Sample records for oncology nurse practitioner

  1. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    PubMed

    Vogel, Wendy H

    2016-01-01

    Oncology care is becoming increasingly complex. The interprofessional team concept of care is necessary to meet projected oncology professional shortages, as well as to provide superior oncology care. The oncology advanced practitioner (AP) is a licensed health care professional who has completed advanced training in nursing or pharmacy or has completed training as a physician assistant. Oncology APs increase practice productivity and efficiency. Proven to be cost effective, APs may perform varied roles in an oncology practice. Integrating an AP into an oncology practice requires forethought given to the type of collaborative model desired, role expectations, scheduling, training, and mentoring.

  2. A scoping review of the nurse practitioner workforce in oncology.

    PubMed

    Coombs, Lorinda A; Hunt, Lauren; Cataldo, Janine

    2016-08-01

    The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed(®) , the Cumulative Index to Nursing and Allied Health Sciences (CINAHL(®) ), Web of Science, Journal Storage (JSTOR(®) ), Google Scholar, and SCOPUS(®) . Using the scoping review criteria, the research question was identified "How much care in oncology is provided by nurse practitioners (NPs)?" Key search terms were kept broad and included: "NP" AND "oncology" AND "workforce". The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  3. The attitudes and beliefs of oncology nurse practitioners regarding direct-to-consumer advertising of prescription medications.

    PubMed

    Viale, Pamela Hallquist; Sanchez Yamamoto, Deanna

    2004-07-01

    To obtain information about the knowledge and attitudes of oncology nurse practitioners (ONPs) concerning the effect of direct-to-consumer (DTC) advertising of prescription medications on prescribing patterns. Exploratory survey. Oncology Nursing Society Nurse Practitioner Special Interest Group members in the United States. 221 of 376 ONPs completed the survey (58%). Researcher-developed 12-question postal survey. Knowledge and attitudes of ONPs on DTC advertising effects on prescribing patterns. The findings were similar to those of previous studies of physicians regarding the number of visits when patients requested DTC-advertised medications. Major differences were the positive attitudes of ONPs toward potentially longer patient visits to explain and educate patients regarding medication requests based on DTC advertising and smaller percentages of ONPs who felt "pressured" to prescribe requested medications. ONPs have mixed opinions regarding the practice of DTC advertising but do not believe that they are influenced heavily by advertising with regard to prescriptive practices. ONPs consider patient encounters for education purposes as appropriate and include information about requested DTC-advertised medications in their approach to patient care. This is an exploratory survey of a specialty group of ONPs. More research is needed to further explore the practice of DTC advertising and potential influences on the prescribing patterns of ONPs. DTC advertising of prescription medications is increasing; ONPs need to increase their knowledge base about the potential for influences of prescriptive practices.

  4. Cancer patients and oncology nursing: Perspectives of oncology nurses in Turkey.

    PubMed

    Kamisli, S; Yuce, D; Karakilic, B; Kilickap, S; Hayran, M

    2017-09-01

    Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. This survey was conducted with 70 oncology nurses working at Hacettepe University Oncology Hospital. Data were collected between January-April 2012. Each participant provided a study form comprising questions about sociodemographic information; about difficulties, positive aspects and required skills for oncology nursing; and questions evaluating level of participation and clinical perception of oncology nursing. Mean age of nurses was 29.9 ± 5.7 years. More than half of the participants were married (51.4%) and 30% had at least one child. Percent of nurses working in oncology for their entire work life was 75.8%. Most frequently expressed difficulties were exhaustion (58.6%), coping with the psychological problems of the patients (25.7%), and frequent deaths (24.3%); positive aspects were satisfaction (37.1%), changing the perceptions about life (30%), and empathy (14.3%); and required skills were patience (60%), empathy (57.1%), and experience (50%). For difficulties of oncology nursing, 28.3% of difficulties could be attributed to job-related factors, 30.3% to patient-related factors, and 77% of difficulties to individual factors. The independent predictors of participation level of the nurses were self-thoughts of skills and positive aspects of oncology nursing. According to the findings of this study, nurses declared that working with cancer patients increase burnout, they are insufficient in managing work stress and giving psychological care to patients, but their job satisfaction, clinical skills and awareness regarding priorities of life has increased.

  5. The Future of Gero-Oncology Nursing.

    PubMed

    Kagan, Sarah H

    2016-02-01

    To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Paediatric oncology information pack for general practitioners

    PubMed Central

    James, J A; Harris, D J; Mott, M G; Oakhill, A

    1988-01-01

    An information pack covering important aspects of paediatric oncology has been developed for general practitioners. Sixty general practitioners who received the information pack found that it helped them in managing children with neoplastic disease and their families. The pack has also improved communications between the oncology unit and general practitioners. Similar packs could be produced by paediatricians working in other specialties. PMID:3122972

  7. Oncology Nurse Generalist Competencies: Oncology Nursing Society’s Initiative to Establish Best Practice

    PubMed

    Gaguski, Michele; George, Kim; Bruce, Susan; Brucker, Edie; Leija, Carol; LeFebvre, Kristine; Thompson Mackey, Heather

    2017-09-25

    A project team was formulated by the Oncology Nursing Society (ONS) to create evidence-based oncology nurse generalist (ONG) competencies to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses. This article aims to describe the process and the development of ONG competencies. This article describes how the ONG competencies were accomplished, and includes outcomes and suggestions for use in clinical practice. Institutions can use the ONG competencies to assess and develop competency programs, offer unique educational strategies to measure and appraise proficiency, and establish processes to foster a workplace environment committed to mentoring and teaching future oncology nurses. 2017 Oncology Nursing Society

  8. “It Depends”: Viewpoints of Patients, Physicians, and Nurses on Patient-Practitioner Prayer in the Setting of Advanced Cancer

    PubMed Central

    Balboni, Michael J.; Babar, Amenah; Dillinger, Jennifer; Phelps, Andrea C.; George, Emily; Block, Susan D.; Kachnic, Lisa; Hunt, Jessica; Peteet, John; Prigerson, Holly G.; VanderWeele, Tyler J.; Balboni, Tracy A.

    2012-01-01

    Context Although prayer potentially serves as an important practice in offering religious/spiritual support, its role in the clinical setting remains disputed. Few data exist to guide the role of patient-practitioner prayer in the setting of advanced illness. Objectives To inform the role of prayer in the setting of life-threatening illness, this study used mixed quantitative-qualitative methods to describe the viewpoints expressed by patients with advanced cancer, oncology nurses, and oncology physicians concerning the appropriateness of clinician prayer. Methods This is a cross-sectional, multisite, mixed-methods study of advanced cancer patients (n = 70), oncology physicians (n = 206), and oncology nurses (n = 115). Semistructured interviews were used to assess respondents’ attitudes toward the appropriate role of prayer in the context of advanced cancer. Theme extraction was performed based on interdisciplinary input using grounded theory. Results Most advanced cancer patients (71%), nurses (83%), and physicians (65%) reported that patient-initiated patient-practitioner prayer was at least occasionally appropriate. Furthermore, clinician prayer was viewed as at least occasionally appropriate by the majority of patients (64%), nurses (76%), and physicians (59%). Of those patients who could envision themselves asking their physician or nurse for prayer (61%), 86% would find this form of prayer spiritually supportive. Most patients (80%) viewed practitioner-initiated prayer as spiritually supportive. Open-ended responses regarding the appropriateness of patient-practitioner prayer in the advanced cancer setting revealed six themes shaping respondents’ viewpoints: necessary conditions for prayer, potential benefits of prayer, critical attitudes toward prayer, positive attitudes toward prayer, potential negative consequences of prayer, and prayer alternatives. Conclusion Most patients and practitioners view patient-practitioner prayer as at least occasionally

  9. Establishing Priorities for Oncology Nursing Research: Nurse and Patient Collaboration.

    PubMed

    Cox, Anna; Arber, Anne; Gallagher, Ann; MacKenzie, Mairead; Ream, Emma

    2017-03-01

    To obtain consensus on priorities for oncology nursing research in the United Kingdom.
. A three-round online Delphi survey.
. Oncology nurses were invited via the United Kingdom Oncology Nursing Society (UKONS) database. Patient participation was invited through patient organizations.
. 50 oncology nurses and 18 patients.
. Eligible and consenting individuals reported five priorities for oncology nursing research (round 1), rated their level of agreement with them (round 2), and restated and revised their responses in light of the group's responses (round 3). Consensus was defined as 80% agreement.
. Research priorities for oncology nursing as reported by oncology nurses and patients. 
. Consensus was reached on 50 of 107 research priorities. These priorities reflected the entire cancer pathway, from diagnosis to palliative care. Highest agreement was reached within and across groups on the need for research relating to prevention, screening, early diagnosis, and psychological care across the cancer trajectory. Little consensus was reached regarding symptoms and side effects. Some evident divergence existed. Oncology nurses and patients do not necessarily prioritize the same research areas. Prevention, screening, and early diagnosis are of the highest priority for future research among oncology nurses and patients. 
. Patients usually play little part in priority setting for research. This study provided the opportunity for meaningful patient and nurse involvement in setting a research agenda for oncology nursing that is relevant and beneficial to oncology nurses and patients.

  10. Follow-up care practices and barriers to breast cancer survivorship: perspectives from Asian oncology practitioners.

    PubMed

    Ng, Terence; Toh, Ming Ren; Cheung, Yin Ting; Chan, Alexandre

    2015-11-01

    The aim of this study is to evaluate the perspectives of Asian oncology practitioners on the physical and psychosocial issues experienced by breast cancer survivors (BCS), current survivorship care practices, and the barriers to follow-up care. This was a cross-sectional survey study. Oncology practitioners were recruited from a major cancer center in Singapore and through two regional cancer meetings that took place in Singapore and Malaysia in 2013. A total of 126 oncology practitioners from various Southeast Asian countries, mostly nurses (58.7 %) and physicians (37.3 %), were recruited. The majority of the respondents agreed that fatigue (78.4 %) and anxiety (69.1 %) were the most common physical and psychosocial problems experienced by BCS. Monitoring for physical and treatment-related adverse effects (80.7 %) and reviewing patients' noncancer medical history (65.3 %) were the most practiced aspects of follow-up care. Compared with the other practitioners, the physicians were more likely to communicate with other healthcare professionals (adjusted OR = 4.24, 95 % CI 1.54 to 11.72; p = 0.005). Most of the respondents also agreed that patient-specific barriers were the main impediments to follow-up care. This study provides insights into the various aspects of breast cancer survivorship care from the perspectives of oncology practitioners and shows that survivorship care is relatively inadequate in Asia. There is a need for new survivorship care models to meet the needs of Asian BCS and to complement the unique healthcare systems of Asia.

  11. Nurse practitioner malpractice data: Informing nursing education.

    PubMed

    Sweeney, Casey Fryer; LeMahieu, Anna; Fryer, George E

    Nurse practitioners (NPs) are often identified in medical malpractice claims. However, the use of malpractice data to inform the development of nursing curriculum is limited. The purpose of this study is to examine medical errors committed by NPs. Using National Practitioner Data Bank public use data, years 1990 to 2014, NP malpractice claims were classified by event type, patient outcome, setting, and number of practitioners involved. The greatest proportion of malpractice claims involving nurse practitioners were diagnosis related (41.46%) and treatment related (30.79%). Severe patient outcomes most often occurred in the outpatient setting. Nurse practitioners were independently responsible for the event in the majority of the analyzed claims. Moving forward, nurse practitioner malpractice data should be continuously analyzed and used to inform the development of nurse practitioner education standards and graduate program curriculum to address areas of clinical weakness and improve quality of care and patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Nursing Practice Environment and Outcomes for Oncology Nursing

    PubMed Central

    Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

    2012-01-01

    Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

  13. Oncology Nurse Generalist Competencies: Oncology Nursing Society's Initiative to Establish Best Practice.

    PubMed

    Gaguski, Michele E; George, Kim; Bruce, Susan D; Brucker, Edie; Leija, Carol; LeFebvre, Kristine B; Mackey, Heather

    2017-12-01

    A project team was formulated to create evidence-based oncology nurse generalist competencies (ONGCs) to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses.
. This article aims to describe the process and the development of ONGCs. 
. This article explains how the ONGCs were accomplished, and includes outcomes and suggestions for use in clinical practice. 
. Institutions can use the ONGCs to assess and develop competency programs, offer educational strategies to measure proficiency, and establish processes to foster a workplace committed to mentoring and teaching future oncology nurses.

  14. The Role of the Advanced Practice Nurse in Geriatric Oncology Care.

    PubMed

    Morgan, Brianna; Tarbi, Elise

    2016-02-01

    To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Communication competencies of oncology nurses in Malaysia.

    PubMed

    Maskor, Nor Aida; Krauss, Steven Eric; Muhamad, Mazanah; Nik Mahmood, Nik Hasnaa

    2013-01-01

    This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.

  16. Palliative Care: Delivering Comprehensive Oncology Nursing Care.

    PubMed

    Dahlin, Constance

    2015-11-01

    To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Nursing: What's a Nurse Practitioner?

    MedlinePlus

    ... nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification in their ... Nurse Practitioners (NAPNAP) and through local hospitals or nursing schools. Also, many doctors share office space with ...

  18. The art of pediatric oncology nursing practice.

    PubMed

    Cantrell, Mary Ann

    2007-01-01

    Pediatric oncology nursing practice must incorporate both the science and the art of the discipline to foster positive physical and psychosocial treatment outcomes for pediatric oncology patients, especially those outcomes related to their health-related quality of life. In this article, the art of nursing care is described within the context of scientifically based care, and the art of nursing practice is evident in the implementation of the scientific principles and standards for pediatric oncology nursing practice. The author proposes that the art of pediatric oncology nursing practice ought to be evident in care activities that the nurse provides within a therapeutic relationship that is steeped in nursing presence. Although the art of nursing care and the nature of an effective therapeutic relationship is tacit, valued knowledge among pediatric oncology nurses, as well as children and adolescents with cancer and their families, it is difficult to describe and challenging to quantify its effect on patient care outcomes. This article discusses the art of pediatric oncology nursing practice and its influence on treatment outcomes.

  19. Nursing 436A: Pediatric Oncology for Nurses.

    ERIC Educational Resources Information Center

    Jackman, Cynthia L.

    A description is provided of "Pediatric Oncology for Nurses," the first in a series of three courses offered to fourth-year nursing students in pediatric oncology. The first section provides a course overview, discusses time assignments, and describes the target student population. Next, a glossary of terms, and lists of course goals, long-range…

  20. Surgical Oncology Nursing: Looking Back, Looking Forward.

    PubMed

    Crane, Patrick C; Selanders, Louise

    2017-02-01

    To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. Review of the literature and Web sites of key organizations. The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. A systematic review on the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.

    PubMed

    Gi, Toh Shir; Devi, Kamala M; Neo Kim, Emily Ang

    2011-01-01

    Nursing shortage is a global issue that which affects oncology nursing. Oncology nurses are more prone to experience job dissatisfaction, stress and burnout when they work in units with poor staffing. There is thus a need for greater understanding of the relationship between the nursing shortage and nursing outcomes in oncology/haematology settings. This review aimed to establish the best available evidence concerning the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings; and to make recommendations for practice and future research. Types of participants: This review considered studies that included oncology registered nurses (RNs) who were more than 18 years of age and worked in either inpatient or outpatient oncology/haematology wards or units for the adult or paediatric patients.Types of intervention: This review considered studies that evaluated the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.Types of outcomes: This review included studies that measured job satisfaction, stress and burnout levels using different outcomes measures. Job satisfaction was determined by the Measure of Job Satisfaction scale, the Misener Nurse Practitioner Job Satisfaction Scale and the Likert scale, stress by the Pediatric Oncology Nurse Stressor Questionnaire and burnout by the Maslash Burnout Inventory scale.Types of studies: This review included descriptive/descriptive-correlational studies which were published in English. The search strategy sought to identify published and unpublished studies conducted between 1990 and 2010. Using a three-step search strategy, the following databases were accessed: CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar. Two independent reviewers assessed each paper for methodological validity prior to inclusion in

  2. Nurse practitioner (NP)

    MedlinePlus

    ... nurse with a graduate degree in advanced practice nursing. This type of provider may also be referred to as an ARNP (Advanced Registered Nurse Practitioner) or APRN (Advanced Practice Registered Nurse). Types of health care providers is a related topic.

  3. Neonatal nurse practitioners: identity as advanced practice nurses.

    PubMed

    Beal, J A; Maguire, D; Carr, R

    1996-06-01

    To define how neonatal nurse practitioners (NNPs) perceive their identity as advanced practice nurses. Non-experimental descriptive and correlational survey. Nationwide random sample drawn from NNPs certified by the National Certification Corporation. Two hundred fifty-eight neonatal nurse practitioners practicing in neonatal intensive-care units across the United States. Neonatal Nurse Practitioners indicated on a visual analogue scale at which point their philosophy of practice fell on a continuum from nursing to medicine and specified on a 5-point bipolar Likert scale how various role socialization factors influenced their identity. The NNPs predominantly were certificate-prepared and aligned themselves with a medical philosophy. Those NNPs who were master's-prepared (p < .01), precepted by another NNP (p < .05), espoused a philosophy of nursing (p < .001), belonged to a professional nursing organization (p < .05), and had an NNP role model (p < .001) were more likely to have a strong nursing identity (95% confidence interval). The issues of role differentiation, socialization, and identity of advanced practice nurses in tertiary care need further exploration. These data support the American Nurses' Association mandate of graduate nursing education for advanced nurse practitioners.

  4. Oncology nursing in Cuba: report of the delegation.

    PubMed

    Sheldon, Lisa Kennedy; Leonard, Kathleen; Gross, Anne; Hartnett, Erin; Poage, Ellen; Squires, Jennifer; Ullemeyer, Vicki; Schueller, Mary; Stary, Susan; Miller, Mary Alice

    2012-08-01

    In December 2011, the first delegation of oncology nurses from the United States visited Havana, Cuba. The delegation included oncology nurses, educators, and leaders from across America and provided opportunities to learn about the healthcare system, cancer, and oncology nursing in Cuba. Delegation members attended lectures, toured facilities, and enjoyed Cuban culture. This exchange highlighted the similarities in cancer care and oncology nursing between countries and opened doors for future collaborations.

  5. Essential Genetic and Genomic Nursing Competencies for the Oncology Nurse

    PubMed Central

    Jenkins, Jean

    2010-01-01

    Objectives To review the opportunities and possibilities for advancing oncology nursing competencies in genetic/genomics through the illustration of case scenarios in clinical care. Data Sources Literature; research reports. Conclusions Oncology nurses have the potential to influence whether or not cutting edge research discoveries are utilized at the bedside. Clinical integration of genetic/genomic information has the potential to optimize health outcomes and lengthen patient lives. Implications for Nursing Practice Oncology nurses need to include genetics/genomics in their practice in order to impact quality patient care today and for the future. PMID:21255714

  6. The Evolution of Gero-Oncology Nursing.

    PubMed

    Bond, Stewart M; Bryant, Ashley Leak; Puts, Martine

    2016-02-01

    This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Stress Levels of Nurses in Oncology Outpatient Units.

    PubMed

    Ko, Woonhwa; Kiser-Larson, Norma

    2016-04-01

    Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.

  8. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Nurse practitioner services. 440.166 Section 440... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services that...

  9. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Nurse practitioner services. 440.166 Section 440... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services that...

  10. The context of oncology nursing practice: an integrative review.

    PubMed

    Bakker, Debra; Strickland, Judith; Macdonald, Catherine; Butler, Lorna; Fitch, Margaret; Olson, Karin; Cummings, Greta

    2013-01-01

    In oncology, where the number of patients is increasing, there is a need to sustain a quality oncology nursing workforce. Knowledge of the context of oncology nursing can provide information about how to create practice environments that will attract and retain specialized oncology nurses. The aims of this review were to determine the extent and quality of the literature about the context of oncology nursing, explicate how "context" has been described as the environment where oncology nursing takes place, and delineate forces that shape the oncology practice environment. The integrative review involved identifying the problem, conducting a structured literature search, appraising the quality of data, extracting and analyzing data, and synthesizing and presenting the findings. Themes identified from 29 articles reflected the surroundings or background (structural environment, world of cancer care), and the conditions and circumstances (organizational climate, nature of oncology nurses' work, and interactions and relationships) of oncology nursing practice settings. The context of oncology nursing was similar yet different from other nursing contexts. The uniqueness was attributed to the dynamic and complex world of cancer control and the personal growth that is gained from the intense therapeutic relationships established with cancer patients and their families. The context of healthcare practice has been linked with patient, professional, or system outcomes. To achieve quality cancer care, decision makers need to understand the contextual features and forces that can be modified to improve the oncology work environment for nurses, other providers, and patients.

  11. 42 CFR 441.22 - Nurse practitioner services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Nurse practitioner services. 441.22 Section 441.22... General Provisions § 441.22 Nurse practitioner services. With respect to nurse practitioner services that... State plan must meet the following requirements: (a) Provide that nurse practitioner services are...

  12. 42 CFR 441.22 - Nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Nurse practitioner services. 441.22 Section 441.22... General Provisions § 441.22 Nurse practitioner services. With respect to nurse practitioner services that... State plan must meet the following requirements: (a) Provide that nurse practitioner services are...

  13. Nurses of Asia: Reflection from Asian Oncology Nursing Society Conference 2015.

    PubMed

    Camarillo, Jimvert I

    2016-01-01

    Another significant milestone from the Executive Board and the Organizing Committee of the Asian Oncology Nursing Society (AONS) transpired last November 20-21, 2015. The 2 nd AONS Conference was held in Seoul, South Korea under the theme of "Flying the Spirits of Asian Oncology Nursing." A total of 687 delegates from USA, Canada, Australia, Romania, and Asian Region supported this groundbreaking event. The objective of this 2-day conference was to facilitate sharing of expertise in the field of oncology nursing from the academe to clinical practice and to research. The issues that have been discussed in this 2-day symposium were Professional Development of Oncology Nursing, Quality of Life, Putting Evidence into Practice, Nursing Research, and Health Insurance for Cancer Care in Asia.

  14. Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice.

    PubMed

    Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran

    2017-09-01

    To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. 
. Descriptive, cross-sectional study.
. Rambam Health Care Campus in northern Israel.
. A convenience sample of 434 hospital nurses with varied oncology experience.
. Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. 
. Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. 
. Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.

  15. Microcomputer Nurse-Practitioner Protocols

    PubMed Central

    Way, Anthony B.; Rowley, Blair A.; White, Melanie A.

    1982-01-01

    We have developed a set of protocols on a microcomputer to assist in the management of a geographically isolated nurse practitioner. If a mid-level practitioner is supervised by a physician, some system is needed to ensure that approved care is being provided. The currently available paper-based protocols do not adequately serve all the needs for training, auditing, and record keeping. Conversely, adequate systems based on large computers are not feasible for small clinics. We have therefore developed a microcomputer-based system of protocols for a small rural nurse-practitioner's clinic. Our programs are designed for direct use by the practitioners while the patient is in the clinic. The user is given immediate feedback about any errors. The supervisor is later provided with a summary of the protocol uses and errors, and a copy of any erroneous records. The system appears to be easy to use by the nurse practitioner. The protocols are quickly learned and auditing is facilitated.

  16. Nurses of Asia: Reflection from Asian Oncology Nursing Society Conference 2015

    PubMed Central

    Camarillo, Jimvert I.

    2016-01-01

    Another significant milestone from the Executive Board and the Organizing Committee of the Asian Oncology Nursing Society (AONS) transpired last November 20-21, 2015. The 2nd AONS Conference was held in Seoul, South Korea under the theme of “Flying the Spirits of Asian Oncology Nursing.” A total of 687 delegates from USA, Canada, Australia, Romania, and Asian Region supported this groundbreaking event. The objective of this 2-day conference was to facilitate sharing of expertise in the field of oncology nursing from the academe to clinical practice and to research. The issues that have been discussed in this 2-day symposium were Professional Development of Oncology Nursing, Quality of Life, Putting Evidence into Practice, Nursing Research, and Health Insurance for Cancer Care in Asia. PMID:27981128

  17. Nurse Practitioner Pharmacology Education.

    ERIC Educational Resources Information Center

    Waigandt, Alex; Chang, Jane

    A study compared the pharmacology training of nurse practitioner programs with medical and dental programs. Seventy-three schools in 14 states (40 nurse practitioner programs, 19 schools of medicine, and 14 schools of dentistry) were surveyed by mailed questionnaire about the number of hours devoted to the study of pharmacology. The major findings…

  18. The Evolution of Gero-Oncology Nursing

    PubMed Central

    Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

    2016-01-01

    Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

  19. Genetics and Genomics in Oncology Nursing: What Does Every Nurse Need to Know?

    PubMed

    Eggert, Julie

    2017-03-01

    In addition to the need for basic education about genetics/genomics, other approaches are suggested to include awareness campaigns, continuing education courses, policy review, and onsite clinical development. These alternative learning strategies encourage oncology nurses across the continuum of care, from the bedside/seatside to oncology nurse research, to integrate genomics into all levels of practice and research in the specialty of oncology nursing. All nurses are warriors in the fight against cancer. The goal of this article is to identify genomic information that oncology nurses, at all levels of care, need to know and use as tools in the war against cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Energy therapies in oncology nursing.

    PubMed

    Coakley, Amanda Bulette; Barron, Anne-Marie

    2012-02-01

    To review the published research related to the interventions of Reiki, Therapeutic Touch, and Healing Touch representing energy therapies in relation to oncology nursing. Peer-reviewed literature. There is growing evidence that energy therapies have a positive effect on symptoms associated with cancer. While there is need for further research, it is clear that an appreciation for the value of research methods beyond the randomized control trial is important. Energy therapies offer additional strategies for oncology nurses providing integrated nursing care to alleviate suffering and symptom distress of patients with cancer. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Scientific Advances Shaping the Future Roles of Oncology Nurses.

    PubMed

    Wujcik, Debra

    2016-05-01

    To discuss the recent scientific advances that influence current oncology care and explore the implications of these advances for the future of oncology nursing. Current nursing, medical and basic science literature; Clinicaltrials.gov. The future of oncology care will be influenced by an aging population and increasing number of patients diagnosed with cancer. The advancements in molecular sequencing will lead to more clinical trials, targeted therapies, and treatment decisions based on the genetic makeup of both the patient and the tumor. Nurses must stay current with an ever changing array of targeted therapies and developing science. Nurses will influence cancer care quality, value, cost, and patient satisfaction. It is critical for oncology nurses and nursing organizations to engage with all oncology care stakeholders in identifying the future needs of oncology patients and the environment in which care will be delivered. Nurses themselves must identify the roles that will be needed to ensure a workforce that is adequate in number and well trained to meet the future challenges of care delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Patient-Centredness, Job Satisfaction and Psychological Distress: a Brief Survey Comparing Oncology Nurses and Doctors.

    PubMed

    Chan, Caryn Mei Hsien; Wan Ahmad, Wan Azman; Yusof, Mastura Md; Ho, Gwo Fuang; Krupat, Edward

    2015-01-01

    We aimed to explore whether levels of patient-centredness, job satisfaction and psychological distress varied between oncology nurses and doctors. In a cross-sectional study using self-administered questionnaires, a total of 24 nurses and 43 doctors were assessed for patient-centredness, psychological distress, and job satisfaction using the Patient-Practitioner Orientation Scale, Hospital Anxiety and Depression Scale, and Job Satisfaction Scale. Data were analysed using descriptive statistics, independent samples t-test and MANCOVA, with p<0.05 considered significant. Overall response rate was 95.6% (43/45) for physicians and 85.7% (24/28) for nurses. Even after adjusting for known covariates, our principal finding was that doctors reported greater psychological distress compared to nurses (p=0.009). Doctors also reported lower job satisfaction compared to nurses (p = 0.017), despite higher levels of patient-centredness found in nurses (p=0.001). Findings may be explained in part by differences in job characteristics and demands. Mental health is an important concern not just in cancer patients but among healthcare professionals in oncology.

  3. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nurse practitioners' services. 410.75 Section 410... Nurse practitioners' services. (a) Definition. As used in this section, the term “physician” means a... Medicare Part B coverage of his or her services, a nurse practitioner must be a registered professional...

  4. Mapping the literature of nurse practitioners.

    PubMed

    Shams, Marie-Lise Antoun

    2006-04-01

    This study was designed to identify core journals for the nurse practitioner specialty and to determine the extent of their indexing in bibliographic databases. As part of a larger project for mapping the literature of nursing, this study followed a common methodology based on citation analysis. Four journals designated by nurse practitioners as sources for their practice information were selected. All cited references were analyzed to determine format types and publication years. Bradford's Law of Scattering was applied to identify core journals. Nine bibliographic databases were searched to estimate the index coverage of the core titles. The findings indicate that nurse practitioners rely primarily on journals (72.0%) followed by books (20.4%) for their professional knowledge. The majority of the identified core journals belong to non-nursing disciplines. This is reflected in the indexing coverage results: PubMed/MEDLINE more comprehensively indexes the core titles than CINAHL does. Nurse practitioners, as primary care providers, consult medical as well as nursing sources for their information. The implications of the citation analysis findings are significant for collection development librarians and indexing services.

  5. Orientation program for hospital-based nurse practitioners.

    PubMed

    Bahouth, Mona N; Esposito-Herr, Mary Beth

    2009-01-01

    The transition from student to practicing clinician is often a challenging and difficult period for many nurse practitioners. Newly graduated nurse practitioners commonly describe feelings of inadequacy in assuming clinical responsibilities, lack of support by team members, unclear expectations for the orientation period, and role isolation. This article describes the formal nurse practitioner orientation program implemented at the University of Maryland Medical Center, a large urban academic medical center, to facilitate the transition of new nurse practitioners into the workforce. This comprehensive program incorporates streamlined administrative activities, baseline didactic and simulation-based critical care education, ongoing and focused peer support, access to formalized resources, and individualized clinical preceptor programs. This formalized orientation program has proven to be one of the key variables to successful integration of nurse practitioners into our acute care clinical teams.

  6. Cooperative m-learning with nurse practitioner students.

    PubMed

    Wyatt, Tami H; Krauskopf, Patricia B; Gaylord, Nan M; Ward, Andrew; Huffstutler-Hawkins, Shelley; Goodwin, Linda

    2010-01-01

    New technologies give nurse academicians the opportunity to incorporate innovative teaching-learning strategies into the nursing curricula. Mobile technology for learning, or m-learning, has considerable potential for the nursing classroom but lacks sufficient empirical evidence to support its use. Based on Mayer's multimedia learning theory, the effect of using cooperative and interactive m-learning techniques in enhancing classroom and clinical learning was explored. The relationship between m-learning and students' learning styles was determined through a multimethod educational research study involving nurse practitioner students at two mid-Atlantic universities. During the 16-month period, nurse practitioner students and their faculty used personal digital assistants (PDAs) to participate in various m-learning activities. Findings from focus group and survey responses concluded that PDAs, specifically the Pocket PC, are useful reference tools in the clinical setting and that all students, regardless of learning style, benefited from using PDAs. It was also demonstrated that connecting students with classmates and other nurse practitioner students at distant universities created a cooperative learning community providing additional support and knowledge acquisition. The authors concluded that in order to successfully prepare nurse practitioner graduates with the skills necessary to function in the present and future health care system, nurse practitioner faculty must be creative and innovative, incorporating various revolutionary technologies into their nurse practitioner curricula.

  7. Distress and Coping Self-Efficacy in Inpatient Oncology Nurses.

    PubMed

    Wahlberg, Lara; Nirenberg, Anita; Capezuti, Elizabeth

    2016-11-01

    To examine distress and coping self-efficacy in inpatient oncology nurses. 
. Cross-sectional survey design.
. Oncology Nursing Society (ONS) chapter meetings and Hunter-Bellevue School of Nursing, both in New York, New York, as well as social media.
. 163 oncology nurses who work with an inpatient adult population.
. Participants were recruited through the ONS New York, New York, area chapter meetings, Hunter College, and ONS Facebook pages. An adapted Nurse Distress Thermometer (NDT) measured distress levels. The Occupational Coping Self-Efficacy Questionnaire for Nurses (OCSE-N) used a Likert-type scale to measure coping self-efficacy. Open-ended questions elicited additional perceptions of nurse respondents. 
. Descriptive statistics summarized sample demographics. A Pearson correlation between distress levels and coping self-efficacy scores was calculated. Low, normal, and high coping scores were compared to mean distress levels. 
. Survey participants showed high levels of distress, with a mean NDT score of 8.06. Those with higher coping self-efficacy scores reported less distress. A moderate, negative correlation was shown, with a statistically significant Pearson coefficient of -0.371. Responses to the open-ended questions revealed common stressors and pointed to solutions that institutions might implement to support nurses.
. Because coping self-efficacy related to lower distress levels in inpatient oncology nurses, institutional-level support for oncology nurses should be provided. 
. Interventions aimed at coping self-efficacy may prepare oncology nurses to cope better with their professional demands. Future research should explore how nurse distress affects patients.

