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Nursing Roles (nursing + role)
Kinds of Nursing Roles Selected AbstractsThe Newborn Triage Nurse: A New Perinatal Nursing RoleNURSING FOR WOMENS HEALTH, Issue 5 2007Jennifer N. Schiewe RN No abstract is available for this article. [source] Genetic Counseling and the Advanced Practice Oncology Nursing Role in a Hereditary Cancer Prevention Clinic: Hereditary Breast Cancer Focus (Part I)THE BREAST JOURNAL, Issue 2009Carrie L. Snyder MSN Abstract:, Interest in hereditary breast cancer has increased rapidly among all health care providers as well as the laity. A major problem for health care providers, however, is the time and skill required for gathering family history, interpreting the pedigree, and providing genetic counseling for the high-risk patient so that BRCA testing, when indicated, can be pursued and screening and prevention strategies employed by the patient. The fields of hereditary cancer and molecular biology have developed at a rate that makes it difficult for physicians to keep up with this explosive knowledge. Therefore, "Who is going to take care of all of these crucial matters for patient benefit?" is a germane question. Our experience has confirmed that the advanced practice oncology nurse who is interested in cancer genetics can become skilled at providing this service to the patient and his/her family. This study portrays the role of such an oncology nurse in meeting this important public health challenge, with special attention devoted to the logistics of this role in the rapidly emerging field of hereditary breast cancer. [source] Developing Evidence-Based Nursing Roles: Lessons Learned From the Health Care Integrator RoleNURSING FORUM, Issue 2 2008Jennifer J. Hatzfeld MEd, RN-BC TOPIC.,Developing evidence-based nursing roles. PURPOSE.,This study examined a unique nursing role in the United States Air Force to determine if it had been well institutionalized and to identify barriers and facilitators during the implementation process. SOURCE OF INFORMATION.,Individuals functioning in the role were surveyed to measure time spent on specific job-related tasks, additional duties, and positive and negative experiences. CONCLUSIONS.,Eighty-seven percent of the respondents (n = 45) indicated that the role had been well implemented, although wide variation existed in tasks performed and major organizational barriers identified. Findings of this study can be used to guide the development of other evidence-based positions. [source] Cardiac rehabilitation programme for coronary heart disease patients: An integrative literature reviewINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2009Nidal F Eshah RN, PhD(c) Previous Western cardiac rehabilitation (CR) purported to improve patients' quality of life and health-related parameters for cardiovascular diseases (CVD). Nursing's role in CR was minimally identified. The purpose of this integrative literature review was to determine the effectiveness of current CR programmes and to determine if nurses are included in multidisciplinary CR teams. An online search of databases for the National Institutes of Health Library, Medline, CINAHL, Blackwell Synergy and PsychINFO electronic databases, with keywords,cardiac rehabilitation, lifestyle modification, secondary prevention, quality of life, effects of rehabilitation,identified 13 articles published 2001,2006 for inclusion. Cardiac rehabilitation programmes provided significant improvement in participants' quality of life, exercise capacity, lipid profile, body mass index, body weight, blood pressure, resting heart rate, survival rate, mortality rate and decreased myocardial infarction (MI) risk factors, although there was limited participation. They also decreased depression and anxiety. Eight studies included Nurses as CR providers, but without clear descriptions of their role. Nurses in developing countries need to participate in CR programmes to improve patients' participation, and to focus on modalities with lower overhead costs, such as home-based CR, and to clearly articulate their unique contributions. [source] Understanding nursing on an acute stroke unit: perceptions of space, time and interprofessional practiceJOURNAL OF ADVANCED NURSING, Issue 9 2009Cydnee C. Seneviratne Abstract Title.,Understanding nursing on an acute stroke unit: perceptions of space, time and interprofessional practice. Aim. This paper is a report of a study conducted to uncover nurses' perceptions of the contexts of caring for acute stroke survivors. Background. Nurses coordinate and organize care and continue the rehabilitative role of physiotherapists, occupational therapists and social workers during evenings and at weekends. Healthcare professionals view the nursing role as essential, but are uncertain about its nature. Method. Ethnographic fieldwork was carried out in 2006 on a stroke unit in Canada. Interviews with nine healthcare professionals, including nurses, complemented observations of 20 healthcare professionals during patient care, team meetings and daily interactions. Analysis methods included ethnographic coding of field notes and interview transcripts. Findings. Three local domains frame how nurses understand challenges in organizing stroke care: 1) space, 2) time and 3) interprofessional practice. Structural factors force nurses to work in exceptionally close quarters. Time constraints compel them to find novel ways of providing care. Moreover, sharing of information with other members of the team enhances relationships and improves ,interprofessional collaboration'. The nurses believed that an interprofessional atmosphere is fundamental for collaborative stroke