Objectives:A framework for the advanced practice nurse(APN)role was developed in our Canadian Tertiary Care Centre,delineating five domains of advanced nursing practice:clinical practice,consultation,research,educatio...Objectives:A framework for the advanced practice nurse(APN)role was developed in our Canadian Tertiary Care Centre,delineating five domains of advanced nursing practice:clinical practice,consultation,research,education and leadership.The goal of this study was to evaluate perceptions of the effectiveness of the implementation of an innovative APN role on an in-patient Neurosurgery unit.Methods:A pre-and-post implementation design,incorporating both qualitative and quantitative data,was utilized.An innovative APN role was implemented within the Neurosurgery program focusing on the clinical domain and required the successful candidates to be NP prepared.This APN role was designed to improve patient flow,documentation,communication and patient and staff satisfaction.Three primary outcomes were measured:pre-implementation questionnaire(nurses),post-implementation questionnaire(nurses and residents)and number of pages to the on-call resident.Results:Survey scores by nurses and residents indicated improvement across all aspects studied.Average scores increased from 1.1 to 2.6,reflecting an overall statistically significant increase.The number of pages to the on-call resident also showed a decrease.Conclusion:Perceptions of patient care delivery and professional collaboration improved following implementation of the APN role.Responses indicated that APNs significantly impacted patient care and improved nurses and residents'job satisfaction.展开更多
Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nu...Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nurse anesthetists(CRNAs).Methods:A survey using the Ethical Stress Scale(ESS)and the Ethical Assessment Skills Survey(EASS)was conducted with 134 CRNAs.Results:Results indicated no significant effect of practice model on level of moral distress or perceived ethical assessment skill knowledge[Wilks's lambda=0.952,F(6,256)=1.068,P=0.382,n^(2)=0.02].A statistically significant positive correlation existed between importance and skill(r=0.275,P=0.001).CRNAs felt skilled to manage the actions or activities they deemed important.Conclusion:CRNAs who perceived a higher skill level in addressing ethical issues experienced lower levels of moral distress.Findings indicate content-specific curricula for the CRNAs need to be evaluated for ethical decision-making skill assessment content.展开更多
Background Advanced practice chronic conditions. However, nurse transitional care has been proofed to be important for older adults with such effectiveness has never been studied in the management of appropriate Warfa...Background Advanced practice chronic conditions. However, nurse transitional care has been proofed to be important for older adults with such effectiveness has never been studied in the management of appropriate Warfarin use in clinical practice. Methods A total of 97 patients were randomly distributed into control group who received usual care, and interventional group who received transitional care provided by APNs. A 12-month observation of both groups were recorded by physicians and APNs and the impact of APNs on the managing of Warfarin therapy was also evaluated based on time in the therapeutic range （TTR）. Results APNs transitional care significantly （P 〈 0.01） improved patients＇ adherence, increased TTR and high TTR ratio compared with control group. Re-admission due to stroke was significantly （P 〈 0.01） reduced by APNs transitional care. Conclusion APNs transitional care improves patients＇ knowledge on AF and reduces stroke risk. The current research strongly suggest the necessity of APNs transitional interventional in managing anticoagulation therapy in AF patients in China.展开更多
Objective Demographic changes,increasing prevalence of chronically ill and multimorbid patients and the ongoing shortage of general practitioners(GPs)collectively present significant challenges for European general pr...Objective Demographic changes,increasing prevalence of chronically ill and multimorbid patients and the ongoing shortage of general practitioners(GPs)collectively present significant challenges for European general practice.Task delegation from GP to practice nurse(PN)-led patient consultations could be a potential solution to tackle those challenges.Therefore,this study aimed to examine the attitudes of GPs and PNs towards PN-led consultations in general and for specific conditions.Design Cross-sectional survey using a self-developed,pretested questionnaire,conducted between September 2023 and November 2024.The questionnaire assessed attitudes towards PN-led consultations,conditions within PN-led consultations,possible benefits and concerns regarding PN-led consultations,sociodemographic characteristics and characteristics on GP offices(GPOs).We performed descriptive statistics,univariable and multivariable regression analyses using SPSS V.27.Setting GPOs located in the German federal states of Saxony-Anhalt and Saxony.Participant From 2071 contacted GPOs,437 GPs and 339 PNs participated(GP response rate:21.1%).Results The majority of