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Introduction: With the development of the medical system and the diversification of patient needs, nurse practitioners (NPs) play an increasingly important role in medical practice, assuming more responsibilities and powers, including the right to prescribe. However, in the process of exercising the right to prescribe, NPs may face various obstacles, and there are also some promoting factors. Therefore, this study aims to deeply explore the obstacles and promoting factors in the prescription process of NPs through a qualitative meta-analysis and comprehensive method, so as to provide a basis for improving the prescription practice of NPs, improving nursing quality and patient satisfaction., Methods and Analysis: This study will adhere to the Joanna Briggs Institute framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. A comprehensive literature search and analysis of studies on nurse are prescribed via PubMed, Embase, Web of Science, CINAHL and the Cochrane Library. Two independent reviewers will select articles, extract data and appraise study quality. Content analysis will be used to synthesise outcomes, and methodological quality and evidence quality will be assessed. The quality of the articles will be assessed using the 10-item Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research., Ethics and Dissemination: Ethical approval will not be required for this study, as it solely encompasses data derived from previously published research. The findings will be disseminated through publication in a peer-reviewed journal. In addition, the results will be actively shared at major academic conferences focused on nursing research and healthcare policy to ensure that the study's outcomes reach key stakeholders, including healthcare practitioners, policymakers and researchers. This targeted dissemination strategy aims to promote the integration of the findings into practice and future research. This protocol is registered with the PROSPERO prospective database of systematic review., Prospero Registration Number: CRD42023398567., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Introduction: Referrals for recurrent epistaxis constitute a significant proportion of paediatric ENT consultations. In order to improve access to secondary care, a nurse-led paediatric epistaxis clinic (NPEC) was developed in collaboration with ENT specialist nurses. The purpose of this study was to describe the structure of NPEC at our institution and to assess the impact including safety, parental satisfaction and referral-to-clinic times., Methods: ENT specialist nurses were trained by an ENT Consultant through teaching sessions and clinic observations. Standard operating procedure was developed, and competencies were granted before commencement of NPEC. Service evaluation was done to assess the impact of NPEC including safety, parental satisfaction and referral-to-clinic times. All patients who attended NPEC from March 2022-February 2023 were included. Parental satisfaction questionnaires completed at the end of the clinic visit were prospectively collected for first 25 consecutive patients. Patient chart review was performed to assess for complications, need for consultant reviews and waiting times., Results: Forty-seven patients attended NPEC during the study period (77 clinic visits). Median age was 10 years (range 3-16 years). Management included antibiotic ointment (25/77), silver nitrate cautery (28/77) and 3 were listed for nasal cautery under general anaesthesia. Among cases which underwent silver nitrate cautery, there was one minor complication reported. Consultant review was required in 18 clinic visits (23.3 %), including 5 patients requiring fiberoptic nasal endoscopy. Over the study period, median referral-to-clinic time for new patients was 77 days, compared to 229 days for consultant clinic (p = 0.003, Wilcoxon rank sum test). Overall quality of care in NPEC was described as "very satisfactory" and "fairly satisfactory" by 92 % and 8 % parents respectively., Conclusion: Nurse led paediatric epistaxis clinics are safe and is associated with high parental satisfaction. Critical to success of NPEC is appropriate patient selection, training and availability of clinician support. These clinics offer a sustainable option to improve access to secondary care for paediatric epistaxis patients., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)

Objective: To compare the performance of the 2016 preliminary gout remission definition and a simplified gout remission definition in a clinical trial of nurse-led gout care., Methods: Data from a 2-year parallel arm, non-blinded, randomised controlled trial of 517 community-derived people with gout were analyzed. Participants were assigned 1:1 to receive nurse-led care or general practitioner usual care. Remission was defined using the 2016 preliminary gout remission definition and a simplified gout remission definition without patient reported outcomes. Binary logistic regression was used to compare intervention groups. General linear models were used to compare Gout Impact Scale (GIS) scores between those in remission and those not in remission using either definition., Results: Participants in the nurse-led care group were more likely to achieve remission using either definition; at Year 2 the odds ratio was 7.92 [95 % CI 4.86-12.92] using the 2016 preliminary definition and 11.88 [95 % CI 7.49-18.84] using the simplified definition. For all participants, the 2016 preliminary definition was fulfilled by 9.9 % at Year 1 and 28.4 % at Year 2, p < 0.001 and the simplified definition was fulfilled by 17.6 % at Year 1 and 42.7 % at Year 2, p < 0.001. People in remission using either definition had better gout outcomes assessed using the GIS, including greater control over their gout., Conclusion: Both definitions discriminated between the intervention groups and showed high construct validity. The simplified definition identified more people as being in gout remission at Year 1 and Year 2. The simplified definition is a feasible and valid option for defining gout remission., Competing Interests: Declaration of competing interest Nicola Dalbeth has received consulting or speaker fees from AstraZeneca, Dyve Biosciences, Horizon, Selecta, Arthrosi, JW Pharmaceutical Corporation, PK Med, LG Chem, JPI, PTC Therapeutics, Protalix, outside the submitted work. Lisa Stamp has received royalties from Up-to-Date and consulting fees from Pharmac NZ. Aliya Sarmanova was affiliated with the Nottingham University at the time of the study conduct and is currently affiliated with Roche Diagnostics International, Clinical Development and Medical Affairs. The other authors have no conflicting interests to report., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Aim: To explore what is known about nurses' experiences and perceptions of running nurse-led clinics., Background: Nurse-led clinics were established to address health care needs. In collaboration with medical practitioners, advanced practice nurses may take a selected group of patients and manage their ongoing healthcare independently. Their experiences in running nurse-led clinics directly impact patient satisfaction and clinical outcomes., Design: Scoping review of the peer-reviewed literature., Data Source: Systematic search through CINAHL, Medline, PsycINFO and Web of Science databases from January 2010 to September 2023., Review Methods: This scoping review is guided by the updated methodological guidance for the conduct of scoping review from Joanna Briggs Institute., Results: Of 2747 retrieved articles, 15 were included in this review. Synthesis of the findings revealed that nurses believed implementing nurse-led clinics was beneficial to themselves, patients, and healthcare systems. However, they faced challenges in running nurse-led clinics, including insufficient support, teamwork obstacles and lack of role recognition., Conclusion: Nurses need to be proactive in promoting their clinics and overcoming challenges. Healthcare organizations are responsible for creating a positive culture to support nurse-led services. Future research should focus on ways to increase global awareness of nurse-led clinics., (© 2024 The Author(s). International Journal of Nursing Practice published by John Wiley & Sons Australia, Ltd.)