practice, despite working in a multiprofessional environment. Conclusion. Understanding how care providers conceive of and respond to space, time and interprofessionalism has the potential to improve acute stroke care. Future research focusing on nurses and other professionals as members of interprofessional teams could help inform stroke care to enhance poststroke outcomes. [source] Doctors' assistants' views of case management to improve chronic heart failure care in general practice: a qualitative studyJOURNAL OF ADVANCED NURSING, Issue 4 2009Rebecca Olbort Abstract Title.,Doctors' assistants' views of case management to improve chronic heart failure care in general practice: a qualitative study. Aim., This paper is a report of a study to explore the views, concerns and experiences of doctors' assistants of case management for patients with chronic heart failure, while experiencing the new role of being a case manager within the Heidelberg Integrated Case Management trial. Background., Case management is being investigated as part of a randomised controlled trial aiming to improve care for patients with chronic systolic heart failure. In a complex, multifaceted intervention, trained doctors' assistants (equivalent to a nursing role) adopted new tasks using standardised case management involving telephone monitoring, home visits and diagnostic screening. Method., In April 2007, 3 months after implementation of the intervention programme, 27 doctors' assistants participated in four focus group interviews discussing their views on, and experiences of, case management. Thematic analysis of the data was undertaken. Findings., Participants believed that the most positive factors in case management were about interaction with patients, including opportunities for identifying disease and psychosocial problems. However, barriers included lack of time allocated to perform case management in addition to their normal role and poor cooperation within the practice team. According to the doctors' assistants, the routine implementation of case management was acceptable, feasible and effective in improving the management of patients with chronic systolic heart failure. Conclusion., Case management enhanced the role of doctors' assistants, leading to increased awareness of the perspective of patients with chronic disease. In the wider international primary care practice nursing context, the orchestrated delegation of tasks using specific case management may be a promising strategy for improving the quality of care of chronically ill patients and enabling patient self-management. [source] Warrior nurse: duality and complementarity of role in the operational environmentJOURNAL OF ADVANCED NURSING, Issue 1 2008Lauren Griffiths Abstract Title.,Warrior nurse: duality and complementarity of role in the operational environment Aim., This paper is a report of a study to explore the nature of military nursing in an environment of war, in particular the union of personal, professional and organizational tenets and to identify the actual or potential effect this had on the nursing role in this unique environment. Background., The history of nursing is intrinsically linked with war. There is an irony to this relationship. Active involvement with military activities has provided a vehicle in which nursing has developed, albeit through fostering war, which itself destroys health and contravenes the ethos of nursing. Military nurses, one would assume, are able to reconcile the dichotomy existing between their caring role and being a member of an organization associated with conflict. Methods., A grounded theory design was adopted and the data were collected from 1999 to 2002 using a series of in-depth interviews and focus group with of 24 military nurses. Findings., Three categories were identified: ,It's Just Different Levels', ,That Double Hat' and ,It's Who We Are!' The first illustrates the reality of conflict. ,That Double Hat' outlines the military nurses dual role: those of caring and the military. ,It's Who We Are!' demonstrates the transition from nurse-to-warrior. These integrate to create the core category: ,Caring for War: Transition to Warrior'. Conclusion., The symbiotic relationship of carer and warrior arises as a consequence of strategies used by military nurses to embrace their dual role. Further research is needed to explore the essence of the caring role within a conflict zone from military and civilian perspectives. [source] Postdischarge nursing interventions for stroke survivors and their familiesJOURNAL OF ADVANCED NURSING, Issue 2 2004Kelly L. McBride MSc RN Background. The physical, cognitive, and emotional sequelae of stroke underscore the need for nursing interventions across the continuum of care. Although there are several published studies evaluating community interventions for stroke survivors, the nursing role has not been clearly articulated. Aim. The aim of this paper is to report a study to describe, using a standardized classification system, the nursing interventions used with stroke survivors during the initial 6 weeks following discharge home. Methods. In the context of a randomized controlled trial, two nurse case managers provided care to 90 community-dwelling stroke survivors who were assigned to the intervention arm of the trial. The nursing documentation was analysed, using the Nursing Intervention Classification (NIC) system, to identify and quantify the interventions that were provided. Findings. Stroke survivors received, on average, six different interventions. There was a trend for those who were older, more impaired, and who lived alone to receive more interventions. The most commonly reported interventions