  8. The Role of Oncology Nurses in Discussing Clinical Trials.

    PubMed

    Flocke, Susan A; Antognoli, Elizabeth; Daly, Barbara J; Jackson, Brigid; Fulton, Sarah E; Liu, Tasnuva M; Surdam, Jessica; Manne, Sharon; Meropol, Neal J

    2017-09-01

    To describe oncology nurses' experiences discussing clinical trials with their patients, and to assess barriers to these discussions.
. A qualitative study designed to elicit narratives from oncology nurses. 
. Community- and academic-based oncology clinics throughout the United States.
. 33 oncology nurses involved in direct patient care in community-based and large hospital-based settings. The sample was drawn from members of the Oncology Nursing Society. 
. In-depth interviews were conducted and analyzed using a 
immersion/crystallization approach to identify themes and patterns. The analyses highlight specific issues, examples, and contexts that present challenges to clinical trial discussions with patients.
. Oncology nurses view their roles as patient educators and advocates to be inclusive of discussion of clinical trials. Barriers to such discussions include lack of knowledge and strategies for addressing patients' common misconceptions and uncertainty about the timing of discussions.
. These data indicate that enabling nurses to actively engage patients in discussions of clinical trials requires educational interventions to build self-efficacy and close knowledge gaps. 
. Oncology nurses can play a critical role in advancing cancer care by supporting patients in decision making about clinical trial participation. This will require training and education to build their knowledge, reduce barriers, and increase their self-efficacy to fulfill this responsibility in various clinical settings.

  9. Perioperative Palliative Care Considerations for Surgical Oncology Nurses.

    PubMed

    Sipples, Rebecca; Taylor, Richard; Kirk-Walker, Deborah; Bagcivan, Gulcan; Dionne-Odom, J Nicholas; Bakitas, Marie

    2017-02-01

    To explore the opportunities to incorporate palliative care into perioperative oncology patient management and education strategies for surgical oncology nurses. Articles related to palliative care and surgical oncology to determine the degree of integration, gaps, and implications for practice. Although evidence supports positive patient outcomes when palliative care is integrated in the perioperative period, uptake of palliative care into surgical settings is slow. Palliative care concepts are not adequately integrated into surgical and nursing education. With appropriate palliative care education and training, surgical oncology nurses will be empowered to foster surgical-palliative care collaborations to improve patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Results of an Oncology Clinical Trial Nurse Role Delineation Study.

    PubMed

    Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

    2017-09-01

    To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

  11. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Nurse practitioner and physician assistant services... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who is... assistant, nurse midwife or specialized nurse practitioner who furnished the service is legally permitted to...

  12. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Nurse practitioner and physician assistant services... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who is... assistant, nurse midwife or specialized nurse practitioner who furnished the service is legally permitted to...

  13. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Nurse practitioner and physician assistant services... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who is... assistant, nurse midwife or specialized nurse practitioner who furnished the service is legally permitted to...

  14. Improving Oncology Nurses' Knowledge About Nutrition and Physical Activity for Cancer Survivors.

    PubMed

    van Veen, Merel R; Hoedjes, Meeke; Versteegen, Joline J; van de Meulengraaf-Wilhelm, Nienke; Kampman, Ellen; Beijer, Sandra

    2017-07-01

    To assess what percentage of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition and/or physical activity (PA), which characteristics were associated with nurses' perception, and whether the content and information sources differed among those nurses.
. A cross-sectional study.
. A web-based survey among oncology nurses in the Netherlands.
. 355 oncology nurses provided advice on nutrition; of these, 327 provided advice on PA.
. From May to July 2013, oncology nurses were invited to complete an online questionnaire. Pearson's chi-squared tests and uni- and multivariate logistic regression analyses were conducted.
. Oncology nurses' perception of having sufficient or insufficient knowledge to be able to provide advice on nutrition and PA, the content of the advice, and the information sources on which the advice was based.
. 43% of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition, and 46% perceived insufficient knowledge to provide advice on PA. Factors associated with perceiving insufficient knowledge on nutrition were being aged younger, having lower education, and providing counseling during treatment only. Those nurses were more likely to suggest taking oral nutritional supplements or visiting a dietitian and were less likely to provide information on fluid intake. Nurses perceiving insufficient knowledge about PA used oncology guidelines less often.
. Almost half of the oncology nurses providing advice on nutrition and PA perceived themselves as having insufficient knowledge to be able to provide such advice. In particular, younger oncology nurses and oncology nurses with an intermediate vocational education may benefit most from education about these topics. 
. Educational training for oncology nurses should include nutrition and PA. Oncology nurses should collaborate with dietitians to discuss what information should be provided to patients by

  15. Ethical problems experienced by oncology nurses.

    PubMed

    da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

    2015-01-01

    To know the ethical problems experienced by oncology nurses. Descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. For the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.

  16. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for nurse practitioners' and clinical nurse... HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners' and clinical nurse specialists' services. (a) Rural areas. For services furnished beginning January 1, 1992 and...

  17. Creating a Culture of Professional Development for Oncology Nursing in Asia.

    PubMed

    Yi, Myungsun

    2016-01-01

    The importance of professional development of oncology nursing in Asia is growing along with growth in the cancer burden and disparity in cancer incidence and mortality between more- and less-developed regions, the latter of which includes most Asian countries. This paper proposes ways to advance the oncology nursing in terms of education, practice, and research in Asia. It also describes major challenges expected in developing and implementing a unique professional role for oncology nurses in Asia. This study will provide insights for Asian oncology nurses in developing culturally sensitive oncology nursing practices with limited health care resources.

  18. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the service. For assistant-at-surgery services, allowed amounts for the services of a nurse... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for nurse practitioners' and clinical nurse... AND OTHER HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners...

  19. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... the service. For assistant-at-surgery services, allowed amounts for the services of a nurse... 42 Public Health 3 2012-10-01 2012-10-01 false Payment for nurse practitioners' and clinical nurse... AND OTHER HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners...

  20. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... the service. For assistant-at-surgery services, allowed amounts for the services of a nurse... 42 Public Health 3 2013-10-01 2013-10-01 false Payment for nurse practitioners' and clinical nurse... AND OTHER HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners...

  1. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... the service. For assistant-at-surgery services, allowed amounts for the services of a nurse... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for nurse practitioners' and clinical nurse... HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners' and clinical...

  2. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nurse practitioner and physician assistant services... Clinic and Federally Qualified Health Center Services § 405.2414 Nurse practitioner and physician... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who is...

  3. Effects of a sexual health care nursing record on the attitudes and practice of oncology nurses.

    PubMed

    Jung, Dukyoo; Kim, Jung-Hee

    2016-10-01

    A nursing record focused on sexual health care for patients with cancer could encourage oncology nurses to provide sexual health care for oncology patients in a simple and effective manner. However, existing electronic information systems focus on professional use and not sexual health care, which could lead to inefficiencies in clinical practice. To examine the effects of a sexual health care nursing record on the attitudes and practice of oncology nurses. Twenty-four full-time registered nurses caring for oncology patients were randomly assigned to the intervention and control groups in Korea. The researchers developed a sexual health care record and applied it to the intervention group for one month. Data were analyzed by Mann-Whitney U test and chi-square test. Content analysis was used to analyze interviews. Oncology nurses using the sexual health care record had significantly higher levels of sexual health care practice at 4 weeks post-intervention as compared to those who provided usual care to patients with cancer. A sexual health care record may have the potential to facilitate oncology nurses' practice of sexual health care. This study highlighted the importance of using SHC records with oncology patients to improve nursing practice related to sexuality issues. A nursing record focused on SHC for patients with cancer could make it easier and more effective for oncology nurses to provide such care to their patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Oncology nursing: Finding the balance in a changing health care system.

    PubMed

    Bakker, Debra; Fitch, Margaret I; Green, Esther; Butler, Lorna; Olson, Karin

    2006-01-01

    Health care restructuring has resulted in significant changes in the workload and work environment for oncology nurses. While recent studies describe the impact of these changes on the general nursing workforce in several countries, there have been no published studies that have focused on worklife issues of Canadian oncology nurses. Therefore, a qualitative study was conducted to gain insight about how oncology nursing has changed over the past decade and how Canadian oncology nurses are managing these changes. Analysis of telephone interviews with 51 practising oncology nurses employed across Canada revealed three major themes. The first theme, "health care milieu", portrayed a picture of the cancer care environment and patient and professional changes that occurred over the past decade. The second theme, "conflicting demands", reflects how the elements of change and social forces have challenged professional oncology nursing practice. The third theme, "finding the way", describes the patterns of behaviour that nurses used to manage the changing health care environment and make meaning out of nurses' work in cancer care. Overall, the findings portray a picture of Canadian oncology nurses in "survival mode". They face many workplace challenges, but are able to keep going "for now" because they find ways to balance their responsibilities on a daily basis and because they know and believe that their specialized nursing knowledge and skills make a difference in patient care.

  5. The role of the nurse practitioner in psychiatric/mental health nursing: exploring consumer satisfaction.

    PubMed

    Wortans, J; Happell, B; Johnstone, H

    2006-02-01

    There is a substantial body of literature pertaining to the role of the nurse practitioner. Research directed towards consumer satisfaction suggests that the care provided by nurse practitioners is perceived as at least equal to that provided by a medical practitioner. However, there is a paucity of literature examining the nurse practitioner role in the psychiatric/mental health field. An evaluation of a Nurse Practitioner demonstration model has recently been undertaken in the Crisis, Assessment and Treatment Team in Victoria, Australia. This article presents the findings of a qualitative, exploratory study. Individual interviews were conducted with consumers (n = 7) who had received care and treatment provided by the nurse practitioner candidate. Data analysis revealed two main themes: the quality of the service provided, and the unique role of the nurse. The findings supported the available literature in articulating the specific aspects of the nurse practitioner role that are favourably perceived by consumers of services. This study contributes to the limited body of knowledge in the psychiatric/mental health nursing field and specifically emphasizes the importance of the relationship between nurse practitioner and consumer in facilitating the provision of effective care and treatment.

  6. Improving oncology nurses' communication skills for difficult conversations.

    PubMed

    Baer, Linda; Weinstein, Elizabeth

    2013-06-01

    When oncology nurses have strong communication skills, they play a pivotal role in influencing patient satisfaction, adherence to plans of care, and overall clinical outcomes. However, research studies indicate that nurses tend to keep communication with patients and families at a superficial, nontherapeutic level. Processes for teaching goals-of-care communication skills and for implementing skills into clinical practice are not clearly defined. Nurses at a large comprehensive cancer center recognized the need for help with this skill set and sought out communication experts to assist in providing the needed education. An educational project was developed to improve therapeutic communication skills in oncology nurses during goals-of-care discussions and giving bad news. The program was tailored to nurses and social workers providing care to patients in a busy, urban, academic, outpatient oncology setting. Program topics included exploring the patient's world, eliciting hopes and concerns, and dealing with conflict about goals. Sharing and discussing specific difficult questions and scenarios were encouraged throughout the program. The program was well attended and well received by oncology nurses and social workers. Participants expressed interest in the continuation of communication programs to further enhance skills.

  7. Physical Activity Promotion, Beliefs, and Barriers Among Australasian Oncology Nurses.

    PubMed

    Keogh, Justin W L; Pühringer, Petra; Olsen, Alicia; Sargeant, Sally; Jones, Lynnette M; Climstein, Mike

    2017-03-01

    To describe the physical activity (PA) promotion practices, beliefs, and barriers of Australasian oncology nurses and gain preliminary insight into how PA promotion practices may be affected by the demographics of the nurses.
. Cross-sectional survey.
. Australia and New Zealand.
. 119 registered oncology nurses.
. Self-reported online survey completed once per participant.
. Questions assessed the PA promotion beliefs (e.g., primary healthcare professionals responsible for PA promotion, treatment stage), PA benefits (e.g., primary benefits, evidence base), and PA promotion barriers of oncology nurses.
. Oncology nurses believed they were the major providers of PA advice to their patients. They promoted PA prior to, during, and post-treatment. The three most commonly cited benefits of PA for their patients were improved quality of life, mental health, and activities of daily living. Lack of time, lack of adequate support structures, and risk to patient were the most common barriers to PA promotion. Relatively few significant differences in the oncology nurses' PA promotion practices, beliefs, and barriers were observed based on hospital location or years of experience.
. Despite numerous barriers, Australasian oncology nurses wish to promote PA to their patients with cancer across multiple treatment stages because they believe PA is beneficial for their patients.
. Hospitals may need to better support oncology nurses in promoting PA to their patients and provide better referral pathways to exercise physiologists and physiotherapists.

  8. Outsourcing issues for nurse practitioner practices.

    PubMed

    Mackey, Thomas A; McNiel, Nancy O; Klingensmith, Kenneth

    2004-01-01

    Nurse practitioner managed practices face multiple business and clinical processes. While most practice managers are prepared as clinicians, they are not well prepared to deal with the daily multiple business infrastructure issues they face. To provide for increased efficiency and effectiveness, nurse practitioner practices should consider outsourcing context business functions.

  9. International collaboration for pediatric oncology nursing leadership: Nicaragua and Canada.

    PubMed

    Orozco, A; Marin, V; Reyes, S; Challinor, J; Carpio, B

    2009-01-01

    In 2005, with financial support from the Pediatric Oncology Group of Ontario, a pilot nursing leadership project linked pediatric oncology nurses from Canada with nurses at the La Mascota Hospital in Managua, Nicaragua. Following consultation with the pediatric oncology team in Nicaragua, a program was developed to strengthen clinical nursing leadership in a clinical setting through continuing education. The nurses believed that care of the patient and family improved due to the increased leadership skills of nurses in the unit and as the profile and credibility of nurses as peers in the health care team became evident. Providing nurses with the autonomy and financing for a project related directly to nursing care represented an important development for leadership in the profession.

  10. The business management preceptorship within the nurse practitioner program.

    PubMed

    Wing, D M

    1998-01-01

    Changes in health care reimbursement practices have affected the way in which primary health care is provided. To be successful, nurse practitioners must have a proficient understanding of basic business functions, including accounting, finance, economics, marketing, and reimbursement practices. Yet, many graduates of nurse practitioner programs are not adequately prepared to make fundamental business decisions. Therefore, it is essential that nurse practitioner faculty provide learning experiences on primary practice business. Because the preceptor experience is an integral aspect of nurse practitioner education, a business preceptorship provides students with pragmatic knowledge of the clinical practice within a business framework. The University of Indianapolis School of Nursing offers a nurse practitioner business preceptorship. The implementation, challenges, and positive outcomes of the course are discussed in this article.

  11. Nurse practitioner job satisfaction: looking for successful outcomes.

    PubMed

    Pasarón, Raquel

    2013-09-01

    To examine overall job satisfaction and its association with extrinsic and intrinsic characteristics of job satisfaction among nurse practitioners at the chosen practice site. The objectives were to identify relevant retention and recruitment strategies, from the nurse practitioners perspective, by examining (1) what role aspects are most satisfying, and (2) approaches for successful, professional development and integration in the role. Supportive professional practice environments are particularly important to nurses' satisfaction with their work and the quality of patient care provided. Hence, research that examines nurse practitioners practice implications and barriers in today's healthcare system is essential. A descriptive-correlational design using survey methodology. A nonprobability sample of convenience was used. The outcome measures were: The Misener Nurse Practitioner Job Satisfaction Scale and two investigator-developed surveys. Participants expressed dissatisfaction with professional and monetary recognition, assertive influence, administrative support and collegial relationships. Interaction of subscale factors on overall job satisfaction and demographic survey findings has important implications for health administrators and nurse practitioners in similar organisations. Stakeholders in healthcare milieus need to be fully engaged in the redesign of the American healthcare system heeding the recommendations of the Institute of Medicine to provide safer health systems to the public. By doing this, issues related to frustration by nurse practitioners related to job satisfaction will be addressed. The need for cooperation, participation, collaboration and instrumental communication are essential in the delivery of safe, quality patient care. A better understanding of intrinsic professional rewards needs to be learned by nurse practitioners who want to seek professional satisfaction and engage in the survival and growth of the profession. Nurse

  12. [The contribution of oncology nursing to the Swiss Research Agenda for Nursing - SRAN].

    PubMed

    Shaha, Maya; Schmid-Büchi, Silvia; Abt, Judith; Mathis-Jäggi, Franziska; Holdener, Eveline; Riederer, Evelyn; Stoll, Hans Ruedi; Fliedner, Monica; Imhof, Lorenz

    2008-12-01

    Worldwide, cancer remains the second most frequent cause of death in adults and children. A cancer diagnosis often marks the beginning of therapies that may continue over months and years. These therapies frequently consist in surgical interventions in combination with chemotherapy and radiotherapy. For all healthcare professionals involved, cancer also signifies a very complex illness with high demands. It is therefore important to identify research priorities in order to successfully and comprehensively address these demands and to provide high quality patient care. In order to identify research priorities in oncology care in Switzerland, a systematic review of literature was conducted. A total of 30 research priorities emerged from the literature. In accordance with SRAN guidelines, 25 were passed on to the SRAN. The systematic identification of research priorities in oncology nursing has, for the first time, resulted in a list of topics in need of investigation in Switzerland. Completing the list of research priorities for oncology nursing with an updated systematic review of literature and presenting it to a larger and more representative group of oncology nurses, experts, and nurse scientists with oncology nursing experience for assessment and valuation, will be crucial for any future revision of the SRAN. In the future, it will be indispensable to include patients and their families in the process.

  13. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner, physician assistant, certified nurse...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker... nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker services. (a) Services and supplies incident to a nurse practitioner, physician assistant...

  14. Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits.

    PubMed

    Ignoffo, Robert; Knapp, Katherine; Barnett, Mitchell; Barbour, Sally Yowell; D'Amato, Steve; Iacovelli, Lew; Knudsen, Jasen; Koontz, Susannah E; Mancini, Robert; McBride, Ali; McCauley, Dayna; Medina, Patrick; O'Bryant, Cindy L; Scarpace, Sarah; Stricker, Steve; Trovato, James A

    2016-04-01

    With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties-certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits. Copyright © 2016 by American Society of Clinical Oncology.

  15. Ethical problems experienced by oncology nurses1

    PubMed Central

    da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

    2015-01-01

    Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude. PMID:26626012

  16. Critical Thinking Disposition of Nurse Practitioners in Taiwan.

    PubMed

    Hsu, Hsiu-Ying; Chang, Shu-Chen; Chang, Ai-Ling; Chen, Shiah-Lian

    2017-09-01

    Critical thinking disposition (CTD) is crucial for nurse practitioners who face complex patient care scenarios. This study explored the CTD of nurse practitioners and related factors. The study was a cross-sectional descriptive design. A purposive sample was recruited from a medical center and its hospital branches in central Taiwan. A structured questionnaire was used to collect data from 210 nurse practitioners. The participants obtained the highest average score on systematicity and analyticity. CTD had a significant positive correlation with fundamental knowledge readiness, professional knowledge readiness, and confidence in making clinical decisions. Professional knowledge readiness, education level, and on-the-job training predicted the score of the participants on overall CTD. On-the-job training and education level may influence the CTD of nurse practitioners. Providing formal or on-the-job continuing education training to nurse practitioners may help enhance their CTD. J Contin Educ Nurs. 2017;48(9):425-430. Copyright 2017, SLACK Incorporated.

  17. Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

    PubMed

    Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

    2017-07-01

    Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

  18. Clinical productivity of primary care nurse practitioners in ambulatory settings.

    PubMed

    Xue, Ying; Tuttle, Jane

    Nurse practitioners are increasingly being integrated into primary care delivery to help meet the growing demand for primary care. It is therefore important to understand nurse practitioners' productivity in primary care practice. We examined nurse practitioners' clinical productivity in regard to number of patients seen per week, whether they had a patient panel, and patient panel size. We further investigated practice characteristics associated with their clinical productivity. We conducted cross-sectional analysis of the 2012 National Sample Survey of Nurse Practitioners. The sample included full-time primary care nurse practitioners in ambulatory settings. Multivariable survey regression analyses were performed to examine the relationship between practice characteristics and nurse practitioners' clinical productivity. Primary care nurse practitioners in ambulatory settings saw an average of 80 patients per week (95% confidence interval [CI]: 79-82), and 64% of them had their own patient panel. The average patient panel size was 567 (95% CI: 522-612). Nurse practitioners who had their own patient panel spent a similar percent of time on patient care and documentation as those who did not. However, those with a patient panel were more likely to provide a range of clinical services to most patients. Nurse practitioners' clinical productivity was associated with several modifiable practice characteristics such as practice autonomy and billing and payment policies. The estimated number of patients seen in a typical week by nurse practitioners is comparable to that by primary care physicians reported in the literature. However, they had a significantly smaller patient panel. Nurse practitioners' clinical productivity can be further improved. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Promoting the nurse practitioner by using a marketing approach.

    PubMed

    Gallagher, S M

    1996-03-01

    Being good at what you do is not enough. Despite strong evidence that the nurse practitioner delivers cost-efficient and outcome-based care, few consumers really understand the nurse practitioner's scope of practice. With the current rapidly changing status of health care, the nurse practitioner is presented with many opportunities. Strategies that ensure survival and growth are critical to longevity. Marketing strategies can offer solutions to these challenges. The 4 P's of marketing are discussed as an approach to promote the role of the nurse practitioner.

  20. State-granted practice authority: do nurse practitioners vote with their feet?

    PubMed

    Perry, John J

    2012-01-01

    Nurse practitioners have become an increasingly important part of the US medical workforce as they have gained greater practice authority through state-level regulatory changes. This study investigates one labor market impact of this large change in nurse practitioner regulation. Using data from the National Sample Survey of Registered Nurses and a dataset of state-level nurse practitioner prescribing authority, a multivariate estimation is performed analysing the impact of greater practice authority on the probability of a nurse practitioner moving from a state. The empirical results indicate that nurse practitioners in states that grant expanded practice are less likely to move from the state than nurse practitioners in states that have not granted expanded practice authority. The estimated effect is robust and is statistically and economically meaningful. This finding is in concert with and strengthens the wider literature which finds states that grant expanded practice authority to nurse practitioners tend to have larger nurse practitioner populations.

  1. A mixed methods study of the work patterns of full-time nurse practitioners in nursing homes.

    PubMed

    Martin-Misener, Ruth; Donald, Faith; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Ploeg, Jenny; Brazil, Kevin; Kaasalainen, Sharon; McAiney, Carrie; Carter, Nancy; Schindel Martin, Lori; Sangster-Gormley, Esther; Taniguchi, Alan

    2015-05-01

    The aim of this study was to explore the integration of the nurse practitioner role in Canadian nursing homes to enable its full potential to be realised for resident and family care. The objective was to determine nurse practitioners' patterns of work activities. Nurse practitioners were introduced in Canadian nursing homes a decade ago on a pilot basis. In recent years, government and nursing home sector interest in the role has grown along with the need for data to inform planning efforts. The study used a sequential mixed methods design using a national survey followed by case studies. A national survey of nurse practitioners included demographic items and the EverCare Nurse Practitioner Role and Activity Scale. Following the survey, case studies were conducted in four nursing homes. Data were collected using individual and focus group interviews, document reviews and field notes. Twenty-three of a target population of 26 nurse practitioners responded to the survey, two-thirds of whom provided services in nursing homes with one site and the remainder in nursing homes with as many as four sites. On average, nurse practitioners performed activities in communicator, clinician, care manager/coordinator and coach/educator subscales at least three to four times per week and activities in the collaborator subscale once a week. Of the 43 activities, nurse practitioners performed daily, most were in the clinician and communicator subscales. Case study interviews involved 150 participants. Findings complemented those of the survey and identified additional leadership activities. Nurse practitioners undertake a range of primary health care and advanced practice activities which they adapt to meet the unique needs of nursing homes. Knowledge of work patterns enables nursing homes to implement the full range of nurse practitioner roles and activities to enhance resident and family care. © 2014 John Wiley & Sons Ltd.

  2. Nursing service innovation: A case study examining emergency nurse practitioner service sustainability.

    PubMed

    Fox, Amanda; Gardner, Glenn; Osborne, Sonya

    2018-02-01

    This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.

  3. The effect of a psychological empowerment program based on psychodrama on empowerment perception and burnout levels in oncology nurses: Psychological empowerment in oncology nurses.

    PubMed

    Özbaş, Azize Atli; Tel, Havva

    2016-08-01

    Oncology nursing is stressful by its nature, and nurses in the field experience a high amount of stress and burnout. In order to cope with occupational stress, nurses need to employ flexible adjustment mechanisms that allow them the power to process their experiences. Failure of efficient stress management causes burnout, and burnout is closely related to powerlessness. It is therefore believed that the occurrence of burnout can be reduced by means of psychological empowerment of nurses. Our study was conducted to determine the effect of a "psychodrama-based psychological empowerment program" on (1) the perception of empowerment and (2) the levels of burnout in oncology nurses. The sample was made up of 82 oncology nurses (38 nurses in the study group and 44 in the control/comparison group). Study data were collected using the Psychological Empowerment Scale, the Nurse Work Empowerment Scale, and Maslach's Burnout Inventory. The study group attended a "psychodrama-based psychological empowerment program" (2 hours, 1 day a week, for 10 weeks). For data assessment, we employed an independent t test and one-way analysis of variance. The psychological empowerment and workplace empowerment scores of nurses in the study group increased and their burnout scores decreased following attendance in the psychodrama-based psychological empowerment program. We found that the psychodrama-based psychological empowerment program increased psychological empowerment and enhanced perception of workplace empowerment while decreasing levels of burnout in oncology nurses. The program is recommended and should allow oncology nurses to benefit from their personal experiences and thus increase self-empowerment, to enhance their perception of empowerment, and to prevent burnout.

  4. Challenges and leadership strategies for managers of nurse practitioners.

    PubMed

    Reay, Trish; Golden-Biddle, Karen; Germann, Kathy

    2003-11-01

    The aim of this paper is to report on the findings from our research into the recent introduction of nurse practitioners in Alberta, Canada. Through an organizational research perspective, we identify the critical role of health care managers in developing a sustainable nurse practitioner role. Previous literature has focused on nurse practitioners themselves as the key factor in their integration into the health care system. Although they are qualified and organizationally well placed, managers of nurse practitioners have been overlooked as a critical part of implementation strategies. We interviewed 25 nurse practitioners and seven of their managers. Through our data analysis we identified three major challenges for managers: (1) clarifying the reallocation of tasks; (2) managing altered working relationships within the team; (3) continuing to manage the team in an evolving situation. Associated with these challenges, we propose leadership strategies that managers may find useful as they work through the consequences of introducing the nurse practitioner role. These strategies are: * encourage all team members to sort out 'who does what'; * ensure that task reallocation preserves job motivating properties; * give consideration to how tasks have been allocated when issues identified as 'personal conflict' arise; * pay attention to all perspectives of the working relationships within the team; * facilitate positive relationships between team members; * lead from a 'balcony' perspective; * work with the team to develop goals that are not over focused on the nurse practitioner; * regularly share with other managers the experiences and lessons learned in introducing nurse practitioners. For managers to be most effective, they need to address three challenges that are of a managerial, not clinical, nature. By implementing specific leadership strategies, managers of nurse practitioners can facilitate the introduction of the new role and improve its sustainability in

  5. Factors influencing the decision to use nurse practitioners in the emergency department.

    PubMed

    McGee, Laurie A; Kaplan, Louise

    2007-10-01

    Emergency department overcrowding is a serious problem nationwide. Of an estimated 14 million visits to hospital emergency departments, only 12.9% are considered emergent. Many emergency departments, however, employ only physicians despite the fact that nurse practitioners have a proven record of providing high quality, cost-effective care in the emergency department. The purpose of the study was to determine factors that influence the decision to use nurse practitioners in the emergency department. Interviews were conducted with ED managers in hospitals that both employ and do not employ nurse practitioners in the emergency department. In this study, the primary reason that nurse practitioners were not employed by emergency departments was that physician groups with whom the hospitals contract refuse to use nurse practitioners. Emergency department managers of facilities with nurse practitioners reported high levels of satisfaction with the nurse practitioners performance. The 2 ED managers without nurse practitioners in their facility were highly supportive of having nurse practitioners in the emergency department and have advocated for hiring nurse practitioners. Education needs to occur with emergency departments regarding the value of the nurse practitioner's role to the facility. Research is needed to investigate why emergency department physician groups resist hiring nurse practitioners. Increased staffing with nurse practitioners in the emergency department can serve to reduce overcrowding, reduce waiting times, and increase patient satisfaction.

  6. Two approaches to bridging the knowledge-practice gap in oncology nursing.

    PubMed

    Peek, Gloanna J

    2015-01-01

    The field of oncology nursing is continually changing. New drugs to aid in the fight against cancer are being developed, complementary therapies to ease symptoms are gaining prominence, and survivorship care is becoming a welcome yet challenging area of subspecialty. For oncology nurses to provide quality care and to develop improved care delivery systems, they must not only have access to the most current knowledge in the field, but also be equipped with the skills necessary to integrate that knowledge into practice for the benefit of patients and families (LoBiondo-Wood et al., 2014). The importance of nursing research and its relationship to the practice of oncology nursing cannot be minimized (Moore & Badger, 2014). Oncology nurse researchers advance knowledge and, consequently, improve the quality of care for patients with cancer and their families. For example, the Oncology Nursing Society (ONS) regularly surveys its membership to identify key areas of research focus that then guide the work of nurse investigators (LoBiondo-Wood et al., 2014; ONS Research Agenda Team, 2009). Unfortunately, the shortage of nurse scientists, particularly in oncology nursing, continues to increase as senior doctoral faculty reach retirement age and doctoral education program development remains stagnant (Glasgow & Dreher, 2010; LoBiondo-Wood et al., 2014). This shortage has and will continue to lead to gaps in the generation and implementation of new knowledge, negatively affecting the quality of patient care. As a result, an urgent need exists for innovative and quality doctoral educational programs to develop nurse scientists (Moore & Badger, 2014).

  7. Hiring appropriate providers for different populations: acute care nurse practitioners.

    PubMed

    Haut, Cathy; Madden, Maureen

    2015-06-01

    Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. ©2015 American Association of Critical-Care Nurses.

  8. 42 CFR 405.2414 - Nurse practitioner, physician assistant, and certified nurse midwife services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Nurse practitioner, physician assistant, and... practitioner, physician assistant, and certified nurse midwife services. (a) Professional services are payable..., physician assistant, or certified nurse midwife who is employed by, or receives compensation from, the RHC...

  9. Gender differences in nurse practitioner salaries.

    PubMed

    Greene, Jessica; El-Banna, Majeda M; Briggs, Linda A; Park, Jeongyoung

    2017-11-01

    While male nurses have been shown to earn considerably more than female nurses, there is less evidence on gender disparities in salary among nurse practitioners (NPs). This study examines whether the gender gap in NP salaries persists after controlling for differences in work setting and demographic factors. We analyzed the relationship between gender and salary (2011 pretax earnings) among 6591 NPs working as NPs at least 35 h per week, using the 2012 National Sample Survey of Nurse Practitioners. We first conducted bivariate regression analyses examining the relationship between gender and earnings, and then developed a multivariate model that controlled for individual differences in demographic and work characteristics. Male NPs earned $12,859 more than female NPs, after adjusting for individual differences in demographics and work characteristics. The gender gap was $7405 for recent NP graduates, and grew over time. Male NPs earned significantly more than female NPs across all clinical specialty areas. The gender disparities in NP salaries documented here regardless of professional seniority or clinical area should spark healthcare organizations to conduct pay equity assessments of their employees' salaries to identify and ameliorate pay inequality. ©2017 American Association of Nurse Practitioners.

  10. Truth-telling to patients' terminal illness: what makes oncology nurses act individually?

    PubMed

    Huang, Shu-He; Tang, Fu-In; Liu, Chang-Yi; Chen, Mei-Bih; Liang, Te-Hsin; Sheu, Shuh-Jen

    2014-10-01

    Nurses encounter the challenge of truth-telling to patients' terminal illness (TTPTI) in their daily care activities, particularly for nurses working in the pervasive culture of family protectiveness and medical paternalism. This study aims to investigate oncology nurses' major responses to handling this issue and to explore what factors might explain oncology nurses' various actions. A pilot quantitative study was designed to describe full-time nurses' (n = 70) truth-telling experiences at an oncology centre in Taipei. The potential influencing factors of nurses' demographic data, clinical characteristics, and truth-telling attitudes were also explored. Most nurses expressed that truth-telling was a physician's responsibility. Nevertheless, 70.6% of nurses responded that they had performed truth-telling, and 20 nurses (29.4%) reported no experience. The reasons for inaction were "Truth-telling is not my duty", "Families required me to conceal the truth", and "Truth-telling is difficult for me". Based on a stepwise regression analysis, nurses' truth-telling acts can be predicted based on less perceived difficulty of talking about "Do not resuscitate" with patients, a higher perceived authorisation from the unit, and more oncology work experience (adjusted R² = 24.1%). Oncology care experience, perceived comfort in communication with terminal patients, and unit authorisation are important factors for cultivating nurses' professional accountability in truth-telling. Nursing leaders and educators should consider reducing nursing barriers for truth-telling, improving oncology nurses' professional accountability, and facilitating better quality care environments for terminal patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Nurse practitioners' perceptions and participation in pharmaceutical marketing.

    PubMed

    Crigger, Nancy; Barnes, Kristen; Junko, Autumn; Rahal, Sarah; Sheek, Casey

    2009-03-01

    This paper reports on a study conducted to describe family nurse practitioners' perceptions towards and participation in pharmaceutical marketing and to explore the relationships among related variables. The pharmaceutical industry's intense global marketing strategies have resulted in widespread concern in healthcare professionals and professional groups, sectors of the public in many countries, and in the World Health Organization. Research on healthcare providers' participation in pharmaceutical marketing indicates that these relationships are conflicts of interests and compromise healthcare providers' prescribing practices and trust. Nursing, as a discipline, appears to be slow to address the impact of pharmaceutical marketing on nursing practice. Questionnaires about perceptions and participation in pharmaceutical marketing were completed by a random sample of 84 licensed family nurse practitioners in the United States of America in 2007. Family nurse practitioners viewed pharmaceutical company marketing uncritically as educational and beneficial. They also perceived other providers but not themselves as influenced by pharmaceutical marketing. The findings supported those found in previous research with nurses and physicians. Lack of education, participation in marketing and psychological and social responses may impede family nurse practitioners' ability to respond critically and appropriately to marketing strategies and the conflict of interest it creates.