Objective: The objective of this study is to assess the scope of existing practice, nature, and impact of nurse-led type 2 diabetic foot prevention services and educational programmes in Sub-Saharan Africa (SSA)., Introduction: Type 2 diabetes mellitus (T2DM) in SSA imposes a heavy burden on current healthcare services. Complications such as foot ulcers can have a significant impact on patient care and healthcare resources. It is imperative to identify patients at risk of developing diabetic foot complications and empower them with diabetes self-management education and support from specialised foot clinics is crucial. However, the availability of such programmes and services in SSA is limited., Inclusion Criteria: Studies of nurse-led diabetic foot prevention services and/or educational programmes in low- or middle-income countries in SSA for adults with T2DM, written in English, between August 2013 and March 2024 were considered., Methods: Following the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting and reporting scoping reviews, searches were conducted on four electronic databases (CINAHL, ProQuest, MEDLINE, and Scopus) and Google Scholar. The titles and abstracts were scrutinised. All eligible papers were retrieved and screened for full text., Results: The review included ten studies (across 14 papers), all of which focused on nurse-led diabetes self-management education (DSME) programmes in SSA. There are no specific educational programmes or services led by nurses that focus exclusively on diabetic foot prevention. The analysis highlighted the components of successful nurse-led DSMEs that led to positive glycaemic control and self-care behaviors, including the focus on behavior change and the DSME should be co-produced with service users. The theoretical aspects of the DSME include evidence-based, structured, interactive, culturally and linguistically appropriate group-based activities. The DSME should be delivered over a period of several weeks, and sessions should last between 1.5 and 2 h. Barriers to delivery and participation include the rainy season, stockouts, time and resources needed, and a DSME that meets diverse levels of literacy and education., Conclusion: There is a heightened need for nurse-led, co-produced, culturally congruent, frugal, and sustainable education interventions or programmes. There is also a need for diabetic foot screening and foot ulcer prevention services that can operate sustainably alongside these educational interventions through task-shifted, simple, and frugal initiatives., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sajith, Ackers, Ackers-Johnson, Parker and Stephens.)

Background: Clients with substance use disorders (SUDs) have a substantial risk of developing Type 2 diabetes mellitus (T2DM). The connection between SUD and DM stems from rapid cell damage, pancreatic beta-cell dysfunction, and glucose dysregulation due to increased oxidative stress and decreased antioxidant activity. This study aims to reduce the risk of T2DM among individuals undergoing SUD recovery treatments., Methods: This nurse-led diabetes prevention program, a 1-year-long, peer-based intervention, was implemented among clients at a federally funded, stand-alone drug addictions treatment center based on evidence that lifestyle modifications in dietary control, physical activity, and health behaviors can halt or delay the progression of Type 2 diabetes. Four trained peer educators delivered diabetes prevention interventions to a sample of individuals in drug addiction treatment in Nigeria. The nurse program leader provided weekly mentoring and guidance to the peer educators and collected, reviewed, and analyzed study participants' logs of weights and self-reported lifestyle modifications., Results: There were significant differences in participants' behaviors pre- and post-lifestyle interventions, except in dairy product intakes as well as cigarette and cannabis use., Conclusion: This diabetes prevention program is innovative and effective with this at-risk population. Interventions were delivered with minor financial resources., Implications for Nursing and Patient Care: SUD treatment must address physical and psychological health and consider the heightened risks of chronic illness in this population. Preventing somatic diseases, such as T2DM, is vital to long-term health and well-being., Competing Interests: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Aim: The aim of this study is to determine the experience of primary health care nurses regarding the application of nurse-led management in patients with acute minor illnesses., Background: Nursing leadership of care for acute minor illnesses is a new challenge faced by nurses in Spain., Design: Qualitative, hermeneutical, interpretive phenomenological approach is used. The Consolidated criteria for reporting qualitative research guidelines were applied., Methods: Twenty primary care nurses participated; three focus group discussions and nine semi-structured interviews were conducted between November 2019 and October 2020. All the focus group discussions and interviews were recorded, transcribed verbatim and analysed using content analysis., Results: Seven main themes emerged from the focus group discussions and interviews: concept, perception of the other actors, practice, history and social context, competencies, training, and legality., Conclusion: The study shows the diversity and complexity of nurses' experience when applying nurse-led management in acute minor illnesses. This work has helped to show the gaps perceived by nurses, including the lack of training in the treatment of conditions historically attended by physicians, the lack of definition of the legal framework and the limitations on nurse prescribing. It also highlighted the power of the nursing profession in terms of autonomy, competencies and role expansion., (© 2023 The Authors. International Journal of Nursing Practice published by John Wiley & Sons Australia, Ltd.)

