Aims
To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery.
Background
There is limited evidence of frontline care delivery models that consistently achieve ...quality patient outcomes. Clinical Nurse Leader integrated care delivery is a promising nursing model with a growing record of success. However, theoretical clarity is necessary to generate causal evidence of effectiveness.
Design
Sequential mixed methods.
Methods
A preliminary Clinical Nurse Leader practice model was refined and survey items developed to correspond with model domains, using focus groups and a Delphi process with a multi‐professional expert panel. The survey was administered in 2015 to clinicians and administrators involved in Clinical Nurse Leader initiatives. Confirmatory factor analysis and structural equation modelling were used to validate the measurement and model structure.
Results
Final sample n = 518. The model incorporates 13 components organized into five conceptual domains: ‘Readiness for Clinical Nurse Leader integrated care delivery’; ‘Structuring Clinical Nurse Leader integrated care delivery’; ‘Clinical Nurse Leader Practice: Continuous Clinical Leadership’; ‘Outcomes of Clinical Nurse Leader integrated care delivery’; and ‘Value’. Sample data had good fit with specified model and two‐level measurement structure. All hypothesized pathways were significant, with strong coefficients suggesting good fit between theorized and observed path relationships.
Conclusions
The validated model articulates an explanatory pathway of Clinical Nurse Leader integrated care delivery, including Clinical Nurse Leader practices that result in improved care dynamics and patient outcomes. The validated model provides a basis for testing in practice to generate evidence that can be deployed across the healthcare spectrum.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Purpose
Symptoms associated with COVID-19 infection have made the assessment and triage of cancer patients extremely complicated. The purpose of this paper is to describe the development and ...implementation of a COVID-19 screening tool for oncology telephone triage.
Methods
An Ambulatory Oncology Clinical Nurse Educator and three faculty members worked on the development of an oncology specific triage tool based on the challenges that oncology nurses were having with the generic COVID triage tool. A thorough search of the published literature, as well as pertinent websites, verified that no screening tool for oncology patients was available.
Results
The screening tool met a number of essential criteria: (1) simple and easy to use, (2) included the most common signs and symptoms as knowledge of COVID-19 infection changed, (3) was congruent with the overall screening procedures of the medical center, (4) included questions about risk factors for and environmental exposures related to COVID-19, and (5) assessed patient’s current cancer history and treatment status. Over a period of 3 weeks, the content and specific questions on the tool were modified based on information obtained from a variety of sources and feedback from the triage nurses.
Conclusion
Within 1 month, the tool was developed and implemented in clinical practice. Oncology clinicians can modify this tool to triage patients as well as to screen patients in a variety of outpatient settings (e.g., chemotherapy infusion units, radiation therapy departments). The tool will require updates and modifications based on available resources and individual health care organizations’ policies and procedures.
The aim of this research was to understand what influences specialist palliative care nurses working in a community setting to engage with research.
Qualitative research using interviews with ...community based clinical nurse specialists (CNS).
A total of five themes were identified: research negativity and enthusiasm, clinical focus, audits, organisational support and keeping up to date.
Except for audit activity, CNS do not view the research pillar as an integral part of their clinical role. Previous research education may not give the CNS the breadth of research skills that they require. The advance professional apprenticeship may resolve these education issues. Managers and organisations need to prioritise EBP skills; supporting nurses with both education and EBP mentors to develop these skills. Nurses require ongoing time to engage with research activity and use these skills to improve both their own clinical practice and those who use them as a research resource.
Purpose
To assess Turkish oncology nurses’ knowledge regarding novel coronavirus (COVID-19) during the current outbreak in Turkey.
Methods
This descriptive study was carried out with the 185 oncology ...nurses between April and May 2020 in Turkey. Research data were collected through online survey using “Nurse Information Form” and “Nurse Information Scale for COVID-19.” Multilinear regression analysis was used in determining the factors affecting oncology nurses’ information regarding COVID-19.
Results
According to the data delivered from 185 oncology nurses, 57.7% of the participants had an undergraduate degree, 74.1% were working in adult oncology units, and 52.4% of them were working as clinical nurses, 48.1% of the nurses received education for COVID-19 (51.9% did not receive) and 70.3% followed and read the COVID-19 Guidelines published by the Ministry of Health (29.7% did not follow guidelines). Using multiple regression analysis, a model based on the relationship between the variables was created. In the model, the descriptive characteristics of the oncology nurses and their experiences of COVID-19 were found to explain 29.1% of their knowledge level for COVID-19. Nurses’ education level, the presence of a relative diagnosed with COVID-19, and following the COVID-19 guidelines were found to statistically significantly affect the knowledge levels of COVID-19.
Conclusion
These findings suggest that hospital management and the Ministry of Health should provide more information for the oncology nurses to better control of cancer patients from the infectious disease.