  12. Developing family planning nurse practitioner protocols.

    PubMed

    Hawkins, J W; Roberto, D

    1984-01-01

    This article focuses on the process of development of protocols for family planning nurse practitioners. A rationale for the use of protocols, a definition of the types and examples, and the pros and cons of practice with protocols are presented. A how-to description for the development process follows, including methods and a suggested tool for critique and evaluation. The aim of the article is to assist nurse practitioners in developing protocols for their practice.

  13. What does it mean to be an oncology nurse? Reexamining the life cycle concepts.

    PubMed

    Cohen, Marlene Z; Ferrell, Betty R; Vrabel, Mark; Visovsky, Constance; Schaefer, Brandi

    2010-09-01

    To summarize the current research pertaining to the concepts initially examined by the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force and related projects completed in 1994. Published articles on the 21 concepts from the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force work. Research published in English from 1995-2009 was obtained from PubMed, CINAHL(R), PsycINFO, ISI Science, and EBSCO Health Source(R): Nursing/Academic Edition databases. Most of the concepts identified from the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force have been examined in the literature. Relationships and witnessing suffering were common concepts among studies of the meaning of oncology nursing. Nurses provide holistic care, and not surprisingly, holistic interventions have been found useful to support nurses. Interventions included storytelling, clinical support of nurses, workshops to find balance in lives, and dream work. Additional support comes from mentoring. The research identified was primarily descriptive, with very few interventions reported. Findings have been consistent over time in diverse countries. This review indicates that although the healthcare system has changed significantly in 15 years, nurses' experiences of providing care to patients with cancer have remained consistent. The need for interventions to support nurses remains.

  14. Reliability and validity of the Nurse Practitioners' Roles and Competencies Scale.

    PubMed

    Lin, Li-Chun; Lee, Sheuan; Ueng, Steve Wen-Neng; Tang, Woung-Ru

    2016-01-01

    The objective of this study was to test the reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale. The role of nurse practitioners has attracted international attention. The advanced nursing role played by nurse practitioners varies with national conditions and medical environments. To date, no suitable measurement tool has been available for assessing the roles and competencies of nurse practitioners in Asian countries. Secondary analysis of data from three studies related to nurse practitioners' role competencies. We analysed data from 563 valid questionnaires completed in three studies to identify the factor structure of the Nurse Practitioners' Roles and Competencies Scale. To this end, we performed exploratory factor analysis using principal component analysis extraction with varimax orthogonal rotation. The internal consistency reliabilities of the overall scale and its subscales were examined using Cronbach's alpha coefficient. The scale had six factors: professionalism, direct care, clinical research, practical guidance, medical assistance, as well as leadership and reform. These factors explained 67·5% of the total variance in nurse practitioners' role competencies. Cronbach's alpha coefficient for the overall scale was 0·98, and those of its subscales ranged from 0·83-0·97. The internal consistency reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale were good. The high internal consistency reliabilities suggest item redundancy, which should be minimised by using item response theory to enhance the applicability of this questionnaire for future academic and clinical studies. The Nurse Practitioners' Roles and Competencies Scale can be used as a tool for assessing the roles and competencies of nurse practitioners in Taiwan. Our findings can also serve as a reference for other Asian countries to develop the nurse practitioner role. © 2015 John Wiley & Sons Ltd.

  15. Effectiveness of a psycho-oncology training program for oncology nurses: a randomized controlled trial.

    PubMed

    Kubota, Yosuke; Okuyama, Toru; Uchida, Megumi; Umezawa, Shino; Nakaguchi, Tomohiro; Sugano, Koji; Ito, Yoshinori; Katsuki, Fujika; Nakano, Yumi; Nishiyama, Takeshi; Katayama, Yoshiko; Akechi, Tatsuo

    2016-06-01

    Oncology nurses are expected to play an important role in psychosocial care for cancer patients. The aim of this study was to examine whether a novel training program aimed at enhancing oncology nurses' ability to assess and manage common psychological problems in cancer patients would improve participants' self-reported confidence, knowledge, and attitudes regarding care of patients with common psychological problems (trial register: UMIN000008559). Oncology nurses were assigned randomly to either the intervention group (N = 50) or the waiting list control group (N = 46). The intervention group received a 16-h program, the content of which focused on four psychological issues: normal reactions, clinically significant distress, suicidal thoughts, and delirium. Each session included a role-play exercise, group work, and didactic lecture regarding assessment and management of each problem. Primary outcomes were changes in self-reported confidence, knowledge, and attitudes toward the common psychological problems between pre-intervention and 3 months post-intervention. Secondary outcomes were job-related stress and burnout. Intervention acceptability to participants was also assessed. In the intervention group, confidence and knowledge but not attitudes were significantly improved relative to the control group. No significant intervention effects were found for job- related stress and burnout. A high percentage (98%) of participants considered the program useful in clinical practice. This psycho-oncology training program improved oncology nurses' confidence and knowledge regarding care for patients with psychological problems. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Providing grief resolution as an oncology nurse retention strategy: a literature review.

    PubMed

    Hildebrandt, Lori

    2012-12-01

    Oncology nurses play a pivotal role in optimizing care provided to patients at the end of life (EOL). Although oncology nurses commonly provide EOL care and witness deaths of patients that they have maintained long-standing relationships with, they are frequently excluded from grief resolution endeavors. With a worldwide shortage of oncology nurses, retention is paramount to ensuring that the care patients with cancer receive is not jeopardized. Various strategies were identified to resolve grief and increase nurse retention, including creating supportive work environments, debriefing with colleagues, providing EOL and grief education, and altering patient care assignments. Future research on emerging technologies and their effects on oncology nurse coping and retention strategies also was suggested.

  17. Central venous access devices: an investigation of oncology nurses' troubleshooting techniques.

    PubMed

    Mason, Tina M; Ferrall, Sheila M; Boyington, Alice R; Reich, Richard R

    2014-08-01

    Experienced oncology nurses use different troubleshooting techniques for clearing occluded central venous access devices (CVADs) with varying degrees of success. The purpose of this study was to explore troubleshooting techniques used for clearing occluded CVADs by experienced oncology RNs and identify the perceived effectiveness of each technique. An invitation for a web-based survey was sent to select RN members of the Oncology Nursing Society. All nurses (N = 224) reported asking patients to raise and/or move their arm. Most nurses asked patients to lie down, cough, and take deep breaths. Respondents considered instilling a thrombolytic agent to be the most effective technique. No associations were found between techniques and respondents' years in oncology nursing, work setting, certification, or academic degree. The findings contribute to knowledge about care of patients with occluded devices and will help formulate direction for additional investigation of CVADs. Establishing the appropriateness of practice-related troubleshooting techniques may eliminate unnecessary steps and save nursing time. Educating nurses on the topic will also help reduce techniques that are not expected to yield results or are contraindicated.

  18. General practitioners' experiences as nursing home medical consultants.

    PubMed

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-03-01

    To describe general practitioners' experiences of being the principal physician responsible for a nursing home. Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety. The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems. © 2016 Nordic College of Caring Science.

  19. Marketing strategies of nurse practitioners in New York State.

    PubMed

    Nolan, C M; Conway, L G; Litteer, T B; Peterson-Sweeney, K; Richardson, K; Smith, S W; Stoler, P M

    1988-08-01

    As competition within the health care field increases, marketing strategies are becoming more important for all members of the health care team, including nurse practitioners. The purpose of this research was to identify marketing strategies being used by nurse practitioners in New York state. A total of 285 practitioners responded to a survey containing questions related to marketing techniques traditionally used in the business world: service differentiation, market segmentation and practice promotion. A majority of respondents did not report using many of the marketing strategies contained in the survey, although most nurse practitioners did report identifying themselves as primary care providers in one-on-one interactions with clients. Significantly higher marketing scores were found for nurse practitioners who attended a workshop or seminar on marketing strategies, had three or more years of experience, or who practiced in private outpatient settings.

  20. Oncology Nurse Navigation: Results of the 2016 Role Delineation Study.

    PubMed

    Lubejko, Barbara G; Bellfield, Sonia; Kahn, Elisa; Lee, Carrie; Peterson, Nicole; Rose, Traudi; Murphy, Cynthia Miller; McCorkle, Michele

    2017-02-01

    In 2011, an oncology nurse navigator (ONN) role delineation survey (RDS) was conducted by the Oncology Nursing Society (ONS) when the role was relatively new to oncology. Results did not demonstrate a unique skill set for the ONN; however, since then, the role has expanded. ONS and the Oncology Nursing Certification Corporation partnered in 2016 to complete an RDS of ONNs to redefine the role and determine the need for an ONN certification examination. A structured RDS was conducted using a formal consensus-building process. A survey was developed and released to examine the specific tasks, knowledge, and skills for the ONN as well as to determine which role possesses more responsibility for the tasks. The ONN role is evolving, and more was learned about its key tasks, including differences in the responsibilities of the ONN and the clinical or staff nurse. However, the RDS did not find an adequate difference in the knowledge required by the ONN and the clinical or staff nurse to support the need for a separate ONN certification.

  1. Nurse practitioner integration: Qualitative experiences of the change management process.

    PubMed

    Lowe, Grainne; Plummer, Virginia; Boyd, Leanne

    2018-04-30

    The aim of this qualitative research was to explore perceptions of organisational change related to the integration of nurse practitioners from key nursing stakeholders. The ongoing delivery of effective and efficient patient services is reliant upon the development and sustainability of nurse practitioner roles. Examination of the factors contributing to the underutilization of nurse practitioner roles is crucial to inform future management policies. A change management theory is used to reveal the complexity involved. Qualitative interviews were undertaken using a purposive sampling strategy of key stakeholders. Thematic analysis was undertaken and key themes were correlated to the theoretical framework. The results confirm the benefits of nurse practitioner roles, but suggest organisational structures and embedded professional cultures present barriers to full role optimization. Complicated policy processes are creating barriers to the integration of nurse practitioner roles. The findings increase understanding of the links between strategic planning, human resource management, professional and organisational cultures, governance and politics in change management. Effective leadership drives the change process through the ability to align key components necessary for success. Sustainability of nurse practitioners relies on recognition of their full potential in the health care team. The results of this study highlight the importance of management and leadership in the promotion of advanced nursing skills and experience to better meet patient outcomes. The findings reinforce the potential of nurse practitioners to deliver patient centred, timely and efficient health care. © 2018 John Wiley & Sons Ltd.

  2. Exploring communication difficulties in pediatric hematology: oncology nurses.

    PubMed

    Citak, Ebru Akgun; Toruner, Ebru Kilicarslan; Gunes, Nebahat Bora

    2013-01-01

    Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.

  3. Nurse Practitioner-Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain.

    PubMed

    Norful, Allison A; de Jacq, Krystyna; Carlino, Richard; Poghosyan, Lusine

    2018-05-01

    Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physicians and specialists. Because nurse practitioners are increasingly managing patient care as independent clinicians, our study objective was to propose a model of nurse practitioner-physician comanagement. We conducted a literature search using the following key words: comanagement; primary care; nurse practitioner OR advanced practice nurse. From 156 studies, we extracted information about nurse practitioner-physician comanagement antecedents, attributes, and consequences. A systematic review of the findings helped determine effects of nurse practitioner-physician comanagement on patient care. Then, we performed 26 interviews with nurse practitioners and physicians to obtain their perspectives on nurse practitioner-physician comanagement. Results were compiled to create our conceptual nurse practitioner-physician comanagement model. Our model of nurse practitioner-physician comanagement has 3 elements: effective communication; mutual respect and trust; and clinical alignment/shared philosophy of care. Interviews indicated that successful comanagement can alleviate individual workload, prevent burnout, improve patient care quality, and lead to increased patient access to care. Legal and organizational barriers, however, inhibit the ability of nurse practitioners to practice autonomously or with equal care management resources as primary care physicians. Future research should focus on developing instruments to measure and further assess nurse practitioner-physician comanagement in the primary care practice setting. © 2018 Annals of Family Medicine, Inc.

  4. Exploring the role of advanced nurse practitioners in leadership.

    PubMed

    Anderson, Claire

    2018-05-02

    There have been several changes to healthcare services in the UK over recent years, with rising NHS costs and increasing demands on healthcare professionals to deliver high-quality care. Simultaneously, public inquiries have identified suboptimal leadership throughout the NHS, which has been linked to a lack of clear leadership across the healthcare professions. In nursing, the role of the advanced nurse practitioner is regarded as a solution to this leadership challenge. This article examines the background to the development of the advanced nurse practitioner role. It also explores the various factors that may affect nurse leadership and the role of the advanced nurse practitioner, including professional identity, gender, nursing's strategic influence, clinical outcomes, and recruitment and retention. The article concludes that while advanced nurse practitioners can positively influence clinical outcomes and cost efficiency, they must also be adequately prepared to undertake a leadership role. © 2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  5. Geriatric Oncology Program Development and Gero-Oncology Nursing.

    PubMed

    Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

    2016-02-01

    To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Diagnostic Reasoning and Cognitive Biases of Nurse Practitioners.

    PubMed

    Lawson, Thomas N

    2018-04-01

    Diagnostic reasoning is often used colloquially to describe the process by which nurse practitioners and physicians come to the correct diagnosis, but a rich definition and description of this process has been lacking in the nursing literature. A literature review was conducted with theoretical sampling seeking conceptual insight into diagnostic reasoning. Four common themes emerged: Cognitive Biases and Debiasing Strategies, the Dual Process Theory, Diagnostic Error, and Patient Harm. Relevant cognitive biases are discussed, followed by debiasing strategies and application of the dual process theory to reduce diagnostic error and harm. The accuracy of diagnostic reasoning of nurse practitioners may be improved by incorporating these items into nurse practitioner education and practice. [J Nurs Educ. 2018;57(4):203-208.]. Copyright 2018, SLACK Incorporated.

  7. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payment for a physician assistant's, nurse... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse specialists...

  8. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payment for a physician assistant's, nurse... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse specialists...

  9. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for a physician assistant's, nurse... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse specialists...

  10. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payment for a physician assistant's, nurse... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse specialists...

  11. Team Development Manual. Family Nurse Practitioner/Physician Assistant Program.

    ERIC Educational Resources Information Center

    Dostal, Lori

    A manual is presented to help incorporate team development into training programs for nurse practitioners, physician assistants, and primary care physicians. It is also directed to practitioners who wish to improve teamwork and is designed to improve the utilization of the nurse practitioners and physician assistants. A group of one or more…

  12. Oncology nurses' communication challenges with patients and families: A qualitative study.

    PubMed

    Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A; Parker, Patricia A; Bylund, Carma L

    2016-01-01

    The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. The core role of the nurse practitioner: practice, professionalism and clinical leadership.

    PubMed

    Carryer, Jenny; Gardner, Glenn; Dunn, Sandra; Gardner, Anne

    2007-10-01

    To draw on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. Enacted legislation provides for mutual recognition of qualifications, including nursing, between New Zealand and Australia. As the nurse practitioner role is relatively new in both countries, there is no consistency in role expectation and hence mutual recognition has not yet been applied to nurse practitioners. A study jointly commissioned by both countries' Regulatory Boards developed information on the core role of the nurse practitioner, to develop shared competency and educational standards. Reporting on this study's process and outcomes provides insights that are relevant both locally and internationally. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner program curricula and interviews with 15 nurse practitioners from the two countries. Data were analysed according to the appropriate standard for each data type and included both deductive and inductive methods. The data were aggregated thematically according to patterns within and across the interview and material data. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care. A clearly articulated and research informed description of the core role of the nurse practitioner provides the basis for development of educational and practice competency standards. These research findings provide

  14. New Trends and Recent Care Approaches in Pediatric Oncology Nursing

    PubMed Central

    Toruner, Ebru Kilicarslan; Altay, Naime

    2018-01-01

    Increased incidence of children diagnosed with cancer and survivors was an impact on changes in pediatric hemato-oncology nursing care. In this review article, it is aimed to investigate the new trends and recent care approaches in pediatric oncology nursing. The recent care topics were common in the literature as family-centered care, technology-based care, program development, primary care of child, health-care provider, survivors and home care, and nonpharmacological care. All of the topics contribute to perform evidence-based care for health promotion and well-being in pediatric hemato-oncology nursing. Research reviews showed that many current topics for the care of children and their parents have entered in the literature. There is a need for more randomized controlled studies to improve the level of evidence of new nursing approaches. PMID:29607375

  15. A case study of nurse practitioner care compared to general practitioner care for children with respiratory tract infections.

    PubMed

    van Vugt, Saskia F; van de Pol, Alma C; Cleveringa, Frits G W; Stellato, Rebecca K; Kappers, Marieke P; de Wit, Niek J; Damoiseaux, Roger A M J

    2018-05-13

    To compare quality of care provided by nurse practitioners with care provided by general practitioners for children with respiratory tract infections in the Netherlands. Nurse practitioners increasingly manage acute conditions in general practice, with opportunities for more protocolled care. Studies on quality of nurse practitioners' care for children with respiratory tract infections are limited to the US health care system and do not take into account baseline differences in illness severity. Retrospective observational cohort study. Data were extracted from electronic healthcare records of children 0-6 years presenting with respiratory tract infection between January-December 2013. Primary outcomes were antibiotic prescriptions and early return visits. Generalized estimating equations were used to correct for potential confounders. A total of 899 respiratory tract infection consultations were assessed (168 seen by nurse practitioner; 731 by general practitioners). Baseline characteristics differed between these groups. Overall antibiotic prescription and early return visit rates were 21% and 24%, respectively. Adjusted odds ratio for antibiotic prescription after nurse practitioner vs. general practitioner delivered care was 1.40 (95% confidence interval 0.89-2.22) and for early return visits 1.53 (95% confidence interval 1.01-2.31). Important confounder for antibiotic prescription was illness severity. Presence of wheezing was a confounder for return visits. Complication and referral rates did not differ. Antibiotic prescription, complication and referral rates for paediatric respiratory tract infection consultations did not differ significantly between nurse practitioner and general practitioner consultations, after correction for potential confounders. General practitioners, however, see more severely ill children and have a lower return visit rate. A randomised controlled study is needed to determine whether nurse practitioner care quality is truly non

  16. 42 CFR 418.304 - Payment for physician and nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for physician and nurse practitioner... Payment for physician and nurse practitioner services. (a) The following services performed by hospice physicians and nurse practitioners are included in the rates described in § 418.302: (1) General supervisory...

  17. Systematic review on the relationship between the nursing shortage and job satisfaction, stress and burnout levels among nurses in oncology/haematology settings.

    PubMed

    Toh, Shir Gi; Ang, Emily; Devi, M Kamala

    2012-06-01

    To establish the best available evidence regarding the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings. Electronic databases (CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar) were searched using a three-step strategy in order to identify published and unpublished studies conducted between 1990 and 2010. Grey literature was excluded in the review. The identified studies were evaluated using standardised critical appraisal instruments from the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). A total of seven descriptive and descriptive-correlational studies published in English were included and data were presented in a narrative summary. Findings revealed a positive bidirectional relationship between the nursing shortage and oncology registered nurses' (RNs') job dissatisfaction, stress and burnout. The extent of the job dissatisfaction, stress and burnout experienced by the oncology RNs and their perception of staffing inadequacy differed according to their demography and work settings. Particularly, nurses who had higher qualifications and positions, who worked full-time and who worked in inpatient settings and non-Magnet hospitals were more likely to attribute staffing inadequacy as one of the main contributing factors for their job dissatisfaction, stress and burnout. This led to a rise in the number of oncology RNs leaving the speciality. Within the constraints of the study and the few quality papers available, it appears that oncology RNs who worked in substandard staffing units often express job dissatisfaction, stress and burnout, which prompt them to seek new employment out of the oncology specialty. This entails a pressing need for organisations to ensure sufficient staffing in oncology/haematology settings, in order to ensure that quality patient care

  18. Understanding nurse practitioner autonomy.

    PubMed

    Weiland, Sandra A

    2015-02-01

    This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.

  19. Canadian oncology nurse work environments: part II.

    PubMed

    Bakker, Debra; Conlon, Michael; Fitch, Margaret; Green, Esther; Butler, Lorna; Olson, Karin; Cummings, Greta

    2012-03-01

    In the aftermath of healthcare restructuring, it is important to pay attention to nurses' perceptions of workplace and professional practice factors that attract nurses and influence their retention. Continuing constraints on cancer care systems make the issue of health human resources an ongoing priority. This paper presents the findings of a follow-up study of a cohort of Canadian oncology nurses that aimed to compare nurses' perceptions of their work environment, job satisfaction and retention over a two-year period. Participants of the follow-up survey represented 65% (397/615) of the initial cohort. Many similar perceptions about the work environment were found over two years; however, at follow-up a larger proportion of nurses reported an absence of enough RNs to provide quality care and a lack of support for innovative ideas. With respect to career status, only 6% (25/397) of the follow-up sample had left oncology nursing. However, the proportion of nurses declaring an intention to leave their current job increased from 6.4% (39/615) on the initial survey to 26% (102/397) on the follow-up survey. Findings suggest that decision-makers need to use both the growing body of workplace knowledge and the input from staff nurses to implement changes that positively influence nurse recruitment and retention. Future research should focus on the implementation and evaluation of strategies that address workplace issues such as nurse staffing adequacy, leadership and organizational commitment.

  20. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists' services and services furnished incident to their professional... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's...

  1. Empathy, Burnout, Demographic Variables and their Relationships in Oncology Nurses.

    PubMed

    Taleghani, Fariba; Ashouri, Elaheh; Saburi, Morteza

    2017-01-01

    Development of nurse-patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. Mean nurses' empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score ( r = -0.189, P = 0.04), depersonalization ( r = -0.218, P = 0.02), and personal accomplishment ( r = -0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment ( P = 0.02), depersonalization ( P = 0.04), and emotional exhaustion ( P = 0.14), respectively. The most influential demographic factor on empathy was work experience ( r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score ( f = 2.39, P = 0.045) and their burnout was lower ( f = 2.56, P = 0.04). Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses.

  2. The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

    PubMed

    Taylor, Anita; Staruchowicz, Lynda

    This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much

  3. Job satisfaction of nurse practitioners: an analysis using Herzberg's theory.

    PubMed

    Koelbel, P W; Fuller, S G; Misener, T R

    1991-04-01

    The current sociopolitical and economic forces affecting health care may lead to job dissatisfaction among nurse practitioners, according to results of a South Carolina study. A mailed survey that consisted of the Index of Job Satisfaction and the Minnesota Satisfaction Questionnaire--Short Form was used to test Herzberg's dual-factor theory of job satisfaction. A response rate of 90 percent was attained, with a final sample of 132 nurse practitioners and midwives. Consistent with the predictions of Herzberg's model, intrinsic factors served as sources of job satisfaction, while extrinsic factors were the primary sources of job dissatisfaction. Nurse practitioners in the sample reported a moderate amount of satisfaction with their "overall jobs." Suggestions are provided for ways both nurse practitioners and health administrators can enhance job satisfaction.

  4. Social Interaction and Collaboration among Oncology Nurses.

    PubMed

    Moore, Jane; Prentice, Dawn; McQuestion, Maurene

    2015-01-01

    Collaboration is a complex process influenced by organizational, professional, interpersonal, and personal factors. Research has demonstrated that collaboration may also be influenced by social factors. Nurses spend much of their time working in collaborative teams, yet little is known about how they socially interact in practice. This qualitative case study explored nurse perceptions of social interaction in relation to collaboration. Data were collected using telephone interviews and documentary reviews from fourteen oncology nurses employed at one cancer center in Canada. Thematic analysis revealed two themes: knowing you is trusting you and formal and informal opportunities. Nurses reported that social interaction meant getting to know someone personally as well as professionally. Social interaction was enacted inside of work during breaks/meals and outside of work at planned events. Social interaction was facilitated by having a long-term current and/or previous professional and personal relationship. The barriers to social interaction included a lack of time to get to know each other, workload issues, and poor interpersonal skills. Findings suggest that social interaction is an important factor in the collaborative relationship among oncology nurses. Nurse leaders need to promote social interaction opportunities and facilitate educational sessions to improve social and interpersonal skills.

  5. Increasing minority patient participation in cancer clinical trials using oncology nurse navigation.

    PubMed

    Holmes, Dennis Ricky; Major, Jacquelyn; Lyonga, Doris Efosi; Alleyne, Rebecca Simone; Clayton, Sheilah Marie

    2012-04-01

    Residential distance from an academic or cancer center is a significant barrier to minority patient participation in cancer research. Most cancer clinical trials (CTs) are only accessible at academic and cancer centers, yet most cancer patients receive treatment in their home communities where access to CTs may be limited. Oncology nurse navigation is an innovative approach for increasing minority CT participation by facilitating access to cancer CTs in communities where minority patients live. The purpose of this study was to evaluate the impact of oncology nurse navigation on community-based recruitment of black patients to breast cancer CTs at a major cancer center. We merged the roles of a traditional oncology research nurse and a professional patient navigator to create a novel health care provider role, the oncology nurse navigator. The primary duties of the oncology nurse navigator were to engage black cancer patients in the offices of their community physicians and to collaborate with community physicians to increase black patient participation in cancer research. The oncology nurse navigator played a key role in all phases of the CT participation process (e.g., screening for eligibility and completion of informed consent and clinical research forms) and guided each patient around barriers in the health care system. The accrual of eligible patients to breast cancer CTs was used to assess the impact of oncology nurse navigation on community-based recruitment of blacks to cancer CTs. Between January 2007 and December 2008, a total of 132 black breast cancer patients were screened by a single oncology nurse navigator for eligibility to University of Southern California-sponsored breast cancer CTs. Fifty-nine patients were eligible for CTs, and each was invited to participate in 1 or more CTs for which they were eligible. Fifty-one of 59 eligible black patients (86% of eligible patients) were enrolled to 1 or more research protocols. The estimated cost per

  6. Evaluating the Outcomes of Advanced Neonatal Nurse Practitioner Programmes.

    ERIC Educational Resources Information Center

    Redshaw, Margaret; Hart, Bev; Harvey, Merryl; Harris, Anne

    The outcomes of advanced neonatal nurse practitioner (ANNP) programs in the United Kingdom were examined. The different programs of education currently available for nurses wishing to become ANNPs were compared, and the outcomes of ANNP programs, as demonstrated in the levels of performance of practitioners undertaking different programs, were…

  7. A Cooperative Education Program for Nurse Practitioners/Physician's Assistants.

    ERIC Educational Resources Information Center

    Fowkes, Virginia; And Others

    1979-01-01

    Traditionally, nurse practitioners and physician's assistants have been trained separately. In l977, the Family Nurse Practitioner Program at the University of California, Davis, and the Primary Care Associate Program at Stanford University merged clinical curricula. The cooperative program is described and its first year evaluated. (Author/JMD)

  8. Defining the unique role of the specialist district nurse practitioner.

    PubMed

    Barrett, Anne; Latham, Dinah; Levermore, Joy

    2007-10-01

    Due to the reorganization of primary care trusts across the country, certain trusts proposed a reduction in the specialist district nurse practitioner numbers in favour of less qualified community nurses and health care assistants. Such proposals in one PCT were blocked, partly in response to documentation compiled by practitioners at the sharp end of nursing practice. With the new agenda of practice based commissioning, it is imperative that commissioners and management alike are aware of the scope of specialist district nurse practitioners. This is the first of a series of articles looking at specific case histories where the role of the district nurse is highlighted. It is the intention to stress the importance of the clinical expertise and confidence required by the district nurse to care for patients with complex needs in the community.

  9. Nurse Practitioners, Physician Assistants and Certified Nurse Midwives in California.

    ERIC Educational Resources Information Center

    California Univ., San Francisco. Center for California Health Workforce Studies.

    Surveys were mailed to all nurse practitioners (NPs), physician assistants (PAs) and certified nurse midwives (CNMs) registered in California, asking questions about education, labor force participation, specialty, and location and type of practice site, as well as the demographic characteristics of these professionals and their patients. Response…

  10. Practice Management Skills for the Nurse Practitioner.

    ERIC Educational Resources Information Center

    Sportsman, Susan; Hawley, Linda J.; Pollock, Susan; Varnell, Gayle

    2001-01-01

    An expert panel identified 20 business concepts important for a family nurse practitioner curriculum. A focus group of practitioners verified the concepts and clarified relevant information to be taught. The business concepts center on management and operations of a clinical practice. (SK)

  11. Practice patterns and organizational commitment of inpatient nurse practitioners.

    PubMed

    Johnson, Janet; Brennan, Mary; Musil, Carol M; Fitzpatrick, Joyce J

    2016-07-01

    Nurse practitioners (NPs) deliver a wide array of healthcare services in a variety of settings. The purpose of this study was to examine the practice patterns and organizational commitment of inpatient NPs. A quantitative design was used with a convenience sample (n = 183) of NPs who attended the American Association of Nurse Practitioners (AANP) national conference. The NPs were asked to complete a demographic questionnaire, the Practice Patterns of Acute Nurse Practitioners tool and the Organizational Commitment Questionnaire. Over 85% of inpatient practice time consists of direct and indirect patient care activities. The remaining nonclinical activities of education, research, and administration were less evident in the NP's workweek. This indicates that the major role of inpatient NPs continues to be management of acutely ill patients. Moderate commitment was noted in the Organizational Commitment Questionnaire. Supportive hospital/nursing leadership should acknowledge the value of the clinical and nonclinical roles of inpatient NPs as they can contribute to the operational effectiveness of their organization. By fostering the organizational commitment behaviors of identification, loyalty, and involvement, management can reap the benefits of these professionally dedicated providers. ©2015 American Association of Nurse Practitioners.

  12. Development of a Post-Master's Fellowship Program in Oncology Nursing Education. Final Report.

    ERIC Educational Resources Information Center

    Siegele, Dorothy; Henderson, Billie

    A one-year Post-Master's Fellowship in Oncology Nursing Education for nurse educators was developed through the collaboration of San Jose State University (California) and University of Alabama at Birmingham. The project was designed to: develop or update undergraduate/graduate oncology nursing programs; provide continuing education for practicing…

  13. Building leadership capacity in advanced nurse practitioners - the role of organisational management.

    PubMed

    Elliott, Naomi

    2017-01-01

    To highlight the organisation-level management's role in building leadership capacity in advanced nurse practitioners and the need for appropriate supports to increase their becoming leaders. Little is published about the role of organisation-level management in building leadership capacity and in developing the next generation of nurse leaders. In times of economic constraint, organisations need to focus their efforts on targeted leadership initiatives. Advanced nurse practitioners are ideally positioned to act as leaders both within and beyond the health care organisation. From the available research evidence, several support structures and mechanisms are identified as enablers for advanced nurse practitioners to enact their leadership role. Health care organisations need to include building leadership capacity as a priority in their strategic plan and take action to build-up the level of advanced nurse practitioner leadership. Nurse executives have a vital role in influencing the organisation's strategic plan and making a business case for prioritising leadership capacity building within advanced nurse practitioners. A challenge for nurse executives faced with competing service and leadership development demands, involves strategic decision-making regarding whether the advanced nurse practitioner's role is limited to service delivery or its potential in leading health care reforms is realised. © 2016 John Wiley & Sons Ltd.

  14. Exploring the scope of oncology specialist nurses' practice in the UK.

    PubMed

    Farrell, Carole; Molassiotis, Alexander; Beaver, Kinta; Heaven, Cathy

    2011-04-01

    Revolutionary changes have taken place to nurses' roles and clinical responsibilities over the past decade, leading to new ways of working and higher levels of nursing practice. However, despite the development of nurse-led clinics and services within oncology there has been little formal evaluation. A survey of 103 UK oncology specialist nurses was undertaken to explore their scope of practice, with emphasis on nurse-led services. The survey highlighted significant developments within nurses' roles and nurse-led services, although there was a distinct lack of clarity between nurses' titles and their roles/responsibilities. Most nurses had extended their role. However there were significant differences in the nature of clinical practice, such as clinical examination and nurse prescribing. Overall, new roles were greatly valued by the multidisciplinary team, reducing waiting times and providing benefits for patients. However other nurses felt frustrated by deficiencies in infrastructure and support, which often overshadowed potential benefits. There is a great diversity in oncology specialist nurses' roles; however lack of clarity in titles, training, competencies and responsibilities is creating confusion. Role developments and nurse-led clinics have been ad hoc and poorly evaluated. The introduction of a competency framework, national standards and a system of clinical appraisals seems key to providing increased transparency and vital safeguards for both nurses and patients. Without further exploration and evaluation of nurse-led initiatives it is difficult to fully appreciate their impact on patients, staff and service delivery. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Using vignettes to study nurse practitioners' performance in suspected domestic violence situations.

    PubMed

    Gagan, M J

    2000-01-01

    Vignettes have often been used to evaluate students or collect data in nursing research. The format is familiar to most nursing students as well as nurses and nurse researchers. This article presents the development and testing of the Nurse Practitioner Performance Tool (NPPT) which used vignettes as an approach to nurse practitioner performance evaluation. In this example, vignettes were used in a quasi-experimental design to collect data from Adult and Family Nurse Practitioners (A/FNP). The focus was on the diagnosis and intervention performance of the A/FNPs when addressing suspected cases of domestic violence.

