTRACT FROM AUTHOR]

Background/Objectives: Parents of premature infants experience depression, anxiety, post-traumatic stress disorder, and increased stress, which can negatively impact parent–infant relationships and infant development. To reduce negative consequences and optimally support families, we developed the Transition to Home model (TtH). In this randomized controlled pilot trial (RCT), the feasibility of performing an experimental study to analyse the effects of TtH on parental mental health over time was evaluated. Methods: The following domains were assessed: recruitment, follow-up and study burden, outcome measures used and parental mental health outcomes. We included n = 22 parent couples with their preterm infants in the control group and n = 23 in the intervention group. Depression, anxiety and post-traumatic stress disorders, parenting stress, and parental self-efficacy were assessed at five timepoints. The study burden was evaluated once at the end of the study. Results: The control and intervention groups had similar socio-demographic characteristics. The groups showed no differences in the mental health outcomes except for depression in mothers at T2 (p = 0.042) and T5 (p = 0.027) and state anxiety in fathers at T2 (p = 0.016). Conclusions: This pilot RCT established a framework for the evaluation of the TtH model of care and demonstrated the viability of the evaluation scheme. The results confirm the suitability of the RCT's structure and the feasibility of the methods and instruments used. Minor adjustments are recommended to include a more diverse sample in future studies. [ABSTRACT FROM AUTHOR]

Objective: Pharmacist-led research is key to optimizing medicines use and improving pharmacy services, yet it is not yet widely embedded into careers. This study aims to identify predictors of confidence in meeting the research learning outcomes in the Royal Pharmaceutical Society (RPS) Post-Registration Foundation and Core Advanced curricula, to provide targeted recommendations for building research capability and capacity within the profession. Methods: The study was a cross-sectional electronic survey, distributed to eligible pharmacists in March 2023 (n = 253). The survey gathered demographic information, research experience, and self-reported confidence in meeting the research learning outcomes in the RPS Post-Registration Foundation and Core Advanced curricula. Pre-determined independent variables were analysed using two binomial logistic regression models (one per curriculum) to identify predictors of the dichotomous variable: confidence with meeting all research learning outcomes in that curriculum. Key findings: Participants were more likely to self-report as confident (versus not confident) with meeting all research learning outcomes in a curriculum if they had recent experience (within the previous 12 months) of research or research-related activities, held a postgraduate research qualification, had undertaken research training outside of a postgraduate qualification, discussed research in their appraisal, or worked in the hospital sector. Conversely, male gender, years practicing, and protected time for research did not predict confidence. Conclusion: A targeted approach, including improving access to research methods training, experience-based learning, mentorship, and linking research projects to key organizational objectives, could be the key to developing research capability and capacity across all sectors and career stages. [ABSTRACT FROM AUTHOR]

Cardiac electrophysiology is a highly specialized field focused on the management of cardiac arrhythmias. Therefore, rigorous training is required for advanced practice providers (APPs) to competently practice independently within the specialty. An in-depth, 12-month training curriculum was created for electrophysiology in conjunction with a previously established APP Fellowship Program for the training of other complex subspecialties at an academic medical center. The Stanford Health Care Electrophysiology APP Fellowship Program is the first in the country to provide in-depth education and training for novice APPs to deliver high level care to patients with cardiac arrhythmias. The training program has proven to be successful in transitioning novice APPs to independent practitioners within the specialty since its inception in 2021.

Abstract This viewpoint paper focuses on challenges for Swiss physiotherapy education institutes related to the transition towards evidence-based practice and the incorporation of advanced roles within the profession. To tackle such challenges, it is essential to establish structured pathways and competency frameworks and position physiotherapists as integral contributors to innovative healthcare.

Aims: The aim of the study was to develop a comprehensive competency framework for advanced practice nurses in Belgium. Design: A co‐design development process was conducted. Methods: This study consisted of two consecutive stages (November 2020–December 2021): (1) developing a competency framework for advanced practice nurses in Belgium by the research team, based on literature and (2) group discussions or interviews with and written feedback from key stakeholders. 11 group discussions and seven individual interviews were conducted with various stakeholder groups with a total of 117 participants. Results: A comprehensive competency framework containing 31 key competencies and 120 enabling competencies was developed based on the Canadian Medical Education Directions for Specialists Competency Framework. These competencies were grouped into seven roles: clinical expert and therapist, organizer of quality care and leader in innovation, professional and clinical leader, collaborator, researcher, communicator and health promoter. Conclusion: The developed competency framework has resemblance to other international frameworks. This framework emphasized the independent role of the advanced practice nurse and provided guidance in a clear task division and delegation to other professionals. It can provide a solid foundation for delivering high‐quality, patient‐centred care by advanced practice nurses in the years to come. Implications for the profession: This competency framework can guide further development of advanced practice nursing education in Belgium and represents a starting point for future evaluation of its feasibility and usability in education and clinical practice. Advanced practice nurses and healthcare managers can also use the framework as an instrument for personal and professional development, performance appraisal, and further alignment of these function profiles in clinical practice. Finally, this framework can inform and guide policymakers towards legal recognition of advanced practice nursing in Belgium and inspire the development of advanced practice nursing profiles in countries where these profiles are still emerging. Impact: What problem did the study address? The absence of a detailed competency framework for advanced practice nurses complicates legal recognition, role clarification and implementation in practice in Belgium.A rigorously developed competency framework could clarify which competencies to integrate in future advanced practice nursing education, mentorship programs and practice. What were the main findings? The competency framework outlined seven roles for advanced practice nurses: clinical expert and therapist, organizer of quality care and leader in innovation, professional and clinical leader, collaborator, researcher, communicator, and health promoter.Differentiation from other expert nursing profiles and clinical autonomy of advanced practice nurses were pivotal. Where and on whom will the research have impact? The comprehensive competency framework for advanced practice nurses and the collaborative methodology used can inspire other countries where these profiles are still emerging.The competency framework can be used as an instrument for role clarification, performance appraisals, continuous professional development, and professional (e‐)portfolios.The competency framework can guide policymakers when establishing Belgian's legal framework for advanced practice nurses. Reporting method: The authors have adhered to CONFERD‐HP: recommendations for reporting COmpeteNcy FramEwoRk Development in health professions. Patient or public contribution: No patient or public contribution in the design of the study. A patient advisory panel commented on the developed competency framework. [ABSTRACT FROM AUTHOR]