Objective: to analyze the applicability of the Nursing Process in interface with best practices. Method: cross-sectional study, conducted with 146 nurses, using a structured survey questionnaire, applied between May and September 2019, analyzed by descriptive and inferential statistics. Results: of the 146 nurses, 115 (78.8%) performed the Nursing Process, and 73 (50%) applied the five steps of the Nursing Process. Of these 115 prevailed the steps of data collection 110 (95.7%) and implementation of care 104 (90.4%). There was a significant association between the application of the steps of the Nursing Process using information systems and evaluation scales. Some steps of the Process were associated with the use of Standardized Language Systems and nursing theories. Conclusion: the Nursing Process is configured as a strategy to consolidate the best practices, basing the actions on scientific evidence and on the needs of the individual through clinical expertise and qualification of the records. [ABSTRACT FROM AUTHOR]

Background: Nurse-led peripherally inserted central venous catheter (PICC) placement teams are common in western hospitals, but they are still in their infancy in Japan. Although implementing a dedicated program may improve ongoing vascular-access management, the direct hospital-level effects of launching a nurse-led PICC team on specific outcomes have not been formally investigated., Objectives: To evaluate the effect of introducing a nurse practitioner (NP)-led PICC-placement program on subsequent utilization of centrally inserted central catheters (CICCs) and to contrast the quality of PICC placements conducted by physicians and NPs., Materials and Methods: Patients who underwent central venous access devices (CVADs) between 2014 and 2020 at a university hospital in Japan were evaluated retrospectively using an interrupted time-series analysis on the trend for monthly CVAD utilization and logistic regression and propensity score-based analyses for PICC-related complications., Results: Among 6007 CVAD placements, 2230 PICCs were inserted into 1658 patients (725 by physicians and 1505 by NPs). The monthly number of CICC utilization fell from 58 in April 2014 to 38 in March 2020, while PICC placements by the NP PICC team increased from 0 to 104. The implementation of the NP PICC program reduced the immediate rate (by 35.5; 95% confidence interval [CI]: 24.1-46.9; p  < 0.001) and post-intervention trend (by 2.3; 95% CI: 1.1-3.5; p  < 0.001) of monthly CICC utilization. Overall immediate complication rates were lower in the NP group than the physician group (1.5% vs 5.1%; adjusted odds ratio = 0.31; 95% CI: 0.17-0.59; p  < 0.001). The cumulative incidences of central line-associated bloodstream infections were comparable between the NP and physician groups (5.9% vs 7.2%; adjusted hazard ratio = 0.96; 95% CI: 0.53-1.75; p  = .90)., Conclusions: This NP-led PICC program reduced CICC utilization without affecting the quality of PICC placement or complication rate., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Prescribing of recommended medications for heart failure (HF) is suboptimal, leaving patients at a high risk of death or rehospitalization post discharge. Nurse-led titration (NLT) clinics are one strategy that could potentially improve the prescription of these medications., Objective: The aim of this article was to determine the effect of NLT clinics on all-cause mortality, all-cause or HF rehospitalizations, and adverse effects in patients with HF., Methods: We searched MEDLINE, EMBASE, Cochrane CENTRAL, International Clinical Trials Registry Platform, and ClinicalTrials.gov to identify randomized controlled trials comparing NLT of β-blocking agents, angiotensin receptor-neprilysin inhibitors, angiotensin-converting enzyme inhibitors, and/or angiotensin receptor blockers to optimization by another health professional in patients with HF. We used the fixed-effects Mantel-Haenszel method or meta-analyses. We assessed heterogeneity between studies using χ 2 and I2 ., Results: Eight studies with 2025 participants were included. Participants in the NLT group experienced a lower rate of all-cause rehospitalizations (relative risk, 0.76, 95% confidence interval, 0.68-0.85; moderate quality of evidence) and less HF-related rehospitalizations (relative risk, 0.47; 95% confidence interval, 0.33-0.66; high quality of evidence) compared with the usual care group. All-cause mortality was lower in the NLT group (relative risk, 0.67; 95% confidence interval, 0.48-0.92; moderate quality of evidence) compared with the usual care group. Authors of one study reported no adverse events, and another study found one adverse event., Conclusion: This meta-analysis indicates that NLT clinics may improve optimization of guideline-recommended medications with the potential to reduce rehospitalization and improve survival in a cohort of patients known for their poor outcomes., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Spinal cord injury (SCI) severely affects motor, sensory, reflex, and other functions, impacting 250,000 to 500,000 individuals globally each year. Bladder voiding dysfunction, a prevalent and serious complication of SCI, results in significant morbidity and reduced quality of life. This study examines the impact of nurse-led clean intermittent catheterization combined with synchronous health education for family members on improving compliance in patients with SCI and bladder voiding dysfunction., Methods: Eighty-four patients with urinary dysfunction post-SCI treated in our hospital from January 2023 to January 2024 were selected. Family members were assigned to a control group (n = 40) or an observation group (n = 44) based on their participation in nurse-led health education. Urinary tract management proficiency, satisfaction, compliance, and complications were observed and statistically analyzed in both groups on the 30th day after self-initiated intermittent catheterization., Results: By the 30th day, the observation group exhibited significantly higher cognitive scores in urinary tract management than the control group ( p < 0.001). Additionally, the observation group showed greater compliance in daily water intake ( p = 0.018), proper timing ( p = 0.018), and correct bladder function training ( p = 0.004). The incidence of urinary tract infections was lower in the observation group ( p = 0.018). Patient satisfaction in the observation group also exceeded that of the control group in all measured aspects and total scores ( p < 0.001)., Conclusions: Nurse-led synchronous health education for family members during clean intermittent catheterization significantly enhances patient compliance, reduces complications, and improves patient satisfaction., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s).)