  16. Level of burnout among nurses working in oncology in an Italian region.

    PubMed

    Quattrin, Rosanna; Zanini, Antonietta; Nascig, Ester; Annunziata, Maria; Calligaris, Laura; Brusaferro, Silvio

    2006-07-01

    To estimate the level of burnout among nurses working on oncology wards and to identify the risk factors of burnout and the strategies used to prevent and deal with stress. Descriptive study. Oncology wards in public hospitals in a northeastern Italian region. 100 nurses working on oncology wards. Head nurses of the oncology wards were personally informed about the aims of the study and were asked to distribute a questionnaire among the staff nurses and collect them after completion. The questionnaire had 58 items divided into three parts: sociodemographic and job characteristics of the population, the Maslach Burnout Inventory modified for Italian healthcare workers, and the respondents' perceptions about coping mechanisms and strategies adopted by the organization to help the nurses cope with stress. Levels of burnout according to the Maslach Burnout Inventory. The global response rate was 71% (100 of 140); 35% of the nurses had a high level of emotional exhaustion, 17% had a high level of depersonalization, and 11% had a high level of personal achievement. Significantly high levels of emotional exhaustion were found in nurses older than 40 with a working seniority of more than 15 years, those who had chosen to work on an oncology ward, and those who wanted another work assignment. The mean emotional exhaustion in subjects who identified lack of coordination (disorganization) as an important cause of stress was 24.5 (SD = 10.6), whereas the mean score in the nurses who did not cite disorganization as a cause of stress was 18.3 (SD = 12.0). An important cause of stress reported by nurses is poor organization; therefore, hospitals should focus attention on specific organizational aspects. Knowledge of the mechanisms of burnout and strategies to prevent and deal with them are important for nurses' psychophysical health and constitute a fundamental requirement in a policy that aims to improve quality in health services.

  17. Empathy, Burnout, Demographic Variables and their Relationships in Oncology Nurses

    PubMed Central

    Taleghani, Fariba; Ashouri, Elaheh; Saburi, Morteza

    2017-01-01

    Introduction: Development of nurse–patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. Materials and Methods: This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. Results: Mean nurses’ empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = −0.189, P = 0.04), depersonalization (r = −0.218, P = 0.02), and personal accomplishment (r = −0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04). Conclusions: Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses. PMID:28382057

  18. Are biochemistry interpretative comments helpful? Results of a general practitioner and nurse practitioner survey.

    PubMed

    Barlow, Ian M

    2008-01-01

    Adding or incorporating clinical interpretative comments on biochemistry results is widespread in UK laboratories; although this consumes considerable human resource, there is still little evidence to suggest that it is either effective or appreciated by our clinical colleagues. I therefore decided to survey our local general practitioners (GPs) and nurse practitioners to analyse whether they found biochemistry comments on reports helpful. A simple questionnaire was designed and sent to 159 GPs and 81 nurse practitioners asking them whether they found this activity useful for the limited range of test groups that we routinely comment on and also whether they would like to see commenting on more groups of tests. Overall, 49.6% of questionnaires were returned. Of these, there was overwhelming support for commenting on reports and 77% would like to see comments on a greater range of tests. Although adding clinical interpretative comments is very time-consuming for senior laboratory staff, there is overwhelming support of this activity among our GPs and nurse practitioner users; therefore, our local policy of routinely adding clinical comments will remain for the foreseeable future.

  19. Improving nurse practitioners' competence with genetics: Effectiveness of an online course.

    PubMed

    Whitt, Karen J; Macri, Charles; O'Brien, Travis J; Wright, Stephanie

    2016-03-01

    The purpose of this study was to assess the effectiveness of an online genetics course for improving nurse practitioners' knowledge, competence, and comfort with genetic principles and their application to clinical practice. A genetics knowledge test and survey were administered to 232 nurse practitioner students, between 2011 and 2013, before and after completing a 15-week online genetics course taught by a multidisciplinary team of instructors at a private east coast U.S. university. The 65-item survey allowed participants to rate competence regarding genetic principles, diseases, and terminology, as well as comfort performing various clinical tasks related to genetics. The 21-item knowledge test contained multiple choice questions regarding core competencies in genetics. Paired t-tests were used to compare mean pre- and postscores. Participants significantly increased postcourse knowledge (p < .001) and comfort with genetic core competencies and clinical skills related to genetics (p < .001). This study demonstrates the effectiveness of an online genetics course for increasing nurse practitioners' knowledge, competence, and confidence with genetics and identifies specific topics educators should consider when designing curricula for nurse practitioners. Findings from this study can improve genetics education for nurse practitioners, which will in turn improve patient health. ©2015 American Association of Nurse Practitioners.

  20. Social support and factors associated with self-efficacy among acute-care nurse practitioners.

    PubMed

    Hu, Sophia H; Yu, Ya-Mei; Chang, Wen-Yin; Lin, Yen-Kuang

    2018-02-01

    To investigate the relationship of nurse practitioners' social support as well as other factors associated with perceived self-efficacy. There is a growing demand for nurse practitioners in Taiwan, for whom self-perceived efficacy is associated with performance. Nevertheless, research on the self-efficacy and social support of nurse practitioners is limited. This is a cross-sectional survey study. Questionnaires were distributed to nurse practitioners in seven hospitals in northern Taiwan from May 2015 to March 2016. In total, data from 335 (78% return rate) certified nurse practitioners were analysed. Social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS) and the Job Content Questionnaire (JCQ), and perceived self-efficacy was measured by the General Self-Efficacy Scale (GSE). Data were analysed by ANOVAs with post hoc test and multiple linear regression. The mean score for self-efficacy was 27.60 ± 6.17. Support scores were 11.574 ± 2.37 for supervisors, 12.795 ± 1.92 for coworkers and 64.07 ± 10.16 for family, friends and significant others. nurse practitioners in the high monthly salary group had significantly higher self-efficacy than nurse practitioners in the medium and low monthly salary group (F = 8.99; p < .01). Social support from coworkers (β = 0.18, p < .01) and family, friends and significant others (β = 0.15, p < .01) and a higher monthly salary were significant factors. The self-efficacy of nurse practitioners in hospitals in Taiwan is insufficient. Monthly salary and levels of social support were found to contribute to nurse practitioners' self-efficacy. Thus, to enhance nurse practitioners' self-efficacy and work performance, nursing leaders should address these issues. The findings inform hospital administrators to be aware of the importance of salary in relation to nurse practitioners' perceptions of social support and self-efficacy. © 2017 John Wiley & Sons Ltd.

  1. Inclusion of disability-related content in nurse practitioner curricula.

    PubMed

    Smeltzer, Suzanne C; Blunt, Elizabeth; Marozsan, Heather; Wetzel-Effinger, Lisa

    2015-04-01

    To examine the integration of disability-content in a national sample of nurse practitioner curricula. Responses of National Organization of Nurse Practitioner Faculties (NONPF) members to an online 34-item survey designed to assess disability-related content included in nurse practitioner (NP) curricula; populations of people with disabilities addressed; models of disability; and resources used to teach about disability, facilitators and barriers to inclusion of disability, and respondents' assessment of the adequacy of coverage of disability in their programs. A survey used previously to assess integration of disability content in undergraduate nursing programs was modified to make it relevant to NP curricula. Nursing faculty and people with disability validated the survey to ensure its completeness and sensitivity to the disability community. Participating programs represent 111 (33.6%) NP programs. Lack of disability-related content reported by NP faculty in the majority of programs suggests that there is considerable room for improvement in efforts to address this often vulnerable population. Because people with disabilities can be found in any setting where health care is provided, all NPs need to be prepared to care for people with disabilities across the life span. Strategies need to be developed and implemented to increase the awareness of NP faculty about the health issues of people with disabilities and integration of disability-related content without disrupting existing overloaded NP curricula. © 2014 American Association of Nurse Practitioners.

  2. An exploration of the experience of compassion fatigue in clinical oncology nurses.

    PubMed

    Perry, Beth; Toffner, Greg; Merrick, Trish; Dalton, Janice

    2011-01-01

    Compassion fatigue (CF) is "debilitating weariness brought about by repetitive, empathic responses to the pain and suffering of others" (LaRowe, 2005, p. 21). The work performed by oncology nurses, and the experiences of the people they care for, place oncology nurses at high risk for CF (Pierce et al., 2007; Ferrell & Coyle, 2008). Thus oncology nurses were chosen as the study focus. This paper details a descriptive exploratory qualitative research study that investigated the experience of CF in Canadian clinical oncology registered nurses (RNs). A conceptual stress process model by Aneshensel, Pearlin, Mullan, Zarit, and Whitlatch (1995) that considers caregivers' stress in four domains provided the study framework (see Figure 1). Nineteen study participants were recruited through an advertisement in the Canadian Oncology Nursing Journal (CONJ). The advertisement directed potential participants to a university-based online website developed for this study. Participants completed a questionnaire and wrote a narrative describing an experience with CF and submitted these through the secure research website. Data were analyzed thematically. Five themes include: defining CF, causes of CF, factors that worsen CF, factors that lessen CF, and outcomes of CF. Participants had limited knowledge about CF, about lack of external support, and that insufficient time to provide high quality, care may precipitate CF. The gap between quality of care nurses wanted to provide and what they were able to do, compounded by coexisting physical and emotional stress, worsened CF. CF was lessened by colleague support, work-life balance, connecting with others, acknowledgement, and maturity and experience. Outcomes of CF included profound fatigue of mind and body, negative effects on personal relationships, and considering leaving the specialty. Recommendations that may enhance oncology nurse well-being are provided.

  3. Cancer patients' expressions of emotional cues and concerns and oncology nurses' responses, in an online patient-nurse communication service.

    PubMed

    Grimsbø, Gro Hjelmeland; Ruland, Cornelia M; Finset, Arnstein

    2012-07-01

    To (1) investigate emotional cues and concerns (C&C) of cancer patients expressed in e-mail communication with oncology nurses in an online patient-nurse communication service (OPNC), and (2) explore how nurses responded to patients' C&C. 283 e-messages sent from 38 breast and 22 prostate cancer patients and 286 e-responses from five oncology nurses were coded with the Verona Coding Definitions of Emotional Sequences. We identified 102 cues and 33 concerns expressed in patients' messages. Cues indicating expression of uncertainty or hope, occurred most frequently (in 38.5% of messages), followed by concerns (in 24.4% of messages). Nurses responded to 85.2% of patients' C&Cs; more than half of patients' C&Cs were met with a mixture of information giving and empathic responses. Patients with breast and prostate cancer express many C&C in e-mail communications with oncology nurses, who demonstrated satisfactory sensitivity to patients' emotions in their responses to patients. Offering e-communication with oncology nurses to cancer patients is a promising and feasible supplement to usual care to address and relieve patients' concerns and emotional distress during illness and recovery. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  4. Effect of the clinical support nurse role on work-related stress for nurses on an inpatient pediatric oncology unit.

    PubMed

    Chang, Ann; Kicis, Jennifer; Sangha, Gurjit

    2007-01-01

    High patient acuity, heavy workload, and patient deaths can all contribute to work-related stress for pediatric oncology nurses. A new leadership role, the clinical support nurse (CSN), was recently initiated on the oncology unit of a large Canadian pediatric hospital to support frontline staff and reduce some of the stresses related to clinical activity. The CSN assists nurses with complex patient care procedures, provides hands-on education at the bedside, and supports staff in managing challenging family situations. This study explores the effect of the CSN role on the nurses' work-related stress using the Stressor Scale for Pediatric Oncology Nurses. A total of 58 nurses participated in this study for a response rate of 86%. The results show that the intensity of work-related stress experienced by nurses in this study is significantly less (P < .001) on shifts staffed with a CSN compared with shifts without a CSN.

  5. Making "cents" of the business side of nurse practitioner practice.

    PubMed

    Luster-Tucker, AtNena

    2016-03-15

    Nurse practitioners produce excellent patient outcomes and should be allowed to practice to the full extent of their education and training. In addition to clinical skills, nurse practitioners need to understand the business side of practice in order to ensure fair and equitable compensation.

  6. Continuing Education Needs of the Office Oncology Nurse.

    ERIC Educational Resources Information Center

    Rogers, Miriam P.

    1999-01-01

    A study determined the learning needs of office oncology nurses (n=290)as a critical first step in planning education programs. Participants ranked cancer-care topics similarly, regardless of age, background, or experience. The highest-ranked needs were clustered in the areas of cancer nursing practice, major cancers, and cancer treatment.…

  7. Alliances of cooperation: negotiating New Hampshire nurse practitioners' prescribing practice.

    PubMed

    Sampson, Deborah A

    2009-01-01

    Nurse practitioner legislation varies among states, particularly in relation to practice without physician oversight, altering the legal environment within which nurse practitioners can use knowledge and skills to meet patient needs. Using New Hampshire as a case study, this historical analysis of nurse practitioners' negotiations over time for independent practice, defined in state practice acts, illuminates the complex social and economic factors affecting nurses' struggle to gain legal rights over their own professional practice without supervision and intervention from another profession. In New Hampshire, not only did organized medicine oppose nurses rights to practice, but pharmacists demanded the right to control all aspects of medication management, including who could prescribe and under what circumstances prescribing could occur. Shifting social and political terrain as well as changes in legislative and state professional board leadership affected the environment and negotiations of a small group of nurses who were ultimately successful in obtaining the right to define their own professional practice.

  8. Job satisfaction among Arizona adult nurse practitioners.

    PubMed

    Schiestel, Charlotte

    2007-01-01

    A literature review for studies of job satisfaction among nurse practitioners (NPs) suggests that the true determinants of job satisfaction have not been discovered. The purpose of this study was to determine job satisfaction among adult health NPs (ANPs) practicing in Arizona. The Misener nurse practitioner job satisfaction scale was mailed to 329 Arizona ANPs who were certified by the Arizona State Board of Nursing (47% response rate). The mean overall satisfaction score was 4.69 out of a possible score of 6.0 for very satisfied. Differences in employer type, gender, annual income, membership in professional nursing organization, or full-time versus part-time employment status did not result in significantly different scores on the job satisfaction scale in this group. A deep and sustained nursing shortage, the exodus of experienced nurses from the profession, and a projected shortage of primary care providers have generated interest among professional groups, private and government healthcare commissions, and the healthcare industry in determining what factors may influence an individual to choose and remain active in nursing practice. Researchers, educators, employers, and the healthcare industry must look beyond well-worn assumptions about job satisfaction to explore what the individual NP finds satisfying about his or her role.

  9. Nonspecialty Nurse Education: Evaluation of the Oncology Intensives Initiative, an Oncology Curriculum to Improve Patient Care

    PubMed

    Bagley, Kimberly A; Dunn, Sarah E; Chuang, Eliseu Y; Dorr, Victoria J; Thompson, Julie A; Smith, Sophia K

    2018-04-01

    A community hospital combined its medical and surgical patients with cancer on one unit, which resulted in nurses not trained in oncology caring for this patient population. The Oncology Intensives Initiative (ONCii) involved the (a) design and implementation of a daylong didactic boot camp class and a four-hour simulation session and (b) the examination of nurses' worries, attitudes, self-efficacy, and perception of interdisciplinary teamwork. A two-group, pre-/post-test design was implemented. Group 1 consisted of nurses who attended the didactic boot camp classes alone, whereas group 2 was comprised of nurses who attended the didactic boot camp classes and the simulation sessions. Results of data analysis showed a decrease in worries and an increase in positive attitudes toward chemotherapy administration in both groups, as well as an increase in self-efficacy among members of group 2.

  10. Continuing education for primary health care nurse practitioners in Ontario, Canada.

    PubMed

    Baxter, Pamela; DiCenso, Alba; Donald, Faith; Martin-Misener, Ruth; Opsteen, Joanne; Chambers, Tracey

    2013-04-01

    The Council of Ontario University Programs in Nursing offers a nine-university, consortium-based primary health care nurse practitioner education program and on-line continuing education courses for primary health care nurse practitioners. Our study sought to determine the continuing education needs of primary health care nurse practitioners across Ontario, how best to meet these needs, and the barriers they face in completing continuing education. Surveys were completed by 83 (40%) of 209 learners who had participated in continuing education offered by the Council of Ontario University Programs in Nursing between 2004 and 2007. While 83% (n=50) of nurse practitioners surveyed indicated that continuing education was extremely important to them, they also identified barriers to engaging in continuing education offerings including; time intensity of the courses, difficulty taking time off work, family obligations, finances and fatigue. The most common reason for withdrawal from a continuing education offering was the difficulty of balancing work and study demands. Continuing education opportunities are important to Ontario primary health care nurse practitioners, and on-line continuing education offerings have been well received, but in order to be taken up by their target audience they must be relevant, readily accessible, flexible, affordable and offered over brief, intense periods of time using technology that is easy to use and Internet sites that are easily navigated. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Addressing changed sexual functioning in cancer patients: A cross-sectional survey among Dutch oncology nurses.

    PubMed

    Krouwel, E M; Nicolai, M P J; van Steijn-van Tol, A Q M J; Putter, H; Osanto, S; Pelger, R C M; Elzevier, H W

    2015-12-01

    In most types of cancer, the disease and its treatment can result in altered sexual function (SF). Oncology nurses are strategically placed to address SF since they have frequent patient interaction. Our aim was to establish their knowledge about and attitudes to SF in oncology care and identify their perceived barriers to addressing the subject. A 37-item questionnaire was administered during the 2012 Dutch Oncology Nursing Congress and mailed to 241 Dutch oncology nursing departments. The majority of 477 nurses (87.6%) agreed that discussing SF is their responsibility. Discussing SF routinely is performed by 33.4% of these nurses, consultations mainly consisted of mentioning treatment side-effects affecting SF (71.3%). There were significant differences depending on experience, knowledge, age, academic degree and department policy. Nurses ≤44 years old (p < 0.001), with <10 years oncology experience (p = 0.001), insufficient knowledge (p < 0.001), no academic degree (p < 0.001), and in whose department policy was lacking or inadequate (p < 0.001), were less comfortable discussing SF. Barriers included lack of training, presence of a third party and no angle or motive for initiating discussion. Findings suggest oncology nurses consider counselling on sexual issues to be an important responsibility, in line with discussing other side-effects caused by the disease or its treatment. Nevertheless, cancer patients may not routinely be receiving a sexual health evaluation by oncology nurses. Results emphasize the potential benefit of providing knowledge, including practical training and a complete department protocol. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Differential Effectiveness of Coping in Managing Stress and Burnout in Oncology Nurses.

    ERIC Educational Resources Information Center

    Rounds, James B., Jr.; Zevon, Michael A.

    High levels of stress experienced by primary care oncology nursing staff, and the competency impairment which results from such stress, has become a matter of much concern in health care settings. This study was conducted to identify the coping strategies employed by oncology nurses, and to relate these strategies to differential indices of stress…

  13. Prevalence and predictors of compassion fatigue, burnout and compassion satisfaction among oncology nurses: A cross-sectional survey.

    PubMed

    Yu, Hairong; Jiang, Anli; Shen, Jie

    2016-05-01

    Cancer is a leading cause of death worldwide. Given the complexity of caring work, recent studies have focused on the professional quality of life of oncology nurses. China, the world's largest developing country, faces heavy burdens of care for cancer patients. Chinese oncology nurses may be encountering the negative side of their professional life. However, studies in this field are scarce, and little is known about the prevalence and predictors of oncology nurses' professional quality of life. To describe and explore the prevalence of predictors of professional quality of life (compassion fatigue, burnout and compassion satisfaction) among Chinese oncology nurses under the guidance of two theoretical models. A cross-sectional design with a survey. Ten tertiary hospitals and five secondary hospitals in Shanghai, China. A convenience and cluster sample of 669 oncology nurses was used. All of the nurses worked in oncology departments and had over 1 year of oncology nursing experience. Of the selected nurses, 650 returned valid questionnaires that were used for statistical analyses. The participants completed the demographic and work-related questionnaire, the Chinese version of the Professional Quality of Life Scale for Nurses, the Chinese version of the Jefferson Scales of Empathy, the Simplified Coping Style Questionnaire, the Perceived Social Support Scale, and the Chinese Big Five Personality Inventory brief version. Descriptive statistics, t-tests, one-way analysis of variance, simple and multiple linear regressions were used to determine the predictors of the main research variables. Higher compassion fatigue and burnout were found among oncology nurses who had more years of nursing experience, worked in secondary hospitals and adopted passive coping styles. Cognitive empathy, training and support from organizations were identified as significant protectors, and 'perspective taking' was the strongest predictor of compassion satisfaction, explaining 23.0% of

  14. Nurse practitioner caseload in primary health care: Scoping review.

    PubMed

    Martin-Misener, Ruth; Kilpatrick, Kelley; Donald, Faith; Bryant-Lukosius, Denise; Rayner, Jennifer; Valaitis, Ruta; Carter, Nancy; Miller, Patricia A; Landry, Véronique; Harbman, Patricia; Charbonneau-Smith, Renee; McKinlay, R James; Ziegler, Erin; Boesveld, Sarah; Lamb, Alyson

    2016-10-01

    To identify recommendations for determining patient panel/caseload size for nurse practitioners in community-based primary health care settings. Scoping review of the international published and grey literature. The search included electronic databases, international professional and governmental websites, contact with experts, and hand searches of reference lists. Eligible papers had to (a) address caseload or patient panels for nurse practitioners in community-based primary health care settings serving an all-ages population; and (b) be published in English or French between January 2000 and July 2014. Level one testing included title and abstract screening by two team members. Relevant papers were retained for full text review in level two testing, and reviewed by two team members. A third reviewer acted as a tiebreaker. Data were extracted using a structured extraction form by one team member and verified by a second member. Descriptive statistics were estimated. Content analysis was used for qualitative data. We identified 111 peer-reviewed articles and grey literature documents. Most of the papers were published in Canada and the United States after 2010. Current methods to determine panel/caseload size use large administrative databases, provider work hours and the average number of patient visits. Most of the papers addressing the topic of patient panel/caseload size in community-based primary health care were descriptive. The average number of patients seen by nurse practitioners per day varied considerably within and between countries; an average of 9-15 patients per day was common. Patient characteristics (e.g., age, gender) and health conditions (e.g., multiple chronic conditions) appear to influence patient panel/caseload size. Very few studies used validated tools to classify patient acuity levels or disease burden scores. The measurement of productivity and the determination of panel/caseload size is complex. Current metrics may not capture

  15. Psychometric evaluation of the Nurse Practitioner Satisfaction Survey (NPSS).

    PubMed

    Agosta, Lucie J

    2009-01-01

    The purpose of this study was to identify and define underlying latent constructs within the concept of patient satisfaction with nurse practitioner delivered primary health care. The Nurse Practitioner Satisfaction Survey (NPSS), a 28-item, Likert-type, researcher developed instrument was completed by 300 clients presenting for primary health care visits in a hospital outpatient clinic. Factor analysis with promax rotation resulted in a three factor model explaining 70.77% of the variance. Eighteen items loaded on general satisfaction. Six items loaded on communication, and four items loaded on accessibility and convenience. Cronbach's alpha internal consistency reliability coefficients were .98, .83, and .76 for the three factors, respectively. The NPSS was found to be reliable and valid for measuring patient satisfaction with nurse practitioner delivered primary health care services.

  16. Oral Health Education for Pediatric Nurse Practitioner Students

    PubMed Central

    Golinveaux, Jay; Gerbert, Barbara; Cheng, Jing; Duderstadt, Karen; Alkon, Abbey; Mullen, Shirin; Lin, Brent; Miller, Arthur; Zhan, Ling

    2014-01-01

    The aim of this study was to evaluate whether an interdisciplinary, multifaceted oral health education program delivered to pediatric nurse practitioner students at the University of California, San Francisco, would improve their knowledge, confidence, attitudes, and behaviors regarding the provision of oral health assessments, consultations, referrals, and services to young children during well-child visits. Thirty pediatric nurse practitioner students were included in the study. Participants completed a written survey before and after receiving an interdisciplinary educational intervention that included didactic education, simulation exercises, and clinical observation by a pediatric dental resident. Between pre-intervention and post-intervention, a significant improvement was seen in the pediatric nurse practitioners’ knowledge of oral health topics (p<0.001), confidence when providing oral health counseling (p<0.001), and attitudes about including oral health counseling in their examinations (p=0.006). In the post-intervention survey, 83 percent of the subjects reported having incorporated oral examinations into their well-child visits. Our study suggests that providing an interdisciplinary oral health educational program for pediatric nurse practitioner students can improve their knowledge, confidence, attitudes, and behaviors regarding the incorporation of oral health care services during routine well-child visits. PMID:23658403

  17. A comparison of burnout among oncology nurses working in adult and pediatric inpatient and outpatient settings.

    PubMed

    Davis, Shoni; Lind, Bonnie K; Sorensen, Celeste

    2013-07-01

    To investigate differences in burnout among oncology nurses by type of work setting, coping strategies, and job satisfaction. Descriptive. A metropolitan cancer center. A convenience sample of 74 oncology nurses. Participants completed a demographic data form, the Nursing Satisfaction and Retention Survey, and the Maslach Burnout Inventory. Burnout, coping strategies, job satisfaction, and oncology work setting (inpatient versus outpatient and adult versus pediatric). The participants most often used spirituality and coworker support to cope. Emotional exhaustion was lowest for youngest nurses and highest for outpatient RNs. Personal accomplishment was highest in adult settings. Job satisfaction correlated inversely with emotional exhaustion and the desire to leave oncology nursing. The findings support that the social context within the work environment may impact emotional exhaustion and depersonalization, and that demographics may be more significant in determining burnout than setting. The findings raise questions of whether demographics or setting plays a bigger role in burnout and supports organizational strategies that enhance coworker camaraderie, encourage nurses to discuss high-stress situations, and share ways to manage their emotions in oncology settings. Spirituality and coworker relationships were positive coping strategies among oncology nurses to prevent emotional exhaustion. Nurses who rely on supportive social networks as a coping mechanism have lower levels of depersonalization. Age was inversely related to emotional exhaustion.

  18. Cyberbullying: implications for the psychiatric nurse practitioner.

    PubMed

    Carpenter, Lindsey M; Hubbard, Grace B

    2014-08-01

    The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.

  19. Introducing Advanced Practice Nurses / Nurse Practitioners in health care systems: a framework for reflection and analysis.

    PubMed

    De Geest, Sabina; Moons, Philip; Callens, Betty; Gut, Chris; Lindpaintner, Lyn; Spirig, Rebecca

    2008-11-01

    An increasing number of countries are exploring the option of introducing Advanced Practice Nurses (APN), such as Nurse Practitioners (NP), as part of the health care workforce. This is particular relevant in light of the increase of the elderly and chronically ill. It is crucial that this introduction is preceded by an in depth understanding of the concept of advanced practice nursing as well as an analysis of the context. Firstly, a conceptual clarification of Advanced Practice Nurses and Nurse Practitioners is provided. Secondly, a framework is introduced that assists in the analysis of the introduction and development of Advanced Practice Nurse roles in a particular health care system. Thirdly, outcomes research on Advanced Practice Nursing is presented. Argumentation developed using data based papers and policy reports on Advanced Practice Nursing. The proposed framework consists of five drivers: (1) the health care needs of the population, (2) education, (3) workforce, (4) practice patterns and (5) legal and health policy framework. These drivers act synergistically and are dynamic in time and space. Outcomes research shows that nurse practitioners show clinical outcomes similar to or better than those of physicians. Further examples demonstrate favourable outcomes in view of the six Ds of outcome research; death, disease, disability, discomfort, dissatisfaction and dollars, for models of care in which Advanced Practice Nurses play a prominent role. Advanced Practice Nurses such as Nurse Practitioners show potential to contribute favourably to guaranteeing optimal health care. Advanced Practice Nurses will wield the greatest influence on health care by focusing on the most pressing health problems in society, especially the care of the chronically ill.

  20. Investigating the Nursing Practitioners Perspectives about Undergraduate Nursing Internship and Apprenticeship Courses: Is Renewing Required?

    PubMed Central

    Jamalmohammadi, Ali; Jafarabadi, Mohammad Asghari; Shajari, Jila; Modares, Maryam

    2013-01-01

    Nurses’ professional capacity plays an important role in the health system to achieve their mission. This study aimed to investigate the perspectives of nursing practitioners about undergraduate nursing internship and apprenticeship courses and possible ways of renewing the courses. This cross sectional survey was performed over 258 bachelors and practitioners of nursing graduates of Alborz University of medical sciences in the second half of 2012. Based on a multi-stage sampling schedule, questionnaires were used to collect data about the perspectives of nursing practitioners about undergraduate nursing internship and apprenticeship courses. There were 81.4% of females and 80.6%, 17.1% and 2.3% of organizational post of participants were nurse, head nurse and supervisor respectively. The occupied posts for 60.1%, 25.6% and 14.1% of subjects, respectively were nurse, head nurse and the supervisor. The application of the internship and apprenticeship courses in bachelor of nursing were in moderate to high levels. The highest percentages of responses for internship and apprenticeship training courses were in internal surgery nursing and special nursing and the minimum percentage of responses were for community hygiene nursing and mental health nursing. Due to observing moderate to high levels of fulfillment and lack of compliance of training courses, renewing to improve the quality and effectiveness of training programs are highly recommended. This can be effective in the future of nursing career and provide a practical training environment to achieve the goals of theoretical training and can lead nurses to become specialized in their field. PMID:23985116

  1. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

    PubMed

    Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

    2016-12-01

    Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

  2. Nurse confidence in gynaecological oncology practice and the evaluation of a professional development module.

    PubMed

    Philp, Shannon; Barnett, Catherine; D'Abrew, Natalie; White, Kate

    2017-04-01

    A tertiary-based education program on gynaecological oncology was attended by 62 registered nurses (RN). The program aimed to update nurses' knowledge, improve skills and ability to manage common situations and to assess program efficacy. Evaluation framework with specifically designed pre-post questionnaire about program content and nurse confidence. RN interested in gynaecological oncology were invited to attend. Nurses rated their confidence about gynaecological oncology skills one week prior to the program, immediately post-course, 3 months post and 12 months post. Speaker presentations were evaluated immediately post-course. Participants indicated improved confidence immediately after participating in the course (z = -6.515, p < .001); whilst confidence subsequently declined and stabilised up to 12 months post-course, it still remained significantly higher than before the course: 3 months post- (z = -5.284, p < .001) and 12 months post- (z = -4.155, p < .001). Results support the value of continuing professional education for improving nurse confidence in the gynaecological oncology setting.

  3. It takes chutzpah: oncology nurse leaders.

    PubMed

    Green, E

    1999-01-01

    Chutzpah, according to the Oxford Dictionary of Current English (1996) is a slang term from the Yiddish language which means shameless audacity. Chutzpah has been used to identify people with courage who take on situations that others avoid and somehow achieve the impossible. Tim Porter-O'Grady (1997) recently wrote that management is dead, and has been replaced by process leadership. Health care organizations have made shifts from hierarchical structures to process or program models where people have dual/multiple reporting/communication relationship. In this new orientation, management functions of controlling, directing, organizing and disciplining are replaced by process leadership functions of coordinating, facilitating, linking and sustaining (Porter O'Grady, 1997). Herein lies the challenge for oncology nurse leaders: "what lies behind us and what lies before us are tiny matters compared to what lies within us" (Ralph Waldo Emerson). Leadership is not a function of job title. The evidence for this is clear in current practice.... There are no/few positions of nurse leaders. Titles have changed to eliminate the professional discipline, and reflect a non-descript orientation. The new titles are process leaders, program leaders, professional practice leaders. Nurse leaders need new points of reference to take in the challenges of influencing, facilitating and linking. Those points of reference are: principle-centered leadership, integrity and chutzpah. This presentation will focus on examining current thinking, defining key characteristics and attributes, and using scenarios to illustrate the impact of leadership. We, as leaders in oncology nursing, must use chutzpah to make positive change and long-term gains for patient care and the profession of nursing.

  4. Peer-supported storytelling for grieving pediatric oncology nurses.

    PubMed

    Macpherson, Catherine Fiona

    2008-01-01

    Telling stories about deceased patients to supportive peers is frequently mentioned as an activity used for meaning-making in anecdotal reports of clinical practice and the literature addressing nurses' experiences caring for dying children. This study examines peer-supported storytelling for grieving pediatric oncology nurses using a mixed methods single-group descriptive repeated measures design. Participants were 6 registered nurses from a tertiary care pediatric hospital inpatient oncology unit who self-identified as experiencing grief. Participants met in self-selected dyads for 2 storytelling sessions. Questionnaires were completed at baseline, midpoint, and study end. Sessions were audio-recorded. Participants reported (1) receiving and providing support during sessions; (2) that sessions had an impact on their grief; (3) that sessions had an impact on their meaning-making, and the explicit session focus on making sense of and identifying benefit in their experiences was particularly helpful. There was a significant positive correlation between participant report of number of special patient deaths during career and impact of sessions on grief.