Innovative programs are needed to build a pipeline of future nurse scientists necessary to generate practice-based evidence for optimal healthcare and to address the serious shortage of PhD-prepared ...nurses. This paper describes two nurse scholar programs based in one large, Magnet® designated healthcare institution that aim to provide clinical registered nurses (RNs) with mentored research opportunities in order to ultimately build an internal pipeline of practice-based nurse scientists. The Clinical Nurse Scholar Program provides clinical RNs the opportunity to conduct a research study under the mentorship of a senior nurse scientist. The Nursing Research Scholar Program provides a clinical RN enrolled in a PhD program or who recently completed a PhD program with an opportunity to gain enhanced research training and acquire new research skills. These two scholar models have the potential to be replicated in other institutions to enhance the development of future nurse scientists and to address a critical national shortage of PhD-prepared nurse scientists.
•Healthcare systems can develop nurse scholar programs based on highlighted program components•Our two scholar programs provide clinical registered nurses with resources to conduct mentored research studies and a unique career development opportunity•Nurse scholars' presentations and publications can be used to meet Magnet® designation standards
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
The purpose of this article is to provide a guide to identifying measurements of value and how to calculate different types of return on investment (ROI). Exemplars of clinical nurse specialist (CNS) ...work efforts with ROI will be presented.
The CNS is the oldest advanced practice role; however, the role can be vague, making it difficult to articulate the value of the CNS in the organization. Functioning in 3 spheres of impact, the CNS can easily impact practice; however, demonstrating the value of this work is not always on top of mind and is rarely taught in academic programs.
This article describes the difference between revenue generation, cost savings, and cost avoidance, as well as various structural, process, and outcome measures that can be used to calculate ROI. Resources available for performing ROI calculations will be described and shared.
Distributing work across the 3 spheres creates various opportunities for the CNS to demonstrate value; however, the CNS must be able to articulate that value to the organization. Developing the skill set to consistently identify metrics can be challenging; however, it is critical to the ongoing success and future of the CNS role. Utilizing these metrics to demonstrate the value and then disseminating the outcomes of these contributions will continue to promote the value of the CNS in the future.
•The framework for developing NSRs in the health care system of Iran includes the following components: role titles, prioritization of the necessary specialties, the necessary competencies of nurses ...at specialist level, the scope of nursing specialist practice, expected authorizations, requirements for role development, and its barriers and facilitators.•This framework can be considered as the basis for developing the roadmap for NSR development in Iran. Such framework needs to be precisely described based on the characteristics of each country and its health care delivery system.•This study provides a deep insight into the framework for NSR development in the health care system of Iran. Policy-makers, decision-makers, legislators, and managers can use the results of this study to develop an appropriate roadmap for NSR development.•The NSR development framework developed in this study can be used in other countries for nursing specialization.•Developing NSRs can improve the quality and the efficiency of nursing care services and thereby, improve the quality of health care services.
A key step to the development of a roadmap for developing nursing specialist roles is to create its framework based on the immediate context.
This study aimed to create the framework for developing nursing specialist roles in the health care system of Iran.
This was a descriptive qualitative study. A purposeful sample of 81 nursing and nonnursing experts was recruited. The directed content analysis approach was used for data analysis.
The framework for developing nursing specialist roles in the health care system include eight main categories. These categories are role titles, prioritization of the necessary specialties, the necessary competencies of nurses at specialist level, the scope of nursing specialist practice, expected authorizations, requirements for role development, and its barriers and facilitators.
Creating a context-based framework for nursing specialist role development based on the characteristics of each country is recommended.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
In the current paper, we aim to emphasize the pivotal role of the specialist headache nurse whose scope of work is clearly defined and detailed in western medical practice within tertiary care.
Sound nursing clinical judgment is at the core of competent and safe client care. New graduate nurses face increasing challenges that underscore the importance of investigating how nurse educators ...teach and measure nursing students' abilities to make clinical judgments. This article presents the National Council of State Boards of Nursing-Clinical Judgment Model (NCSBN-CJM) and discusses the use of the model.
A multidisciplinary team conducted a qualitative comparative analysis of the relationships between the NCSBN-CJM and the three leading frameworks for providing clinical judgment education to entry-level nurses.
The NCSBN-CJM aligns with the Information-Processing Model and the Intuitive-Humanistic Model. The NCSBN-CJM also can be used to assess the Dual Process Reasoning Theory.
The NCSBN-CJM can assist nurse educators in designing effective tools for assessing clinical judgment by helping them target specific cognitive operations. This flexible model expresses the complexities associated with decision making in a simplified manner to enable better measurement of clinical judgment. J Nurs Educ. 2019;58(2):72-78..
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