GPs(61.7%)and PNs(61.2%)were open towards PN-led consultations.In multivariable analysis,GPs showed greater openness if they had prior positive delegation experiences(OR=5.88,95%CI(3.01 to 11.48))or already delegated special tasks(OR=5.34,95%CI(2.29 to 12.46)).GPs were less open if they worked in urban GPOs(OR=0.44,95%CI(0.22 to 0.88))or owned a single GPO(OR=0.41,95%CI(0.20 to 0.83)).In multivariable analysis,PNs were more open towards PN-led consultations if they had prior positive delegation experiences(OR=3.03,95%CI(1.12 to 8.18))and advanced PN training(OR=3.50,95%CI(1.44;8.51)).The three most accepted conditions by GPs and PNs for PN-led consultations were chronic wounds,diabetes mellitus and arterial hypertension.Conclusion Our findings demonstrate broad openness among both GPs and PNs towards PN-led consultations in German GPOs in general,and for various acute and chronic conditions.PN-led consultations are already partially practised.The results indicate considerable potential for further delegation beyond current national agreements.Future pilot studies should further develop PN roles and provide evidence of feasibility and non-inferiority of PN-led consultations compared to GP-led consultations.Conditions and participant characteristics investigated may serve as a foundation for study design and participant recruitment.展开更多
This paper focuses on the key role and practical paths of operating room nurses in infection control,and studies the difficult problems in the prevention and control of surgical site infections.Analyze the infection r...This paper focuses on the key role and practical paths of operating room nurses in infection control,and studies the difficult problems in the prevention and control of surgical site infections.Analyze the infection risk links in the operating room and the core responsibilities of nurses,reveal the multiple role mechanisms of nurses in infection control,design practical strategies from dimensions such as process optimization,skill improvement,and monitoring feedback,and construct an infection control system involving all staff.Research shows that operating room nurses can effectively reduce the risk of infection,improve medical quality,provide core guarantees for patient safety,and promote the transformation of operating room infection control towards refined management through practical actions such as standardized operation execution,real-time risk monitoring,and team collaboration supervision.展开更多
Objective:This article employs a scoping review methodology,integrates knowledge and information about current pediatric nurses'practices and perceptions regarding family-centered care in pediatric settings.Method...Objective:This article employs a scoping review methodology,integrates knowledge and information about current pediatric nurses'practices and perceptions regarding family-centered care in pediatric settings.Methods:Published articles were retrieved from databases including EBSCO host,PubMed,Springer,Science Direct,Ovid,and CINAHL between 2013 and 2023.Results:The finding shows a better understanding of pediatric nurses'perceptions of family-centered care in association with their clinical settings.However,the evidence indicates that integrating family-centered care components into health care services is difficult and confusing to nurses and is often not implemented in a clinical setting.As evidenced by this review,studies have consistently reported similar results;family-centered care was a good perception and understood by pediatric nurses as a concept but inconsistently used in a daily practice setting.Conclusions:This scoping review is the first phase in promoting a strategic plan to provide educational interventions for pediatric nurses to implement family-centered care in their daily practice settings.It's necessary to recognize pediatric nurses'perceptions and practices concerning family-centered care to provide optimal healthcare services in pediatric settings.展开更多
<strong>Aim:</strong> This study aimed to examine the effect of a seminar to continuously reinforce ethical nursing practices among pediatric nurses. <strong>Methods:</strong> This seminar was ...<strong>Aim:</strong> This study aimed to examine the effect of a seminar to continuously reinforce ethical nursing practices among pediatric nurses. <strong>Methods:</strong> This seminar was based on a 24-point pediatric nursing care model (PNCM) that provided specific examples of basic ethical nursing practices for children undergoing medical procedures and their families. Participants’ knowledge level and application frequencies, regarding these practices, were assessed face-to-face in the first session and via email 2 and 5 months later, using the PNCM checklist and qualitative data about ethical practices. <strong>Results:</strong> Results revealed that 8 PNCM items about frequency remained the same as the first session after 5 months;however, 16 items reported increased application. The qualitative data collected 2 months later suggested that the nurses could have adapted better to implement ethical pediatric nursing;however, the one collected 5 months later confirmed the effect of the seminar on ethical nursing practices with children and their families. The continuous effect of the seminar became more evident from the responses received 5 months later than those received 2 months later. <strong>Conclusions:</strong> The findings confirmed a reinforced effect on ethical pediatric nursing practice with child patients and their parents after 5 months.展开更多