  5. Implementing two nurse practitioner models of service at an Australian male prison: A quality assurance study.

    PubMed

    Wong, Ides; Wright, Eryn; Santomauro, Damian; How, Raquel; Leary, Christopher; Harris, Meredith

    2018-01-01

    To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service. The study was guided by Donabedian's structure, processes and outcomes framework. Routinely collected information included surveys of staff attitudes to the implementation of the nurse practitioner models (n = 21 staff), consultation records describing clinical processes and time use (n = 289 consultations), and a patient satisfaction survey (n = 29 patients). Data were analysed descriptively and compared to external benchmarks where available. Over the two-month period, the nurse practitioners provided 289 consultations to 208 prisoners. The presenting problems treated indicated that most referrals were appropriate. A significant proportion of consultations involved medication review and management. Both nurse practitioners spent more than half of their time on individual patient-related care. Overall, multidisciplinary team staff agreed that the nurse practitioner services were necessary, safe, met patient need and reduced treatment delays. Findings suggest that the implementation of nurse practitioners into Australian correctional facilities is acceptable and feasible and has the potential to improve prisoners' access to health services. Structural factors (e.g., room availability and limited access to prisoners) may have reduced the efficiency of the nurse practitioners' clinical processes and service implementation. Results suggest that nurse practitioner models can be successfully integrated into a

  6. Oncology patients' perceptions of "the good nurse": a descriptive study in Flanders, Belgium.

    PubMed

    Van der Elst, Elisa; Dierckx de Casterlé, Bernadette; Biets, Robin; Rchaidia, Leila; Gastmans, Chris

    2013-11-01

    The image of "the good nurse" is mainly studied from the perspective of nurses, which often does not match the image held by patients. Therefore, a descriptive study was conducted to examine oncology patients' perceptions of "the good nurse" and the influence of patient- and context-related variables. A cross-sectional, comparative, descriptive design was used. The sample comprised 557 oncology patients at one of six Flemish hospitals, where they were treated in an oncology day-care unit, oncology hospital ward, or palliative care unit. Data were collected using the Flemish Care-Q instrument. Factor analysis summarised the most important characteristics of "the good nurse". We reassessed the reliability and construct validity of the Flemish Care-Q and examined the influence of patient- and context-related variables on patient perceptions. Using factor analysis, we grouped the different items of the Flemish Care-Q according to three characteristics: "the good nurse" (I) has a supportive and communicative attitude towards patient and family, (II) is competent and employs a professional attitude, and (III) demonstrates personal involvement towards patient and family. Median factor scores of Factors I, II, and III, respectively, were 8.00, 9.00, and 8.00 (varying from 1, not important, to 10, very important). In order of importance, Factors II, I, and III were identified as valuable characteristics of "the good nurse". Gender, care setting, and province were influential variables. As perceived by oncology patients, "the good nurse" has a broad range of qualities, of which competence and professionalism are the most valuable.

  7. Supporting nurse practitioners' practice in primary healthcare settings: a three-level qualitative model.

    PubMed

    Chouinard, Véronique; Contandriopoulos, Damien; Perroux, Mélanie; Larouche, Catherine

    2017-06-26

    While greater reliance on nurse practitioners in primary healthcare settings can improve service efficiency and accessibility, their integration is not straightforward, challenging existing role definitions of both registered nurses and physicians. Developing adequate support practices is therefore essential in primary healthcare nurse practitioners' integration. This study's main objective is to examine different structures and mechanisms put in place to support the development of primary healthcare nurse practitioner's practice in different healthcare settings, and develop a practical model for identifying and planning adequate support practices. This study is part of a larger multicentre study on primary healthcare nurse practitioners in the province of Quebec, Canada. It focuses on three healthcare settings into which one or more primary healthcare nurse practitioners have been integrated. Case studies have been selected to cover a maximum of variations in terms of location, organizational setting, and stages of primary healthcare nurse practitioner integration. Findings are based on the analysis of available documentation in each primary healthcare setting and on semi-structured interviews with key actors in each clinical team. Data were analyzed following thematic and cross-sectional analysis approaches. This article identifies three types of support practices: clinical, team, and systemic. This three-level analysis demonstrates that, on the ground, primary healthcare nurse practitioner integration is essentially a team-based, multilevel endeavour. Despite the existence of a provincial implementation plan, the three settings adopted very different implementation structures and practices, and different actors were involved at each of the three levels. The results also indicated that nursing departments played a decisive role at all three levels. Based on these findings, we suggest that support practices should be adapted to each organization's environment and

  8. Can nurse practitioners and physicians beat parochialism into plowshares?

    PubMed

    Phillips, Robert L; Harper, Doreen C; Wakefield, Mary; Green, Larry A; Fryer, George E

    2002-01-01

    Nurse practitioners have evolved into a large and flexible workforce. Far too often, nurse practitioner and physician professional organizations do not work together but rather expend considerable effort jousting in policy arenas. Turf battles interfere with joint advocacy for needed health system change and delay development of interdisciplinary teams that could help patients. A combined, consistent effort is urgently needed for studying, training, and deploying a collaborative, integrated workforce aimed at improving the health care system of tomorrow. The country can ill afford doctors and nurses who ignore one another's capabilities and fail to maximize each other's contributions cost-effectively.

  9. Nurse Practitioner Residency Programs: An Educational Journey

    ERIC Educational Resources Information Center

    Rys, Gregory P.

    2016-01-01

    Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with…

  10. Professional development utilizing an oncology summer nursing internship.

    PubMed

    Mollica, Michelle; Hyman, Zena

    2016-01-01

    The aim of this study was to examine the effect of an oncology student nursing internship on role socialization and professional self-concept. This mixed-methods study utilized a convergent parallel approach that incorporated a quasi-experimental and qualitative design. Data was collected through pre and post-survey and open-ended questions. Participants were 11 baccalaureate nursing students participating in a summer oncology student nursing internship between their junior and senior years. Investigators completed a content analysis of qualitative questionnaires resulted in categories of meaning, while the Wilcoxon signed-ranks test was used to compare pre and post internship scores. Aggregated mean scores from all instruments showed an increase in professionalism, role socialization, and sense of belonging from pre to post-internship, although no differences were significant. Qualitative data showed participants refined their personal philosophy of nursing and solidified their commitment to the profession. Participants did indicate, however, that the internship, combined with weekly debriefing forums and conferences, proved to have a positive impact on the students' role socialization and sense of belonging. Despite quantitative results, there is a need for longitudinal research to confirm the effect of nursing student internships on the transition from student to professional. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Oncology Nurses' Use of the Internet for Continuing Education: A Survey of Oncology Nursing Society Congress Attendees.

    ERIC Educational Resources Information Center

    Cobb, Susan C.; Baird, Susan B.

    1999-01-01

    A survey to determine whether oncology nurses (n=670) use the Internet and for what purpose revealed that they use it for drug information, literature searches, academic information, patient education, and continuing education. Results suggest that continuing-education providers should pursue the Internet as a means of meeting the need for quick,…

  12. Playing music improves well-being of oncology nurses.

    PubMed

    Ploukou, Stella; Panagopoulou, Efharis

    2018-02-01

    Nurses experience high levels of stress associated with the demands of their workplace. Anxiety and depression symptoms are common in this occupational group and the necessity of supportive actions is vital. This is especially true for nurses working in high intensity and demanding settings such as oncology units. This study examined the effects of a music intervention on anxiety, depression, and psychosomatic symptoms of oncology nurses. Forty-eight oncology nurses, were randomized to either an intervention group (n = 22) attending four consecutive weekly 1-h music classes or a control group with no intervention (n = 26) who maintained their usual lifestyle habits, for one month. Intervention group played and improvised music using percussion instruments. Courses consisted of varied multitask exercises of progressive difficulty, sometimes involving team playing, or individual performances. Depression, anxiety, and physical symptoms were measured before and after the end of the intervention. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. Psychosomatic symptoms were assessed with Pennebaker Inventory οf Limbic Languidness. Anxiety, depression and psychosomatic symptoms significantly reduced for the intervention group at the end of the study. No statistical significant change was observed for the control group in any of the three psychological indicators. The findings of our study highlight the fact that music can be a cost-effective resource in developing interventions to reduce stress and improve well-being. Playing music can be the next step for further investigation, since we already know that listening to music is beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Personality Traits of Nurses in Anesthesia and Family Nurse Practitioner Masters Degree Programs

    DTIC Science & Technology

    1998-02-01

    careers by acquiring on advanced clinical skills such as nurse anesthesia, family nurse practitioner or nurse midwifery . Nurses are drawn to specific...disastrous situation. Attempts to alleviate stress often involve alcohol and drugs . Most nurses who abuse alcohol and drugs are the high achievers, the so...alcohol and drug addiction than other medical specialties with the exception of psychiatrists (McAuliffe, 1984). If students do not enjoy working in

  14. The Employment of Nurse Practitioners and Physician Assistants in U.S. Nursing Homes

    ERIC Educational Resources Information Center

    Intrator, Orna; Feng, Zhanlian; Mor, Vince; Gifford, David; Bourbonniere, Meg; Zinn, Jacqueline

    2005-01-01

    Purpose: Nursing facilities with nurse practitioners or physician assistants (NPs or PAs) have been reported to provide better care to residents. Assuming that freestanding nursing homes in urban areas that employ these professionals are making an investment in medical infrastructure, we test the hypotheses that facilities in states with higher…

  15. Cognitive dissonance experienced by nurse practitioner faculty.

    PubMed

    Fontenot, Holly B; Hawkins, Joellen W; Weiss, Josie A

    2012-08-01

    The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid. Expecting all faculty members to excel in practice, research, teaching, and service may create unrealistic workloads for NP faculty members. Examining expectations and considering creation of a clinical track for faculty who practice may be options administrators of NP programs might explore. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  16. Investigating nurse practitioners in the private sector: a theoretically informed research protocol.

    PubMed

    Adams, Margaret; Gardner, Glenn; Yates, Patsy

    2017-06-01

    To report a study protocol and the theoretical framework normalisation process theory that informs this protocol for a case study investigation of private sector nurse practitioners. Most research evaluating nurse practitioner service is focused on public, mainly acute care environments where nurse practitioner service is well established with strong structures for governance and sustainability. Conversely, there is lack of clarity in governance for emerging models in the private sector. In a climate of healthcare reform, nurse practitioner service is extending beyond the familiar public health sector. Further research is required to inform knowledge of the practice, operational framework and governance of new nurse practitioner models. The proposed research will use a multiple exploratory case study design to examine private sector nurse practitioner service. Data collection includes interviews, surveys and audits. A sequential mixed method approach to analysis of each case will be conducted. Findings from within-case analysis will lead to a meta-synthesis across all four cases to gain a holistic understanding of the cases under study, private sector nurse practitioner service. Normalisation process theory will be used to guide the research process, specifically coding and analysis of data using theory constructs and the relevant components associated with those constructs. This article provides a blueprint for the research and describes a theoretical framework, normalisation process theory in terms of its flexibility as an analytical framework. Consistent with the goals of best research practice, this study protocol will inform the research community in the field of primary health care about emerging research in this field. Publishing a study protocol ensures researcher fidelity to the analysis plan and supports research collaboration across teams. © 2016 John Wiley & Sons Ltd.

  17. The transition to first position as nurse practitioner.

    PubMed

    Kelly, N R; Mathews, M

    2001-04-01

    The nurse who graduates from a nurse practitioner program leaves a comfort zone of nursing practice to enter a new position where feelings of insecurity and stress are common. Because the role of the nurse practitioner (NP) continues to evolve and is influenced by many environmental issues, the preparation of the NP by the academic institution needs to be assessed on a frequent basis. The purpose of this research was to obtain a better understanding of the transitional phase to the first position as NP after graduation. The perceptions of preparation, gains, losses, barriers, facilitators, and strategies for adjustment were explored. A qualitative approach using focus groups was developed in which 21 recent NP graduates from a large university participated in one of four focus groups. Peer debriefing and participant verification were techniques used to ensure credibility and trustworthiness of the data and subsequent analysis. The themes identified were: loss of personal control of time and privacy; changes and losses in relationships; feelings of isolation and uncertainty in establishing the NP role; and a special bonding with clients. Although the participants perceived they were adequately prepared for their role, they also described feelings of guilt and uncertainty from not knowing information they believed they should know. They concluded that they functioned differently than the physician as well as other nurses and found it necessary to distance themselves from the role of other health care providers. This study has implications for colleagues, academic institutions, and the individual nurse practitioner.

  18. NURSE PRACTITIONERS. THE ROAD LESS TRAVELLED.

    PubMed

    Dragon, Natalie

    2016-11-01

    With the Australian healthcare system struggling to keep up with surging demand, nurse practitioners are ideally placed and suited to fulfill the role for which they were envisioned. Natalie Dragon looks at the challenges to realize the NP potential.

  19. Using second life to facilitate peer storytelling for grieving oncology nurses.

    PubMed

    Rice, Karen L; Bennett, Marsha J; Billingsley, Luanne

    2014-01-01

    Oncology nurses often experience intense emotional reactions to patient deaths but may be forced to ignore or hide their feelings because of work-related responsibilities. The complexity of nurses' work and personal lives creates obstacles for participating in traditional support groups where grieving nurses can bond and share. We hypothesized that using a web-based, three-dimensional (3-D) virtual world technology (Second Life) may provide a venue to facilitate peer storytelling to support nurses dealing with grief. We used a mixed-methods approach involving focus groups and surveys to explore the use of peer storytelling for grieving oncology nurses. Nine acute and ambulatory oncology nurses in groups of 3 participated using avatars in 5 group moderator-guided sessions lasting 1 hour each in a private 3-D outdoor virtual meeting space within Second Life. Baseline information was collected using a 12-item demographic and professional loss survey. At the end of the study, a 20-item survey was administered to measure professional losses during the study, exchange of support during sessions, and meaning-making and to evaluate peer storytelling using Second Life. Overall, nurses reported peer storytelling sessions in Second Life were helpful in making sense of and in identifying a benefit of their grief experience. They felt supported by both the group moderator and group members and were able to personally support group members during storytelling. Although nurses reported Second Life was helpful in facilitating storytelling sessions and expressed overall satisfaction with using Second Life, open-ended comments registered difficulties encountered, mostly with technology. Three central themes emerged in sessions, representing a dynamic relationship between mental, spiritual, and emotional-behavioral responses to grief: cognitive readiness to learn about death, death really takes death experience, and emotional resilience. This study suggests a potential benefit in

  20. Using Second Life to Facilitate Peer Storytelling for Grieving Oncology Nurses

    PubMed Central

    Rice, Karen L.; Bennett, Marsha J.; Billingsley, Luanne

    2014-01-01

    Background Oncology nurses often experience intense emotional reactions to patient deaths but may be forced to ignore or hide their feelings because of work-related responsibilities. The complexity of nurses' work and personal lives creates obstacles for participating in traditional support groups where grieving nurses can bond and share. We hypothesized that using a web-based, three-dimensional (3-D) virtual world technology (Second Life) may provide a venue to facilitate peer storytelling to support nurses dealing with grief. Methods We used a mixed-methods approach involving focus groups and surveys to explore the use of peer storytelling for grieving oncology nurses. Nine acute and ambulatory oncology nurses in groups of 3 participated using avatars in 5 group moderator-guided sessions lasting 1 hour each in a private 3-D outdoor virtual meeting space within Second Life. Baseline information was collected using a 12-item demographic and professional loss survey. At the end of the study, a 20-item survey was administered to measure professional losses during the study, exchange of support during sessions, and meaning-making and to evaluate peer storytelling using Second Life. Results Overall, nurses reported peer storytelling sessions in Second Life were helpful in making sense of and in identifying a benefit of their grief experience. They felt supported by both the group moderator and group members and were able to personally support group members during storytelling. Although nurses reported Second Life was helpful in facilitating storytelling sessions and expressed overall satisfaction with using Second Life, open-ended comments registered difficulties encountered, mostly with technology. Three central themes emerged in sessions, representing a dynamic relationship between mental, spiritual, and emotional-behavioral responses to grief: cognitive readiness to learn about death, death really takes death experience, and emotional resilience. Conclusion This

  1. Smoking behavior and patient education practices of oncology nurses in six countries.

    PubMed

    Lally, Robin M; Chalmers, Karen I; Johnson, Judith; Kojima, Misako; Endo, Emiko; Suzuki, Shizue; Lai, Yeur-Hur; Yang, Young-Hee; Degner, Lesley; Anderson, Elsie; Molassiotis, Alexander

    2008-09-01

    Worldwide, tobacco is the leading cause of preventable death, resulting in approximately 5 million deaths annually. Nurses are keenly positioned to work toward reducing tobacco-related illness and deaths. Therefore, guided by the health belief model, the purpose of this study was to explore the smoking behavior, beliefs, smoking cessation education practices, and existing smoking policies at the institutions of a sample of practicing oncology nurses in Canada, Japan, Korea, Taiwan, United Kingdom, and the United States. A 27-item structured survey, designed for this study in English and translated and reverse translated by the Asian countries, was distributed to a convenience sample of nurses attending oncology meetings in each country. Totally 759 surveys were completed and analyzed using descriptive statistics. Principle findings indicate that 4.5% of these nurses currently smoke, although 23.3% reported smoking previously. While many nurses (74%) reported frequently assessing the smoking status of patients, only 50% reported discussing cessation with their patients that smoke. Although the majority (80%) reported feeling comfortable with asking their patients about smoking, only 23% felt it was the nurse's role. The findings indicate that while internationally oncology nurses recognize the importance of smoking cessation, significant room for improvement exists in translating this into practice.

  2. Pediatric nurse practitioners: influences on career choice.

    PubMed

    Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura

    2014-01-01

    The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  3. Nurse practitioners in Taiwan: today and tomorrow.

    PubMed

    Wei, Ching-Wen; Tung, Heng-Hsin; Tsay, Shiow-Luan; Lin, Che-Wei

    2012-03-01

    To describe the barriers that nurse practitioners (NPs) face and their hopes for the future. The study used a qualitative research design, with 10 certified NPs who were recruited through convenience sampling. Data were collected through a face-to-face semi-structured interview, and content analysis was used to analyze the data. NPs in Taiwan are challenged by a number of barriers; however, they remain positive that their circumstances will improve. The results of this study suggest that there is a need for better communication between policymakers and NPs. Additionally, as recommended by the International Council of Nursing, there is a need for NPs to earn a master's degree and to have formal training prior to beginning work as an NP. Furthermore, to evaluate the NPs' performance, outcome studies need to be conducted. Implementing such recommendations should enable NPs to earn the respect and support of healthcare professionals and administrators. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  4. Managing distress in oncology patients: description of an innovative online educational program for nurses.

    PubMed

    Pasacreta, Jeannie V; Kenefick, Amy L; McCorkle, Ruth

    2008-01-01

    The American Psychosocial Oncology Society and the Individual Cancer Assistance Network have launched the online continuing education accredited program "ICAN: Distress Management for Oncology Nursing" to address the ability of oncology nurses to assess, treat, and refer patients with a range of psychosocial problems. An important goal of the program is to reduce traditional barriers to psychosocial oncology education by providing the oncology nursing community with easy access to information from experts in the field. There are 4 Internet webcasts: Nurse's Role in Recognizing Distress in Patients and Caregivers; Assessment Recommendations; Treatment Strategies; and Principles and Guidelines for Psychotherapy and Referral. The program examines the prevalence and dimensions of patient distress and offers instruction on how to effectively integrate screening tools, such as the Distress Thermometer and Problem Check List, into clinical practice. It provides details on relevant interventions and referral algorithms based on the National Comprehensive Cancer Network Guidelines for Distress Management. It explores the devastating impact of psychological distress on quality of life, and the unique position of nurses in busy inpatient settings, outpatient clinics, and offices to detect, intervene, and refer to appropriate services. Providing information over the Internet addresses common barriers to learning, including schedule and time constraints.

  5. Using a Web-Based e-Visit Simulation to Educate Nurse Practitioner Students.

    PubMed

    Merritt, Lisa Schaeg; Brauch, Allison N; Bender, Annah K; Kochuk, Daria

    2018-05-01

    The purpose of this pilot study was to develop and implement a Web-based, e-Visit simulation experience for nurse practitioner students and evaluate student satisfaction and perceived learning. The convenience sample consisted of 26 senior-level Master of Science in Nursing students in the Pediatric Nurse Practitioner and Adult-Gerontology Nurse Practitioner programs. A Likert survey was used for evaluation that measured items from 1 (strongly disagree) to 5 (strongly agree). Students reported that the simulation cases closely resembled real-world patients (97%; M = 4.42, SD = 0.69), providing them with a better understanding of complaints commonly addressed via telehealth services (96%; M = 4.46, SD = 0.57). Accuracy of diagnosis and treatment on first attempt was 95%. A Web-based, e-Visit simulation can be a useful learning experience for nurse practitioner students with knowledge gained that is transferable to real clinical situations. [J Nurs Educ. 2018;57(5):304-307.]. Copyright 2018, SLACK Incorporated.

  6. Nursing Fatigue: An Evidence-Based Practice Review for Oncology Nurses
.

    PubMed

    Ferris, Jordan

    2015-12-01

    Nursing fatigue is a current and well-researched topic. Many negative outcomes and consequences exist for patients and nurses that have been linked to nursing fatigue. Medical errors are one such consequence, and these errors have become one of the top three preventable deaths in the United States. Oncology nurses are not immune to fatigue, and the consequences of their fatigue can be much more harmful to patients.

  7. Evaluation of Online Learning Modules for Improving Physical Activity Counseling Skills, Practices, and Knowledge of Oncology Nurses.

    PubMed

    Karvinen, Kristina H; Balneaves, Lynda; Courneya, Kerry S; Perry, Beth; Truant, Tracy; Vallance, Jeff

    2017-11-01

    To examine the effectiveness of online learning modules for improving physical activity counseling practices among oncology nurses. 
. Randomized, controlled trial.
. Online.
. 54 oncology nurses.
. Oncology nurses were randomly assigned to the learning modules group or control group. The learning modules group completed six online learning modules and quizzes focused on physical activity for cancer survivors, general physical activity principles, and motivational interviewing.
. Percentage of cancer survivors counseled, self-efficacy for physical activity counseling, knowledge of physical activity, and perceived barriers and benefits of physical activity counseling.
. Analyses of covariance revealed no significant difference between the learning modules and control groups in the percentage of cancer survivors that oncology nurses counseled. Significant differences were found in self-efficacy for physical activity counseling and perceived barriers to physical activity counseling at postintervention. 
. The online learning intervention tested in this study improved some parameters of physical activity counseling but did not increase the percentage of cancer survivors that oncology nurses counseled. Additional pilot work is needed to refine the intervention.
. This study suggests the potential utility of an evidence-based online learning strategy for oncology nurses that includes information on physical activity and its benefits in cancer survivorship. The findings offer a framework on how to implement physical activity counseling skills in oncology nursing practice.

  8. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods.

    PubMed

    Schadewaldt, Verena; McInnes, Elizabeth; Hiller, Janet E; Gardner, Anne

    2016-07-29

    In 2010 policy changes were introduced to the Australian healthcare system that granted nurse practitioners access to the public health insurance scheme (Medicare) subject to a collaborative arrangement with a medical practitioner. These changes facilitated nurse practitioner practice in primary healthcare settings. This study investigated the experiences and perceptions of nurse practitioners and medical practitioners who worked together under the new policies and aimed to identify enablers of collaborative practice models. A multiple case study of five primary healthcare sites was undertaken, applying mixed methods research. Six nurse practitioners, 13 medical practitioners and three practice managers participated in the study. Data were collected through direct observations, documents and semi-structured interviews as well as questionnaires including validated scales to measure the level of collaboration, satisfaction with collaboration and beliefs in the benefits of collaboration. Thematic analysis was undertaken for qualitative data from interviews, observations and documents, followed by deductive analysis whereby thematic categories were compared to two theoretical models of collaboration. Questionnaire responses were summarised using descriptive statistics. Using the scale measurements, nurse practitioners and medical practitioners reported high levels of collaboration, were highly satisfied with their collaborative relationship and strongly believed that collaboration benefited the patient. The three themes developed from qualitative data showed a more complex and nuanced picture: 1) Structures such as government policy requirements and local infrastructure disadvantaged nurse practitioners financially and professionally in collaborative practice models; 2) Participants experienced the influence and consequences of individual role enactment through the co-existence of overlapping, complementary, traditional and emerging roles, which blurred perceptions of

  9. Validation of Nurse Practitioner Primary Care Organizational Climate Questionnaire: A New Tool to Study Nurse Practitioner Practice Settings.

    PubMed

    Poghosyan, Lusine; Chaplin, William F; Shaffer, Jonathan A

    2017-04-01

    Favorable organizational climate in primary care settings is necessary to expand the nurse practitioner (NP) workforce and promote their practice. Only one NP-specific tool, the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), measures NP organizational climate. We confirmed NP-PCOCQ's factor structure and established its predictive validity. A crosssectional survey design was used to collect data from 314 NPs in Massachusetts in 2012. Confirmatory factor analysis and regression models were used. The 4-factor model characterized NP-PCOCQ. The NP-PCOCQ score predicted job satisfaction (beta = .36; p < .001) and intent to leave job (odds ratio = .28; p = .011). NP-PCOCQ can be used by researchers to produce new evidence and by administrators to assess organizational climate in their clinics. Further testing of NP-PCOCQ is needed.

  10. Nurse practitioner role transition: a concept analysis.

    PubMed

    MacLellan, Lorna; Levett-Jones, Tracy; Higgins, Isabel

    2015-07-01

    Transitioning from registered nurse to nurse practitioner (NP) can be challenging personally and professionally. Insight into transition experiences may help validate the experiences of new NPs and provide greater understanding of the challenges faced during their professional journey. The purpose of this article is to report a concept analysis of transition from registered nurse to NP. The article provides new knowledge, understanding, and clarity about the concept of transition. Walker and Avants' framework for concept analysis was used to identify the attributes, antecedents, and consequences of the concept. A literature review of refereed journals was undertaken. Model cases from an ethnographic study conducted in Australia provide real life examples of the attributes of transition. Transitioning to the role of NP is complex and dependent on the individual and the attitudes of healthcare colleagues. Change and adaptation are required of both the NP and members of the healthcare team. Failure to adapt by either party undermines the potential for NPs to deliver improved health care. Mentorship along with a nurturing environment may be effective strategies for increasing the NP's self-confidence and ensuring a smooth and successful transition period. ©2014 American Association of Nurse Practitioners.

  11. Burnout syndrome in surgical oncology and general surgery nurses: a cross-sectional study.

    PubMed

    Książek, Ilona; Stefaniak, Tomasz J; Stadnyk, Magdalena; Książek, Janina

    2011-09-01

    The occurrence of burnout syndrome is strongly associated with and modulated by multiple personality and environmental factors. In Poland, nurses experience a discrepancy between the demands, expectations and social status of the position of their profession and low salaries. Such a situation provokes frustration and depression, and further leads to problems of adaptation including burnout syndrome. The aim of this study was to evaluate the occurrence of burnout syndrome among nurses working in general surgery and surgical oncology specialties. The study was designed as a cross-sectional questionnaire survey. It was undertaken in the largest Hospital in the Pomeranian region of Poland. The participants included 60 nurses working in two departments: General Surgery and Surgical Oncology. The study was based upon an anonymous self-test composed of a questionnaire and three psychological measures: Maslach Burnout Inventory (MBI), Psychological Burden Scale and a self-constructed questionnaire on job satisfaction. Intensity of burnout syndrome was significantly higher among oncology nurses than among surgical ones. There was also a strong but not significant trend towards higher Psychological Burden Scale in the group of oncology nurses. The study revealed a high degree of emotional burden and burnout in nurses working in the study hospital suggesting that nurses are at great occupational risk. The findings of the study provide evidence of the potential need to restructure the system and suggest that nurses need more control of their work including a higher degree of involvement in clinical decision-making. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Measuring job satisfaction of advanced nurse practitioners and advanced midwife practitioners in the Republic of Ireland: a survey.

    PubMed

    O'Keeffe, Anne Paula; Corry, Margarita; Moser, Debra K

    2015-01-01

    To describe the level of job satisfaction of advanced nurse practitioners (ANP) and advanced midwife practitioners in the Republic of Ireland (RoI). Job satisfaction is related to productivity, performance, turnover and health, and thus is a challenge for nursing and healthcare organisations. Job satisfaction data were collected from 47 ANPs using the Misener Nurse Practitioner Job Satisfaction Scale. High levels of global job satisfaction were reported. All ANPs reported satisfaction with autonomy, sense of accomplishment, challenge, social interaction and status in the organisation. Lower levels of job satisfaction were attributed to the amount of involvement in research (55%), opportunities to receive compensation for services provided outside normal working hours (55%), the amount (44%) and the quality of administrative support (51%), and the opportunity to negotiate bonuses and resources in return for productivity (36%). Advanced nurse practitioners in RoI have high levels of job satisfaction with areas relating to clinical practice but are dissatisfied with areas that lead to empowerment within organisations. Efforts to improve the negotiating and leadership skills of ANPs may improve job satisfaction. Enhancing inter-professional collegial relationships and improving managerial recognition of the role within nursing are key areas to be targeted to promote job satisfaction of ANPs. © 2013 John Wiley & Sons Ltd.

  13. Establishing a nurse practitioner collaborative: evolution, development, and outcomes.

    PubMed

    Quinn, Karen; Hudson, Peter

    2014-09-01

    The first Australian palliative care nurse practitioner (NP) was endorsed in 2003. In 2009 the Victoria Department of Health funded the development of the Victorian Palliative Care Nurse Practitioner Collaborative (VPCNPC). Its aim was to promote the NP role, develop resources, and provide education and mentorship to NPs, nurse practitioner candidates (NPCs), and health service managers. Four key objectives were developed: identify the demographic profile of palliative care NPCs in Victoria; develop an education curriculum and practical resources to support the training and education of palliative care NPCs and NPs; provide mentorship to NPs, NPCs, and service managers; and ensure effective communication with all key stakeholders. An NPC survey was also conducted to explore NPC demographics, models of care, the hours of study required for the role, the mentoring process, and education needs. This paper reports on the establishment of the VPCNPC, the steps taken to achieve its objectives, and the results of the survey. The NP role in palliative care in Australia continues to evolve, and the VPCNPC provides a structure and resources to clearly articulate the benefits of the role to nursing and clinical services.

  14. Job satisfaction and perceived autonomy for nurse practitioners working in nurse-managed health centers.

    PubMed

    Pron, Ann Linguiti

    2013-04-01

    More primary care providers are needed to deliver health care to Americans living in poverty and those soon to be insured under the Affordable Care Act. Nurse practitioners (NPs) in nurse-managed health centers (NMHCs) are poised to meet this need. This research study examined the characteristics of NPs working in NMHCs and measured job satisfaction and perceived level of autonomy. No studies about job satisfaction or autonomy for NPs working in NMHCs had been previously reported. This descriptive, quantitative study surveyed primary care NPs working in NMHCs that are part of the National Nursing Centers Consortium (NNCC). NP e-mail addresses were obtained from NNCC center directors. Of 198 NPs invited to the electronic survey, 99 completed the Misener Nurse Practitioner Job Satisfaction Scale, demographic questionnaire, questions about perceived autonomy, and whether they would recommend working in an NMHC. Participants came from 16 states and 46 NMHCs. NPs working in NMHCs have job satisfaction, perceive their role as autonomous, and are satisfied with the autonomy they have. NMHCs can provide access to primary health care for many Americans. More NPs may choose employment in NMHCs for job satisfaction and autonomy. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  15. Development of the Nurse Practitioner Standards for Practice Australia

    PubMed Central

    Buckley, Thomas; Donoghue, Judith; Heartfield, Marie; Bryce, Julianne; Cox, Darlene; Waters, Donna; Gosby, Helen; Kelly, John; Dunn, Sandra V.

    2015-01-01

    This article describes the context and development of the new Nurse Practitioner Standards for Practice in Australia, which went into effect in January 2014. The researchers used a mixed-methods design to engage a broad range of stakeholders who brought both political and practice knowledge to the development of the new standards. Methods included interviews, focus groups, surveys, and work-based observation of nurse practitioner practice. Stakeholders varied in terms of their need for detail in the standards. Nonetheless, they invariably agreed that the standards should be clinically focussed attributes. The pillars common in many advanced practice nursing standards, such as practice, research, education, and leadership, were combined and expressed in a new and unique clinical attribute. PMID:26162455

  16. Professionalism and professional quality of life for oncology nurses.

    PubMed

    Jang, Insil; Kim, Yuna; Kim, Kyunghee

    2016-10-01

    To identify the relationship between professionalism and professional quality of life among oncology nurses working at tertiary hospitals in Korea. Oncology nurses are combined with core competencies and qualities required in cancer patient care. Professionalism that means compassion satisfaction and compassion fatigue is a main concept in problem-solving strategies as motivation. Their satisfaction is representative of professionalism and professional quality of life. However, little research has focused on professionalism and professional quality of life. A cross-sectional study with self-administered questionnaires. A total of 285 nurses from two tertiary hospitals were included. Data collection was undertaken using Korean version of professionalism scale derived from the Hall Professional Inventory Scale and professional quality of life. Data were analysed by spss 21.0 for Windows Program using t-test, anova, and multiple regression. The mean score of professionalism in oncology nurses was 77·98 ± 7·31. The mean professional quality of life score for compassion satisfaction, compassion fatigue and secondary traumatic stress was 33·84 ± 5·62, 28·38 ± 5·36 and 28·33 ± 5·48. Compassion satisfaction was affected by factors of professionalism with an explanatory power of 49·2%. Burnout and secondary traumatic stress were affected by factors of professionalism with an explanatory power of 39·3% and 4·8%. The higher the professionalism leads to the higher the compassion satisfaction, the lower the compassion fatigue. The relationship between professionalism and professional quality of life for a health work environment requires further investigation. Our study supports the idea that enhancing professionalism can increase professional quality of life. It is necessary to develop professionalism by recognised qualifications and applied rewards in advanced nursing organisational culture. Furthermore, compassion satisfaction is increased by

  17. Immunologic advances in monoclonal antibody therapy: implications for oncology nursing.

    PubMed

    Karius, D; Marriott, M A

    1997-04-01

    To provide an overview of monoclonal antibody (MoAb) formation, therapeutic and diagnostic uses of MoAbs, and the implications for oncology nurses. Books and Journal articles (including research studies). Clinical trials have demonstrated the diagnostic and therapeutic potential of MoAb therapy. Advances in hybridoma technology and gene-splicing techniques have led to the formation of chimeric MoAbs, which exhibit decreased immunogenicity in the recipient. Clinical limitations with MoAb therapy include cross-reactivity with normal tissues, heterogeneity of antigen expression, presence of circulating antigen, antigenic modulation, tumor size and vascularity, and the anti-antibody response. MoAbs currently are used for diagnostic purposes and in phase I, II, and III clinical trials for cancer treatment. As research progresses, MoAbs are likely to be incorporated into the mainstream of cancer therapy as have other biologic response modifiers. Current uses of MoAb therapy in clinical trials involve nurses in many roles, including clinical nurse specialist, staff nurse, and research nurse. As more oncology nurses encounter MoAb therapy in practice, they will have to have an increased understanding of basic immunologic principles and the expertise to manage the unique toxicities associated with MoAb therapy.