Introduction: Global demand for healthcare is escalating, prompting exploration of innovative strategies to augment service capacity. Independent prescribing (IP) helps to address this challenge, allowing non-medical professionals to prescribe medication. Paramedics in the UK were granted prescribing privileges in 2018, yet uptake remains low. Despite qualitative evidence indicating that paramedic prescribing is beneficial, quantitative comparisons of medication provision between prescribers and non-prescribers are lacking. Paramedics provide patients with non-emergency medication by three different routes: IP, using a patient group direction (PGD) or with prescriber support. Advanced paramedic practitioners who are not qualified as independent prescribers, rotating through ambulance and general practitioner out-of-hours services, offered an opportunity to quantitatively compare medication supply. Methods: This study compares medication supply by three advanced paramedic practitioners using PGDs with three prescribing nurses in a Welsh general practitioner out-of-hours service. A cross-sectional design was employed to retrospectively review electronic patient clinical records between 1 December 2019 and 30 November 2020, including patients presenting with one of five generalised clinical conditions (urinary, soft tissue, respiratory, abdominal pain, ear). Descriptive analysis and non-parametric tests compared medications prescribed or supplied, how patients received medication and reasons for seeking prescriber support. Results: A total of 397 patient records were analysed. Paramedics supplied medications more frequently with prescriber support (68.2%) than via PGD (27.9%). Nurses predominantly prescribed medication independently (99.3%). Medication provision was comparable when paramedics had prescriber support. Reasons for paramedic support-seeking included having no PGD available (34.1%) and PGD being excluded from use (28.4%). Conclusions: Advanced paramedic practitioner medication supply using PGDs and prescriber support was comparable to that of prescribing nurse colleagues. However, autonomy restrictions highlight the need for paramedic prescribing in services where prescriber availability is limited. Further research evaluating the efficiency and cost-effectiveness of PGD use versus IP is necessary. Additionally, the qualitative benefits of IP, such as improved patient care and satisfaction, warrant due consideration when implementing future healthcare strategies. [ABSTRACT FROM AUTHOR]

Background: Following a change in legislation in 2018, paramedics gained prescribing rights but, as this is a recent change, no reviews have been carried out into their experiences. Aim: The overarching aim of this article is to understand the thoughts and opinions of current and future paramedic prescribers on non-medical independent prescribing. It also aims to identify potential barriers to paramedic independent prescribing (PIP), investigating the gaps within medication options, and the role of PIP in the autonomous scope of paramedic practice. Methods: A literature search of MEDLINE, CINAHL, PubMed and CENTRAL was undertaken in January 2023, with articles also gathered from grey literature, Google Scholar, citation searching and author contacting to identify literature for review. Six articles underwent thematic analysis, and four themes were identified: advanced practice; improved medication management; barriers to implementation; and effect on current practice. Findings: Overall, there are significant positives to paramedic independent prescribing, such as improved patient experiences, more medication options and fewer hospital admissions. However, there were concerns, which centred on the implementation process, underpinning support and increased responsibility. [ABSTRACT FROM AUTHOR]

Aim: To identify the roles of nurse‐surgeons in the provision of surgical care. Design: Scoping review. Methods: This scoping review adhered to the JBI guideline for scoping reviews and EQUATOR Network's PRISMA‐ScR checklist. Searches were performed from May 2022 to July 2022 using a combination of MeSH headings, keywords and filters via database and hand searching based on the eligibility criteria. Keywords included nurse‐surgeon, nurse endoscopist, nurse hysteroscopist and nurse cystoscopist. Data sources were CINAHL, Cochrane, Google Scholar, PubMed and Scopus. Descriptive analysis was used to report the findings. Results: Ninety‐six included records indicated nurse‐surgeon practice in 26 countries. Forty‐one nurse‐surgeon titles were found, the majority of which were types of nurse practitioner. A total of 5,684,198 surgeries were performed by nurse‐surgeons varying from laparotomies to biopsies. Nine records reported that nurse‐surgeons perform surgeries safely and on par with physicians with zero to minimal complications. Nineteen records reported improved surgical care efficiency by nurse‐surgeons in terms of patient access to surgery, waiting times, surgery times, patient show rates, patient education, physician workload and junior physicians' training. Seven records reported high patient satisfaction. Nurse‐surgeons were cost‐effective according to five records. Thirteen records recommended the standardization of nurse‐surgeon practice. Conclusion: Nurse‐surgeons performed millions of surgeries worldwide assisting in easing the global surgical burden. This review identified the roles and benefits nurse‐surgeons play in global surgical care. Research gaps on nurse‐surgeon roles were discovered including the ambiguity in nurse‐surgeon titles and the need to regulate nurse‐surgeon practice. Impact: This research addressed the clinical safety, quality, contribution to timely surgical access and cost efficiency of nurse‐surgeon performed surgeries, as well as the need to standardize nurse‐surgeon practice and use a more consistent nurse‐surgeon title to ensure role identification and monitoring. [ABSTRACT FROM AUTHOR]