included those directed towards ensuring continuity of care between acute and community care, family care, and modifying stroke risk factors. The study was limited to the nursing documentation, which may represent an underestimation of the care delivered. Conclusions. The NIC system was useful in capturing the interventions delivered by the nurse case managers. Nursing interventions are often not clearly articulated and less often use standardized terminology. Describing nursing activities in a standard manner will contribute to an increase in nursing knowledge and to evidence-based practice. [source] Incongruence between nurses' and patients' understandings and expectations of rehabilitationJOURNAL OF CLINICAL NURSING, Issue 12 2009Julie Pryor Aims and objectives., To explore nurses' understandings and expectations of rehabilitation and nurses' perceptions of patients' understandings and expectations of rehabilitation. Background., Within the context of a broadening appreciation of the benefits of rehabilitation, interest in the nature of rehabilitation is growing. Some believe that rehabilitation services do not adequately meet the needs of patients. Others are interested in the readiness of patients to participate in rehabilitation. Design., Qualitative. Method., Grounded theory using data collected during interviews with nurses in five inpatient rehabilitation units and during observation of the nurses' everyday practice. Findings., According to nurses working in inpatient rehabilitation units, there is a marked incongruence between nurses' understandings and expectations of rehabilitation and what they perceive patients to understand and expect. Conclusion., Given these different understandings, an important nursing role is the education of patients about the nature of rehabilitation and how to optimise their rehabilitation. Relevance to clinical practice., Before patients are transferred to rehabilitation, the purpose and nature of rehabilitation, in particular the roles of patients and nurses, needs to be explained to them. The understandings of rehabilitation that nurses in this study possessed provide a framework for the design of education materials and orientation programmes that inform patients (and their families) about rehabilitation. In addition, reinforcement of the differences between acute care and rehabilitation will assist patients new to rehabilitation to understand the central role that they themselves can play in their recovery. [source] The clinical nurse leader: a catalyst for improving quality and patient safetyJOURNAL OF NURSING MANAGEMENT, Issue 5 2008FAAN, JOAN M. STANLEY PhD Aim, The clinical nurse leader (CNL®) is a new nursing role introduced by the American Association of Colleges of Nursing (AACN). This paper describes its potential impact in practice. Background, Significant pressures are being placed on health care delivery systems to improve patient care outcomes and lower costs in an environment of diminishing resources. Method, A naturalistic approach is used to evaluate the impact the CNL has had on outcomes of care. Case studies describe the CNL implementation experiences at three different practice settings within the same geographic region. Results, Cost savings, including improvement on Centers for Medicare and Medicaid Services (CMS) core measures, are realized quickly in settings where the CNL role has been integrated into the care delivery model. Conclusions, With the growing calls for improved outcomes and more cost-effective care, the CNL role provides an opportunity for nursing to lead innovation by maximizing health care quality while minimizing costs. Implications for nursing management, Nursing is in a unique position to address problems that plague the nation's health system. The CNL represents an exciting and promising opportunity for nursing to take a leadership role, in collaboration with multiple practice partners, and implement quality improvement and patient safety initiatives across all health care settings. [source] Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approachesJOURNAL OF NURSING MANAGEMENT, Issue 5 2004PG Dip., Renee Adomat BA (Hons) Background, A huge range of patient classification systems/tools are used in critical care units to inform workforce planning, however, they are not always applied appropriately. Many of these systems/tools were not originally developed for the purposes of workforce planning and so their use in determining the nurse:patient ratio required in critical care settings raises a number of issues for the organisation and management of these services. Aim, The aim of this paper is to review the three main assessment systems that are commonly used in critical care settings in the UK and evaluate their effectiveness in accurately determining nurse : patient ratios. If the application of these systems/tools is to enhance care, a thorough understanding of their origins and purpose is necessary. If this is lacking, then decisions relating to workload planning, particularly when calculating nurse : patient ratios, may be flawed. Conclusions, Patient dependency/classification systems and patient dependency scoring systems for severity of illness are robust measures for predicting morbidity and mortality. However, they are not accurate if used to calculate nurse : patient ratios because they are not designed to measure nursing input. Nursing intensity measures provide a useful framework for calculating the cost of providing a nursing service in critical care and can serve as a measure of nursing input, albeit a fairly basic one. However, many components of the nursing role are not ,accounted' for in these measures. Implications, The