Background:Surgical site infections are the most frequent type of preventable hospital acquired infections with a serious and undesirable outcome of surgery associated with increase morbidity,mortality rate,hospital s...Background:Surgical site infections are the most frequent type of preventable hospital acquired infections with a serious and undesirable outcome of surgery associated with increase morbidity,mortality rate,hospital stay,readmission and excess cost.Surgical site infection prevention is one of the most important challenge in delivering optimal nursing care.Studies suggest that the nurses’practices of surgical site infection prevention is not well addressed.Moreover,there is clearly paucity of information,in Africa including the study area.Objective:The aim of this study was to assess surgical site infection prevention practices and associated factors among nurses working in government hospitals of Harari Regional State and Dire Dawa City Administration,Eastern Ethiopia from March 01 to 28,2019.Method and Materials:An institutional based cross-sectional study design was employed for a total of 515 nurses.Simple random sampling method was used to select study participants.Data were collected using pretested structured self-administered questionnaire supplemented by observation.Data were checked,coded,entered and cleaned using Epi-data version 3.1 and exported to SPSS version 20 for analysis.Bivariate and multivariate analysis were undertaken and P values less than 0.05 at 95%confidence interval were considered as statistically significant.Result:The overall self-reported level of SSI prevention practice was found to be 40.8%(95%CI:36.9%,45.4%).Nurses with BSc and above[Adjusted odds ratio(AOR)=2.52,95%CI(1.14,5.54)],trained on infection prevention[AOR=2.22,95%CI(1.29,3.82)],good knowledge[AOR=2.21,95%CI(1.32,3.71)],good attitude[AOR=5.11,95%CI(3.05,8.57)],got supply of personal protective equipment[AOR=2.57,95%CI(1.46,4.49)],had management support[AOR=3.41,95%CI(1.90,6.12)],experience of 5 to 10 years[AOR=5.38,95%CI(2.82,10.27)]and≥11 years[AOR=3.48,95%CI(1.47,8.25)],were found to be statistically and positively associated with nurses SSI prevention practice.Conclusion:In this study,the level of surgical site infection prevention practice was poor.Being BSc and above,being knowledgeable and good attitude,got personal protective equipment,had management support,serving for≥5 years and trained on infection prevention were found to be significantly associated with surgical site infection prevention practice.Updating knowledge and practice of nurses through in-service education and training on latest evidence-based practice,regularly supplying of personal protective equipment,developing hospital policy and procedures for surgical site infection prevention practice is recommended.展开更多
Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was cond...Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was conducted at obstetric wards and intrapartum units at Nasser Institute Hospital. Sample: All nurses provide guided direct care, there were 40 nurses included in the study. Tools: Three tools were used to collect data named self-administered questionnaire sheet, labor supportive measures’ observational checklists, and nurses’ satisfaction sheet. Results: There was a highly significant improvement in total knowledge and total practical skills among the studied sample pre-intervention compared to immediate post and follow-up intervention (p ≤ 0.01). Additionally, 95% of the studied sample was satisfied with the advanced knowledge included in the guidelines. Conclusion: The supportive measures guidelines had an efficient improving nurses’ knowledge and practices post-intervention. Also, the majority of the studied sample was satisfied with the implemented guidelines. Recommendations: Implementation of labor supportive measure guidelines in different childbirth units to improve nurses’ practice. Further research is required to investigate parturient woman’s satisfaction with the childbirth process after implementing labor supportive measures and the effect of labor supportive measures on childbirth process outcome.展开更多
Objective:This study aims to outline the background of advanced nursing practice(ANP),potential issues,and the prospects for its establishment in the Moroccan health care system.Methods:A review was performed with dat...Objective:This study aims to outline the background of advanced nursing practice(ANP),potential issues,and the prospects for its establishment in the Moroccan health care system.Methods:A review was performed with databases that included articles published between 2016 and 2023.Results:The study found 14 articles agreeing that ANP is a solution to the shortage of medical and nursing staff.Moreover,its establishment in the Moroccan health care system is subject to many challenges,which require an in-depth study.Conclusions:The training of advanced practice nurse(APN)is needed to meet the requirements of the national health care system.It can be incorporated if the context is examined,considering all the challenges that may arise when implementing this program.展开更多
Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the esse...Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.展开更多
This study aims to clarify the conceptual characteristics of artifact utilization in nursing practice instruction. Five selected articles were analyzed using the concept analysis method by Walker and Avant. The attrib...This study aims to clarify the conceptual characteristics of artifact utilization in nursing practice instruction. Five selected articles were analyzed using the concept analysis method by Walker and Avant. The attributes, antecedents, and consequences of the concept were extracted from the target literature. The analysis revealed two attributes (“connecting people to people” and “connecting people to objects”);two antecedents (“recognition of artifacts” and “selection of artifacts”);and two consequences (“designing a fulfilling learning environment” and “improving the quality of education”). The concept was defined as “promoting the utilization of artifacts by recognizing and selecting them, connecting people to people and people to objects, designing a fulfilling learning environment, and improving the quality of education”.展开更多
Objective:There were studies evaluating advanced nursing practice independently in the mainland and Hong Kong Special Administrative Region of China,but there was no attempt to make a comparison of practice between th...Objective:There were studies evaluating advanced nursing practice independently in the mainland and Hong Kong Special Administrative Region of China,but there was no attempt to make a comparison of practice between them.This study employed a case study method to examine and compare advanced nursing practice in Hong Kong and Guangzhou.Method:Purposive sampling method was used to recruit 24 advanced practice nurses(APN)who came from the specialty of medical,surgical and pediatric in Hong Kong and Guangzhou.A questionnaire survey and semi-structured interview were conducted to solicit quantitative and qualitative data for exploring the structure-process-outcome of advanced nursing practice.The structure component explored the factors influencing advanced nursing practice.The process part examined APN role components and illustrations of exemplary advanced nursing practice.The outcomes described outcome indicators that best reflected advanced nursing practice.Findings:Findings revealed that in the structure domain,APN education and career development,team approach in healthcare,and support from management,physicians and professional associations were important contextual factors for APN development in both cities.For the process domain,participants had at least 80%of their time practicing independently/interdependently and were engaged in APN activities including direct/indirect patient care,research/project work,initiation of staff and patient protocols.All participants demonstrated competencies with impacts on patient,service and profession in their description of exemplary practice.Participants from both cities ranked patient-related outcomes as top indicators for their advanced nursing practice.Conclusion:This study has revealed that APNs in Guangzhou and Hong Kong shared similar work involvement and impacts and their demonstrated competencies were on par with international counterparts.Continued efforts need to be put in establishing formal APN education,clear clinical career pathway and title protection to empower nurses to provide optimal care to the fullest extent that they are prepared for.展开更多
This paper provides an overview of Advanced Practice Nursing(APN)in the USA,Canada,Australia and Hong Kong.It is based upon documents presented to the China Medical Board(CMB)China Nursing Network(CNN)as background fo...This paper provides an overview of Advanced Practice Nursing(APN)in the USA,Canada,Australia and Hong Kong.It is based upon documents presented to the China Medical Board(CMB)China Nursing Network(CNN)as background for discussions held by the CNN in Shanghai.It discusses the APN role in these countries and regions according to topics identified by the CNN.These are APN educational preparation;role legitimacy;capacity requirements;scope of practice,domains of activities and limited rights for prescription and referral;professional promotion ladder;accreditation system;and,perfor-mance evaluation system.Both Canada and Australia have adapted many aspects of the USA model of APN to fit their specific legislative requirements and local conditions.Hong Kong has taken a different path which may be of interest in the Chinese context.展开更多
There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs) improve health care and outcomes.The China Medical Board (CMB)China Nursing Network (CC...There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs) improve health care and outcomes.The China Medical Board (CMB)China Nursing Network (CCNN) began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities.This paper presents the discussion,recommendations and action plans developed at the inaugural planning meeting on June 26,2015 at Fudan University in Shanghai.The recommendations are:Develop standards for advanced nursing practice;Develop Master's level curricula based on the standards;Commence pilot projects across a number of University affiliated hospitals;and Prepare clinical tutors and faculty.The strategic directions and actions are: Develop a clinical career ladder system;Expand the nursing role from hospital to community;and Build a specialty nurse accreditation system.展开更多
BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with ...BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.展开更多
The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger dis...The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.展开更多
Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognize...Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.展开更多
In this paper, we elucidate the concept and characteristics of action learning as well as summarize the re？exivity, cooperativeness, and subjectivity of this approach. Furthermore, we describe the effects and limitat...In this paper, we elucidate the concept and characteristics of action learning as well as summarize the re？exivity, cooperativeness, and subjectivity of this approach. Furthermore, we describe the effects and limitations of action learning when applied in nursing management, nursing education, and clinical practice, among various ？elds.展开更多
The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s aut...The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.展开更多
文摘Objectives:A framework for the advanced practice nurse(APN)role was developed in our Canadian Tertiary Care Centre,delineating five domains of advanced nursing practice:clinical practice,consultation,research,education and leadership.The goal of this study was to evaluate perceptions of the effectiveness of the implementation of an innovative APN role on an in-patient Neurosurgery unit.Methods:A pre-and-post implementation design,incorporating both qualitative and quantitative data,was utilized.An innovative APN role was implemented within the Neurosurgery program focusing on the clinical domain and required the successful candidates to be NP prepared.This APN role was designed to improve patient flow,documentation,communication and patient and staff satisfaction.Three primary outcomes were measured:pre-implementation questionnaire(nurses),post-implementation questionnaire(nurses and residents)and number of pages to the on-call resident.Results:Survey scores by nurses and residents indicated improvement across all aspects studied.Average scores increased from 1.1 to 2.6,reflecting an overall statistically significant increase.The number of pages to the on-call resident also showed a decrease.Conclusion:Perceptions of patient care delivery and professional collaboration improved following implementation of the APN role.Responses indicated that APNs significantly impacted patient care and improved nurses and residents'job satisfaction.
文摘Objective:The aim of this study was to examine the relationship between moral distress that may affect patient safety,and the clinical practice model,assessing ethical decision-making skills of certified registered nurse anesthetists(CRNAs).Methods:A survey using the Ethical Stress Scale(ESS)and the Ethical Assessment Skills Survey(EASS)was conducted with 134 CRNAs.Results:Results indicated no significant effect of practice model on level of moral distress or perceived ethical assessment skill knowledge[Wilks's lambda=0.952,F(6,256)=1.068,P=0.382,n^(2)=0.02].A statistically significant positive correlation existed between importance and skill(r=0.275,P=0.001).CRNAs felt skilled to manage the actions or activities they deemed important.Conclusion:CRNAs who perceived a higher skill level in addressing ethical issues experienced lower levels of moral distress.Findings indicate content-specific curricula for the CRNAs need to be evaluated for ethical decision-making skill assessment content.
文摘Background Advanced practice chronic conditions. However, nurse transitional care has been proofed to be important for older adults with such effectiveness has never been studied in the management of appropriate Warfarin use in clinical practice. Methods A total of 97 patients were randomly distributed into control group who received usual care, and interventional group who received transitional care provided by APNs. A 12-month observation of both groups were recorded by physicians and APNs and the impact of APNs on the managing of Warfarin therapy was also evaluated based on time in the therapeutic range （TTR）. Results APNs transitional care significantly （P 〈 0.01） improved patients＇ adherence, increased TTR and high TTR ratio compared with control group. Re-admission due to stroke was significantly （P 〈 0.01） reduced by APNs transitional care. Conclusion APNs transitional care improves patients＇ knowledge on AF and reduces stroke risk. The current research strongly suggest the necessity of APNs transitional interventional in managing anticoagulation therapy in AF patients in China.
基金funded by the‘Stiftung Perspektive Hausaztinnen und Hausazte‘(‘Foundation for General Practice Perspectives’)supported by the General Practitioner’s Associations of Saxony-Anhalt and Saxony.