Background: Patients with diabetes often face psychological challenges, particularly depression. The coexistence of these two conditions can significantly impact both the mental and physical health of individuals. This study aims to investigate the effects of nurse-led exercise training on elderly patients diagnosed with type 2 diabetes mellitus and comorbid depression through experimental research. By selecting appropriate exercise programs for patients, the study seeks to identify effective strategies for improving both their physical health and depressive symptoms. Additionally, it aims to offer tailored exercise recommendations to enhance the overall well-being of these patients., Method: The observation group (n = 53) and the control group (n = 53) were selected based on the interventions documented in the patients' medical records, with eligible patients identified as research participants. The control group received standard medication, while the observation group engaged in intensive exercise training in addition to their standard treatment, dedicating 60-90 min per day to exercise. Prior to and following the intervention, blood glucose indices, levels of 5-hydroxytryptamine (5-HT) and norepinephrine (NE), self-rating depression scale (SDS), Self-Rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI), and Generic Quality of Life Inventory (GQOLI-74) scores were assessed to evaluate the impact of the exercise training intervention., Result: Following the intervention, levels of fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and Hemoglobin A1c (HbA1c) were reduced compared to pre-intervention levels, with the exercise group exhibiting lower levels than the control group (p < 0.05). Additionally, post-intervention, patients' levels of 5-HT and NE increased, with the exercise group demonstrating higher levels than the control group (p < 0.05). Moreover, post-intervention, SDS and SAS scores decreased, with more significant improvements observed in the observation group (p < 0.05). Furthermore, the intervention improved sleep quality and quality of life among patients in the exercise group compared to those in the control group (p < 0.05)., Conclusion: Nurse-guided exercise training demonstrates a significant capacity to ameliorate glycemic indexes among patients with diabetes mellitus comorbid with depression. It not only diminishes depression and anxiety levels but also enhances the expression of 5-HT and NE. Furthermore, it effectively elevates patients' sleep quality and quality of life. These findings underscore the potential of nurse-led exercise interventions for clinical promotion and widespread application.

Objective: To understand the practices developed by nurses in primary care in southern Brazil., Method: Qualitative study, with data collection via online interviews, conducted between October 2020 and May 2021, and recorded. 174 nurses from 24 municipalities in southern Brazil participated. Data analysis used inductive thematic analysis., Results: The activity that stood out among nurses was the nurse consultation, for all age groups and health conditions, especially when dealing with chronic disease, prenatal care, attention to women and children, mental health, home visits, and the management of the nursing team and the health unit., Final Considerations: This study demonstrated that an excess of responsibilities associated to care and management, added to a lack of balance in the activities common to the team make it difficult for nurses to develop clinical practices.

Objective: Review of the ISO 18104 technical standard for a Nursing Categorial structure to best represent nursing practice in EMR/EHRs and digital health ecosystems., Methods: Application of ISO standard review guidelines in consultation with ISO member stakeholders., Results: Comprehensive views of the nursing practice knowledge domain are presented as mindmaps. Groups of patients can now be identified using the 'type of subject of care' category. The collaborative role of nurses is now recognized. This high level structured information model recognises nursing diagnosis, nursing actions and nurse sensitive outcomes relative to other categories and sub-categories known to influence nursing actions and nurse sensitive outcomes., Discussion: This nursing practice framework reflects the nursing process. It supports conceptual and logical analysis of patient journey related nursing practice., Conclusion: This updated categorial structure is a good fit with today's information technologies. Its adoption enables the value of nursing services provided to be demonstrated.