implications of these findings for the organization and management of critical care services are discussed. Careful consideration of these areas is vital if a cost efficient and cost-effective critical care service is to be delivered. [source] The role of second health professionals under New Zealand mental health legislationJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006A. J. O'BRIEN rgn rpn ba mphil The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for he second health professional role is suggested as a way of supporting clinical practice in this area. [source] Quality of life: a basis for clinical decision-making in community psychiatric careJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2004E. H. CLARK rn msn med phd This descriptive study used grounded theory methodology to illuminate how the concept of quality of life influences the practice of community psychiatric nurses caring for individuals with serious mental illnesses. In-depth interviews captured the practice wisdom of expert nurses. Data were verified through focus groups, member checks and peer debriefing. The constant comparative method was used to categorize data and identify key themes and concepts. Informants regarded the concept of quality of life as central to nursing practice. They cited examples of how it serves as a goal and philosophy of care, a basis for forming relationships, and a lens through which the nursing role becomes clearer. Quality of life is acknowledged to be a subjective concept. It is assessed in light of the individual's hopes, dreams and values, and within the context of his or her whole life. A quality of life focus is supported by the philosophies of holism and empowerment. Nurses promote quality of life through symptom management, educating and advocating for clients. Minimizing barriers to quality of life and helping the individual to have a broader vision of what his or her life could be, are also central to the psychiatric nursing role. [source] Rheumatology nurse practitioners' perceptions of their roleMUSCULOSKELETAL CARE, Issue 2 2006Leslie Goh MRCP(UK) Abstract Objectives:,To identify the current practices of rheumatology nurse practitioners and ascertain their perceptions of how their role could be enhanced. Method:,A cross-sectional questionnaire study of currently employed nurse practitioners in rheumatology in the United Kingdom (UK) was undertaken. Results:,200 questionnaires were distributed and 118 nurses responded. Ninety-five respondents met the inclusion criteria for undertaking an advanced nursing role. Typical conditions dealt with included: rheumatoid arthritis (96.8%); psoriatic arthritis (95.8%); osteoarthritis (63.2%); ankylosing spondylitis (62.8%); systemic lupus erythematosus (51.6%); and scleroderma (34.7%). Drug monitoring, education, counselling of patients and arranging basic investigations were routinely performed by more than 80% of respondents. A smaller proportion performed an extended role that included dealing with referrals, research and audit, the administration of intra-articular injections, and admission of patients. Specific attributes identified as being necessary for competence were: knowledge and understanding of rheumatic diseases (48.4%); drug therapy (33.7%); good communication skills (35.8%); understanding of the roles of the team (27.4%); working effectively (23.2%) as part of a multidisciplinary team; assessment of patients by physical examination (28.4%); teaching (26.3%), research (17.9%); organizational skills (14.7%); and the interpretation of investigations (9.5%). Factors that could enhance their role included: attendance at postgraduate courses (30.5%); obtaining further qualifications (13.7%); active participation in the delivery of medical education (41.1%); training in practical procedures (31.6%); protected time and resources for audit and research (11.6%); formal training in counselling (11.6%); and implementation of nurse prescribing (10.5%). Conclusion:,Nurse practitioners already have a wide remit and play an invaluable part in the delivery of modern rheumatology services. An extended role could improve patient care and enhance nursing career pathways in rheumatology. Copyright © 2006 John Wiley & Sons, Ltd. [source] Developing Evidence-Based Nursing Roles: Lessons Learned From the Health Care Integrator RoleNURSING FORUM, Issue 2 2008Jennifer J. Hatzfeld MEd, RN-BC TOPIC.,Developing evidence-based nursing roles. PURPOSE.,This study examined a unique nursing role in the United States Air Force to determine if it had been well institutionalized and to identify barriers and facilitators during the implementation process. SOURCE OF INFORMATION.,Individuals functioning in the role were surveyed to measure time spent on specific job-related tasks, additional duties, and positive and negative experiences. CONCLUSIONS.,Eighty-seven percent of the respondents (n = 45) indicated that the role had been well implemented, although wide variation existed in tasks performed and major organizational barriers identified. Findings of this study can be used to guide the development of other evidence-based positions. [source] Behaviour rating scales for older people with dementia: Which is the best for use by nurses?AUSTRALASIAN JOURNAL ON AGEING, Issue 4 2001Christine C. Neville When rating scales are to be administered by nurses, scale characteristics must take into account the limitations of the nursing role and the nature of the environment in which nurses work. This paper reviews thirty-one rating scales that have been used to measure behaviour in dementia. From this analysis, five scales were identified as suitable for use by nurses when measuring