This core text for the DNP curriculum explores the historical and evolving advanced practice doctoral role as envisioned by leading DNP scholars and educators. Its distinctive point-counterpoint ...format—consisting of commentaries that dispute or support the opinions of chapter authors--provides a foundation of varying opinions that stimulate vigorous critical dialogue. The second edition has been revised to examine the latest developments in the ongoing evolution of doctoral-level roles along with the specific skills that advance these roles. With six completely new chapters, the second edition provides essential content on role theory, examines the meaning of nursing roles, and addresses their continued evolution in a variety of arenas.
As nurses know firsthand, the impact of psychological trauma is not limited to those who experience it. Others-including nurses and caregivers-are indirectly affected. In healthcare, patients' ...psychological trauma may manifest in odd, uncomfortable, or confusing behaviors. Nurses and healthcare workers must recognize that patients may be feeling unsafe or struggling with low self- esteem, anxiety, grief, loneliness, or depression born from trauma. As nurses listen to, empathize with, and sometimes grieve with the people they care for, they need to comprehend the "why" behind these feelings and actions. The Influence of Psychological Trauma in Nursing helps nurses gain awareness and knowledge about trauma and recovery so they can heal and bring holistic healing to others. Authors Karen J. Foli and John R. Thompson provide a primer on psychological trauma, helping readers identify and understand the common forms of trauma in society. Filled with examples, tools, assessments, and learning objectives, this book helps nurses move forward as trauma-informed caregivers.
Background and Objectives: Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner ...and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives.Methods: An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The study was launched in August 2018 at the 10th Annual ICN NP/APNN Conference in Rotterdam, Netherlands. Links to the survey were provided there and via multiple platforms over the next year.Results: Survey results from 325 respondents, representing 26 countries, were analyzed through descriptive techniques. Although progress was reported, particularly in education, results indicated the APN profession around the world continues to struggle over titling, title protection, regulation development, credentialing, and barriers to practice.Conclusions and Practice/Policy Relevance: APNs have the potential to help the world reach the Sustainable Development Goal of universal health coverage. Several recommendations are provided to help ensure APNs achieve these goals.
Background
Studies have reported on the important role of the clinical research nurse in clinical studies. Yet, there is no international consensus about the role's competencies and tasks. ...Furthermore, the literature offers a little description of the career pathway from a ward‐based registered nurse to a clinical research nurse. More knowledge about this specific role could benefit the nursing profession as well as increase the quality of clinical research.
Aim
The aim of the study was to explore Swedish registered nurses' experiences transitioning into the clinical research nurse role.
Design
The study had a qualitative design. Data were collected via semi‐structured interviews. Inductive qualitative content analysis was employed.
Methods
Ten participants (i.e., clinical research nurses) were interviewed in the spring of 2017. A semi‐structured interview guide was used to address the transition into the clinical research nurse role, experience working in a new role, experience of ethical dilemmas and experience of organizational and professional issues related to the role. The interviews were analysed inductively using qualitative content analysis.
Results
The registered nurses described experiencing reality shock when they became clinical research nurses; that is, it was a challenging and transforming experience. The main theme, a challenging transition, was developed from the four subthemes highlighting that it defied their previous nursing role. They experienced an unclear professional identity, extended professional mandate, increased professional status and growing ethical consciousness in their new role.
Conclusion
The results highlight that registered nurses who became clinical research nurses had needs that were both distinct from and overlapped with those of their former professional role as registered nurses. To avoid reality shocks, the development of clear competence pathways for nurses to become clinical research nurses, including introduction, mentorship and continued support, is necessary. Making their professional title more homogeneous, nationally and internationally, would facilitate role identification and comparisons in research.
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Aim
To identify and differentiate the practice patterns of generalist, specialist and advanced practice nursing roles in specialist and central hospital contexts.
Background
In Finland, as in other ...Nordic countries, advanced practice nursing roles emerged around 2000. There are over 60,000 registered nurses/midwives in Finland and the clinical career pathway from a registered nurse to advanced practice nurse has been described yet not fully implemented in healthcare organizations. However, the number and activities of nonadvanced and advanced practitioner roles are not well known.