  18. Expanding collaborative boundaries in nursing education and practice: The nurse practitioner-dentist model for primary care.

    PubMed

    Dolce, Maria C; Parker, Jessica L; Marshall, Chantelle; Riedy, Christine A; Simon, Lisa E; Barrow, Jane; Ramos, Catherine R; DaSilva, John D

    The purpose of this paper is to describe the design and implementation of a novel interprofessional collaborative practice education program for nurse practitioner and dental students, the Nurse Practitioner-Dentist Model for Primary Care (NPD Program). The NPD Program expands collaborative boundaries in advanced practice nursing by integrating primary care within an academic dental practice. The dental practice is located in a large, urban city in the Northeast United States and provides comprehensive dental services to vulnerable and underserved patients across the age spectrum. The NPD Program is a hybrid curriculum comprised of online learning, interprofessional collaborative practice-based leadership and teamwork training, and clinical rotations focused on the oral-systemic health connection. Practice-based learning promotes the development of leadership and team-based competencies. Nurse practitioners emerge with the requisite interprofessional collaborative practice competencies to improve oral and systemic health outcomes. Copyright © 2017. Published by Elsevier Inc.

  19. Continuity of care by cardiothoracic nurse practitioners: impact on outcome.

    PubMed

    Southey, Dawn; Mishra, Pankaj Kumar; Nevill, Alan; Aktuerk, Dincer; Luckraz, Heyman

    2014-10-01

    There have been recent reports on increased mortality in British National Health Service hospitals during weekends. This study aimed to assess the impact on patient care following the introduction of nurse practitioner cover for the cardiothoracic ward, including weekends. Prospectively collected and validated data of patients operated on from January 2005 to October 2011 were analyzed. The patients were grouped according to era: before (n = 2385) and after (n = 3910) the introduction of nurse practitioners in October 2007. There were no significant differences in preoperative patient characteristics such as age, logistic EuroSCORE, sex, smoking, and extracardiac vascular problems. There were more patients from an Asian background (p < 0.01), more with noninsulin-dependent diabetes (p < 0.01), and more requiring urgent cardiac surgery (p < 0.01) in the later era. Following the introduction of nurse practitioner grade, there was a decrease in the rate of cardiac intensive care unit readmission from 2.6% to 1.9% (p = 0.05) and length of hospital stay from 10 to 8 days (p < 0.01). There was a significant improvement in overall survival after cardiac surgery from 96.5% to 98.0% (p < 0.01). Logistic regression analysis confirmed that the presence of nurse practitioners on the ward was the strongest predictor of survival with an odds ratio of 1.9 (95% confidence interval: 1.23-3.01). The introduction of the nurse practitioner grade to provide continuity in patient care including at weekends has been confirmed to improve patient outcomes including survival after cardiac surgery. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Nurse Practitioner Care Improves Renal Outcome in Patients with CKD

    PubMed Central

    van Zuilen, Arjan D.; van den Brand, Jan A.J.G.; Bots, Michiel L.; van Buren, Marjolijn; ten Dam, Marc A.G.J.; Kaasjager, Karin A.H.; Ligtenberg, Gerry; Sijpkens, Yvo W.J.; Sluiter, Henk E.; van de Ven, Peter J.G.; Vervoort, Gerald; Vleming, Louis-Jean; Blankestijn, Peter J.; Wetzels, Jack F.M.

    2014-01-01

    Treatment goals for patients with CKD are often unrealized for many reasons, but support by nurse practitioners may improve risk factor levels in these patients. Here, we analyzed renal endpoints of the Multifactorial Approach and Superior Treatment Efficacy in Renal Patients with the Aid of Nurse Practitioners (MASTERPLAN) study after extended follow-up to determine whether strict implementation of current CKD guidelines through the aid of nurse practitioners improves renal outcome. In total, 788 patients with moderate to severe CKD were randomized to receive nurse practitioner support added to physician care (intervention group) or physician care alone (control group). Median follow-up was 5.7 years. Renal outcome was a secondary endpoint of the MASTERPLAN study. We used a composite renal endpoint of death, ESRD, and 50% increase in serum creatinine. Event rates were compared with adjustment for baseline serum creatinine concentration and changes in estimated GFR were determined. During the randomized phase, there were small but significant differences between the groups in BP, proteinuria, LDL cholesterol, and use of aspirin, statins, active vitamin D, and antihypertensive medications, in favor of the intervention group. The intervention reduced the incidence of the composite renal endpoint by 20% (hazard ratio, 0.80; 95% confidence interval, 0.66 to 0.98; P=0.03). In the intervention group, the decrease in estimated GFR was 0.45 ml/min per 1.73 m2 per year less than in the control group (P=0.01). In conclusion, additional support by nurse practitioners attenuated the decline of kidney function and improved renal outcome in patients with CKD. PMID:24158983

  1. Telehealth and eHealth in nurse practitioner training: current perspectives

    PubMed Central

    Rutledge, Carolyn M; Kott, Karen; Schweickert, Patty A; Poston, Rebecca; Fowler, Christianne; Haney, Tina S

    2017-01-01

    Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this article focuses on topics including 1) defining telehealth, 2) telehealth etiquette, 3) interprofessional collaboration, 4) regulations, 5) reimbursement, 6) security/Health Insurance Portability and Accountability Act (HIPAA), 7) ethical practice in telehealth, and 8) satisfaction of patients and providers. A multimodal approach based on a review of the literature is presented for providing the training: 1) didactics, 2) simulations including standardized patient encounters, 3) practice immersions, and 4) telehealth projects. Studies found that training using the multimodal approach allowed the students to develop comfort, knowledge, and skills needed to embrace the utilization of telehealth in health care. PMID:28721113

  2. Coping With Moral Distress in Oncology Practice: Nurse and Physician Strategies.

    PubMed

    Lievrouw, An; Vanheule, Stijn; Deveugele, Myriam; Vos, Martine; Pattyn, Piet; Belle, Van; Benoit, Dominique D

    2016-07-01

    To explore variations in coping with moral distress among physicians and nurses in a university hospital oncology setting.
. Qualitative interview study.
. Internal medicine (gastroenterology and medical oncology), gastrointestinal surgery, and day clinic chemotherapy at Ghent University Hospital in Belgium.
. 17 doctors and 18 nurses with varying experience levels, working in three different oncology hospital settings. 
. Patients with cancer were interviewed based on the critical incident technique. Analyses were performed using thematic analysis.
. Moral distress lingered if it was accompanied by emotional distress. Four dominant ways of coping (thoroughness, autonomy, compromise, and intuition) emerged, which could be mapped on two perpendicular continuous axes. Moral distress is a challenging phenomenon in oncology. However, when managed well, it can lead to more introspection and team reflection, resulting in a better interpersonal understanding.
. Team leaders should recognize their own and their team members' preferred method of coping and tailored support should be offered to ease emotional distress.

  3. Integrative Review of Facility Interventions to Manage Compassion Fatigue in Oncology Nurses.

    PubMed

    Wentzel, Dorien; Brysiewicz, Petra

    2017-05-01

    Oncology nurses are regularly exposed to high-stress situations that may lead to compassion fatigue, and many institutions have implemented interventions to reduce burnout in nurses, but knowledge on the feasiblity, effectiveness, and nurses' experience of interventions is lacking.
. Electronic search of literature published from 1992-2015 was performed to evaluate in-facility interventions to manage compassion fatigue in oncology nurses. Databases used included CINAHL®, PubMed, Web of Science, Google Scholar, and PsycINFO®. 
. The goal was to evaluate the effectiveness, feasibility, and nurses' experience of interventions to manage compassion fatigue. The study designs, methods, and limitations were independently screened by the authors. 
. Of 164 studies, 31 met eligibility criteria. 
. The majority of the studies were conducted in Western countries, which suggests the need for additional research in other settings to determine effective interventions that address compassion fatigue and stress cross-culturally. Quantitative and qualitative studies failed to gain high scores in terms of quality. Limited conclusions can be drawn from small studies that report on outcomes with many confounding variables, such as turnover rate or general health of nurses, from a single institution. 
. Lack of empirical precision in evaluating the effectiveness, feasibility, and nurses' experiences of interventions indicates a need for future, more rigorously designed experimental studies. Because of the global increase in the number of patients being diagnosed and living with cancer, oncology nurses should be able to recognize and manage compassion fatigue.

  4. An Assessment of the Current US Radiation Oncology Workforce: Methodology and Global Results of the American Society for Radiation Oncology 2012 Workforce Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vichare, Anushree; Washington, Raynard; Patton, Caroline

    Purpose: To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. Methods and Materials: An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results ismore » presented in this paper. Results: A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. Conclusions: This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark

  5. An assessment of the current US radiation oncology workforce: methodology and global results of the American Society for Radiation Oncology 2012 Workforce Study.

    PubMed

    Vichare, Anushree; Washington, Raynard; Patton, Caroline; Arnone, Anna; Olsen, Christine; Fung, Claire Y; Hopkins, Shane; Pohar, Surjeet

    2013-12-01

    To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results is presented in this paper. A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark for future studies, as many changes in the healthcare field

  6. Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey: A Cross-Sectional Survey.

    PubMed

    Gok Metin, Zehra; Izgu, Nur; Karadas, Canan; Arikan Donmez, Ayse

    In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.

  7. Decreasing barriers for nurse practitioner social entrepreneurship.

    PubMed

    Sharp, Dayle B; Monsivais, Diane

    2014-10-01

    To describe difficulties associated with the business-related aspects of practice in role transition of rural nurse practitioners (NPs), and to give practice implications. This focused ethnographic study derived data from semi-structured interviews. Participants provided information about rural NP practice ownership and barriers. The sample consisted of 24 rural NPs living throughout the United States. The majority were 51-60 years of age (45%) and females (93%) who had been in rural practice for 1 to over 20 years. NP social entrepreneurs experience difficulties related to scope of practice, business skills, and role conflict. To decrease barriers for NP clinic ownership and management, NPs need to receive education related to financing a rural practice, legal/regulatory practices, strategic planning, leadership, and clinic management. ©2014 American Association of Nurse Practitioners.

  8. Relation of Compassionate Competence to Burnout, Job Stress, Turnover Intention, Job Satisfaction and Organizational Commitment for Oncology Nurses in Korea.

    PubMed

    Park, Sun-A; Ahn, Seung-Hee

    2015-01-01

    Nursing focuses on the development of an empathic relationship between the nurse and the patients. Compassionate competence, in particular, is a very important trait for oncology nurses. The current study sought to determine the degree of compassionate competence in oncology nurses, as well as to determine the relationships between compassionate competence, burnout, job stress, turnover intention, degrees of job satisfaction, and organizational commitment in oncology nurses. A descriptive correlational study evaluating the relationships between compassionate competence, burnout, job stress, turnover intention, degrees of job satisfaction, and organizational commitment in 419 oncology nurses was conducted between January 30 and February 20, 2015. The average score of compassionate competence for oncology nurses in the current study was higher than for clinical nurses. The correlational analysis between compassionate competence and organizational commitment, burnout, job stress, turnover intention, and degree of job satisfaction revealed a high correlation between compassionate competence and positive job satisfaction and organizational commitment. Compassionate competence was higher in oncology nurses than in nurses investigated in previous studies and positively correlated with work experience. Job satisfaction and organizational commitment in nurses may be improved through compassionate competence enhancement programs that employ a variety of experiences.

  9. Oncology nurses and the experience of participation in an evidence-based practice project.

    PubMed

    Fridman, Mary; Frederickson, Keville

    2014-07-01

    To illuminate the experiences of oncology nurses who participated in an evidence-based practice (EBP) project in an institution with an EBP organizational structure. A descriptive phenomenologic approach and in-depth interviews with each participant. An oncology-focused academic medical center with an established organizational infrastructure for EBP. 12 RNs working in an oncology setting who participated in an EBP project. Descriptive, qualitative phenomenologic approach through use of interviews and analysis of interview text. Four essential themes (i.e., support, challenges, evolution, and empowerment) and 11 subthemes emerged that reflected nurses' professional and personal growth, as well as the creation of a culture of EBP in the workplace. The participants described the EBP project as a positive, empowering personal and professional evolutionary experience with supports and challenges that resulted in improvements in patient care. To the authors' knowledge, the current study is the first qualitative study to demonstrate improved nursing outcomes (e.g., professional growth, improved nursing performance) and nurses' perception of improved patient outcomes (e.g., ongoing healthcare collaboration, evidence-based changes in practice).

  10. Canadian nurse practitioner job satisfaction.

    PubMed

    LaMarche, Kimberley; Tullai-McGuinness, Susan

    2009-01-01

    To examine the level of job satisfaction and its association with extrinsic and intrinsic job satisfaction characteristics among Canadian primary healthcare nurse practitioners (NPs). A descriptive correlational design was used to collect data on NPs' job satisfaction and on the factors that influence their job satisfaction. A convenience sample of licensed Canadian NPs was recruited from established provincial associations and special-interest groups. Data about job satisfaction were collected using two valid and reliable instruments, the Misener Nurse Practitioner Job Satisfaction Survey and the Minnesota Satisfaction Questionnaire. Descriptive statistics, Pearson correlation and regression analysis were used to describe the results. The overall job satisfaction for this sample ranged from satisfied to highly satisfied. The elements that had the most influence on overall job satisfaction were the extrinsic category of partnership/collegiality and the intrinsic category of challenge/autonomy. These findings were consistent with Herzberg's Dual Factor Theory of Job Satisfaction. The outcomes of this study will serve as a foundation for designing effective human health resource retention and recruitment strategies that will assist in enhancing the implementation and the successful preservation of the NP's role.

  11. The effectiveness of nurse practitioners working at a GP cooperative: a study protocol.

    PubMed

    Wijers, Nancy; Schoonhoven, Lisette; Giesen, Paul; Vrijhoef, Hubertus; van der Burgt, Regi; Mintjes, Joke; Wensing, Michel; Laurant, Miranda

    2012-08-07

    In many countries out-of-hours care faces serious challenges, including shortage of general practitioners, a high workload, reduced motivation to work out of hours, and increased demand for out-of-hours care. One response to these challenges is the introduction of nurse practitioner as doctor substitutes, in order to maintain the (high) accessibility and safety of out of hours care. Although nurse practitioners have proven to provide equally safe and efficient care during daytime primary care, it is unclear whether substitution is effective and efficient in the more complex out of hours primary care. This study aims to assess the effects of substitution of care from general practitioners to nurse practitioners in an out of hours primary care setting. A quasi experimental study is undertaken at one "general practitioner cooperative" to offer out-of-hours care for 304.000 people in the South East of the Netherlands. In the experimental condition patient care is provided by a team of one nurse practitioner and four general practitioners; where the nurse practitioner replaces one general practitioner during one day of the weekend from 10 am to 5 pm. In the control condition patient care is provided by a team of five general practitioners during the other day of the weekend, also from 10 am to 5 pm. The study period last 15 months, from April 2011 till July 2012. Data will be collected on number of different outcomes using a range of methods. Our primary outcome is substitution of care. This is calculated using the number and characteristics of patients that have a consultation at the GP cooperative. We compare the number of patients seen by both professionals, type of complaints, resource utilization (e.g. prescription, tests, investigations, referrals) and waiting times in the experimental condition and control condition. This data is derived from patient electronic medical records. Secondary outcomes are: patient satisfaction; general practitioners workload; quality

  12. Trends in nurse practitioners' prescribing to older adults in Ontario, 2000-2010: a retrospective cohort study

    PubMed Central

    Tranmer, Joan E.; Colley, Lindsey; Edge, Dana S.; Sears, Kim; VanDenKerkhof, Elizabeth; Levesque, Linda

    2015-01-01

    Background: Nurse prescribing is a practice that has evolved and will continue to evolve in response to emerging trends, particularly in primary care. The goal of this study was to describe the trends and patterns in medication prescription to adults 65 years of age or older in Ontario by nurse practitioners over a 10-year period. Methods: We conducted a population-based descriptive retrospective cohort study. All nurse practitioners registered in the Corporate Provider Database between Jan. 1, 2000, and Dec. 31, 2010, were identified. We identified actively prescribing nurse practitioners through linkage of dispensed medications to people aged 65 years or older from the Ontario Drug Benefit database. For comparison, all prescription medications dispensed by family physicians to a similar group were identified. Geographic location was determined based on site of nurse practitioner practice. Results: The number and proportion of actively prescribing nurse practitioners prescribing to older adults increased during the study period, from 44/340 (12.9%) to 888/1423 (62.4%). The number and proportion of medications dispensed for chronic conditions by nurse practitioners increased: in 2010, 9 of the 10 top medications dispensed were for chronic conditions. There was substantial variation in the proportion of nurse practitioners dispensing medication to older adults across provincial Local Health Integration Networks. Interpretation: Prescribing by nurse practitioners to older adults, particularly of medications related to chronic conditions, increased between 2000 and 2010. The integration of nurse practitioners into primary care has not been consistent across the province and has not occurred in relation to population changes and perhaps population needs. PMID:26457291

  13. Oncology nurses and indoor tanning: stylish or risky behavior?

    PubMed

    Leong, Christina Marie; Palos, Guadalupe R

    2014-06-01

    Being tan has become a social norm, and some nurses engage in that widely accepted lifestyle. Mounting evidence of the increased risk to melanoma and nonmelanoma skin cancers associated with indoor tanning supports the need for nurses to integrate skin cancer education, counseling, and referrals into routine practice. The current article presents an overview of the risks associated with indoor tanning, discusses its acceptance as a social norm, and offers strategies to support oncology nurses in changing the widespread trend.

  14. Articulating nurse practitioner practice using King's theory of goal attainment.

    PubMed

    de Leon-Demare, Kathleen; MacDonald, Jane; Gregory, David M; Katz, Alan; Halas, Gayle

    2015-11-01

    To further understand the interactions between nurse practitioners (NPs) and patients, King's nursing theory of goal attainment was applied as the conceptual framework to describe the interactions between NPs and patients in the primary care setting. Six dyads of NPs and their patients were video- and audio-taped over three consecutive clinic visits. For the purposes of this arm of the study, the audio-taped interactions were transcribed and then coded using King's concepts in her theory of goal attainment. King's theory was applicable to describe NP practice. King's concepts and processes of nurse-patient interactions, such as disturbances, mutual goal setting, and transactions, were observed in NP-patient interactions. Disturbances during clinical encounters were essential in the progression toward goal attainment. Elements, such as social exchange, symptom reporting, role explanation, and information around clinical processes facilitated relationship building. NPs as practitioners need to be reflective of their own practice, embrace disturbances in the clinical encounter, and attend to these as opportunities for mutual goal setting. ©2015 American Association of Nurse Practitioners.

  15. Nurse Practitioners' Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia.

    PubMed

    Hughes, Linda; Adair, Jean; Feng, Feng; Maciejewski, Stephanie; Sharma, Harsha

    2016-01-01

    In the United States, fibromyalgia affects 2%-5% of the adult population, rendering it the most common chronic, widespread pain condition. The American College of Rheumatology has published diagnostic criteria for fibromyalgia, with the latest version in 2010. The purpose of this study was to evaluate nurse practitioners' education and awareness of fibromyalgia and to evaluate nurse practitioners' practices for the management of fibromyalgia. Sixty-six nurse practitioners voluntarily completed an online survey regarding their education, diagnosis, and treatment options for patients with fibromyalgia. The majority of participants reported that they always or occasionally had difficulty diagnosing fibromyalgia and worried about labeling their patients as having fibromyalgia. The most commonly used agents were nonsteroidal anti-inflammatory drugs (70%), serotonin norepinephrine reuptake inhibitors (61%), selective serotonin reuptake inhibitors (51%), and muscle relaxants (44%). Nondrug therapies included exercise (88%), cognitive behavior therapy (58%), and nutrition (56%). Further education is needed for nurse practitioners to increase confidence in diagnosing and managing fibromyalgia.

  16. Oncology nurses' use of National Comprehensive Cancer Network clinical practice guidelines for chemotherapy-induced and febrile neutropenia.

    PubMed

    Nirenberg, Anita; Reame, Nancy K; Cato, Kenrick D; Larson, Elaine L

    2010-11-01

    To describe oncology nurses' use of National Comprehensive Cancer Network (NCCN) clinical practice guidelines for chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN). Cross-sectional survey design; descriptive, correlational analysis. E-mail invitation to Web-based survey. Random sample of 309 Oncology Nursing Society (ONS) members with e-mail addresses who provide care to adult patients receiving chemotherapy. The investigator-developed Neutropenia Oncology Nurses Survey was used. Descriptive tests compared respondents' personal and professional characteristics to those of general ONS members; nonparametric chi-square and Kruskal-Wallis tests were used to correlate respondents' survey subscale scores with demographic data. Significant associations were entered into multiple logistic regression models. The Neutropenia Oncology Nurses Survey's subscales measured subjective norm, attitude, perceived competence and confidence, perceived barriers, and use of NCCN clinical practice guidelines for CIN and FN. Response rate of nurses who opened the survey was 50%. Most practiced in community versus academic centers. Eighty percent reported using the NCCN clinical practice guidelines for CIN and FN. Respondents were more likely to use clinical practice guidelines when they were expected to by physician and nurse colleagues, they perceived fewer barriers, or they held advanced oncology certification. This study was the first to assess oncology nurses' reported use of NCCN clinical practice guidelines for CIN and FN. It also demonstrated the feasibility of partnering with ONS for Web-based survey research. The findings give insight into work-place barriers to evidence-based practice in various settings. Expanding dissemination and implementation of clinical practice guideline recommendations will support the development of oncology nursing standards for risk assessment, management, and patient and family education in CIN and FN.

  17. Anxiety symptoms and quality of interaction among oncology nurses: a correlational, cross-sectional study.

    PubMed

    Karanikola, Maria Nk; Giannakopoulou, Margarita; Kalafati, Maria; Kaite, Charis P; Patiraki, Elisabeth; Mpouzika, Meropi; Papathanassoglou, Elisabeth E D; Middleton, Nicos

    2016-01-01

    To explore the severity of Anxiety Symptoms (AS) among Greek oncology nursing personnel, the degree of satisfaction from professional relationships, and potential association between them. A descriptive cross-sectional correlational study was performed in 2 Greek Oncology Hospitals, in 72 members of nursing personnel. Hamilton Anxiety Scale was used for the assessment of AS severity and the Index of Work Satisfaction subscale "Satisfaction from Interaction" for the degree of satisfaction from professional relationships among nursing personnel (NN) and between nursing personnel and physicians (NP). 11% of the sample reported clinical AS [≥26, scale range (SR): 0-52]. Satisfaction from NN [5.10 (SD: 1.04), SR: 1-7], and NP [4.21 (SD: 0.77), SR: 1-7] professional interaction were both moderate. Statistically significantly associations were observed between clinical AS and satisfaction from NN (p=0.014) and NP (p=0.013) professional interaction. Anxiety reduction interventions and improvement of professional relationships are essentials in order to reduce oncology nurses' psychological distress.

  18. Prevalence of burnout syndrome in oncology nursing: A meta-analytic study.

    PubMed

    Cañadas-De la Fuente, Guillermo A; Gómez-Urquiza, Jose L; Ortega-Campos, Elena M; Cañadas, Gustavo R; Albendín-García, Luis; De la Fuente-Solana, Emilia I

    2018-05-01

    To determine the prevalence of high levels of emotional exhaustion and depersonalization and low personal accomplishment in nursing professionals in oncology services. A meta-analytical study was performed. The search was carried out in March 2017 in Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN, and LILACS databases. Studies using Maslach Burnout Inventory for the assessment of burnout were included. The total sample of oncology nurses was n = 9959. The total number of included studies was n = 17, with n = 21 samples for the meta-analysis of emotional exhaustion and n = 18 for depersonalization and low personal accomplishment. The prevalence of emotional exhaustion and of depersonalization was 30% (95% CI = 26%-33%) and 15% (95% CI = 9%-23%), respectively, and that of low personal performance was 35% (95% CI = 27%-43%). The are many oncology nurses with emotional exhaustion and low levels of personal accomplishment. The presence and the risk of burnout among these staff members are considerable. Copyright © 2018 John Wiley & Sons, Ltd.

  19. Job satisfaction in an oncology nursing team.

    PubMed

    Silva, Vagnára Ribeiro da; Velasque, Luciane de Souza; Tonini, Teresa

    2017-01-01

    to identify the level of attributed, perceived and real job satisfaction of oncology nursing professionals and analyze the relationships between the levels of satisfaction among these workers. a descriptive, quantitative cross-sectional study was conducted using the Index of Work Satisfaction (IWS) to evaluate the nursing team, nurses and technicians/auxiliaries. A total of 348 workers answered the questionnaire, of which 216 were fully completed and considered for the IWS calculation. Autonomy was considered the most important item in attributed satisfaction for the nursing team and nurses. Salary was valorized most by the technicians/auxiliaries. For perceived satisfaction, Professional Status was the most important for all workers. Regarding real satisfaction, Interaction was the most important for the nursing team and technicians/auxiliaries; while the nurses valorized Autonomy. The nurses presented the greatest job satisfaction. a discrepancy was observed in job satisfaction among the oncology nurses, indicating the importance of further quantitative research. identificar o nível de satisfação profissional atribuído, percebido e o real no trabalho de profissionais de enfermagem oncológica e analisar as relações entre os níveis de satisfação desses trabalhadores. estudo quantitativo, descritivo, transversal que utilizou o Índice de Satisfação Profissional (ISP) para avaliar a equipe de enfermagem, enfermeiros e técnicos/auxiliares. Dentre os profissionais, 348 destes responderam o questionário, dos quais 216 foram totalmente preenchidos e considerados para o cálculo do ISP. Autonomia foi mais importante na satisfação atribuída para a equipe de enfermagem e enfermeiros, Remuneração foi mais valorizada pelos técnicos/auxiliares. Para a satisfação percebida, Status profissional foi mais importante para todos os profissionais. Sobre a real satisfação, Interação foi o mais importante para a equipe de enfermagem e técnicos/auxiliares; os

  20. Fertility preservation counselling in Dutch Oncology Practice: Are nurses ready to assist physicians?

    PubMed

    Krouwel, E M; Nicolai, M P J; van Steijn-van Tol, A Q M J; Putter, H; Osanto, S; Pelger, R C M; Elzevier, H W

    2017-11-01

    Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended. © 2016 John Wiley & Sons Ltd.

  1. The relationship between job stress and burnout levels of oncology nurses.

    PubMed

    Tuna, Rujnan; Baykal, Ülkü

    2014-01-01

    Job stress and burnout levels of oncology nurses increase day-by-day in connection with rapidly increasing cancer cases worldwide as well as in Turkey. The purpose of this study was to establish job stress and burnout levels of oncology nurses and the relationship in between. The sample of this descriptive study comprised of 189 nurses that are selected by nonprobability sampling method, employed by 11 hospitals in Istanbul. Survey form of 20 questions, Job Stressors Scale and Maslach Burnout Inventory (MBI) were used during collection of data. Data were evaluated using percentage, Kruskal-Wallis, Mann-Whitney U and Spearman correlation analyses. In the study, there was a positively weak correlation between "Work Role Ambiguity" subdimension of Job Stressors Scale and "Emotional Exhaustion" and "Personal Accomplishment" subdimensions, whereas a positively weak and medium correlation was encountered between "Work Role Conflict" subdimension and "Emotional Exhaustion" and "Depersonalization" subdimensions. A negatively weak correlation was found between "Work Role Overload" subdimension and "Emotional Exhaustion" and "Depersonalization" subdimensions. A significant relationship was established between subdimensions of job stress level and of burnout level, that a lot of oncology nurses who have participated in the study wanted to change their units, because of the high attrition rate.

  2. Confidence and authority through new knowledge: An evaluation of the national educational programme in paediatric oncology nursing in Sweden.

    PubMed

    Pergert, Pernilla; Af Sandeberg, Margareta; Andersson, Nina; Márky, Ildikó; Enskär, Karin

    2016-03-01

    There is a lack of nurse specialists in many paediatric hospitals in Sweden. This lack of competence is devastating for childhood cancer care because it is a highly specialised area that demands specialist knowledge. Continuing education of nurses is important to develop nursing practice and also to retain them. The aim of this study was to evaluate a Swedish national educational programme in paediatric oncology nursing. The nurses who participated came from all of the six paediatric oncology centres as well as from general paediatric wards. At the time of the evaluation, three groups of registered nurses (n=66) had completed this 2year, part-time educational programme. A study specific questionnaire, including closed and open-ended questions was sent to the 66 nurses and 54 questionnaires were returned. Answers were analysed using descriptive statistics and qualitative content analysis. The results show that almost all the nurses (93%) stayed in paediatric care after the programme. Furthermore, 31% had a position in management or as a consultant nurse after the programme. The vast majority of the nurses (98%) stated that the programme had made them more secure in their work. The nurses were equipped, through education, for paediatric oncology care which included: knowledge generating new knowledge; confidence and authority; national networks and resources. They felt increased confidence in their roles as paediatric oncology nurses as well as authority in their encounters with families and in discussions with co-workers. New networks and resources were appreciated and used in their daily work in paediatric oncology. The programme was of importance to the career of the individual nurse and also to the quality of care given to families in paediatric oncology. The national educational programme for nurses in Paediatric Oncology Care meets the needs of the highly specialised care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Professional identity of Korean nurse practitioners in the United States.

    PubMed

    Seo, Kumsook; Kim, Miyoung

    2017-04-01

    Despite nurse practitioners' (NPs) professional identity having important implications for the confirmation of nursing practice characteristics, few studies have examined the professional identity of NPs overlaid with the immigrant experience. The aim of this study was to explore the career characteristics of Korean nurse immigrants who became NPs in the United States. Seven Korean NPs in the United States underwent in-depth interviews from August 2013 to May 2015. Content analysis was employed for data analysis. Five themes were identified regarding their professional identity as NPs: patient-centered thinking, responsibility for patient care, dedicated life, diligence, and feelings of achievement. Of these, patient-centered thinking appeared to be the overriding theme. The findings add to nursing knowledge about immigrant nurses and their abilities and striving to develop into new roles in nursing. The participants focused on listening, interpersonal relationships, and education in patient care, which helped differentiate their roles from those of other healthcare professionals. Nurse managers should consider the study findings when making policies to assist immigrant nurses to acculturate into practice, and there is a need for the development of educational materials to guide and promote the NPs' professional role. ©2017 American Association of Nurse Practitioners.

  4. Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India.

    PubMed

    LeBaron, Virginia T; Palat, Gayatri; Sinha, Sudha; Chinta, Sanjeeva Kumari; Jamima, Beaulah John Battula; Pilla, Usha Lakshmi; Podduturi, Nireekshana; Shapuram, Yadamma; Vennela, Padma; Rapelli, Vineela; Lalani, Zahra; Beck, Susan L

    2017-01-01

    Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. Qualitative ethnography. The study was conducted at a government cancer hospital in urban South India. Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study. Data were collected over 9 months (September 2011- June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews. Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns. Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training. Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.

  5. Essential nurse practitioner business knowledge: An interprofessional perspective.

    PubMed

    LaFevers, David; Ward-Smith, Peggy; Wright, Wendy

    2015-04-01

    To describe business practice knowledge from the perspectives of nurse practitioners (NPs) who are practicing clinicians, academic instructors, and clinic managers. Using the eight domains of business practice attitudes identified by the Medical Group Management Associations Body of Knowledge (MGMA), which are supported by the American Association of Colleges of Nursing (AACN), a study-specific survey was developed. Data, which describe the knowledge and attitudes with respect to business practices, were obtained from 370 participants. Regardless of their job classification, these participants described (1) quality management, (2) risk management, and (3) patient care systems as critical business practice knowledge. Consensus was also achieved when ranking the content for business practice knowledge: (1) patient care systems, (2) business operation, and (3) financial management. These data identify gaps in business practice knowledge and content that should be included in educational programs. Business practice knowledge is essential for a successful clinical practice and should be a professional practice skill for the NP. ©2015 American Association of Nurse Practitioners.