The number of urgent '2-week-wait' referrals to hospital for people with suspected head and neck cancer being sent by primary care is constantly growing and it is becoming increasingly difficult for head and neck cancer services to meet this demand. In order for trusts to meet their Faster Diagnosis Standards, there needs to be an effective and efficient way to ensure there is capacity for patients to receive the appropriate assessments and diagnostic investigations without compromising the quality of care delivered. This article presents the proposal of introducing a nurse-led 2-week-wait clinic to meet the ever-growing demands on the service. There is discussion of the consultant-led training programme used to upskill an advanced nurse practitioner in a single-centre study, as well as explanation of the processes followed to maintain patient safety throughout the pilot project. There will also be consideration of clinical governance and discussion of how patient satisfaction with the novel service will be measured.

Background: Medicaid payment reforms and delivery model innovations are needed to fully transform U.S. healthcare structuring and provision., Purpose: To synthesize nurse-led models of care and their implications for improving health care access, quality, and reducing costs for Medicaid recipients., Methods: A critical review of the literature regarding nurse-led models and implications for addressing social determinants of health (SDOH), adopting population health approaches, managing complex care, and integrating behavioral and physical health care within Medicaid., Discussion: Three interrelated findings emerged (a) investing in dynamic nurse-led models is important for mitigating SDOH and adopting value-based care, (b) regulations preventing nurses from practicing at the fullest extent of their training and licensure limit clinical impact and value, and (c) directed payments can establish value-based expectations for Medicaid managed care., Conclusion: Adoption of a nurse-led model of care has the potential to advance the goals of reducing inequity and promoting whole-person health within Medicaid and nationally., Competing Interests: Declaration of Competing Interest Vincent Guilamo-Ramos reports grants from ViiV Healthcare outside the submitted work, and he serves as co-chair of the U.S. Presidential Advisory Council on HIV/AIDS; as a member of the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis, and STD Prevention and Treatment; and of the HHS Panel on Antiretroviral Guidelines for Adults and Adolescents. Megan Ingraham is a current employee of Manatt Health, which works with a diverse group of clients, including states, state and federal policy makers and agencies, payers, health care providers and systems, foundations, associations, consumer organizations, and pharmaceutical, biotech, and device companies. In particular, Manatt has worked with Duke School of Nursing, with whom they collaborated on this article. The other authors have no conflicts of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Competing interests: CG designed and developed a digital sleep intervention, SleepFix.

Competing Interests: Competing interests: None declared.

Approximately 80% of patients presenting with leg ulcers are venous in origin. However, lack of standardisation of care has a human and financial impact for patients and service providers. Increases in the aging population and number of patients entering older age with co-morbidities results in increases in the demand for venous leg ulcer treatments. A joint initiative between a Registered Advanced Nurse Practitioner (RANP) in tissue viability and wound care, and a vascular consultant, identified deficits in patient care delivery and quality of life. A joint initiative Implementing the principles of the 'Sláintecare' policy was established as the Leg Ulcer Centre Ireland (LUCI) to deliver a pathway for the treatment and management of lower limb venous ulcers. The RANP provides a "one stop shop" for patients, offering a complete care package from diagnosis to surgical intervention - endovenous ablation, follow-up post operative care and discharge. Audit findings include; reduced hospital admissions and waiting times; increased patient satisfaction; and, improved interdisciplinary integrated referral pathways. The RANP offers an effective, efficient diagnosis-to-end treatment service for patients. The results demonstrate improved treatment, cost outcomes and value-based outcomes for patients. The new integrated service facilitates expansion of the service and further enhancement of the nursing skills and role., Competing Interests: Declaration of Competing Interest There is no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)

Background: In 2015 our centre introduced a nurse-led renal cell cancer follow-up protocol and clinic for patients who have undergone partial or radical nephrectomy for organ-confined kidney tumours. The main aims of this clinic were to improve healthcare efficiency and standardize follow-up processes., Objectives: The primary objective was to assess the effectiveness of a nurse-led renal cell cancer follow up clinic in regard to surveillance protocol compliance and the timely identification and appropriate management of recurrences. A secondary objective was to evaluate this locally developed follow up protocol against the current European Association of Urology (EAU) guidelines surveillance protocol., Patient and Methods: All patients who underwent a partial or radical nephrectomy between 2015 and 2021 at a single Western Australia institution for a primary renal malignancy were included. Data was collected from local clinical information systems and protocol adherence, recurrence characteristics and management were assessed. The current EAU guidelines were applied to the cohort to assess differences in risk-stratification and theoretical outcomes between the protocols., Results: After a mean follow up period of 31.2 months (range 0-77 months), 75.5% (185/245) of patients had all follow up imaging and reviews within 1 month of the timeframe scheduled on the protocol. 17.1% (42/245) had a delay in their follow up of more than a month at some stage, 5.7% (14/245) did not attend for follow up but had documented attempts to facilitate their compliance, and 0.4% (1/245) were lost to follow up with no evidence of attempted contact. 15.5% (38/245) of patients had recurrence of malignancy detected during follow up and these were all discussed in a multi-disciplinary team (MDT) meeting. The recurrence rate was 2.5% (3/119) for low risk, 17.7% (14/79) for intermediate risk, and 44.7% (21/47) for high risk patients when they were re-stratified according to EAU risk categories. No recurrences were detected through ultrasound (USS) or chest x-ray (CXR) in this cohort and our protocol tended to place patients in higher risk-stratification groups as compared to current EAU guidelines., Conclusion: Nurse-led renal cell cancer follow up is a safe, reliable and effective clinical framework that has significant benefits in regard to resource utilization. USS and CXR are ineffective in detecting recurrence and Computerized tomography (CT) should be considered the imaging modality of choice for this purpose. The EAU surveillance protocol appears superior to our protocol, and we have therefore transitioned to the EAU guideline protocol going forward., (© 2024 Royal Australasian College of Surgeons.)