文摘Objective Demographic changes,increasing prevalence of chronically ill and multimorbid patients and the ongoing shortage of general practitioners(GPs)collectively present significant challenges for European general practice.Task delegation from GP to practice nurse(PN)-led patient consultations could be a potential solution to tackle those challenges.Therefore,this study aimed to examine the attitudes of GPs and PNs towards PN-led consultations in general and for specific conditions.Design Cross-sectional survey using a self-developed,pretested questionnaire,conducted between September 2023 and November 2024.The questionnaire assessed attitudes towards PN-led consultations,conditions within PN-led consultations,possible benefits and concerns regarding PN-led consultations,sociodemographic characteristics and characteristics on GP offices(GPOs).We performed descriptive statistics,univariable and multivariable regression analyses using SPSS V.27.Setting GPOs located in the German federal states of Saxony-Anhalt and Saxony.Participant From 2071 contacted GPOs,437 GPs and 339 PNs participated(GP response rate:21.1%).Results The majority of GPs(61.7%)and PNs(61.2%)were open towards PN-led consultations.In multivariable analysis,GPs showed greater openness if they had prior positive delegation experiences(OR=5.88,95%CI(3.01 to 11.48))or already delegated special tasks(OR=5.34,95%CI(2.29 to 12.46)).GPs were less open if they worked in urban GPOs(OR=0.44,95%CI(0.22 to 0.88))or owned a single GPO(OR=0.41,95%CI(0.20 to 0.83)).In multivariable analysis,PNs were more open towards PN-led consultations if they had prior positive delegation experiences(OR=3.03,95%CI(1.12 to 8.18))and advanced PN training(OR=3.50,95%CI(1.44;8.51)).The three most accepted conditions by GPs and PNs for PN-led consultations were chronic wounds,diabetes mellitus and arterial hypertension.Conclusion Our findings demonstrate broad openness among both GPs and PNs towards PN-led consultations in German GPOs in general,and for various acute and chronic conditions.PN-led consultations are already partially practised.The results indicate considerable potential for further delegation beyond current national agreements.Future pilot studies should further develop PN roles and provide evidence of feasibility and non-inferiority of PN-led consultations compared to GP-led consultations.Conditions and participant characteristics investigated may serve as a foundation for study design and participant recruitment.
文摘This paper focuses on the key role and practical paths of operating room nurses in infection control,and studies the difficult problems in the prevention and control of surgical site infections.Analyze the infection risk links in the operating room and the core responsibilities of nurses,reveal the multiple role mechanisms of nurses in infection control,design practical strategies from dimensions such as process optimization,skill improvement,and monitoring feedback,and construct an infection control system involving all staff.Research shows that operating room nurses can effectively reduce the risk of infection,improve medical quality,provide core guarantees for patient safety,and promote the transformation of operating room infection control towards refined management through practical actions such as standardized operation execution,real-time risk monitoring,and team collaboration supervision.
文摘Objective:This article employs a scoping review methodology,integrates knowledge and information about current pediatric nurses'practices and perceptions regarding family-centered care in pediatric settings.Methods:Published articles were retrieved from databases including EBSCO host,PubMed,Springer,Science Direct,Ovid,and CINAHL between 2013 and 2023.Results:The finding shows a better understanding of pediatric nurses'perceptions of family-centered care in association with their clinical settings.However,the evidence indicates that integrating family-centered care components into health care services is difficult and confusing to nurses and is often not implemented in a clinical setting.As evidenced by this review,studies have consistently reported similar results;family-centered care was a good perception and understood by pediatric nurses as a concept but inconsistently used in a daily practice setting.Conclusions:This scoping review is the first phase in promoting a strategic plan to provide educational interventions for pediatric nurses to implement family-centered care in their daily practice settings.It's necessary to recognize pediatric nurses'perceptions and practices concerning family-centered care to provide optimal healthcare services in pediatric settings.
文摘<strong>Aim:</strong> This study aimed to examine the effect of a seminar to continuously reinforce ethical nursing practices among pediatric nurses. <strong>Methods:</strong> This seminar was based on a 24-point pediatric nursing care model (PNCM) that provided specific examples of basic ethical nursing practices for children undergoing medical procedures and their families. Participants’ knowledge level and application frequencies, regarding these practices, were assessed face-to-face in the first session and via email 2 and 5 months later, using the PNCM checklist and qualitative data about ethical practices. <strong>Results:</strong> Results revealed that 8 PNCM items about frequency remained the same as the first session after 5 months;however, 16 items reported increased application. The qualitative data collected 2 months later suggested that the nurses could have adapted better to implement ethical pediatric nursing;however, the one collected 5 months later confirmed the effect of the seminar on ethical nursing practices with children and their families. The continuous effect of the seminar became more evident from the responses received 5 months later than those received 2 months later. <strong>Conclusions:</strong> The findings confirmed a reinforced effect on ethical pediatric nursing practice with child patients and their parents after 5 months.