Advanced practice is well established in the health professions with multiprofessional capabilities in place in England. To recognise achievement of these capabilities an ePortfolio (supported) route was initiated in 2022. This study aimed to review the demographics and experiences of radiographers applying for recognition in the first year of operation. The multi method evaluation consisted of quantitative data analysis of information regarding the first three cohorts of radiographers (n = 40) participating in the NHS England (NHSE) scheme. Interviews with 12 participants was undertaken with thematic analysis of the transcripts. Self-rated scores of expertise were significantly higher by therapeutic radiographers (n = 8) compared to their 32 diagnostic colleagues (t = 5.556; p < 0.01). Radiographers saw the ePortfolio as an opportunity to validate their experience and to evidence parity with other professions. Participants felt the process also enabled critical reflection and gave unseen insight into themselves and their roles. The support of experienced educational supervisors was felt to be vital in this process and for successful completion of portfolio. Several radiographers have now achieved the necessary standards to achieve NHSE recognition. The evaluation exposed that most radiographers did not have the relevant evidence to hand and the ongoing collection of evidence around capabilities and impact is critical to evidencing advanced practice capabilities. Radiographers are able to achieve the capabilities expected for multiprofessional practice. Cultural change is required to normalise recording of evidence within practice including case-based discussions, clinical supervision and feedback from colleagues and patients. The support of an experienced educational supervisor aided the critical reflection on practice level. [ABSTRACT FROM AUTHOR]

This article aims to outline the fundamental principles of consultations with and clinical assessments of patients with symptoms that may be indicative of respiratory system pathology. The article explores how to perform a respiratory system-focused patient history and physical examination. An evaluation of clinical 'red flags' to reduce the risk of omitting serious illness is also considered, alongside the exploration of features of respiratory pathology and evidence-based clinical decision-making tools that may be used to support clinical diagnosis. [ABSTRACT FROM AUTHOR]

There is an urgent need to develop an international competency and capability framework to support standardization of education and roles in advanced practice physiotherapy (APP). This need arose due to the rapid growth of the APP model of care, implemented out of necessity in the absence of agreement as to the competencies and capabilities or formal education required for the roles. This study explores the views and perceptions of practitioners and key stakeholders on a draft competency and capability framework for advanced practice physiotherapists. The purpose of this study was to: 1) gather feedback from key stakeholders (advanced practice physiotherapists, researchers, and leaders) on a draft competency and capability framework and 2) use that feedback to revise and improve the draft framework. Qualitative study using a series of four multi-national online focus groups. Thematic analysis was conducted according to Braun and Clarke. Sixteen participants from the United Kingdom, Ireland, Canada, Australia, and New Zealand participated in the study. Five themes were generated after data analysis: clinical expert, experienced communicator, strong leader, collaborator, and knowledge creator). A modified competency and capability framework was developed based on feedback from the focus groups and input from subject matter experts (SMEs). This study provides a modified core competency and capability framework comprising 24 competencies grouped under six domains. This study is a step toward international standardization of advanced practice physiotherapy based on a commonly agreed framework for the education and training of advanced practice physiotherapists. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated emerging roles among specialist child health nurses (CHNs) in Malawi. Advanced nursing role development is globally advocated. Nursing role descriptions provide an evidential basis for workforce planning. Rigorously developed role descriptions are scarce worldwide, especially for Africa. Advanced nursing roles were introduced in Malawi's child health system a decade ago. Design and Methods: We followed guidance on generating nursing role descriptions to collect and analyse qualitative data from interviews and focus groups, using qualitative content analysis. We used COREQ reporting standards. Results: More than half (41/80) of Malawi's child health nursing workforce participated. Richly descriptive accounts of roles elicited three themes: leading and developing new services and improving existing ones; holding rare knowledge which uplifts care quality; and responsibility for developing the role. These responsibilities are experienced as a privilege and a burden, often meaning CHNs are 'pulled to the four corners'. Practice Implications: We found evidence of remarkable achievements by Malawi's CHNs but also suggestions that they are under heavy strain. Because multi‐stakeholder agreement about role content is crucial to successfully implementing advanced nursing roles, we hope the approach taken by this study, and the information generated, could be useful as part of human resources for health strategy development in other lower‐resourced countries globally. [ABSTRACT FROM AUTHOR]