disruptive behaviour in older people with dementia. [source] An exploration of the contribution of the community nurse to rehabilitationHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2003Rosie Kneafsey RGN BSc Abstract Effective hospital and community rehabilitation services are increasingly recognised as a means of meeting the changing pattern of health and social care need. While the district or community nurse has the potential to play a central part in community rehabilitation provision, this role has received relatively scant attention in the literature. This paper describes research findings on community nurses' perceptions of their role and potential contribution to rehabilitation. As part of a wider, 2-year, qualitative investigation of the role of the nurse in rehabilitation, fieldwork was undertaken with both district and community staff nurses. This comprised focus group discussions and interviews with staff recruited as a consequence of the follow-up of patients' experiencing rehabilitation. The findings indicate that community-based nurses contributed to patient rehabilitation by making assessments, referring on to other members of the multi-professional team, advocating for and liaising with other services, helping people to adapt, teaching and motivating patients and carers, supporting and involving families, and providing technical care. A number of challenges to community-based nursing roles were apparent, including feelings of exclusion, lack of recognition, a lack of time for rehabilitation and paucity of referrals for rehabilitation. Greater clarity and recognition is needed of the community-based nursing contribution to rehabilitation, and there is a need to ensure that community nursing assessments contribute to patients' rehabilitation goals and the promotion of independent living. [source] Nursing information systems in JordanINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2009Fadia Hasna PhD RN This paper analyses how informatics are used in knowledge management in Jordan and includes conceptual frameworks for knowledge initiatives and an illustration of how data are transformed to knowledge through the processing of information; nursing informatics are mapped. Finally, applications of informatics in USA and Jordan are explored comparatively with focus on nursing roles in informatics and the key relevance to ethical challenges once these applications happen. [source] Innovations in United States genetics nursing: Practice and researchJAPAN JOURNAL OF NURSING SCIENCE, Issue 2 2005Dale H. LEA Abstract Aim:, Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics-related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods:, The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics-related health services, research, education, and public policy. Results:, Genetics nurses in the US have developed innovative responses to genetics-related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health-care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics-related research; and (vi) participation in high-level genetics advisory groups. Conclusions:, The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses' organization known as the International Society of Nurses in Genetics (ISONG) has provided this base. [source] Impoverished Children With Asthma: A Pilot Study of Urban Healthcare AccessJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2004Andrea Wallace ND ISSUES AND PURPOSE Using Andersen's Behavioral Model of Health Care Use, this pilot study was conducted to better understand the experiences of children with asthma as they access an urban healthcare system. DESIGN AND METHODS This descriptive study used a convenience sample of 34 families of pediatric asthma patients who participated in semistructured interviews and closed medical record review. RESULTS Only one patient reported having a written exacerbation management plan. Beliefs regarding medication addiction and side effects were frequently reported as barriers to medication adherence, and children seeking asthma care in primary care settings saw many care providers. PRACTICE IMPLICATIONS Exploring how expanded nursing roles can help address both family and system factors serving as barriers to health care ought to be a key priority for nursing. [source] An integrative review and meta-synthesis of the scope and impact of intensive care liaison and outreach servicesJOURNAL OF CLINICAL NURSING, Issue 23 2009Ruth Endacott Aim., To determine activities and outcomes of intensive care unit Liaison Nurse/Outreach services. The review comprised two stages: (1) integrative review of qualitative and quantitative studies examining intensive care liaison/outreach services in the UK and Australia and (2) meta-synthesis using the Nursing Role Effectiveness Model as an a priori model. Background., Acute ward patients are at risk of adverse events and patients recovering from critical illness are vulnerable to deterioration. Proactive and reactive strategies have been implemented to facilitate timely identification of patients at risk. Design., Systematic review. Methods., A range of data bases was searched from 2000,2008. Studies were eligible for review if they included adults in any setting where intensive care unit Liaison Nurse or Outreach services were provided. From 1423 citations and 65 abstracts, 20 studies met the inclusion criteria. Results., Intensive care liaison/outreach services had a beneficial impact on intensive care mortality, hospital mortality, unplanned intensive care admissions/re-admissions, discharge delay and rates of adverse events. A range of research methods were used; however, it was not possible to