Background: Patient education is a vital role of nurses in nurse-led clinics(NLCs). Since 2011, independent NLCs entitled health education Nurse-led clinics(HENLCs) have been established in Iran. In order for this newly developed service to be able to perform perfectly in implementation and evaluation, it should be explained based on one of the quality evaluation models. The objective of the study was to determine the dimension of service quality in HENLCs based on service providers' and service recipients' experience., Methods: This research is a qualitative study of directed content analysis type conducted between May and November 2020. Twenty-nine participants who had rich experiences in the patient education in HENLCs were interviewed in this study. Asarroodi et al.'s (2018) qualitative content analysis method was used for data analysis, and MaxQDA software was used for data management. We used credibility, dependability, and Confirmability to confirm the trustworthiness of the study's findings., Results: In this study service providers including managers, policymakers, decision-makers, nurses, physicians, and service recipients including patients and families participated. Seven generic categories, including (1) a competent and self-motivated nurse educator, (2) an easily accessible and comfortable environment, (3) informational-educational materials and health education equipment, (4) motivational facilities, (5) access to the health education support team, (6) organizational communication supporting the education process, and (7) receiving the patient education fee, constituted the main category of structure. Five generic categories, including (1) assessment and determination of the educational needs of the target group, (2) description of the nurse's duties, (3) teaching-learning methods, (4) patient referral, and (5) the process of preparing and publishing educational content, constituted the main category of process. One generic category called evaluation constituted the main category of outcome., Conclusion: Based on the results of this study, it is suggested to managers to pay attention to the dimensions of the quality model of Donabedian (SPO) in setting up and developing the performance of HENLCs, it is recommended that future quantitative studies based on the categories formed in this study evaluate the observance of the dimensions of structure, process and outcome., (© 2024. The Author(s).)

Objective: To study the effects of nurse-led cognitive behavioural therapy on anxiety, depression and quality of life in patients with urinary incontinence after radical prostatectomy., Methods: Patients with urinary incontinence after undergoing radical prostatectomy in our hospital from January 2019 to January 2023 were selected as the research objects. They were divided into the observation and control groups in accordance with whether they received nurse-led cognitive behavioural therapy. The general data of the patients were collected, and the baseline data of the two groups were balanced by propensity score matching. The disease-related knowledge; Urinary catheter indwelling time; Urinary incontinence duration; And scores on the Exercise of Self-Care Agency Scale (ESCA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Nursing Effect and Health Questionnaire (SF-36) were compared between the two groups after matching., Results: At discharge, the ESCA, SF-36 and disease cognition scores of the observation group were higher than those of the control group ( p < 0.05). The HAMA and HAMD scores of the observation group were lower than those of the control group ( p < 0.001), and the total effective rate of the observation group (89.83%) was higher than that of the control group (76.27%) ( p < 0.05)., Conclusions: In patients with urinary incontinence after radical prostatectomy, the implementation of nurse-led cognitive behavioural therapy can effectively improve self-care and disease cognition abilities, relieve anxiety and depression and improve quality of life., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s).)