文摘Background:Surgical site infections are the most frequent type of preventable hospital acquired infections with a serious and undesirable outcome of surgery associated with increase morbidity,mortality rate,hospital stay,readmission and excess cost.Surgical site infection prevention is one of the most important challenge in delivering optimal nursing care.Studies suggest that the nurses’practices of surgical site infection prevention is not well addressed.Moreover,there is clearly paucity of information,in Africa including the study area.Objective:The aim of this study was to assess surgical site infection prevention practices and associated factors among nurses working in government hospitals of Harari Regional State and Dire Dawa City Administration,Eastern Ethiopia from March 01 to 28,2019.Method and Materials:An institutional based cross-sectional study design was employed for a total of 515 nurses.Simple random sampling method was used to select study participants.Data were collected using pretested structured self-administered questionnaire supplemented by observation.Data were checked,coded,entered and cleaned using Epi-data version 3.1 and exported to SPSS version 20 for analysis.Bivariate and multivariate analysis were undertaken and P values less than 0.05 at 95%confidence interval were considered as statistically significant.Result:The overall self-reported level of SSI prevention practice was found to be 40.8%(95%CI:36.9%,45.4%).Nurses with BSc and above[Adjusted odds ratio(AOR)=2.52,95%CI(1.14,5.54)],trained on infection prevention[AOR=2.22,95%CI(1.29,3.82)],good knowledge[AOR=2.21,95%CI(1.32,3.71)],good attitude[AOR=5.11,95%CI(3.05,8.57)],got supply of personal protective equipment[AOR=2.57,95%CI(1.46,4.49)],had management support[AOR=3.41,95%CI(1.90,6.12)],experience of 5 to 10 years[AOR=5.38,95%CI(2.82,10.27)]and≥11 years[AOR=3.48,95%CI(1.47,8.25)],were found to be statistically and positively associated with nurses SSI prevention practice.Conclusion:In this study,the level of surgical site infection prevention practice was poor.Being BSc and above,being knowledgeable and good attitude,got personal protective equipment,had management support,serving for≥5 years and trained on infection prevention were found to be significantly associated with surgical site infection prevention practice.Updating knowledge and practice of nurses through in-service education and training on latest evidence-based practice,regularly supplying of personal protective equipment,developing hospital policy and procedures for surgical site infection prevention practice is recommended.
文摘Objectives: To investigate the effect of supportive measures guidelines on nurses’ practices during labor. Methods: A quasi-experimental design (an interventional pre and post-test study). Setting: The study was conducted at obstetric wards and intrapartum units at Nasser Institute Hospital. Sample: All nurses provide guided direct care, there were 40 nurses included in the study. Tools: Three tools were used to collect data named self-administered questionnaire sheet, labor supportive measures’ observational checklists, and nurses’ satisfaction sheet. Results: There was a highly significant improvement in total knowledge and total practical skills among the studied sample pre-intervention compared to immediate post and follow-up intervention (p ≤ 0.01). Additionally, 95% of the studied sample was satisfied with the advanced knowledge included in the guidelines. Conclusion: The supportive measures guidelines had an efficient improving nurses’ knowledge and practices post-intervention. Also, the majority of the studied sample was satisfied with the implemented guidelines. Recommendations: Implementation of labor supportive measure guidelines in different childbirth units to improve nurses’ practice. Further research is required to investigate parturient woman’s satisfaction with the childbirth process after implementing labor supportive measures and the effect of labor supportive measures on childbirth process outcome.
文摘Objective:This study aims to outline the background of advanced nursing practice(ANP),potential issues,and the prospects for its establishment in the Moroccan health care system.Methods:A review was performed with databases that included articles published between 2016 and 2023.Results:The study found 14 articles agreeing that ANP is a solution to the shortage of medical and nursing staff.Moreover,its establishment in the Moroccan health care system is subject to many challenges,which require an in-depth study.Conclusions:The training of advanced practice nurse(APN)is needed to meet the requirements of the national health care system.It can be incorporated if the context is examined,considering all the challenges that may arise when implementing this program.