This paper presents motivational factors to engage, start a research project and pursue a research career. The study aimed to investigate radiographer's motivation for engaging in research. Eight radiographers from Denmark with experience in research were interviewed in a 2-h focus group interview in October 2023. This qualitative approach was selected to allow the participants to discuss their opinions and values. The discussions were audio recorded and transcribed before the thematic analysis was performed. The analysis revealed six main themes: the importance of radiographic research, the importance of radiographers' participation in research, research radiographers' motivation, funding and participation in research projects, demotivation and difficulties, and facilitating radiographic research in the future. The participants were motivated by different factors. The participants found both research in radiography and radiographers' participation in research-related activities important, although they found lack of support from managers, funding, and time to be demotivational factors. This study contributes to the limited literature on motivational factors for becoming a researcher within radiography. [ABSTRACT FROM AUTHOR]

Educational programs to prepare nurse practitioners (NPs) were historically built upon foundational nursing experience. Originally prepared as certificate programs in 1965, the educational requirements for nurse practitioners (NPs) rapidly shifted from certificate programs to the Master's degree (DellaBella, 2015; Fairman, 2008). As Doctor of Nursing Practice (DNP) degree programs increase in number, it is unknown whether this foundational nursing experience has changed, or if it differs by certification type for pediatric nurse practitioners (PNPs). This study aimed to evaluate the educational preparation and prior nursing experience of primary care and acute care certified PNPs. A national survey of members of the Pediatric Nurse Practitioner Certification Board (N = 17,530) was completed (Mudd et al., 2022). A sub-analysis of this data was conducted (n = 1974). Results: There was no statistical evidence among either primary or acute care PNPs of an association between previous nursing experience and type of degree preparation (Master's or DNP). There was only a weak association between educational preparation and experience among acute care nurse practitioners. Most respondents were prepared at the Master's level, and 85% of all respondents had >1 year of nursing experience prior to returning for additional PNP education. This study adds to the literature as it describes the educational preparation and foundational nursing experience of primary and acute care PNPs. It can serve as a benchmark as the move to the DNP continues for Advanced Practice Registered Nurse preparation. • Most PNPs returned to school with more than a year of nursing experience, regardless of whether they were seeking pediatric primary or acute care educational preparation. • Most PNP's returned to school with more than a year of nursing experience, regardless of whether they were seeking Master's or DNP degrees. • Most PNP's (primary and acute care certified) continue to be prepared at the Master's level, despite the increase in Doctor of Nursing Practice (DNP) programs. [ABSTRACT FROM AUTHOR]

Purpose: The study’s goal was to evaluate the impact of a Radiation Oncologist (RO)—Radiation Therapist (RTT) mentorship on image approval rates for a breast population undergoing radiation therapy in a high-volume practice. The mentorship was undertaken within a large health system in partial fulfillment of the Expert Practice Module for a Masters (MSc) in Advanced Practice Radiotherapy and Oncology. Methods: Images were retrieved from the MOSAIQ EMR on breast diagnostic code. 1,295 images/115 patients were reviewed pre-mentorship (October 2019-March 2020) and compared with 1,047 images/91patients during/post-mentorship (April 2020-September 2020). The Anderson-Gill (AG) model was used to estimate the hazard ratio for image rejection. Rejected images were classified by reason and compared using Fisher’s exact test. Concordance data (RO/RTT image rejection) were collected during Phase Three of the mentorship. Results: Of 115 patients assessed pre-mentorship, 16 (14 %) had at least 1 image rejected at any session. Of 91 patients assessed post-mentorship, 8 (9 %) had at least 1 image rejected. Likelihood of image rejection decreased by 54 %, with a hazard ratio of 0.46 [95 % CI: 0.24, 0.88]; p = 0.0195. Reasons for image rejection differed pre- and post-mentorship. Poor imaging technique accounted for rejection of 9 of 24 images (37.5 %) before compared to 0 of 11 images (0 %) post-mentorship. Other reasons for image rejection: depth at isocenter (25 % pre-mentorship; 18 % post-mentorship), supraclavicular medial border position (12.5 % vs. 9.09 %), isocenter location (12.5 % vs. 0 %), arm position (4.17 % vs. 54.55 %); hip alignment (8.33 % vs. 18.18 %). Concordance rate was 100 %. Conclusions: The mentorship proved successful in elevating the RTT’s skills and image approval rates, while contributing to improvements in departmental imaging best practices.

Aims: An advanced practice radiation therapist (APRT) role in vaginal vault brachytherapy (VBT) was first introduced in 2015. The aim of this manuscript was to clarify how the introduction of an APRT can improve efficiencies within service delivery while maintaining non inferior clinical outcomes of recurrence. Materials and methods: This was a single-centred retrospective comparative service evaluation of stage 1 endometrial cancer patients treated with postoperative high dose rate VBT alone. Sixty patients in total were included in the evaluation. They were divided into two equal groups of ‘before’ and ‘after’ based on the introduction of the APRT-led role and changes made to treatment processes. Quantitative analysis of waiting times from surgery to adjuvant VBT (weeks), duration of day one treatment procedure (minutes), rate of isolated vaginal recurrence and loco regional recurrence (vaginal and pelvic) were compared between the groups. Results: The mean time from surgery to treatment between the ‘before’ and ‘after’ groups was 13.1 and 9.1 weeks respectively. The mean time for day one treatment procedure was 91 min in the ‘before’ group and 59 min in the ‘after’ group. Vaginal free recurrence (VFR) was 100 % for both groups.. Conclusion: An APRT led vaginal vault service, with learnt role extension, allows for a more efficient and effective service delivery.