Design
A descriptive comparative study.
Methods
An online self‐report survey was conducted between August and October 2020 using an advanced practice role delineation tool. A census sample of registered nurses, registered midwives, specialist nurses and advanced practice nurses in five university hospitals and one central hospital was recruited. Descriptive statistics were used to summarize the characteristics of participants and group differences were compared using analysis of variance (ANOVA). The STROBE checklist was used as the reporting guideline.
Results
A total of 1497 responses were obtained (response rate = 10%). Overall, nurses used comprehensive care and education activities most frequently. The least used activities were research and publication and professional leadership. Univariate analysis of variance test between role effects, when education and grouped age were taken into account, showed statistically significant difference in all of the observed five activities (p < .001).
Conclusion
Identifying activities in different levels of nursing is a crucial first step in delineating nursing roles thus improving the governance of the human resource management.
Impact
The study results add to the international literature, delineating nursing roles in the spectrum of generalist to advanced practice nursing. As these roles become more formalized, we may incorporate novel ways of promoting the career development and optimal use and assessment of nursing roles and practice in various career levels.
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Aims
To identify types of nurse‐led interventions for multimorbidity and which outcomes are positively affected by them.
Design
Mixed‐methods systematic review following the Joanna Briggs Institute ...(JBI) methods for convergent‐integrated reviews. PROSPERO ID: CRD42020197956.
Data Sources
Cochrane CENTRAL, CINAHL, Embase and MEDLINE were searched in October 2020. Grey literature sources included OpenGrey, the Journal of Multimorbidity and Comorbidity and reference mining.
Review Methods
English‐language reports of nurse‐led interventions for people with multimorbidity were included based on author consensus. Two reviewers performed independent quality appraisal using JBI tools. Data were extracted and synthesized using a pre‐existing taxonomy of interventions and core outcome set.
Results
Twenty studies were included, with a median summary quality score of 77.5%. Interventions were mostly case‐management or transitional care interventions, with nurses in advanced practice, support to self‐manage conditions, and an emphasis on continuity of care featuring frequently. Patient‐centred outcomes such as quality of healthcare and health‐related quality of life were mostly improved, with mixed effects on healthcare utilization, costs, mortality and other outcomes.
Conclusion
Interventions such as case management are agreeable to patients and transitional care interventions may have a small positive impact on healthcare utilization. Interventions include long‐term patient management or short‐term interventions targeted at high‐risk junctures. These interventions feature nurses in advanced practice developing care plans in partnership with patients, to simplify and improve the quality of care both in the long and short‐term.
Impact
This is the first mixed‐methods review which includes all types of nurse‐led interventions for multimorbidity and does not focus on specific comorbidities or elderly/frail populations. Using adapted consensus‐developed frameworks for interventions and outcomes, we have identified the common features of interventions and their overall typology. We suggest these interventions are of value to patients and healthcare systems but require localization and granular evaluation of their components to maximize potential benefits.
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Aim
To identify nurse leaders’ strategies to cultivate nurse resilience.
Background
High nursing turnover rates and nursing shortages are prominent phenomena in health care. Finding ways to promote ...nurse resilience and reduce nurse burnout is imperative for nursing leaders.
Methods
This is a qualitative descriptive study that occurred from November 2017 to June 2018. This study explored strategies to foster nurse resilience from nurse leaders who in this study were defined as charge nurses, nurse managers and nurse executives of a tertiary hospital in the United States. A purposive sampling method was used to have recruited 20 nurse leaders.
Results
Seven strategies are identified to cultivate nurse resilience: facilitating social connections, promoting positivity, capitalizing on nurses’ strengths, nurturing nurses’ growth, encouraging nurses’ self‐care, fostering mindfulness practice and conveying altruism.
Conclusions
Fostering nurse resilience is an ongoing effort. Nurse leaders are instrumental in building a resilient nursing workforce. The strategies identified to foster nurse resilience will not only impact the nursing staff but also improve patient outcomes.