  6. Faculty mentorship: support for nurse practitioner students and staff within the rural community health setting.

    PubMed

    Hanson, C M; Hilde, E

    1989-01-01

    As pointed out in the introduction, there are certain practical concepts within our base of nursing knowledge that can only be taught through experience. Many things are easier to teach by example. As we turn back the clock in nursing, we can see how Florence Nightingale, Clara Barton, and Lillian Wald were role models to their nursing peers in their era. They taught nursing by example, by role modeling their clinical expertise. Today, this model is still effective and faculty mentoring of nurse practitioner students and CHNs in a compassionate and collegial leadership results in higher quality of health care for our nation's needy clients and their families. But greater yet are the opportunities for flexible nurse practitioner faculty practice and personal interactions on many levels for nursing faculty who wish to share their expertise. Mentorship by nurse practitioner faculty for nurse practitioner students and CHNs in a rural clinical setting has revealed many positive aspects in providing quality care for rural clients and growth for nurses. Exposure to the rural community health system helps us, as nurses, to identify the many strengths it possesses for innovative rural nursing practice.

  7. Equity in Cancer Care: Strategies for Oncology Nurses.

    PubMed

    Truant, Tracy

    2017-03-01

    There is growing evidence of inequities among people living with cancer. Aligning with nursing's social justice imperative, addressing these inequities is an integral, yet underdeveloped, aspect of the nurses' role. Understanding the social determinants of health, and the factors, contexts, and structures that influence individuals' opportunities for health, is an essential foundation for moving the health equity agenda forward. Oncology nurses can implement a two-pronged approach to further this agenda through strategies focusing on the direct care of individuals and communities, and addressing the root causes of inequity through leadership, policy influence, advocacy, education, and research. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. The effectiveness of Nurse Practitioners working at a GP cooperative: a study protocol

    PubMed Central

    2012-01-01

    Background In many countries out-of-hours care faces serious challenges, including shortage of general practitioners, a high workload, reduced motivation to work out of hours, and increased demand for out-of-hours care. One response to these challenges is the introduction of nurse practitioner as doctor substitutes, in order to maintain the (high) accessibility and safety of out of hours care. Although nurse practitioners have proven to provide equally safe and efficient care during daytime primary care, it is unclear whether substitution is effective and efficient in the more complex out of hours primary care. This study aims to assess the effects of substitution of care from general practitioners to nurse practitioners in an out of hours primary care setting. Design A quasi experimental study is undertaken at one “general practitioner cooperative” to offer out-of-hours care for 304.000 people in the South East of the Netherlands. In the experimental condition patient care is provided by a team of one nurse practitioner and four general practitioners; where the nurse practitioner replaces one general practitioner during one day of the weekend from 10 am to 5 pm. In the control condition patient care is provided by a team of five general practitioners during the other day of the weekend, also from 10 am to 5 pm. The study period last 15 months, from April 2011 till July 2012. Methods Data will be collected on number of different outcomes using a range of methods. Our primary outcome is substitution of care. This is calculated using the number and characteristics of patients that have a consultation at the GP cooperative. We compare the number of patients seen by both professionals, type of complaints, resource utilization (e.g. prescription, tests, investigations, referrals) and waiting times in the experimental condition and control condition. This data is derived from patient electronic medical records. Secondary outcomes are: patient satisfaction

  9. A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service.

    PubMed

    Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard

    2014-09-01

    To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Pragmatic randomized controlled trial at one site with 260 participants. This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce. Trial registration details: Australian and New Zealand Clinical Trials Registry dated 18th August 2013, ACTRN12613000933752. © 2014 John Wiley & Sons Ltd.

  10. Assessing the learning needs of oncology nurses.

    PubMed

    Cannon, Carol A; Watson, Lisa K; Roth, Matt T; LaVergne, Shirley

    2014-10-01

    The Nurse Oncology Education Program (NOEP) is a nonprofit organization of the Texas Nurses Foundation that develops and provides education for nurses in all fields of practice on cancer prevention, detection, treatment, and survivorship. To meet the most current educational needs of nurses, NOEP conducts a biannual needs assessment survey to better understand its audience and inform its course development. The 2013 NOEP needs assessment survey used a convenience sample of licensed nurses throughout the United States. Nurses completed the online survey, and results revealed several priority areas for educational programs, including management of cancer symptoms and treatment side effects, complementary and alternative or integrative medicine, and screening recommendations. Time was noted as the largest barrier to educating patients and families about primary prevention practices. Results from this survey can be compared to those from previous surveys, particularly the 2009 and 2011 surveys, to determine changes in the demographics of NOEP's constituency, as well as consistencies in educational gaps. The results from the 2013 NOEP needs assessment survey offer valuable information about the learning needs of nurses across the country. The data can be used by the nurse educators and faculty who are responsible for providing cancer-specific education to nurses.

  11. Evaluation Study of Family Nurse Practitioners in US Army Health Care.

    DTIC Science & Technology

    1982-01-01

    Practitioners: The Family Nurse Practitioner Survey consisted of five parts: (1) Demographic; (2) Attitude Scale; (3) Present Assignment; (4) Role...Demographics; (2) Attitudes ; and (3) Role Functions/Diagnostic Categories. All results are displayed in Appendix 2. The information on the functions/diagnostic...requirements at least at the major Family Practice Departments for the FNP. This attitude is shared by a great majority of the ANC nurse managers queried

  12. Development and testing of an instrument to measure holistic nursing values in nurse practitioner care.

    PubMed

    Kinchen, Elizabeth

    2015-01-01

    As primary care delivery evolves in the United States with nurse practitioners (NPs) as key providers, exploring the patient's perception of the nature and quality of NPs' care is of critical importance to healthcare consumers, providers, educators, policy makers, and underwriters. The aim of this study was to describe the development and testing of the Nurse Practitioner Holistic Caring Instrument, a new, investigator-developed measure of the preservation of holistic nursing values in NP care. Results suggest that NPs provide patient-centered, comprehensive, and clinically competent care, rendering them ideally suited to leading primary health care delivery. However, further testing in more diverse populations and settings is needed to strengthen preliminary findings.

  13. Role of nurse practitioners in reducing cardiovascular risk factors: a retrospective cohort study.

    PubMed

    Klemenc-Ketis, Zalika; Terbovc, Alenka; Gomiscek, Bostjan; Kersnik, Janko

    2015-11-01

    To determine the impact of nurse practitioners' counselling on reducing cardiovascular risk factors in patients participating in routine preventive check-ups. A new model of 'renewed' family practice was introduced in Slovenia as a pilot project in 2011, in which nurse practitioners are included in a team carrying out preventive activities and managing patients with stable chronic diseases. A retrospective cohort study. This study was conducted in 16 family medicine practices (eight renewed and eight regular family practices). In each family practice, a systematic sample was selected of registered patients participating in a cardiovascular preventive check-up. Data on sex, age, blood pressure, cholesterol, blood sugar, smoking, level of physical activity and cardiovascular risk were collected. Patients attending renewed family practices received counselling on risk factors from nurse practitioners (test group), and patients attending regular family practices received counselling from family physicians (control group). Data were collected again at least one and no more than five years after the baseline consultation. There were 128 patients in the test group and 129 patients in the control group. At the control visit, the patients counselled by nurse practitioners had significantly lower levels of systolic blood pressure and cholesterol and practiced regular physical activity significantly more often than patients counselled by family physicians. Nurse practitioners can be at least as successful as physicians when counselling patients on cardiovascular risk factors during their preventive check-ups. This study showed that nurse practitioners have an important role in managing patients at the primary care level. © 2015 John Wiley & Sons Ltd.

  14. A qualitative exploration of oncology nurses' family assessment practices in Denmark and Australia.

    PubMed

    Coyne, Elisabeth; Dieperink, Karin B

    2017-02-01

    The nurses' ability to provide supportive care to the patient and the family is influenced by their family assessment skills, which provide them with understanding of the family needs and strengths. When a patient is diagnosed with cancer, it is the family who provides the long-term support for the patient, and nurses need to understand the family needs in order to provide holistic care. The objective of the present study is to understand the factors that influence nurses' family assessment practices in adult oncology setting in Denmark and Australia. An interpretive qualitative study was conducted guided by the family systems theory. Focus groups were completed with 62 nurses working in adult oncology areas in Denmark and Australia. A thematic analysis and a computer-generated concept mapping were completed to identify themes within the data. Overall, the nurses valued family as part of the patient care and worked to understand the family concerns. However, the family assessment process was unstructured and did not enable holistic family support. Nurses from both countries discussed that experience and ability to engage with the family influenced the nurse's role in family assessment. This study identified that nurses value family as part of patient care, however struggle to assess and support families during oncology care. There is a need for a structured assessment approach and education on family assessment, which could be used across the two countries and possibly internationally.

  15. Reflections on the Emotional Hazards of Pediatric Oncology Nursing: Four Decades of Perspectives and Potential.

    PubMed

    Boyle, Deborah A; Bush, Nancy Jo

    Pediatric oncology nurses are particularly vulnerable to emotional distress. Responsible for the oversight of a child's care, these nurses sustain close interactions with multiple patients and families over time, many of whom are coping with life-limiting diagnoses. The world of pediatric oncology nurses is one where tragedy is routinely witnessed thus demanding self-care and healing across a continuum. The aim of this article is to outline and review the emotional sequelae of pediatric oncology nurses' work and to suggest interventions to support well-being in light of prolonged caregiving. Three major categories that are addressed include the aspects of clinical practice that influence caregiving, the risks of burnout, compassion fatigue, moral distress and grief, and interventions to counteract these phenomena. Future-nursing research should focus upon the development of validated, psychometrically sound measurement tools to assess nurse-specific variants of burnout, compassion fatigue, moral distress, and nurse grief. Qualitative research should investigate the relationship between personal variables, workplace and team characteristics, age and experience, and their influence on the predominance of burnout, compassion fatigue, moral distress, and nurse grief. Lastly, the phenomena of resiliency demands further study. Copyright © 2018. Published by Elsevier Inc.

  16. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... practitioner and physician assistant services. 405.2415 Section 405.2415 Public Health CENTERS FOR MEDICARE... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under this...

  17. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... practitioner and physician assistant services. 405.2415 Section 405.2415 Public Health CENTERS FOR MEDICARE... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under this...

  18. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... practitioner and physician assistant services. 405.2415 Section 405.2415 Public Health CENTERS FOR MEDICARE... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under this...

  19. The relationship between job stress and burnout levels of oncology nurses

    PubMed Central

    Tuna, Rujnan; Baykal, Ülkü

    2014-01-01

    Objective: Job stress and burnout levels of oncology nurses increase day-by-day in connection with rapidly increasing cancer cases worldwide as well as in Turkey. The purpose of this study was to establish job stress and burnout levels of oncology nurses and the relationship in between. Methods: The sample of this descriptive study comprised of 189 nurses that are selected by nonprobability sampling method, employed by 11 hospitals in Istanbul. Survey form of 20 questions, Job Stressors Scale and Maslach Burnout Inventory (MBI) were used during collection of data. Data were evaluated using percentage, Kruskal–Wallis, Mann–Whitney U and Spearman correlation analyses. Results: In the study, there was a positively weak correlation between “Work Role Ambiguity” subdimension of Job Stressors Scale and “Emotional Exhaustion” and “Personal Accomplishment” subdimensions, whereas a positively weak and medium correlation was encountered between “Work Role Conflict” subdimension and “Emotional Exhaustion” and “Depersonalization” subdimensions. A negatively weak correlation was found between “Work Role Overload” subdimension and “Emotional Exhaustion” and “Depersonalization” subdimensions. Conclusion: A significant relationship was established between subdimensions of job stress level and of burnout level, that a lot of oncology nurses who have participated in the study wanted to change their units, because of the high attrition rate. PMID:27981080

  20. "Under the radar": nurse practitioner prescribers and pharmaceutical industry promotions.

    PubMed

    Ladd, Elissa C; Mahoney, Diane Feeney; Emani, Srinivas

    2010-12-01

    To assess nurse practitioners' interactions with pharmaceutical industry promotional activities and their perception of information reliability and self-reported prescribing behaviors. Self-administered online survey. A nationally randomized sample of nurse practitioner prescribers was surveyed. Eligibility criteria included current clinical practice and licensure to prescribe medications in their state of practice. A total of 263 responses were analyzed. Almost all respondents (96%) reported regular contact with pharmaceutical sales representatives, and most (71%) reported receiving information on new drugs directly from pharmaceutical sales representatives some or most of the time. A large portion (66%) dispensed drug samples regularly to their patients, and 73% believed that samples were somewhat or very helpful in learning about new drugs. Eighty-one percent of respondents thought that it was ethically acceptable to give out samples to anyone, and 90% believed that it was acceptable to attend lunch and dinner events sponsored by the pharmaceutical industry. Almost half (48%) stated that they were more likely to prescribe a drug that was highlighted during a lunch or dinner event. Most respondents stated that it was ethically acceptable for speakers to be paid by industry. Nurse practitioner prescribers had extensive contact with pharmaceutical industry promotional activities such as pharmaceutical representative contact, receipt of drug samples, and regular attendance at industry-sponsored meal events and continuing education programs. They reported that industry interface with nurse practitioner prescribers in the form of sponsored meals, education events, and paid speakers was ethically acceptable.

  1. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Services and supplies incident to nurse... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under this...

  2. Compassion Fatigue, Burnout, and Compassion Satisfaction Among Oncology Nurses in the United States and Canada.

    PubMed

    Wu, Stacey; Singh-Carlson, Savitri; Odell, Annie; Reynolds, Grace; Su, Yuhua

    2016-07-01

    To examine the experiences of compassion fatigue, burnout, and compassion satisfaction among oncology nurses in the United States and Canada. 
. Quantitative, descriptive, nonexperimental.
. Online survey with members from the Canadian Association of Nursing Oncology and the Oncology Nursing Society.
. 486 American and 63 Canadian practicing oncology nurses.
. The Professional Quality of Life (ProQOL) scale, version 5, and modified Abendroth Demographic Questionnaire were administered through FluidSurveys™, an online data collection instrument. Chi-square tests of independence were used to investigate associations between demographic characteristics, health, personal stressors, and work-related characteristics to experiences of compassion fatigue, burnout, and compassion satisfaction. Compassion fatigue was measured using the subscales of secondary traumatic stress and burnout. 
. Compassion fatigue, burnout, and compassion satisfaction.
. Demographic characteristics were similar in American and Canadian participants, and both cohorts reported comparable levels of compassion fatigue, burnout, and compassion satisfaction. Perception of team cohesiveness within the workplace environment was found to be significant for both groups, as indicated by significant relationships in all three subscales of secondary traumatic stress, burnout, and compassion satisfaction in the ProQOL.
. Healthy and supportive work environments are imperative to nurses' health, well-being, and satisfaction. Improvements in the workplace can help prevent negative sequelae, as well as improve health outcomes for patients and nurses, decrease nurse turnover, and reduce healthcare expenditures. 
. Findings can be used to implement institutional changes, such as creating policies and guidelines for the development of preventive interventions and psychosocial support for nurses.

  3. Oncology Nurses' Attitudes Toward the Edmonton Symptom Assessment System: Results From a Large Cancer Care Ontario Study.

    PubMed

    Green, Esther; Yuen, Dora; Chasen, Martin; Amernic, Heidi; Shabestari, Omid; Brundage, Michael; Krzyzanowska, Monika K; Klinger, Christopher; Ismail, Zahra; Pereira, José

    2017-01-01

    To examine oncology nurses' attitudes toward and reported use of the Edmonton Symptom Assessment System (ESAS) and to determine whether the length of work experience and presence of oncology certification are associated with their attitudes and reported usage.
. Exploratory, mixed-methods study employing a questionnaire approach.
. 14 regional cancer centers (RCCs) in Ontario, Canada.
. Oncology nurses who took part in a larger province-wide study that surveyed 960 interdisciplinary providers in oncology care settings at all of Ontario's 14 RCCs.
. Oncology nurses' attitudes and use of ESAS were measured using a 21-item investigator-developed questionnaire. Descriptive statistics and Kendall's tau-b or tau-c test were used for data analyses. Qualitative responses were analyzed using content analysis.
. Attitudes toward and self-reported use of standardized symptom screening and ESAS.
. More than half of the participants agreed that ESAS improves symptom screening, most said they would encourage their patients to complete ESAS, and most felt that managing symptoms is within their scope of practice and clinical responsibilities. Qualitative comments provided additional information elucidating the quantitative responses. Statistical analyses revealed that oncology nurses who have 10 years or less of work experience were more likely to agree that the use of standardized, valid instruments to screen for and assess symptoms should be considered best practice, ESAS improves symptom screening, and ESAS enables them to better manage patients' symptoms. No statistically significant difference was found between oncology-certified RNs and noncertified RNs on attitudes or reported use of ESAS.
. Implementing a population-based symptom screening approach is a major undertaking. The current study found that oncology nurses recognize the value of standardized screening, as demonstrated by their attitudes toward ESAS.
. Oncology nurses are integral to providing high

  4. Burnout and its relationship with personality factors in oncology nurses.

    PubMed

    De la Fuente-Solana, Emilia I; Gómez-Urquiza, José L; Cañadas, Gustavo R; Albendín-García, Luis; Ortega-Campos, Elena; Cañadas-De la Fuente, Guillermo A

    2017-10-01

    To assess burnout levels in oncology nurses, to evaluate at what stage of burnout suffering they are and to analyze the relationship between burnout with personality factors. A quantitative, observational, cross-sectional multicenter study was done. Oncology nurses (n = 101) from the Andalusian Health Service (Andalusia, Spain) were included. The main variables were personality factors, assessed with the NEO-FFI questionnaire, anxiety and depression, assessed with the Educational-Clinical Questionnaire: Anxiety and Depression, and burnout, evaluated with the Maslach Burnout Inventory. Student t-statistic was used for hypothesis contrasts and Pearson's correlation coefficient was used to establish the association between personality factors and burnout. According to the burnout phases model, 29.6% of the sample is in the most severe phases. Emotional exhaustion and depersonalization are positively correlated with neuroticism and negatively correlated with agreeableness, conscientiousness, extraversion and openness. Personal accomplishment has a negative correlation with neuroticism and negative correlations with agreeableness, conscientiousness, extraversion and openness. Finally, emotional exhaustion and depersonalization have a positive correlation with anxiety and depression, while personal accomplishment has a negative correlation with anxiety and depression. A significant number of oncology nurses are in the most severe stages of burnout suffering. Personality factors have a key role in burnout development. The importance of personality factors in burnout development should be taken into account. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Journey to Becoming a Neonatal Nurse Practitioner: Making the Decision to Enter Graduate School.

    PubMed

    Brand, M Colleen; Cesario, Sandra K; Symes, Lene; Montgomery, Diane

    2016-04-01

    Neonatal nurse practitioners (NNPs) play an important role in caring for premature and ill infants. Currently, there is a shortage of NNPs to fill open positions. Understanding how nurses decide to become NNPs will help practicing nurse practitioners, managers, and faculty encourage and support nurses in considering the NNP role as a career choice. To describe how nurses decide to enter graduate school to become nurse practitioners. A qualitative study using semistructured interviews to explore how 11 neonatal intensive care unit nurses decided to enter graduate school to become NNPs. Key elements of specialization, discovery, career decision, and readiness were identified. Conditions leading to choosing the NNP role include working in a neonatal intensive care unit and deciding to stay in the neonatal area, discovering the NNP role, deciding to become an NNP, and readiness to enter graduate school. Important aspects of readiness are developing professional self-confidence and managing home, work, and financial obligations and selecting the NNP program. Neonatal nurse practitioners are both positive role models and mentors to nurses considering the role. Unit managers are obligated to provide nurses with opportunities to obtain leadership skills. Faculty of NNP programs must be aware of the impact NNP students and graduates have on choices of career and schools. Exploring the decision to become an NNP in more geographically diverse populations will enhance understanding how neonatal intensive care unit nurses decide to become NNPs.

  6. Introducing the nurse practitioner into the surgical ward: an ethnographic study of interprofessional teamwork practice.

    PubMed

    Kvarnström, Susanne; Jangland, Eva; Abrandt Dahlgren, Madeleine

    2017-08-22

    The first nurse practitioners in surgical care were introduced into Swedish surgical wards in 2014. Internationally, organisations that have adopted nurse practitioners into care teams are reported to have maintained or improved the quality of care. However, close qualitative descriptions of teamwork practice may add to existing knowledge of interprofessional collaboration when introducing nurse practitioners into new clinical areas. The aim was to report on an empirical study describing how interprofessional teamwork practice was enacted by nurse practitioners when introduced into surgical ward teams. The study had a qualitative, ethnographic research design, drawing on a sociomaterial conceptual framework. The study was based on 170 hours of ward-based participant observations of interprofessional teamwork practice that included nurse practitioners. Data were gathered from 2014 to 2015 across four surgical sites in Sweden, including 60 interprofessional rounds. The data were analysed with an iterative reflexive procedure involving inductive and theory-led approaches. The study was approved by a Swedish regional ethics committee (Ref. No.: 2014/229-31). The interprofessional teamwork practice enacted by the nurse practitioners that emerged from the analysis comprised a combination of the following characteristic role components: clinical leader, bridging team colleague and ever-present tutor. These role components were enacted at all the sites and were prominent during interprofessional teamwork practice. The participant nurse practitioners utilised the interprofessional teamwork practice arrangements to enact a role that may be described in terms of a quality guarantee, thereby contributing to the overall quality and care flow offered by the entire surgical ward team. © 2017 Nordic College of Caring Science.

  7. 42 CFR Appendix B to Part 130 - Confidential Physician or Nurse Practitioner Affidavit

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Confidential Physician or Nurse Practitioner Affidavit B Appendix B to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... 130—Confidential Physician or Nurse Practitioner Affidavit ER31MY00.002 ER31MY00.003 ...

  8. 42 CFR Appendix B to Part 130 - Confidential Physician or Nurse Practitioner Affidavit

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Confidential Physician or Nurse Practitioner Affidavit B Appendix B to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... 130—Confidential Physician or Nurse Practitioner Affidavit ER31MY00.002 ER31MY00.003 ...

  9. An explanatory model of nurse practitioner job satisfaction.

    PubMed

    Koelbel, P W; Fuller, S G; Misener, T R

    1991-01-01

    Job satisfaction influences employee retention, worker productivity, and performance quality. To retain qualified nurse practitioners (NPs), health administrators must identify sources of job satisfaction and dissatisfaction. Herzberg's dual-factor theory of job satisfaction addresses extrinsic and intrinsic work-related factors. Expansion of the model to include global job satisfaction and individual differences provided a broad framework for the assessment of nurse practitioner job satisfaction. The expanded model was used to analyze the job satisfaction of 132 NPs registered with the South Carolina State Board of Nursing in 1988 (final response rate = 90%). Participants completed the Index of Job Satisfaction (IJS), the Minnesota Satisfaction Questionnaire-Short Form (MSQ-SF), and the Personal and Work Background Questionnaire (PWBQ). Although the NPs were moderately satisfied with their overall jobs, extrinsic factors were found to be major sources of dissatisfaction. The optimal combination of variables predicted by regression analysis to influence global job satisfaction were age, number of children, urban locations, achievement, company policies and practices, creativity, independence, and compensation. Implications for health administrators to improve the work environments of NPs are discussed.

  10. Theoretical links supporting the use of problem-based learning in the education of the nurse practitioner.

    PubMed

    Chikotas, Noreen Elaine

    2008-01-01

    The need to evaluate current strategies in educating the advanced practice nurse, specifically the nurse practitioner, is becoming more and more imperative due to the ever-changing health care environment. This article addresses the role of problem-based learning (PBL) as an instructional strategy in educating and preparing the nurse practitioner for future practice.Two theoretical frameworks supporting PBL, andragogy and constructivism, are presented as important to the use of PBL in the education of the nurse practitioner.

  11. Patient and Oncology Nurse Preferences for the Treatment Options in Advanced Melanoma: A Discrete Choice Experiment.

    PubMed

    Liu, Frank Xiaoqing; Witt, Edward A; Ebbinghaus, Scot; DiBonaventura Beyer, Grace; Basurto, Enrique; Joseph, Richard W

    2017-10-25

    Understanding the perceptions of patients and oncology nurses about the relative importance of benefits and risks associated with newer treatments of advanced melanoma can help to inform clinical decision-making. The aims of this study were to quantify and compare the views of patients and oncology nurses regarding the importance of attributes of treatments of advanced melanoma. A discrete choice experiment (DCE) was conducted in US-based oncology nurses and patients diagnosed with advanced melanoma. Patients and nurses were enlisted through online panels. In a series of scenarios, respondents had to choose between 2 hypothetical treatments, each with 7 attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (DoT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3 or 4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to estimate preference weights. A total of 200 patients with advanced melanoma and 150 oncology nurses participated. The relative importance estimates of attributes by patients and nurses, respectively, were as follows: OS, 33% and 28%; AEs, 29% and 26%; ORR, 25% and 27%; PFS, 12% and 15%; DS, 2% and 3%; DoT, 0% and 0%; and MoA, 0% and 0%. Both patients and oncology nurses valued OS, ORR, and AEs as the most important treatment attributes for advanced melanoma, followed by PFS, whereas DS, DoT, and MoA were given less value in their treatment decisions. Oncology nurses and patients have similar views on important treatment considerations for advanced melanoma, which can help build trust in shared decision-making.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  12. Biomarkers: an overview for oncology nurses.

    PubMed

    Richmond, Ellen S; Dunn, Debra

    2012-05-01

    To provide an overview of the basic principles of biomarker use in clinical oncology practice and discuss the range of biomarker forms (from genes to constitutional characteristics), biomarker functions (both disease- and drug-related), modalities (protein expression patterns to patient history), the criteria for biomarker validation, and the integral role of bioinformatics. Published nursing and medical literature. The premise of nursing assessment is the same as that of biomarker use - biological variables that appear at one level of biological organization (eg, molecule, organelle, cell, tissue, organ, and organism) correspond to processes or events occurring at other levels of biologic organization. The advent of genomic technologies has logarithmically increased the volume of biomarkers, which are expected to provide new insights that improve patient care. Nurses and patients will benefit greatly from the incorporation of molecular biomarkers into patient care. Nurses will be able to better assess (and anticipate) patient needs with the new insights that are available in the post-genomic, personalized medicine era of health care. Although the rapid rate of technological changes and new discoveries will require continuing concerted educational efforts, the improved quality of patient care will be rewarded by better outcomes. Published by Elsevier Inc.

  13. Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.

    PubMed

    Nobel Murray, Alexandra; Chrisler, Joan C; Robbins, Mark L

    2016-08-01

    Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP. This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer. 116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively. Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.

  14. Remote nursing certified practice: viewing nursing and nurse practitioner practice through a social justice lens.

    PubMed

    Tarlier, Denise S; Browne, Annette J

    2011-06-01

    Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.

  15. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... statutory exclusions; and (3) Performs them while working in collaboration with a physician. (i) Collaboration is a process in which a nurse practitioner works with one or more physicians to deliver health... State in which the services are performed. (ii) In the absence of State law governing collaboration...

  16. Effects of the Use of the Provider Resilience Mobile Application in Reducing Compassion Fatigue in Oncology Nursing.

    PubMed

    Jakel, Patricia; Kenney, Jillian; Ludan, Natalia; Miller, Pamela S; McNair, Norma; Matesic, Edith

    2016-12-01

    Oncology nurses have increased exposure to the prolonged illness, tragedy, loss, and premature death of patients. As a result, they are at higher risk for developing compassion fatigue. The aim of this study was to examine if use of the Provider Resilience mobile application (PRMA) will improve oncology nurses' professional quality of life. The quasiexperimental design was comprised of a longitudinal approach to evaluate the effect of an intervention program, PRMA, on professional quality of life between two nonrandomized groups (intervention and control) using pre- and post-tests in a sample of oncology RNs. The findings of this study demonstrated no significant relationships between the intervention and control groups on secondary traumatic stress, compassion satisfaction, and burnout among oncology nurses.

  17. Developing emotional intelligence ability in oncology nurses: a clinical rounds approach.

    PubMed

    Codier, Estelle; Freitas, Beth; Muneno, Lynn

    2013-01-01

    To explore the feasibility and impact of an emotional intelligence ability development program on staff and patient care. A mixed method, pre/post-test design. A tertiary care hospital in urban Honolulu, HI. Rounds took place on a 24-bed inpatient oncology unit. 33 RNs in an oncology unit. After collection of baseline data, the emotional intelligence rounds were conducted in an inpatient oncology nursing unit on all shifts during a 10-month period. Demographic information, emotional intelligence scores, data from rounds, chart reviews of emotional care documentation, and unit-wide satisfaction and safety data. The ability to identify emotions in self and others was demonstrated less frequently than expected in this population. The low test response rate prevented comparison of scores pre- and postintervention. The staff's 94% participation in rounds, the positive (100%) evaluation of rounds, and poststudy improvements in emotional care documentation and emotional care planning suggest a positive effect from the intervention. Additional research is recommended over a longer period of time to evaluate the impact emotional intelligence specifically has on the staff's identification of emotions. Because the intervention involved minimal time and resources, feasibility for continuation of the intervention poststudy was rated "high" by the research team. Research in other disciplines suggests that improvement in emotional intelligence ability in clinical staff nurses may improve retention, performance, and teamwork in nursing, which would be of particular significance in high-risk clinical practice environments. Few research studies have explored development of emotional intelligence abilities in clinical staff nurses. Evidence from this study suggests that interventions in the clinical environment may be used to develop emotional intelligence ability. Impact from such development may be used in the future to not only improve the quality of nursing care, but also

  18. Factors influencing oncology nurses' use of hazardous drug safe-handling precautions.

    PubMed

    Polovich, Martha; Clark, Patricia C

    2012-05-01

    To examine relationships among factors affecting nurses' use of hazardous drug (HD) safe-handling precautions, identify factors that promote or interfere with HD precaution use, and determine managers' perspectives on the use of HD safe-handling precautions. Cross-sectional, mixed methods; mailed survey to nurses who handle chemotherapy and telephone interviews with managers. Mailed invitation to oncology centers across the United States. 165 nurses who reported handling chemotherapy and 20 managers of nurses handling chemotherapy. Instruments measured the use of HD precautions and individual and organizational factors believed to influence precaution use. Data analysis included descriptive statistics and hierarchical regression. Manager interview data were analyzed using content analysis. Chemotherapy exposure knowledge, self-efficacy, perceived barriers, perceived risk, interpersonal influences, and workplace safety climate. Nurses were well educated, experienced, and certified in oncology nursing. The majority worked in outpatient settings and administered chemotherapy to an average of 6.8 patients per day. Exposure knowledge, self-efficacy for using personal protective equipment, and perceived risk of harm from HD exposure were high; total precaution use was low. Nurse characteristics did not predict HD precaution use. Fewer barriers, better workplace safety climate, and fewer patients per day were independent predictors of higher HD precaution use. HD handling policies were present, but many did not reflect current recommendations. Few managers formally monitored nurses' HD precaution use. Circumstances in the workplace interfere with nurses' use of HD precautions. Interventions should include fostering a positive workplace safety climate, reducing barriers, and providing appropriate nurse-patient ratios.

  19. The effectiveness of a nurse practitioner-led pain management team in long-term care: A mixed methods study.

    PubMed

    Kaasalainen, Sharon; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Brazil, Kevin; Donald, Faith; Martin-Misener, Ruth; DiCenso, Alba; Hadjistavropoulos, Thomas; Dolovich, Lisa

    2016-10-01

    Considering the high rates of pain as well as its under-management in long-term care (LTC) settings, research is needed to explore innovations in pain management that take into account limited resource realities. It has been suggested that nurse practitioners, working within an inter-professional model, could potentially address the under-management of pain in LTC. This study evaluated the effectiveness of implementing a nurse practitioner-led, inter-professional pain management team in LTC in improving (a) pain-related resident outcomes; (b) clinical practice behaviours (e.g., documentation of pain assessments, use of non-pharmacological and pharmacological interventions); and, (c) quality of pain medication prescribing practices. A mixed method design was used to evaluate a nurse practitioner-led pain management team, including both a quantitative and qualitative component. Using a controlled before-after study, six LTC homes were allocated to one of three groups: 1) a nurse practitioner-led pain team (full intervention); 2) nurse practitioner but no pain management team (partial intervention); or, 3) no nurse practitioner, no pain management team (control group). In total, 345 LTC residents were recruited to participate in the study; 139 residents for the full intervention group, 108 for the partial intervention group, and 98 residents for the control group. Data was collected in Canada from 2010 to 2012. Implementing a nurse practitioner-led pain team in LTC significantly reduced residents' pain and improved functional status compared to usual care without access to a nurse practitioner. Positive changes in clinical practice behaviours (e.g., assessing pain, developing care plans related to pain management, documenting effectiveness of pain interventions) occurred over the intervention period for both the nurse practitioner-led pain team and nurse practitioner-only groups; these changes did not occur to the same extent, if at all, in the control group

  20. The role of the clinical nurse specialist/neonatal nurse practitioner in a breastfeeding clinic: a model of advanced practice.

    PubMed

    Gibbins, S A; Green, P E; Scott, P A; MacDonell, J W

    2000-03-01

    A commitment to quality health care requires the development of innovative models of care. An example of such a model is the Clinical Nurse Specialist/Neonatal Nurse Practitioner in the role as consultant to Lactation Consultants in a large breastfeeding clinic. The role of the Clinical Nurse Specialist/Neonatal Nurse Practitioner in this ambulatory setting encompasses all the dimensions of the advanced practice model including research, leadership, education, and clinical practice. The evolution of this model of care is described. A conceptual framework of this advanced practice model is presented, supported by examples of the role in the clinic.