conclude unequivocally that the intensive care liaison/outreach service had resulted in improved outcomes. The major unmeasured benefit across all studies was improved communication pathways between critical care and ward staff. Outcomes for nurses in the form of improved confidence, knowledge and critical care skills were identified in qualitative studies but not measured. Conclusion., The varied nature of the intensive care liaison/outreach services reviewed in these studies suggests that they should be treated as bundled interventions, delivering a treatment package of care. Further studies should examine the impact of critical care support on the confidence and skills of ward nurses. Relevance to clinical practice., Advanced nursing roles can improve outcomes for patients who are vulnerable to deterioration. The Nursing Role Effectiveness Model provides a useful framework for evaluating the impact of these roles. [source] A literature review of principles, policies and practice in extended nursing roles relating to UK intensive care settingsJOURNAL OF CLINICAL NURSING, Issue 20 2008Namita Srivastava Aims., To provide an overview of the literature relating to the principles, policy and practice of extended nursing roles in UK intensive care settings to date; to review and critically assess evidence of impact, outcomes and effect on practice and provide suggestions for future research. Background., It is known that career development opportunities, new technologies, patient needs, as well as the reduction in junior doctors' hours, are driving the development of new roles for nurses. Policy initiatives aim to expand nursing roles to support professional substitution. In adult, neonatal and paediatric intensive care, specialist trained nurses and designated advanced nursing practitioners are increasingly taking on extended practice of clinical tasks previously undertaken by medical staff. As yet there are no statutory regulations on the perceived scope and definition of the role of extended and advanced roles. Design., Systematic review. Methods., Search of electronic databases and selection of policy and peer-reviewed reports and reviews of extended nursing roles or advanced nursing practitioners in UK intensive care settings. Results., Chronological review shows policy development proceeding in a relatively ad hoc way. There is limited information available about how extensively or effectively extended nursing roles are being implemented in intensive care settings in the UK, particularly in adult and paediatric intensive care. To test local initiative findings for reliability and generalisability, a more robust evidence base is required. Conclusions., More data are needed on definition and outcomes of extended nursing roles in intensive care and care process measures should be developed to better inform implementation of nurse role development in the UK. Relevance to clinical practice., The review of policy and research evidence in this paper may better inform clinicians working in adult, neonatal or paediatric intensive care, as they continue to be challenged by expansion and development of their role. It may also help to form a basis and evaluation for future research into extended and advanced nursing roles in intensive care settings. [source] Stoma coloproctology nurse specialist: a case studyJOURNAL OF CLINICAL NURSING, Issue 6 2007Ursula Chaney DPSN Aims and objectives., The aim of this paper is to provide insight into the role of a Stoma Coloproctology Nurse Specialist. This paper presents the findings of an in-depth case study of a stoma coloproctology nurse specialist employed in one health board area in Northern Ireland. This case study was part of a larger study exploring innovative nursing and midwifery roles in Northern Ireland. Background., Specialist nursing roles have evolved and developed in response to changing health care needs, patient expectations, changes in professional regulation and government initiatives. Design., A case study approach was adopted. Method., Semi-structured interviews with the post holder (PH), her line manager and the human resource manager were undertaken. Non-participant observation of the PH's practice was also carried out. Analysis was undertaken on secondary data such as job specification, annual reports and other documentation relating to the post. Results., Findings illustrate the PH's function and the impact of the role on patient care. Examples of innovative practices relating to providing care, support and guidance for patients and their families were identified; however, limitations to her role were also identified. Conclusions., The PH provides an invaluable service to patients, demonstrating a positive impact on care. However, the findings suggest the importance of establishing clear role boundaries, which may lead to professional growth and practice development. Relevance to clinical practice., Although this study provides a valuable insight into the role of a Stoma Coloproctology Nurse Specialist a number of challenges exist, as the CNS role requires policy and appropriate educational preparation to practice at an advanced level. Further research investigating the development of the CNS role in the clinical setting and its relationship to members of the multi-professional team would be beneficial. [source] Atrophy and anarchy: third national survey of nursing skill-mix and advanced nursing practice in ophthalmologyJOURNAL OF CLINICAL NURSING, Issue 12 2006Dip Nursing, Wladyslawa J. Czuber-Dochan MSc Aims and objectives., The aims of the study were to investigate the advanced nursing practice and the skill-mix of nurses working in ophthalmology. Background., The expansion