Background: Credentialing of advanced and specialist pharmacist practice (ASPP) provides essential quality assurance for ASPP, which is significantly different to entry-level practice and is developing worldwide. Several credentialing models are in place or under development internationally. Synthesis of the views and experiences of pharmacists and other relevant stakeholders on credentialing is an important research gap. Objective(s): To determine pharmacy stakeholders' views and experiences of ASPP credentialing and to explore facilitators and barriers to credentialing implementation and uptake. Methods: The Joanna Briggs Institute convergent integrated approach for mixed methods systematic reviews was followed. The review protocol was pre-registered with PROSPERO. Five electronic databases (Medline, CINAHL, Embase, Web of Science, Google Scholar) were searched from inception to August 2022 for qualitative, quantitative, or mixed methods studies that reported the views and experiences of pharmacy stakeholders on ASPP credentialing. The Mixed Methods Appraisal Tool was used to quality appraise included studies. Thematic synthesis was undertaken to analyse and integrate data from included studies. All screening and data analysis steps were performed by two reviewers independently, with additional author input where required. Results: Sixty studies were included, after screening titles and abstracts (n = 9055) and full texts (n = 228). Studies represented the views of pharmacists, pharmacy managers/employers and professional/representative bodies in hospital, community pharmacy, general practice/primary care, and academic sectors, from 40 countries. Four analytical themes were generated describing the factors, including facilitators and barriers, to be considered when developing or optimising ASPP credentialing: I. Drivers of credentialing, II. Developing ASPP competence, III. Optimising credentialing implementation, and IV. Enhancing credentialing uptake. Conclusions: This systematic review is the first to synthesise pharmacy stakeholders' views and experiences of ASPP credentialing. A conceptual framework highlights contextual factors, facilitators, barriers, and inter-relationships which should be considered by pharmacists, policymakers, and other key stakeholders when implementing ASPP credentialing.

The International Council of Nurses (ICN) 2025 Congress, themed "Nursing Power to Change the World," will convene in Helsinki, Finland, from 9 to 13 June 2025. This landmark event celebrates a century of nursing progress and addresses contemporary challenges in healthcare. The Congress emphasises the pivotal role of nurses in enhancing healthcare equity, accessibility, and outcomes, aligning with global health policy goals such as Universal Health Coverage (UHC). It will feature contributions from key international organisations like the WHO and the International Committee of the Red Cross, highlighting the event's global significance. With over 10 000 abstract submissions, the Congress promises a rich scientific programme, fostering knowledge exchange and professional development. Subthemes will explore nursing leadership, healthcare quality, education and the impact of transformative technologies. The Congress will also focus on advocacy, providing a platform for policy discussions on pressing global health issues. Networking opportunities will connect nurses with peers and leaders, promoting collaboration and career advancement. The inclusion of nursing students and early‐career professionals underscores the commitment to nurturing the next generation of nurses. The ICN 2025 Congress is a call to action for nurses worldwide to lead transformative change in healthcare, ensuring the profession remains dynamic and influential. Join us in Helsinki to celebrate the power of nursing and explore the many ways in which nurses can lead the change in advancing global health. [ABSTRACT FROM AUTHOR]

The evolution of radiation therapy techniques goes hand in hand with the evolution of the profession of radiation therapist. In the particular context of online adaptive radiotherapy based on cone beam computed tomography images, delegation of certain tasks from the physician to the radiation therapist is possible within the framework of a cooperation protocol. This delegation requires prior theoretical and practical training. It enriches the practice of radiation therapists by allowing them to acquire new skills and greater autonomy. It foreshadows access for radiation therapists to advanced practice. [ABSTRACT FROM AUTHOR]

IntroductionObjectiveMethodsResultsConclusionThe need for a global core competency and capability framework for advanced practice physiotherapy is important due to the rapidly changing nature of health care delivery internationally and the need to standardize advanced practice physiotherapy.To determine the importance of a proposed international core competency and capability framework for advanced practice physiotherapy.We conducted a cross-sectional online survey of advanced practice physiotherapists across seven countries. The importance of each competency and capability was rated on a five-point agreement Likert scale. Participants were from the United Kingdom, Ireland, Australia, New Zealand, Canada, Switzerland and Argentina.A total of 99 participants completed the survey, comprising 63% (57/90) females and 33% (30/90) males. Sixty percent, 60% (54/90), had over 20 years of experience. The survey participants represented a diverse geographic distribution, with 25% (23/90) from Australia, 25% (23/90) from Canada, 18% (6/90) from New Zealand, and 18% (6/90) from the United Kingdom. Four percent 4% (4/90) from Ireland, and 4% (4/90) from other countries (Switzerland and Argentina). The survey revealed a strong consensus among participants, with all competencies and capabilities ranked as high and considered important to advanced practice.This study demonstrates a consensus among advanced practice physiotherapists across seven countries on the importance of a proposed competency and capability framework. The findings highlight the need for a global standard in advanced practice physiotherapy, particularly in light of the rapidly changing healthcare landscape. [ABSTRACT FROM AUTHOR]