Aims: To define nurse-led clinics in primary health care, identify barriers and enablers that influence their successful implementation, and understand what impact they have on patient and population health outcomes., Background: Nurse-led clinics definitions remain inconsistent. There is limited understanding regarding what enablers and barriers impact successful nurse-led clinic implementation and their impact on patient health care., Design: Scoping review using narrative synthesis., Methods: PubMed, MEDLINE, Web of Science, Scopus, CINAHL and PsycINFO were searched to identify nurse-led clinic definitions and models of care between 2000 and 2023. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Narrative synthesis enabled to communicate the phenomena of interest and follows the PRISMA for Scoping Reviews (PRISMA-ScR) checklist., Results: Among the 36 identified studies, key principles of what constitutes nurse-led clinics were articulated providing a robust definition. Nurse-led clinics are, in most cases, commensurate with standard care, however, they provide more time with patients leading to greater satisfaction. Enablers highlight nurse-led clinic success is achieved through champions, partners, systems, and clear processes, while barriers encompass key risk points and sustainability considerations., Conclusion: The review highlights several fundamental elements are central to nurse-led clinic success and are highly recommended when developing interventional nurse-led strategies. Nurse-led clinics within primary health care seek to address health care through community driven, health professional and policy supported strategies. Overall, a robust and contemporary definition of nurse-led care and the clinics in which they operate is provided., Relevance to Clinical Practice: The comprehensive definition, clear mediators of success and the health impact of nurse-led clinics provide a clear framework to effectively build greater capacity among nursing services within primary health care. This, in addition, highlights the need for good health care policy to ensure sustainability., Patient or Public Contribution: No Patient or Public Contribution., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Background: Previous systematic reviews suggest that nurse-led interventions improve short-term blood pressure (BP) control for people with hypertension. However, the long-term effects, adverse events, and appropriate target BP level are unclear. This study aimed to evaluate the long-term efficacy and safety of nurse-led interventions., Methods: We conducted a systematic review and meta-analysis. We searched the Cochrane Central Register of Controlled Trials, PubMed, and CINAHL, as well as three Japanese article databases, as relevant randomized controlled trials from the oldest possible to March 2021. This search was conducted on 17 April 2021. We did an update search on 17 October 2023. We included studies on adults aged 18 years or older with hypertension. The treatments of interest were community-based nurse-led BP control interventions in addition to primary physician-provided care as usual. The comparator was usual care only. Primary outcomes were long-term achievement of BP control goals and serious adverse events (range: 27 weeks to 3 years). Secondary outcomes were short-term achievement of BP control goals and serious adverse events (range: 4 to 26 weeks), change of systolic and diastolic BP from baseline, medication adherence, incidence of hypertensive complications, and total mortality., Results: We included 35 studies. Nurse-led interventions improved long-term BP control (RR 1.10, 95%CI 1.03 to 1.18). However, no significant differences were found in the short-term effects of nurse-led intervention compared to usual care about BP targets. Little information on serious adverse events was available. There was no difference in mortality at both terms between the two groups. Establishing the appropriate target BP from the extant trials was impossible., Conclusions: Nurse-led interventions may be more effective than usual care for achieving BP control at long-term follow-up. It is important to continue lifestyle modification for people with hypertension. We must pay attention to adverse events, and more studies examining appropriate BP targets are needed. Nurse-led care represents an important complement to primary physician-led usual care., (© 2024. The Author(s).)

Objectives: Currently, gout management, particularly urate-lowering therapy (ULT), is often suboptimal. Nurses successfully manage various diseases including gout. As gout prevalence is rising, and rheumatologists and general practitioners face shortages, a new approach is imperative. This real-life prospective cohort study evaluated the effectiveness of nurse-led care employing a treat-to-target strategy for gout management over a 2-year period., Methods: All consecutively confirmed gout patients were included. The nurse-led clinic provided a structured treatment plan with consultations, patient leaflets, telephone contacts and laboratory monitoring. After a year of nurse-led care, patients transitioned to continued care in general practice. Follow-up data were complete through registries. The primary outcome was achieving target p-urate levels (<0.36 mmol/L) at 2 years after diagnosis. Secondary outcomes included treatment continuation and achievement of target p-urate levels in specific subgroups. The results were compared with patients diagnosed in the same clinic but followed up in 'usual care'., Results: In the nurse-led group (n=114), 83% achieved target p-urate levels and ULT was continued by 98%. This trend persisted across various patient subgroups. Only 44% of patients in usual care achieved target p-urate and with insufficient doses of allopurinol . Nurse-led care involved an average of two visits and three telephone contacts over 336 days. The 2-year mortality rate was 15%., Conclusions: Nurse-led gout care, employing a targeted approach, was associated with a very high uptake of and adherence to ULT. The encouraging results were not achieved in usual care although a direct comparison might be influenced by selection bias., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: to evaluate the use of realistic simulation as a strategy to promote teaching about pressure injuries. Method: This is a quasi-experimental study. A modified and translated version of the Pieper Pressure Ulcer knowledge test was applied. Kappa statistical analysis was used to assess the professionals’ knowledge in the realistic simulation using the SPSS software. A p-value

ABSTRACT Over the years, various recommendations have been made in pursuit of controlling resistance to antituberculosis drugs, especially multidrug resistance, in Brazil. Given the importance of standardizing those recommendations, the aim of this study was to describe the main recommendations of the Brazilian guidelines, primarily those related to the treatment and follow-up of cases of tuberculosis. From August through October of 2018, a document search was conducted via the websites of the Brazilian National Ministry of Health, the Brazilian National Tuberculosis Control Program, the JBP, and the Official Gazette of the Federal Republic of Brazil. Data were collected systematically by using a protocol designed specifically for this study. Documents published between 2004 and 2018 were selected. It was possible to understand and trace the history of the measures for the control of multidrug-resistant tuberculosis in Brazil from 2004, when the first documents related to the disease were published, up to 2018, when the second edition of the Brazilian National Guidelines for the Control of Tuberculosis was published. The contents of the documents were analyzed and grouped by case definition, diagnostic criteria, treatment, use of directly observed treatment; mechanisms of social protection for patients; data tools; and organization of care. This analysis allowed us to understand the efforts towards standardizing some measures in Brazil, not only identifying advances in the alignment with international prerogatives (case definition, incorporation of diagnostic technology, and treatment regimens) but also underscoring the need for greater clarity regarding the mechanisms of social protection and the organization of the care provided via the Brazilian health care system.