of new nursing roles in the United Kingdom in the past decade is set against the background of a nursing shortage. The plan to modernize the National Health Service and improve the efficiency and delivery of healthcare services as well as to reduce junior doctors' hours contributes towards a profusion of new and more specialized and advanced nursing roles in various areas of nursing including ophthalmology. Design., A self-reporting quantitative questionnaire was employed. The study used comparative and descriptive statistical tests. Method., The questionnaires were distributed to all ophthalmic hospitals and units in the United Kingdom. Hospital and unit managers were responsible for completing the questionnaires. Results., Out of a total 181 questionnaires 117 were returned. There is a downward trend in the total number of nurses working in ophthalmology. The results demonstrate more nurses working at an advanced level. However, there is a general confusion regarding role interpretation at the advanced level of practice, evident through the wide range of job titles being used. There was inconsistency in the qualifications expected of these nurses. Conclusion., Whilst there are more nurses working at an advanced level this is set against an ageing workforce and an overall decline in the number of nurses in ophthalmology. There is inconsistency in job titles, grades, roles and qualifications for nurses who work at an advanced or higher level of practice. The Agenda for Change with its new structure for grading jobs in the United Kingdom may offer protection and consistency in job titles, pay and qualifications for National Health Service nurse specialists. The Nursing and Midwifery Council needs to provide clear guidelines to the practitioners on educational and professional requirements, to protect patients and nurses. Relevance to clinical practice., The findings indicate that there is a need for better regulations for nurses working at advanced nursing practice. [source] The impact of role discrepancy on nurses' intention to quit their jobsJOURNAL OF CLINICAL NURSING, Issue 9 2006BNurs, DipNurs, MNurs, Miyuki Takase RN Aims and objective., The purpose of this study was to investigate the impact of role discrepancy on nurses' intention to quit their jobs. Background., Nurses experience role discrepancy, which refers to incompatibility between the roles nurses desire and expect to take, and the roles they actually engage in at work. However, there is a paucity of information as to how this role discrepancy affects nurses' intention to quit their jobs. Design., A correlational design was used to investigate the impact of role discrepancy on nurses' intention to quit their jobs. Methods., A total of 346 Australian nurses participated in this study by completing questionnaires. The results were analysed by t -test, polynomial regression and response surface analysis. Results., Nurses tended to experience role discrepancy, in particular, in decision making with hospital policies and provision of patient education. The overall results show that this role discrepancy contributes to nurses' intention to quit their jobs. Nurses' intention to quit their jobs also increased when they had a low desire to engage in nursing roles and when they only performed a few roles. When specific dimensions of nursing roles were examined, a role discrepancy in the use of nursing skills, such as participation in decision making and providing patient education and emotional support, had little impact on their turnover intention. On the contrary, a role discrepancy in task delegation practice showed a significant association with nurses' intention to leave their jobs. Conclusions., Role discrepancy has been experienced by many nurses, and this discrepancy partially contributes to nurses' intention to quit their jobs. Relevance to clinical practice., To reduce nursing turnover, it is important to create a work environment where nurses are inspired to engage in various nursing roles and their work desires are reinforced by existing work opportunities. [source] Forensic nursing in secure environmentsJOURNAL OF FORENSIC NURSING, Issue 3 2009Deborah Shelton PhD Abstract There are few well-designed studies of corrections or prison nursing roles. This study seeks to describe the corrections or prison role of forensic nurses in the United States who provide care in secure environments. National data detailing the scope of practice in secure environments are limited. This pencil and paper survey describes the roles of 180 forensic nurses from 14 states who work in secure environments. Descriptive statistics are utilized. A repeated measures ANOVA with post hoc analyses was implemented. These nurses were older than average in age, but had 10 years or less experience in forensic nursing practice. Two significant roles emerged to "promote and implement principles that underpin effective quality and practice" and to "assess, develop, implement, and improve programs of care for individuals." Significant roles varied based upon the security classification of the unit or institution in which the nurses were employed. Access to information about these nurses and their nursing practice was difficult in these closed systems. Minimal data are available nationally, indicating a need for collection of additional data over time to examine changes in role. It is through such developments that forensic nursing provided in secure environments will define its specialization and attract the attention it deserves. [source] Nurses' experiences of practice and political reform in long-term aged care in Australia: implications for the retention of nursing personnelJOURNAL OF