Background: There is increasing global evidence on the impact of advanced nursing and midwifery practitioners, and Kenya's healthcare system has an excellent opportunity to develop scopes of practice and other regulatory frameworks for the integration of these roles. Objective: The primary purpose of this gap analysis was to explore the existing evidence on opportunities and threats toward the integration of the advanced practice nursing (APN) and advanced practice midwifery (APM) roles in Kenya's healthcare system. Methods: The study team conducted a structured electronic database search of PubMed, CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrieve articles and credible websites for reports highlighting the opportunities and threats toward the integration of the APN and APM roles in Kenya's healthcare systems. The retrieved articles were screened for relevance and synthesized for reporting using the traditional literature review approach. Results: The Kenya Health Policy Framework 2014–2030, growing population needs, and implementation of universal health coverage provide an opportunity to harness and leverage advanced practice roles in nursing and midwifery. There is also momentum to develop advanced practice because of strategic alliances and global evidence showing the contributions and quality of services offered by advanced practice nurses and advanced practice midwives. However, lack of financial support, structural challenges, and lack of national policies, regulations, and legislation continue to obstruct progress. Conclusion and implications for nursing policy: Developing scopes of practice for APN and APM in Kenya will benefit the professions, the country's healthcare delivery system, and the population. Achieving universal health coverage depends on a health workforce trained and practicing at optimal levels in tandem with education and training to deliver quality care. [ABSTRACT FROM AUTHOR]

The development of advanced practice nursing has evolved globally over the past decades and has become an important component in the contemporary healthcare system. The term 'advanced practice nurse' is used to refer to nurses practising at a higher level than traditional nurses and is defined as a registered nurse who has acquired the expert knowledge base, complex decision‐making skills and clinical competencies for expanded practice. In 2003, Singapore embarked on the development of advanced practice nurses as an initiative to improve the nursing professional image, retain excellent clinical nurses and fill the gaps in the provision of healthcare services for the ageing population. This paper documents Singapore's journey of advanced practice nursing development and shares our unique learning experience in the aspects of education, certification, registration and scope of practice. [ABSTRACT FROM AUTHOR]

Introduction. Advanced and extended primary health care practice roles have been developed in Aotearoa New Zealand (NZ) for dietetics, nursing, pharmacy, and physiotherapy professions. Advanced musculoskeletal physiotherapy roles in primary health care could address escalating health care costs, challenges to workforce sustainability and inefficient primary/secondary care interfaces. Little is known about how stakeholders perceive the recently introduced Advanced Practice Physiotherapist (APP) scope of practice. Aim. This study aimed to explore health professionals' perceptions of the APP scope of practice in NZ and how APPs could influence physiotherapy service delivery for people with musculoskeletal conditions in primary health care. Methods. Qualitative, face-to-face, semi-structured interviews were conducted with 15 participants including physiotherapists, general practitioners, medical specialists and Accident Compensation Corporation case managers. Inductive interpretive analysis was undertaken. Results. Five themes were identified: perceptions of current musculoskeletal management in primary health care; lack of a career pathway; ways in which APPs might facilitate change and what their role would be; characteristics of an APP; and the implementation of the APP role into practice. Discussion. Stakeholders were supportive of the APP scope of practice and thought it has the potential to improve patient pathways, health care delivery and health outcomes for those with musculoskeletal conditions. Stakeholders also thought it would fill an important gap in the physiotherapy clinical career pathway. Successful implementation will require assessment of applicants' personal attributes as well as clinical experience and academic qualifications to ensure all stakeholders have confidence to engage with the service, clear communication, active promotion and specific funding. [ABSTRACT FROM AUTHOR]

Background: One of the means of easing increased pressure on emergency care worldwide has been the development of advanced musculoskeletal physiotherapy practice in the emergency department setting. This model of care is in its infancy in Ireland. Aims: To evaluate the effectiveness of an advanced practice physiotherapist working as a primary contact clinician in the emergency department at St. James's Hospital, Dublin. Methods: A three-month retrospective chart review was undertaken for patients assigned the advanced practice physiotherapist as their primary clinician during their emergency department attendance. Three widely accepted measures of quality in emergency medicine were used to evaluate effectiveness, namely, time from attendance to discharge, time from triage to assessment, and unplanned reattendance within seven days. Results: A total of 129 patients were included in this study. Time from attendance to discharge was significantly less in the APP group (mean 208.5 min, standard deviation 122.4 min) than in the ED group (mean 377.1 min, standard deviation 314.7 min) (mean difference − 168.61 (95% C.I − 191.24– − 145.98)) (p < 0.001). Time from triage to assessment was significantly less in the APP group (mean 72.1 min, standard deviation 51.9 min) than in the ED group (mean 94.1 min, standard deviation 96.5 min) (mean difference − 22.08 (95% C.I − 31.28– − 12.89)) (p < 0.001). The unplanned reattendance rate was 3.9%. No adverse events were identified. Conclusions: The findings of this study indicate that an advanced practice physiotherapist can provide a timely, effective, and safe service for patients attending the emergency department with musculoskeletal complaints in Ireland. [ABSTRACT FROM AUTHOR]