Implications for Nursing Management
The strategies presented are simple and can be easily implemented in any settings. Nurse leaders have an obligation to model and enable evidence‐based strategies to promote nurses’ resilience.
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28.
DNP capstone projects Anderson, Barbara A; Knestrick, Joyce M; Barroso, Rebeca
2015., 2014, 2014-09-22
eBook
"This unique book not only explains the introduction of the Doctor of Nursing Practice (DNP) role but also bridges the DNP essentials with the evidence- based practice framework. It includes ...wonderful examples of exciting scholarship, but also illustrates how the evidence is then translated into clinical practice...This is a wonderful resource for students completing a DNP degree. It is an excellent book for expanding the understanding of the capstone project and the importance of dissemination of nursing knowledge to improve patient care and outcomes. Weighted Numerical Score: 100 - 5 Stars!" Kathleen Woodruff Doody's Medical Reviews With a unique focus on exemplary, completed DNP capstone projects, this book delivers key information on designing, constructing, and completing a high quality capstone project. It demonstrates the impact that a well-conceived capstone project can have on facilitating change and addresses all program, administrative, policy, and clinical issues that DNP students may encounter during the capstone process. The book examines a variety of capstone projects from across the U.S.--quality improvement projects, strategic plans, advocacy, clinical case narratives, and other innovations--that demonstrate efficacy in clinical nursing practice outcomes and positive impact upon the health care environment. The book analyzes the components of these exemplary capstones to demonstrate how each has provided leadership for change in practice, promoted interdisciplinary collaboration, contributed to advocacy and policy change, and enhanced quality improvement in health care systems. Key Features: * Focuses on a wide range of exemplary, completed DNP capstone projects * Provides a roadmap for excellence in creating capstone projects * Analyzes components of capstones that have effected positive change * Includes strategies for implementing evidence-based practices for nurses and other health care providers * Highlights DNP leadership and resulting positive changes in clinical practice
The Textbook of Non-Medical Prescribing addresses all the key issues relevant to non-medical prescribing, bringing together essential knowledge, key issues, and skills in a single text. This ...accessible, engaging and comprehensive resource explores the history of non-medical prescribing; prescribing in context; ethical, legal and professional issues in relation to prescribing practice; factors influencing prescribing; effective consultations; essential pharmacology; the role of the multi-disciplinary team; clinical skills; prescribing for specific groups; and the future of nurse prescribing. With case studies throughout, The Textbook of Non-Medical Prescribing is essential reading for all students on non-medical prescribing courses. It is also of use to qualified health professionals, be they prescribers themselves or interested in the concepts of non-medical prescribing.
Aim
This study examined transition shock experiences in newly graduated nurses as well as its relative influence on job outcomes (job satisfaction, stress and burnout, and intent to leave their ...organisation) and select patient outcomes (missed care, adverse events and perceived quality of care).
Background
Transition shock is a reality common among newly graduated nurses and has been considered an issue relevant to nursing administrators. To date, the mechanism by which transition shock perception is linked with nurse and patient outcomes remains unexplored.
Methods
A descriptive, cross‐sectional design was used. One hundred seventy‐six newly graduated nurses (nurses with <1 year of work experience) were included in the study. Data were collected using seven standardized scales.
Results
Hospital classification (e.g., being employed in a government‐owned hospital) (β = 0.255; p = .001) predicted transition shock. Overall, newly graduated nurses reported greatest challenges with regard to their expectations of the actual work environment (mean = 2.60, standard deviation = 0.42) and in balancing their professional and personal lives (mean = 2.51, standard deviation = 0.35). Higher levels of reality shock were associated with adverse patient events (β = 0.821; p = .001).
Conclusion
New graduates experience great challenges in balancing their professional and personal lives. Ensuring work–life balance and work readiness in newly graduated nurses may potentially reduce the occurrence of missed nursing care and adverse events.
Implications for Nursing Management
Nurse managers can adequately support newly graduated nurses' transition through the implementation of empirically based transition programmes. By providing flexible work arrangement, reasonable workload, adequate nurse staffing, limited mandatory overtime and self‐scheduling, nurse managers can effectively assist newly graduated nurses in attaining work–life balance.
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