NURSING MANAGEMENT, Issue 1 2007LORRAINE VENTURATO PhD Aim, The aim of the study was to explore registered nurses' experiences in long-term aged care in light of the political reform of aged care services in Australia. Background, In Australia, the aged care industry has undergone a lengthy period of political and structural reform. Despite reviews into various aspects of these reforms, there has been little consideration of the effect these are having on the practice experiences and retention of nursing staff in long-term care. Methods, In this critical hermeneutic study, 14 nurses from long-term care facilities in Australia were interviewed about their experiences during the reform period. Results, The data revealed a sense of tension and conflict between nurses' traditional values, roles and responsibilities and those supported by the reforms. Nurses struggled to renegotiate both their practice roles and values as the reforms were implemented and the system evolved. Nursing management support was an important aspect in mediating the effect of reforms on nursing staff. Conclusion, This research highlights both the tensions experienced by nurses in long-term aged care in Australia and the need to renegotiate nursing roles, responsibilities and values within an evolving care system. This research supports a role for sensitive and proactive nursing management during periods of industry reform as a retention strategy for qualified nursing personnel. [source] New nursing roles: the experience of Scotland's consultant nurse/midwivesJOURNAL OF NURSING MANAGEMENT, Issue 2 2006JOANNE BOOTH BSc Aim, To describe career pathways of consultant nurses/midwives and identify postholders views on key factors in role initiation, development and progression to inform future development and appointment of nurse/midwife consultants in National Health Service Scotland. Background, Nurse/midwife consultants represent the highest levels of clinical practice. Given the Scottish Executive Health Department's aim to treble numbers conditions and circumstances that enable them to flourish must be identified. Method, A postal survey was undertaken of all nurse/midwife consultants in post (n = 16). Results, Key themes emerged around factors that consultant nurse/midwives considered important including mentorship, autonomy and clinical credibility. Barriers to role delivery included lack of understanding of roles and the wide scope of some posts. Considerable variation in support, conditions of service and line management arrangements was found. Conclusions, Development of a recognized career pathway and a consistent approach to employment and support of postholders is recommended. [source] How Do Expert Labor Nurses View Their Role?JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 6 2003Dotti C. James Objective: To examine how expert perinatal nurses in a nurse-managed labor model view their role in caring for mothers during labor and birth. Design: Focus group methodology. Data were analyzed using inductive coding methods to gain understanding from the perspective of those providing the care. Setting: Labor and birth units in four large Midwestern medical centers. Participants: Fifty-four expert labor nurses. Inclusion criteria: 5 years experience in nursing care during labor and birth in institutions where nurse-managed labor was the predominant practice model. Results: Four common themes related to nursing roles were identified. These included knowing the labor process and the intuitive nature of nursing care provided by expert labor nurses based on years of experience, knowing the woman and letting her body guide labor, advocacy for laboring woman, and the autonomous nature of the nurse-managed labor model. Conclusions: Expert labor nurses developed a keen sense of intuitive knowledge based on their years of experience. They reported using hands-on high-touch supportive care techniques with the potential to affect labor and birth outcomes. Autonomy is perceived as a key component of practice within the nurse-managed labor model. [source] Evaluation of a community-based mental health drug and alcohol nurse in the care of people living with HIV/AIDSJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2009J. ALLEN rn ba (hons) m psych (counselling psychology) There is a growing need for advanced practice mental health and drug and alcohol nursing roles in the care of people living with HIV/AIDS; however, limited publications address these domains. This study evaluated a community-based mental health drug and alcohol nurse role caring for people living with HIV/AIDS (Mental Health D&A Nurse) in a large not-for-profit district nursing organization providing care to people living with HIV/AIDS in an Australian city. Outcomes from a client assessment and 6,8-week follow-up by the Mental Health D&A Nurse are presented as captured by the Depression Anxiety Stress Scales (DASS 21), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Health of the Nation Outcome Scales (HONOS) and WHOQoL BREF. Mean scores and caseness were analysed, and significant differences were found on the ,impairment' and ,social problems' subscales of the HONOS. Results of semi-structured interviews with clients describe effective and supportive mental health care and health-promoting education following visits by the Mental Health D&A Nurse. These positive findings support continuing implementation of the role within this community setting and indicate that even greater benefits will ensue as the role develops further. Findings are of interest to clinicians and policy makers seeking to implement similar roles in community-based HIV/AIDS care. [source] | |||||||||||||||||||||||||