文摘Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.
文摘This study aims to clarify the conceptual characteristics of artifact utilization in nursing practice instruction. Five selected articles were analyzed using the concept analysis method by Walker and Avant. The attributes, antecedents, and consequences of the concept were extracted from the target literature. The analysis revealed two attributes (“connecting people to people” and “connecting people to objects”);two antecedents (“recognition of artifacts” and “selection of artifacts”);and two consequences (“designing a fulfilling learning environment” and “improving the quality of education”). The concept was defined as “promoting the utilization of artifacts by recognizing and selecting them, connecting people to people and people to objects, designing a fulfilling learning environment, and improving the quality of education”.
文摘Objective:There were studies evaluating advanced nursing practice independently in the mainland and Hong Kong Special Administrative Region of China,but there was no attempt to make a comparison of practice between them.This study employed a case study method to examine and compare advanced nursing practice in Hong Kong and Guangzhou.Method:Purposive sampling method was used to recruit 24 advanced practice nurses(APN)who came from the specialty of medical,surgical and pediatric in Hong Kong and Guangzhou.A questionnaire survey and semi-structured interview were conducted to solicit quantitative and qualitative data for exploring the structure-process-outcome of advanced nursing practice.The structure component explored the factors influencing advanced nursing practice.The process part examined APN role components and illustrations of exemplary advanced nursing practice.The outcomes described outcome indicators that best reflected advanced nursing practice.Findings:Findings revealed that in the structure domain,APN education and career development,team approach in healthcare,and support from management,physicians and professional associations were important contextual factors for APN development in both cities.For the process domain,participants had at least 80%of their time practicing independently/interdependently and were engaged in APN activities including direct/indirect patient care,research/project work,initiation of staff and patient protocols.All participants demonstrated competencies with impacts on patient,service and profession in their description of exemplary practice.Participants from both cities ranked patient-related outcomes as top indicators for their advanced nursing practice.Conclusion:This study has revealed that APNs in Guangzhou and Hong Kong shared similar work involvement and impacts and their demonstrated competencies were on par with international counterparts.Continued efforts need to be put in establishing formal APN education,clear clinical career pathway and title protection to empower nurses to provide optimal care to the fullest extent that they are prepared for.
文摘This paper provides an overview of Advanced Practice Nursing(APN)in the USA,Canada,Australia and Hong Kong.It is based upon documents presented to the China Medical Board(CMB)China Nursing Network(CNN)as background for discussions held by the CNN in Shanghai.It discusses the APN role in these countries and regions according to topics identified by the CNN.These are APN educational preparation;role legitimacy;capacity requirements;scope of practice,domains of activities and limited rights for prescription and referral;professional promotion ladder;accreditation system;and,perfor-mance evaluation system.Both Canada and Australia have adapted many aspects of the USA model of APN to fit their specific legislative requirements and local conditions.Hong Kong has taken a different path which may be of interest in the Chinese context.
文摘There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs) improve health care and outcomes.The China Medical Board (CMB)China Nursing Network (CCNN) began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities.This paper presents the discussion,recommendations and action plans developed at the inaugural planning meeting on June 26,2015 at Fudan University in Shanghai.The recommendations are:Develop standards for advanced nursing practice;Develop Master's level curricula based on the standards;Commence pilot projects across a number of University affiliated hospitals;and Prepare clinical tutors and faculty.The strategic directions and actions are: Develop a clinical career ladder system;Expand the nursing role from hospital to community;and Build a specialty nurse accreditation system.
基金Supported by Basic scientific research industry of Heilongjiang Provincial undergraduate universities in 2019,No.2019-KYYWF-1213.
文摘BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.
基金The work was supported by the Comprehensive investment strategic emerging industries related construction projects in“twelfth five-year”for Tianjin(Tianjin Education Committee[2011]no.61).
文摘The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.
文摘Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.
基金supported by 2014 Higher Education Reform Project of Education Department of Henan,China(No.2014SJGLX119)
文摘In this paper, we elucidate the concept and characteristics of action learning as well as summarize the re？exivity, cooperativeness, and subjectivity of this approach. Furthermore, we describe the effects and limitations of action learning when applied in nursing management, nursing education, and clinical practice, among various ？elds.
文摘The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.