Aims Clinical guidelines recommend people with heart failure are managed within a multidisciplinary team to receive optimal evidence-based management of the syndrome. There is increasing evidence that Nurse Practitioners (NP) in heart failure demonstrate positive patient outcomes. However, their roles as key stakeholders in a multidisciplinary heart failure team are not clearly defined. The aim of the review was to explore the literature related to NP-sensitive outcomes in heart failure. Methods and results A scoping review was conducted according to accepted guidelines using the Joanna Briggs Institute framework for conducting a scoping review, to identify the literature that related to NP-sensitive outcomes in heart failure management. Sixteen texts were selected for data extraction and analysis. The most common outcome measures reported were readmission rates, self-care measurement scales, functional status scores, quality of life measurements, and medication optimization outcomes. No two studies collected or reported on the same outcome measurements. Conclusion This review highlights that the reporting of heart failure (HF) NP outcome indicators was inconsistent and disparate across the literature. The outcome measures reported were not exclusive to NP interventions. Nurse Practitioner roles are not clearly defined, and resulting outcomes from care are difficult to characterize. Standardized NP-specific outcome measures would serve to highlight the effectiveness of the role in a multidisciplinary HF team. [ABSTRACT FROM AUTHOR]

Non-medical professionals in the United Kingdom (UK) have been granted prescribing rights to improve patient care quality and cost-effectiveness. There is limited evidence on how therapeutic radiographer prescribers have impacted medicine management or patient services. An online survey was conducted amongst non-medical prescribing therapeutic radiographers in the UK between 2019 and 2022. The study teams initially analysed the individual data sets, subsequently combined, and secondary analysis was performed to provide a UK perspective, to understand the services provided and identify areas for improvement. Data was analysed using descriptive statistics from Microsoft Excel® and SPSS®. 74 non-medical prescribing therapeutic radiographers who were predominantly over 40 years old and in full-time work participated. The main job categories were consultant radiographers (n = 23, 31.1%) and advanced practice practitioners (n = 18, 24.3%). Many use their prescribing qualifications (87.5%, n = 62), issuing a mean of 15 independent and seven items by supplementary and prescribing per week. Most received assessment and diagnostic skills training before prescribing courses (91.6%, n = 67). Respondents prescribed from a median of six areas, with the highest being in GI (82%), skin (68%), infections (58%), urinary tract disorders (55%) and ear, nose, and oropharynx conditions (54%). This study presents the first report on therapeutic radiographers prescribing in the UK, offering insights into current practices and highlighting the success of non-medical prescribing. Therapeutic radiographers' roles continue to expand into advanced practice and medicine-prescribing responsibilities, contributing to holistic and patient-centred care. The results are relevant for nations grappling with oncology workforce shortages and contemplating similar roles for therapeutic radiographers. The study can be a valuable resource for policymakers and healthcare organisations worldwide. [ABSTRACT FROM AUTHOR]

Adapting radiotherapy services with workforce innovation using skills-mix or task-shifting optimises resources, supporting current and future demands. Advanced practitioners (APs) work at a different level of practice (beyond initial registration) across four pillars: clinical practice, leadership and management, education, and research. There is limited cross-country research on the advanced therapeutic radiographers/radiation therapists (TR/RTTs), particularly in Europe. This study aimed to investigate European radiotherapy stakeholders' perceptions regarding current and future advanced practice (AP). From June to September 2022, one-to-one online semi-structured interviews were conducted in English, and audio and video were recorded. Full verbatim audio files were independently transcribed and checked by interviewer and interviewees. Braun and Clarke's seven steps guided the thematic analysis (using NVivo). Thirty-three interviewees working or studying in 16 European countries represented practitioners (n=14), managers (n=6), educators (n=4), professional bodies (n=4), students (n=3), and regulators (n=2). Four overarching themes emerged: "AP drivers and outcomes", "AP challenges vs enablers", "Current vs future AP", "Becoming and being advanced practitioner". Participants identified research as the neglected AP pillar due to a lack of protected time, limited staff skills, no research culture, no funding, workload, and clinical priorities. Interviewees highlighted the importance of consistency in job titles, harmonisation of education models and curricula, definition of AP requirements, and support for all AP pillars through job plans and workforce planning. Neither the profession nor education of TR/RTTs are harmonised across Europe, which is highly reflected in advanced-level practice. Advanced TR/RTTs should work across all pillars, including research, and these should be embedded in master's programmes, including leadership. This study highlights a policy gap in the education and practice of APs in radiotherapy. [ABSTRACT FROM AUTHOR]

The practice of sonography in the United Arab Emirates is evolving rapidly. This study explores the professional landscape and challenges of sonography practice in the United Arab Emirates, focusing on identifying areas for improvement in education, practice scope, and professional development. Employing qualitative methodologies, using focus group discussions and thematic analysis, this research gathers insights from practicing sonographers across various healthcare settings in the UAE to assess current practices, educational needs, and workplace challenges. Findings reveal a consensus among sonographers on the need for a structured professional framework, standardized education pathways, and clear career progression routes. Additionally, the study highlights a desire among sonographers for an expanded scope of practice, particularly in specialized areas, amidst challenges such as workload and equipment quality. The study concludes that enhancing the sonography profession in the UAE requires a comprehensive approach that includes developing a regulatory framework, improving access to specialized training, and recognizing sonographers' advanced practice roles. Recommendations include establishing accredited educational programs, developing a formal competency framework, and advocating for role expansion and professional recognition. These steps are essential for meeting the evolving needs of the healthcare system and improving patient care outcomes. [ABSTRACT FROM AUTHOR]