Aim: To evaluate the clinical effectiveness and implementation strategies of telecare consultations in post-stroke nurse-led clinics., Background: Telecare consultations could be an alternative to conventional in-person consultations and improve continuity of care for stroke survivors following their discharge from hospital. Previous studies utilizing telecare consultations only focused on testing their clinical effectiveness on stroke survivors; the appropriateness and feasibility of adopting this new delivery modality in a real-world setting were not examined., Design: A Type II hybrid effectiveness-implementation design will be adopted., Methods: Eligible stroke survivor participants will be randomly assigned to the intervention group (telecare consultation) or control group (usual in-person clinic consultation). Both groups will receive the same nursing intervention but delivered through different channels. The Reach, Effectiveness, Adoption, Implementation, Maintenance framework will be used to evaluate the clinical effectiveness and implementation outcomes. The primary outcome is the non-inferiority of the degree of disability between the two groups at 3 months into the intervention and at 3 months post-intervention. The paper complies with the SPIRIT guidelines for study protocols adapted for designing and reporting parallel group randomized trials., Conclusion: The findings of this study will provide key insights into the processes for implementing and adopting telecare consultations into long-term services for post-stroke patients., Impact: This study contributes to the translation of telecare consultations for stroke survivors into real-life settings. If effective, this program may provide guidance for expanding telecare consultations to other post-stroke nurse-led clinics or to patients with other chronic diseases., Trial Registration: This study has been registered at clinicaltrials.gov (identifier: NCT05183672). Registered on 10 January 2022., (© 2023 John Wiley & Sons Ltd.)

Background: The quality of life for individuals with chronic wounds is diminished due to poor health-related outcomes and the financial burden of wound care. The literature has shown nurse-led wound care to have a positive impact on wound healing and psychosocial wellbeing. However, there is minimal research investigating the lived experience of attending a nurse-led clinic for chronic wounds. The purpose of this study was to explore the client and family experience of attending a nurse-led clinic for chronic wounds., Methods: Qualitative descriptive study. Semi-structured telephone interviews were transcribed verbatim and thematic analysis was undertaken., Results: Twelve clients and two family members participated, and the average length of interviews was 20min. Three main themes emerged: (1) expecting and managing pain; (2) receiving expert advice and reflecting on previous care; and (3) managing the cost of care. There was an emphasis on the impact of chronic wounds on pain and the ability to complete the activities of daily living. Expert advice, client satisfaction and physical accessibility were highlighted as benefits of the clinic. Cost and minimal client education were identified as challenges of the clinic., Conclusions: The findings demonstrated that chronic wounds have a significant impact on the client and family attending the nurse-led clinic. Comprehensive pain assessment, improved social support, better client education and cost-effective care is required to optimise the experience for people attending the nurse-led clinic.

We evaluated Klick, a nurse-led, digitally enabled model of HIV outpatient care, launched in 2020. Klick's smartphone app offers online booking, remote nurse-led consultations, and results. An audit of Klick nurse-led consultations was conducted against BHIVA monitoring guidelines, and nurses were interviewed about their experience. Of 40 Klick patients audited, 4 of 5 BHIVA standards were met: 100% had documented co-medications, smoking history, blood pressure, and viral load data, and 89% received a cardiovascular risk calculation (Targets 97%-90%-90%-90%-90%). Compared to national BHIVA audit findings, Klick performed better across 22 of 24 comparable measures. Nurses safely managed a cohort comprising some complexity (eg, co-morbidities, polypharmacy); no cases were escalated off the pathway, and all were virologically suppressed. Using a digitally supported model, nurses effectively provided safe care to HIV-positive patients with predominantly stable health, enabling consultants to focus on more complex caseloads. Care was comprehensive and person-centered and obtained better outcomes compared to previous national audits., Competing Interests: Declaration of Conflicting InterestsSD, RW, YF-Y, SO-A, and CR have no conflicts of interest. AM is an employee of ViiV Healthcare and may own stock in GSK. CA received travel bursaries and conference registration fees from and participated in advisory boards for ViiV Healthcare and has appeared in peer support information videos for Gilead Sciences. DA participated in advisory boards for ViiV Healthcare.

Aim: To explore the Chinese nurses' current practices and challenges to trauma-informed care (TIC) for accidentally injured patients, which can provide the way forward of improvement in the future., Design: A qualitative study., Methods: Sixteen Chinese nurses who had experience working with accidentally injured patients were invited into the semi-structured interviews. Following each interview, the dialogue was transcribed verbatim. Subsequently, we analysed the data in accordance with the principles of thematic analysis., Results: Four common themes emerged from the analysis: (a) Awareness of patients' psychological trauma; (b) Recognition of psychological trauma; (c) Response to psychological trauma; (d) Perceived barriers to implementing TIC. This research indicated an urgent need for interventions in the future, such as TIC education and training, time constraints, heavy workload, emotional exhaustion and mood self-regulation, giving policy incentives, strengthening leadership support and internal cooperation. Identifying those factors of TIC practice among accidentally injured patients helps promote TIC development in hospitals., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)