In this novel advanced practice physiotherapy (APP) model of care, advanced practice physiotherapists (APPTs) assess, triage, and manage adults with spinal disorders to alleviate the growing demands in specialized spine medical care. To describe this APP model of care, to assess change in disability 3 months after rehabilitation care and to assess surgical triage and diagnostic concordance between APPTs and spine surgeons. In this retrospective observational study, consecutive patients who completed the 3-month follow-up data were analyzed. Sociodemographic, clinical characteristics, and self-reported disabilities including the Oswestry Disability Index (ODI) and Neck Disability Index (NDI) at baseline and 3 months were extracted. Paired t-tests were used to assess changes in disability. Surgical triage and diagnostic concordance between APPTs and surgeons were measured with raw agreement, Cohen's Kappa, and PABAK. In this model, trained APPTs triaged surgical candidates and provided rehabilitation care including education and exercises to patients with spinal disorders. The APPTs referred only 18/46 participants to spine surgeons. Surgical triage and diagnostic concordance were high with raw agreement of 94% and 89%. At the 3-month follow-up, significant improvements in disability were observed among nonsurgical candidates with back (mean difference (MD): −13.0/100 [95%CI: −19.8 to −6.3], n = 23) or neck disorders (MD: −16.0/100 [95%CI: −29.6 to −2.4], n = 5), but not among surgical candidates referred by APPTs to spine surgeons. In this limited sample, adults with spinal disorders that were initially referred to a spine surgeon by family physicians were effectively assessed, triaged, and managed by an APPT. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the main characteristics of master’s degree programmes and the expectations of master’s students • To learn about the benefits of a master’s degree for patient outcomes • To consider the relationship between critical thinking and critical reflection. Undertaking a master’s degree has become an integral part of nurses’ continuing professional development. However, there can be uncertainty among nurses about the requirements and expectations of this level of education, and about the benefits for patients and nurses. This article describes the main characteristics of master’s degree programmes and the expectations of master’s students. It also explores the literature on the benefits of a master’s degree in relation to patient outcomes, nurses’ clinical competence and professional autonomy and nurses’ career development. The author considers the concepts of, and relationship between, critical thinking and critical reflection and how nurses’ ability to apply these concepts in practice can be enhanced through undertaking master’s level education. [ABSTRACT FROM AUTHOR]

Advanced practitioners are healthcare professionals that are highly skilled with a particular area of expertise. These roles have been successfully implemented in many healthcare settings, improving efficiency of the service, as well as enhancing the standard of care received by patients. Although advanced practice roles have been implemented in some radiation therapy departments, their implementation have yet to be facilitated in the majority of countries. The purpose of this review is to scope the literature available regarding established advanced practice roles in radiation therapy. The PRISMA strategy for the identification of relevant literature was adhered to. Two data bases, EMBASE and PubMed, were searched using combinations of the key words ‘Advanced’, ‘Practice’, ‘APRT’, ‘Radiation’, ‘Therapy’ and ‘Radiotherapy’. Exclusion criteria were applied, and citation lists were also screened for additional relevant sources, including grey literature sources. A total of 35 relevant sources were identified that discussed advanced practice radiation therapy roles in the United Kingdom, Singapore, Canada, Australia and the USA. Means of role establishment and scope of practice were defined, and a number of advantages and challenges for advanced practice radiation therapist roles were identified. There are many benefits of implementing advanced practice roles in radiation therapy departments. Though the implementation of these roles can be challenging, the existing evidence indicates that it would be beneficial for the patient, the radiation therapist and the department as a whole. A more systematic approach, including reporting of quantitative outcomes may assist in the more widespread implementation of these roles. [ABSTRACT FROM AUTHOR]

Midwifery is undergoing increasing complexity attributed to global epidemiological, socio-economic and technological shifts. Coupled with a shortage of workforce and the imperative for cost-effectiveness and high-quality care, there is an ongoing international discourse and establishment of new care models and specialized roles, notably Advanced Midwifery Practice (AMP). While countries like the UK and Ireland have embraced AMP roles, Switzerland lags behind with only a few pioneering roles. The absence of regulatory frameworks for AMP within the Swiss legal and healthcare system, hinders the evolution of APM roles necessary to address contemporary needs in perinatal healthcare provision. To effectively harness the midwifery workforce and mitigate premature attrition, Switzerland must formulate distinct career trajectories for postgraduate midwives, particularly for Advanced Practice Midwives (APM). This involves establishing legal standards for educational and clinical prerequisites, delineating guidelines for APM responsibilities and competencies, and devising compensation schemes that mirror the autonomy and leadership competencies integral to these advanced roles within inpatient and outpatient perinatal care models. The incorporation of evaluation and research into AMP is indispensable, contributing to improved patient outcomes and the ongoing professionalization of midwifery. In conjunction with the Swiss Federation of Midwives, all Universities of Applied Sciences in Switzerland have collaboratively drafted a national position paper underscoring the significance of developing APM roles to ensure the provision of high-quality perinatal care. This article aims to elucidate current developments in perinatal care within the Swiss context, providing a comprehensive definition for AMP, delineating its contribution to enhancing and sustaining the quality of care. [ABSTRACT FROM AUTHOR]