  1. Perceptions of the Utilization of Family Nurse Practitioners by Current Air Force Outpatient Physicians

    DTIC Science & Technology

    1996-03-26

    detection and management of acute self-limiting conditions and management of chronic stable conditions within a family . A FNP provides primary...APPROVAL SHEET Title of thesis: "Perceptions of the Utilization of Family Nurse Practitioners by Current Air Force Outpatient Physicians" Name...of Candidate: Patrick Edward Bertz Master of Science in Nursing Family Nurse Practitioner APPROVED, ~J.~ Comm~tte Chalrperson ·Committee Me her

  2. Precepting nurse practitioner students: A new view-Results of two national surveys of nurse practitioner preceptors.

    PubMed

    Roberts, Mary Ellen; Wheeler, Kathy J; Tyler, Diane O; Padden, Diane L

    2017-08-01

    The aim of two national studies was to identify characteristics of nurse practitioners (NPs) who precept and the benefits, incentives, and barriers associated with the NP preceptor role. Stratified randomized sampling was used to invite a representative number of NPs from each state to participate in a 2015 survey and a follow-up survey in 2016. These descriptive, exploratory studies distributed electronic questionnaires to 5000 randomly selected NPs in the 2015 survey and 40,000 NPs in the 2016 survey. Responses from 10.9% (n = 548) and 9.9% (n = 3970), respectively, were analyzed. The findings show strong support among our NP colleagues to assist with educating future NPs. Several benefits, barriers, and motivators among stakeholders were identified that need to be considered when working with preceptors. This study provides a basis for understanding the current climate in education when working with clinical preceptors. Many areas become apparent where NP education could enhance the experience for both the student and the preceptor. Educational settings need to consider preceptor time, issues with online learning, and the rise of specialty practices. Offering incentives linked to the most valued, positive aspects of the role and methods to overcome barriers should be explored. ©2017 American Association of Nurse Practitioners.

  3. Building nurses' capacity to address health inequities: incorporating lesbian, gay, bisexual and transgender health content in a family nurse practitioner programme.

    PubMed

    Yingling, Charles T; Cotler, Karen; Hughes, Tonda L

    2017-09-01

    To describe our experience in incorporating lesbian, gay, bisexual and transgender health content into the family nurse practitioner curriculum at a Midwestern college of nursing in the United States. Globally, lesbian, gay, bisexual and transgender people face disparities in the domains of physical health, behavioural risks, mental health and victimisation. There remains a paucity of nursing research on most aspects of lesbian, gay, bisexual and transgender health and access to care. To date, nursing leadership and curricular bodies have not provided clear guidance on the role of nurse educators in preparing nursing students to provide care to lesbian, gay, bisexual and transgender people. Discursive paper describing the development of a lesbian, gay, bisexual and transgender health learning module for inclusion in a family nurse practitioner programme. We summarise health disparities experienced by lesbian, gay, bisexual and transgender people, describe the process of module development and outline the learning content included in the module. We also discuss challenges faced in incorporating lesbian, gay, bisexual and transgender content into nursing curricula. Despite the lack of formal direction from the nursing sector, nursing faculty should prepare nursing students to provide culturally sensitive and competent care to lesbian, gay, bisexual and transgender people. Our experience incorporating lesbian, gay, bisexual and transgender-specific content into the family nurse practitioner programme has proven to be positive for both students and faculty. Given their large numbers and presence across systems of care, nurses are uniquely positioned to address barriers to care faced by lesbian, gay, bisexual and transgender people. Modules such as the one described here can be used by nurse faculty to guide the inclusion of lesbian, gay, bisexual and transgender-specific content in family nurse practitioner or other nursing courses-as well as to guide the development

  4. Medical Cannabis: The Oncology Nurse's Role in Patient Education About the Effects of Marijuana on Cancer Palliation
.

    PubMed

    Clark, Carey S

    2018-02-01

    Cannabis, also known as marijuana, is legal either medicinally or recreationally in 29 states and the District of Columbia, with a majority of the U.S. adult population now living in states where cannabis is legal for medicinal use. As an advocate for patient autonomy and informed choice, the oncology nurse has an ethical responsibility to educate patients about and support their use of cannabis for palliation.
. This article aims to discuss the human endocannabinoid system as a basis for better understanding the palliative and curative nature of cannabis as a medicine, as well as review cannabis delivery methods and the emerging role of the oncology nurse in this realm.
. This article examines the literature and uses a theoretical-conceptual method to explore the oncology nurse's role in supporting the use of medicinal cannabis by patients with cancer. 
. The oncology nurse can play a pivotal role in supporting patients' use of cannabis for palliation.

  5. Advanced nursing practice hours as part of endorsement requirements for nurse practitioners in Australia: a definitional conundrum.

    PubMed

    Scanlon, Andrew; Cashin, Andrew; Watson, Ngaire; Bryce, Julianne

    2012-11-01

    To define what can be considered to be nursing practice, time that can be calculated as the practice of nursing as well as what is considered to be advanced nursing practice and how all this can be related to the current endorsement process for nurse practitioner (NP) in Australia. Current codes and guidelines cited by the Nurse and Midwifery Board of Australia related to nursing practice and NPs, cited competency standards from the Australian Midwifery Accreditation Council, as well as published material of peak nursing bodies from within Australia as well as internationally were used. Information was also obtained through government health and professional organization websites. All information in the literature regarding current and past status and nomenclature of advanced practice nursing was considered relevant. The definitional entanglement of what is considered to be nursing practice, the calculation of specific hours and what is advanced nursing practice interferes with endorsement of NPs in Australia, and a clear understanding of what is meant by advanced practice is required to move forward. Dependent on how practice is interpreted by the Nurse and Midwifery Board of Australia directly affects the outcome of the endorsement proceedings for individual NP candidates. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  6. How do we capture the emergency nurse practitioners' contribution to value in health service delivery?

    PubMed

    Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael

    2017-03-01

    The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

  7. Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest-intervention-posttest study.

    PubMed

    Dauer, Lawrence T; Kelvin, Joanne F; Horan, Christopher L; St Germain, Jean

    2006-06-08

    Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses.

  8. Practice activities of privately-practicing nurse practitioners: Results from an Australian survey.

    PubMed

    Currie, Jane; Chiarella, Mary; Buckley, Thomas

    2018-03-01

    To facilitate expansion of privately-practicing nurse practitioners in community and primary care settings, a legislative amendment in 2010 made privately-practicing nurse practitioners eligible to provide services subsidised through the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme. To evaluate their practice activities, a national survey of privately-practicing nurse practitioners in Australia was conducted, and data analysed using descriptive statistics and thematic analysis (n = 73). As part of their role, 96% (n = 70) participants reported undertaking direct patient care, 95% (n = 69) patient education and health promotion, 95% (n = 69) prescribed medications, 92% (n = 67) referred patients for diagnostic investigations, and 88% (n = 64) reported making a diagnosis. Over 50% of participants saw up to 15 patients daily, and 80% (n = 58) treated the same patients on a regular basis. Of the participants, 59% (n = 43) perceived that they worked to their full scope of practice. The mainstay of privately-practicing nurse practitioner services is provision of direct patient care in community and primary healthcare settings, suggesting they have emerging potential in addressing the ever-increasing demand for healthcare in Australia. © 2017 John Wiley & Sons Australia, Ltd.

  9. Human trafficking education for nurse practitioners: Integration into standard curriculum.

    PubMed

    Lutz, Rebecca M

    2018-02-01

    Human trafficking is a crime resulting in serious negative health outcomes for the victims. To provide optimal care, thus improving health outcomes, healthcare providers must be able to identify victims as they seek care for acute and chronic physical illness, communicable diseases, sexually transmitted infections, and mental health disorders (Lederer and Wetzel, 2014; Oram et al., 2012). Unfortunately, healthcare providers lack appropriate knowledge of clues that would lead to victim identification. This may result in a failure to identify victims (Beck et al., 2015; Ross et al., 2015; Konstantopoulos et al., 2013; Chisolm-Straker et al., 2012). Increasing the number of healthcare providers able to identify, treat, and refer victims of trafficking for further care is imperative. The study evaluated the knowledge level of student nurse practitioners enrolled in an adult, family, or pediatric clinical course. Knowledge domains included the definitions, laws, prevalence, identification, treatment, and community and social service resources. The study was designed as a non-probability sampling of adult, family, and pediatric nurse practitioner students (n=73). Participants included students enrolled in the Adult & Older Adult I or the Primary Care of the Child & Adolescent I course at a large public university. The study was designed as a one hour educational intervention intended for presentation in a lecture-style format. The educational intervention included a PowerPoint lecture and embedded videos. The pre-survey, designed as a paper survey, contained a demographic section followed by six survey questions covering the six domains of interest. Following the intervention, participants completed the post-survey prior to leaving the classroom. Pre-survey results pinpointed knowledge gaps across all six domains under investigation. Post-survey results revealed an increase in knowledge across all six domains of interest. The educational intervention increased knowledge

  10. Geriatric assessment in daily oncology practice for nurses and allied health care professionals: Opinion paper of the Nursing and Allied Health Interest Group of the International Society of Geriatric Oncology (SIOG).

    PubMed

    Burhenn, Peggy S; McCarthy, Alexandra L; Begue, Aaron; Nightingale, Ginah; Cheng, Karis; Kenis, Cindy

    2016-09-01

    The management of older persons with cancer has become a major public health concern in developed countries because of the aging of the population and the steady increase in cancer incidence with advancing age. Nurses and allied health care professionals are challenged to address the needs of this growing population. The International Society of Geriatric Oncology (SIOG) Nursing and Allied Health (NAH) Interest Group described key issues that nurses and allied health care professionals face when caring for older persons with cancer. The domains of the Geriatric Assessment (GA) are used as a guiding framework. The following geriatric domains are described: demographic data and social support, functional status, cognition, mental health, nutritional status, fatigue, comorbidities, polypharmacy, and other geriatric syndromes (e.g. falls, delirium). In addition to these geriatric domains, quality of life (QoL) is described based on the overall importance in this particular population. Advice for integration of assessment of these geriatric domains into daily oncology practice is made. Research has mainly focused on the role of treating physicians but the involvement of nurses and allied health care professionals is crucial in the care of older persons with cancer through the GA process. The ability of nurses and allied health care professionals to perform this assessment requires specialized training and education beyond standard oncology knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Nurse-Led Programs to Facilitate Enrollment to Children's Oncology Group Cancer Control Trials.

    PubMed

    Haugen, Maureen; Kelly, Katherine Patterson; Leonard, Marcia; Mills, Denise; Sung, Lillian; Mowbray, Catriona; Landier, Wendy

    2016-09-01

    The progress made over the past 50 years in disease-directed clinical trials has significantly increased cure rates for children and adolescents with cancer. The Children's Oncology Group (COG) is now conducting more studies that emphasize improving quality of life for young people with cancer. These types of clinical trials are classified as cancer control (CCL) studies by the National Cancer Institute and require different resources and approaches to facilitate adequate accrual and implementation at COG institutions. Several COG institutions that had previously experienced problems with low accruals to CCL trials have successfully implemented local nursing leadership for these types of studies. Successful models of nurses as institutional leaders and "champions" of CCL trials are described. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

  12. Preparing Nursing Students for Interprofessional Practice: The Interdisciplinary Curriculum for Oncology Palliative Care Education.

    PubMed

    Hermann, Carla P; Head, Barbara A; Black, Karen; Singleton, Karen

    2016-01-01

    Interprofessional educational experiences for baccalaureate nursing students are essential to prepare them for interprofessional communication, collaboration, and team work. Nurse educators are ideally positioned to develop and lead such initiatives. The purpose of this article is to describe the development and implementation of an interprofessional education (IPE) project involving students in nursing, medicine, social work, and chaplaincy. The Interdisciplinary Curriculum for Oncology Palliative Care Education project uses team-based palliative oncology education as the framework for teaching students interprofessional practice skills. The need for IPE is apparent, but there are very few comprehensive, successful projects for nurse educators to use as models. This article describes the development of the curriculum by the interprofessional faculty team. Issues encountered by nursing faculty members as they implemented the IPE experience are discussed. Solutions developed to address the issues and ongoing challenges are presented. This project can serve as a model of a successful IPE initiative involving nursing students. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. An Exemplar Interprofessional Academic Emergency Nurse Practitioner Program: A Blueprint for Success.

    PubMed

    Evans, Dian Dowling; Ashooh, Meredith Pollock; Kimble, Laura P; Heilpern, Katherine L

    Emergency department census rates and manpower gaps have continued to rise over the past decade, creating a demand for well-prepared emergency nurse practitioners (ENPs). The implementation of the consensus model for advanced practice nurses has brought acknowledgment by leading health care, physician, and nursing organizations of the ENP specialty as critical to building a high-quality emergency care workforce. Recognition of the ENP's unique skill set, and therefore need of specialty certification, has led to a growing interest in the expansion of nurse practitioner curricula in emergency care. This article describes a novel approach for ENP education based on an interprofessional training model, with an in-depth discussion of curriculum development and clinical placement, as well as program outcomes and implications.

  14. Oncology/haematology nurses: a study of job satisfaction, burnout, and intention to leave the specialty.

    PubMed

    Barrett, Linda; Yates, Patsy

    2002-01-01

    The impact of the current nursing shortage on the health care system is receiving attention by both state and federal governments. This study, using a convenience sample of 243 oncology/haematology nurses working in 11 Queensland health care facilities, explored factors that influence the quality of nurses' working lives. Although nurses reported high levels of personal satisfaction and personal accomplishment, results indicated that nearly 40% of registered nurses (RNs) are dealing with workloads they perceive excessive, 48% are dissatisfied regarding pay, and professional support is an issue. Furthermore, emotional exhaustion is a very real concern: over 70% of the sample experienced moderate to high levels. Over 48% of the sample could not commit to remaining in the specialty for a further 12 months. Health care managers and governments should implement strategies that can increase nurses' job satisfaction and reduce burnout, thereby enhancing the retention of oncology/haematology nurses.

  15. The Impact of a Knitting Intervention on Compassion Fatigue in Oncology Nurses.

    PubMed

    Anderson, Lyndsay W; Gustavson, Christina U

    2016-02-01

    Compassion fatigue is the emotional exhaustion and stress that nurses can feel when caring for terminally ill patients. This can contribute to high nursing turnover rates, result in poor job satisfaction, and lead to decreased ability to provide quality care. Oncology nurses are vulnerable to compassion fatigue because they develop relationships with patients battling life-threatening illnesses, provide end-of-life care, and encounter ethical dilemmas related to cancer treatment. 
.

  16. Communication skills training on how to break bad news for Japanese nurses in oncology: effects of training on nurses' confidence and perceived effectiveness.

    PubMed

    Fukui, Sakiko; Ogawa, Keiko; Fukui, Naoshi

    2010-03-01

    Delivering bad news is an important communication skill for oncology nurses. No Asian study has developed a communication skills training program. We investigated the effect of such a program on the confidence and practical competence of Japanese oncology nurses. Thirty-one nurses participated, based on Western work in a 6-h workshop; the effect was assessed for 3 months. We evaluated the program effect by measuring nurse-rated confidence regarding communication with patients three times (before, immediately after, and 3 months after the program), in addition to interviewing them on the perception of the program at T3. On nurse-rated confidence in communication, 16/21 items were significantly increased 3 months after the program, and almost all nurses were positive about the course effectiveness. Communication skills training increased Japanese nurses' confidence as well as being perceived as effective.

  17. An ethnographic study exploring the role of ward-based Advanced Nurse Practitioners in an acute medical setting.

    PubMed

    Williamson, Susan; Twelvetree, Timothy; Thompson, Jacqueline; Beaver, Kinta

    2012-07-01

    This article is a report of a study that aimed to examine the role of ward-based Advanced Nurse Practitioners and their impact on patient care and nursing practice. Revised doctor/nurse skill mix combined with a focus on improving quality of care while reducing costs has had an impact on healthcare delivery in the western world. Diverse advanced nursing practice roles have developed and their function has varied globally over the last decade. However, roles and expectations for ward-based Advanced Nurse Practitioners lack clarity, which may hinder effective contribution to practice. An ethnographic approach was used to explore the advanced nurse practitioner role. Participant observation and interviews of five ward-based Advanced Nurse Practitioners working in a large teaching hospital in the North West of England during 2009 were complemented by formal and informal interviews with staff and patients. Data were descriptive and broken down into themes, patterns and processes to enable interpretation and explanation. The overarching concept that ran through data analysis was that of Advanced Nurse Practitioners as a lynchpin, using their considerable expertise, networks and insider knowledge of health care not only to facilitate patient care but to develop a pivotal role facilitating nursing and medical practice. Sub-themes included enhancing communication and practice, acting as a role model, facilitating the patients' journey and pioneering the role. Ward-based Advanced Nurse Practitioners are pivotal and necessary for providing quality holistic patient care and their role can be defined as more than junior doctor substitutes. © 2012 Blackwell Publishing Ltd.

  18. The NNP/DNP shortage: transforming neonatal nurse practitioners into DNPs.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2009-01-01

    Neonatal nurse practitioners (NNPs) represent a high-demand specialty practice that is especially targeted for US secondary and tertiary care neonatal intensive care units (NICUs). NNPs make primary decisions about the caregiving of high-risk newborns at the time of admission, throughout hospitalization, at transfer, and at discharge that require an advanced knowledge base in neonatology as well as NICU clinical experience. NNPs prepared at the master's level are currently in very short supply, with some estimates suggesting that for each NNP who graduates, there are 80 positions open across the country. Even with the present shortage, due to the high cost of NNP education, NNP programs are diminishing and those that are remaining are not graduating a sufficient number of new NNPs each year to keep up with the demand. To add to the basic shortage problem, in 2004 the American Association of Colleges of Nursing decided that by 2015, the terminal degree for all nurse practitioners should move from the master's degree to the doctor of nursing practice (DNP) degree. That decision added a minimum of 12 months of full-time education to the advanced education requirements for nurse practitioners. What impact will the decision to require a DNP degree have on NNP specialty practice? Will even more NNP programs close because of faculty shortages of NNPs prepared at the DNP level? If a worse shortage occurs in the number of NNPs prepared to practice in NICUs, will physician assistants or other nonphysician clinicians who meet the need for advanced neonatal care providers replace NNPs? What steps, if any, can nursing take to ensure that NNP specialty practice is still needed and survives after supplementing the DNP requirement to NNP education?

  19. Lack of genotoxicity in medical oncology nurses handling antineoplastic drugs: effect of work environment and protective equipment.

    PubMed

    Gulten, Tuna; Evke, Elif; Ercan, Ilker; Evrensel, Turkkan; Kurt, Ender; Manavoglu, Osman

    2011-01-01

    In this study we aimed to investigate the genotoxic effects of antineoplastic agents in occupationally exposed oncology nurses. Genotoxic effects mean the disruptive effects in the integrity of DNA and they are associated with cancer development. Biomonitoring of health care workers handling antineoplastic agents is helpful for the evaluation of exposure to cytostatics. The study included an exposed and two control groups. The exposed group (n=9) was comprised of oncology nurses. The first (n=9) and second (n=10) control groups were comprised of subjects who did not come into contact with antineoplastic drugs working respectively in the same department with oncology nurses and in different departments. Genotoxicity evaluation was performed using SCE analysis. After applying culture, harvest and chromosome staining procedures, a total of 25 metaphases were analyzed per person. Kruskal Wallis test was used to perform statistical analysis. A statistically significant difference of sister chromatid exchange frequencies was not observed between the exposed and control groups. Lack of genotoxicity in medical oncology nurses might be due to good working conditions with high standards of technical equipment and improved personal protection.

  20. How do nurse practitioners work in primary health care settings? A scoping review.

    PubMed

    Grant, Julian; Lines, Lauren; Darbyshire, Philip; Parry, Yvonne

    2017-10-01

    This scoping review explores the work of nurse practitioners in primary health care settings in developed countries and critiques their contribution to improved health outcomes. A scoping review design was employed and included development of a research question, identification of potentially relevant studies, selection of relevant studies, charting data, collating, summarising and reporting findings. An additional step was added to evaluate the methodological rigor of each study. Data sources included literature identified by a search of electronic databases conducted in September 2015 (CINAHL, Informit, Web of Science, Scopus and Medline) and repeated in July 2016. Additional studies were located through hand searching and authors' knowledge of other relevant studies. 74 articles from eight countries were identified, with the majority emanating from the United States of America. Nurse practitioners working in communities provided care mostly in primary care centres (n=42), but also in community centres (n=6), outpatient departments (n=6), homes (n=5), schools (n=3), child abuse clinics (n=1), via communication technologies (n=6), and through combined face-to-face and communication technologies (n=5). The scope of nurse practitioner work varied on a continuum from being targeted towards a specific disease process or managing individual health and wellbeing needs in a holistic manner. Enhanced skills included co-ordination, collaboration, education, counselling, connecting clients with services and advocacy. Measures used to evaluate outcomes varied widely from physiological data (n=25), hospital admissions (n=10), use of health services (n=15), self-reported health (n=13), behavioural change (n=14), patient satisfaction (n=17), cost savings (n=3) and mortality/morbidity (n=5). The majority of nurse practitioners working in community settings did so within a selective model of primary health care with some examples of nurse practitioners contributing to

  1. 5-years later - have faculty integrated medical genetics into nurse practitioner curriculum?

    PubMed

    Maradiegue, Ann H; Edwards, Quannetta T; Seibert, Diane

    2013-10-31

    Abstract Many genetic/genomic educational opportunities are available to assist nursing faculty in their knowledge and understanding of genetic/genomics. This study was conducted to assess advance practice nursing faculty members' current knowledge of medical genetics/genomics, their integration of genetics/genomics content into advance practice nursing curricula, any prior formal training/education in genetics/genomics, and their comfort level in teaching genetics/genomic content. A secondary aim was to conduct a comparative analysis of the 2010 data to a previous study conducted in 2005, to determine changes that have taken place during that time period. During a national nurse practitioner faculty conference, 85 nurse practitioner faculty voluntarily completed surveys. Approximately 70% of the 2010 faculty felt comfortable teaching basic genetic/genomic concepts compared to 50% in 2005. However, there continue to be education gaps in the genetic/genomic content taught to advance practice nursing students. If nurses are going to be a crucial member of the health-care team, they must achieve the requisite competencies to deliver the increasingly complex care patients require.

  2. Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses.

    PubMed

    Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine

    2017-10-01

    A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

  3. Does contact by a family nurse practitioner decrease early school absence?

    PubMed

    Kerr, Jill; Price, Marva; Kotch, Jonathan; Willis, Stephanie; Fisher, Michael; Silva, Susan

    2012-02-01

    Chronic early school absence (preschool through third grade) is associated with school failure. The presence of school nurses may lead to fewer absences, and nurse practitioners in school-based health centers (SBHCs) can facilitate a healthier population resulting in improved attendance. Efforts to get students back to school are unexplored in nursing literature. This article describes a nursing intervention to decrease early school absence in two elementary schools K-3 (N = 449) and a Head Start program (N = 130). The Head Start Family Nurse Practitioner (FNP) contacted families of chronically and excessively absent students by telephone, clinic visit at school, or home visit. The aggregate percentage attendance was evaluated by grades (preschool to third grade), schools (Head Start, Elementary Schools 1 and 2), and grades and schools and compared with publicly available school district aggregate data. There were statistically significant increases in attendance from Year 1 to Year 2 at p < .05 at the elementary level but not at the Head Start level. Student demographics, types of contacts, absence reasons (including sick child), and medical diagnoses are described.

  4. Between two roles - Experiences of newly trained nurse practitioners in surgical care in Sweden: A qualitative study using repeated interviews.

    PubMed

    Jangland, Eva; Yngman Uhlin, Pia; Arakelian, Erebouni

    2016-11-01

    The position of Nurse Practitioner is a new role in Nordic countries. The transition from a registered nurse to the Nurse Practitioner role has been reported to be a personal challenge. This study, guided by the Nordic theoretical model for use in the education of advanced practice nurses, represents a unique opportunity to describe this transition for newly graduated Nurse Practitioners in an interprofessional surgical care team in Sweden. The aim was to explore how the first Nurse Practitioners in surgical care experienced the transition into a new role and what competences they used in the team. Eight new Nurse Practitioners with parallel work in clinical practice were interviewed twice around the time of their graduation. The qualitative analyses show that the participants integrated several central competences, but the focus in this early stage in their new role was on direct clinical praxis, consultation, cooperation, case management, and coaching. Transition from the role of clinical nurse specialist to nurse practitioner was a challenging process in which the positive response from patients was a driving force for the new Nurse Practitioners. The participants felt prepared for and determined to solve the challenging situations they approached working in the interprofessional team. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Oncology nurses' perceptions of end-of-life care in a tertiary cancer centre in Qatar.

    PubMed

    Libo-On, Izette Larraine M; Nashwan, Abdulqadir J

    2017-02-02

    Nurses who work in oncology settings may lack the knowledge and skills required for end-of-life (EoL) care. A clear understanding of nurses' perceptions of EoL care is crucial for the successful improvement of care for terminally ill patients with cancer. Although many studies have underlined nurses' perspectives on EoL care, this is the first such study conducted on oncology nurses in Qatar. This study primarily sought to measure nurses' perceptions of EoL care at the National Center for Cancer Care and Research (NCCCR) in Qatar. A quantitative, cross-sectional, self-reported study. Nurses at the NCCCR reported their perceptions of EoL care using the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, which consisted of 30 items scored on a five-point Likert scale. Seventy-eight nurses working in oncology settings completed the tool. Approximately one third (33-35%) of the participants had positive perceptions of EoL care. The majority (67%) of the participants were uncertain or ambivalent regarding EoL events and situations. There was no significant relationship between the participants' profiles and their perceptions of EoL care. However, very few of them had completed educational courses in death and dying. Nurses have an important impact on EoL care, and continuous education is necessary to improve their confidence when they work with dying patients and their families. An in-house programme to help nurses cope with compassionate exhaustion and humanistic and relational care is highly recommended.

  6. Challenges of assessing critical thinking and clinical judgment in nurse practitioner students.

    PubMed

    Gorton, Karen L; Hayes, Janice

    2014-03-01

    The purpose of this study was to determine whether there was a relationship between critical thinking skills and clinical judgment in nurse practitioner students. The study used a convenience, nonprobability sampling technique, engaging participants from across the United States. Correlational analysis demonstrated no statistically significant relationship between critical thinking skills and examination-style questions, critical thinking skills and scores on the evaluation and reevaluation of consequences subscale of the Clinical Decision Making in Nursing Scale, and critical thinking skills and the preceptor evaluation tool. The study found no statistically significant relationships between critical thinking skills and clinical judgment. Educators and practitioners could consider further research in these areas to gain insight into how critical thinking is and could be measured, to gain insight into the clinical decision making skills of nurse practitioner students, and to gain insight into the development and measurement of critical thinking skills in advanced practice educational programs. Copyright 2014, SLACK Incorporated.

  7. Evaluation of a Pharmacist and Nurse Practitioner Smoking Cessation Program.

    PubMed

    Afzal, Zubair; Pogge, Elizabeth; Boomershine, Virginia

    2017-08-01

    To evaluate the efficacy of a smoking cessation program led by a pharmacist and a nurse practitioner. During a 6-month period, patients attended 7 one-on-one face-to-face smoking cessation counseling sessions with a pharmacist and 1 to 2 one-on-one face-to-face smoking cessation counseling sessions with a nurse practitioner. The primary outcome was smoking cessation point prevalence rates at months 1, 3, and 5 post-quit date. Secondary outcomes included medication adherence rates at months 1, 3, and 5 post-quit date, nicotine dependence at baseline versus program end, and patient satisfaction. Nine (47%) of 19 total participants completed the program. Seven of the 9 patients who completed the program were smoke-free upon study completion. Point prevalence rates at months 1, 3, and 5 post-quit date were 66%, 77%, and 77%, respectively, based on patients who completed the program. Medication adherence rates were 88.6%, 54.6%, and 75% at months 1, 3, and 5 post-quit date, respectively. Based on the Fagerstrom test, nicotine dependence decreased from baseline to the end of the study, 4.89 to 0.33 ( P < .001). Overall, participants rated the program highly. A joint pharmacist and nurse practitioner smoking cessation program can assist patients in becoming smoke-free.

  8. Conceptual framework of acute care nurse practitioner role enactment, boundary work, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Lamothe, Lise; Ritchie, Judith A; Doran, Diane

    2013-01-01

    This article describes a new conceptual framework for acute care nurse practitioner role enactment, boundary work and perceptions of team effectiveness. Acute care nurse practitioners contribute positively to patient care by enacting an expanded scope of practise. Researchers have found both positive and negative reactions to the introduction of acute care nurse practitioners in healthcare teams. The process of role enactment, shifting role boundaries, and perceptions of team effectiveness has been studied disparately. A framework linking team structures and processes to desirable outcomes is needed. Literature was obtained by searching CINAHL, PsycInfo, MedLine, PubMed, British Nursing Index, Cochrane Library, JSTOR Archive, Web of Science, and Google Scholar from 1985-2010. A descriptive multiple-case study was completed from March 2009-May 2009. A new conceptual framework describing how role enactment and boundary work affect perceptions of team effectiveness was developed by combining theoretical and empirical sources. The framework proposes proximal indicators used by team members to assess their team's performance. The framework identifies the inter-related dimensions and concepts that different stakeholders need to consider when introducing nurse practitioners in healthcare teams. Further study is needed to identify team-level outcomes that reflect the contributions of all providers to quality patient care, and explore the patients' and families' perceptions of team effectiveness following the introduction of acute care nurse practitioners. The new framework can guide decision-making and research related to the structures, processes, and outcomes of nurse practitioner roles in healthcare teams. © 2012 Blackwell Publishing Ltd.

  9. Exploring the transition from registered nurse to family nurse practitioner.

    PubMed

    Poronsky, Cathlin Buckingham

    2013-01-01

    There is limited information available regarding the transition from registered nurse (RN) to family nurse practitioner (FNP). Several authors described this transition as taking place in 4 stages, and others described it as a 2-phase process. However, there is a lack of consensus about the definition of these stages and phases and at what point they occur for nurses who are making the transition from an RN to an FNP. From what is known, this multistage/2-phase transition is accompanied by feelings of anxiety, stress, role confusion, and emotional turmoil. As a nurse faculty member, the author theorized that nurse faculty might be in a position to provide support for graduate students making this transition in role. However, there was little information available about the transition phases, stages, and needs of students during graduate school. The search for a framework to explore transition yielded transition theory, which is described and applied to FNP transition in this article. Transition theory may be useful for examining more fully the phases and stages of RN-to-FNP transition. In this time of increased need for qualified primary care providers, it is essential that graduates of FNP programs transition into practice following graduation. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Practice pattern and professional issues of nurse practitioners in mechanical circulatory support programs in the United States: a survey report.

    PubMed

    Casida, Jesus M; Pastor, Jessica

    2012-09-01

    Few data-based reports about the role and work environment of advanced practice nurses, specifically nurse practitioners in mechanical circulatory support programs, have been published. To describe the practice pattern and professional issues confronted by nurse practitioners in the rapidly evolving and expanding mechanical circulatory support programs in the United States. A descriptive research design was employed using the data from the 2010 mechanical circulatory support nurses survey. Quantitative and qualitative data that pertained to the demographic and practice profiles as well as barriers and overall issues faced by the nurse practitioners in their clinical practice were analyzed. Nonrandom sample of 48 nurse practitioners from 95 mechanical circulatory support programs nationwide. The practice pattern of nurse practitioners in mechanical circulatory support programs is similar to the practice pattern reported for nurse practitioners in acute and critical care settings. However, only 44% and 10% of nurse practitioners in mechanical circulatory support programs are authorized to admit and transfer patients into and out of the hospital, respectively. High workload, lack of institutional support, knowledge deficit, role ambiguity, lack of professional recognition, and burnout were the common issues faced by the participants in their clinical practice. The results provide preliminary evidence on the practice pattern, restrictions, and work environment issues that may threaten the viability of an mechanical circulatory support program in which nurse practitioners play a crucial role. Implications for clinical practice, research, and policy development are discussed.

  11. Quality measures for nurse practitioner practice evaluation.

    PubMed

    Kleinpell, Ruth; Kapu, April N

    2017-08-01

    Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

  12. A modest proposal: nurse practitioners to improve clinical quality and financial viability in critical access hospitals.

    PubMed

    Marsh, Leslie; Diers, Donna; Jenkins, Allan

    2012-11-01

    Rural health care has achieved a new focus of attention with the passage of the Affordable Care Act (ACA). This article argues that nurse practitioners may be an important resource to help rural hospitals, especially critical access hospitals (CAH), achieve their mission of community service while protecting their always-delicate financial sustainability. Nurse practitioners' scope of practice is well suited to the needs of rural patients, and their ability to participate in expanding preventive services is especially essential in remote areas. Barriers to nurse practitioner practice include restrictive state laws and federal and state policies.

  13. ENRICH: A promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients.

    PubMed

    Vadaparampil, Susan T; Gwede, Clement K; Meade, Cathy; Kelvin, Joanne; Reich, Richard R; Reinecke, Joyce; Bowman, Meghan; Sehovic, Ivana; Quinn, Gwendolyn P

    2016-11-01

    We describe the impact of ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare), a web-based communication-skill-building curriculum for oncology nurses regarding AYA fertility and other reproductive health issues. Participants completed an 8-week course that incorporated didactic content, case studies, and interactive learning. Each learner completed a pre- and post-test assessing knowledge and a 6-month follow-up survey assessing learner behaviors and institutional changes. Out of 77 participants, the majority (72%) scored higher on the post-test. Fifty-four participants completed the follow-up survey: 41% reviewed current institutional practices, 20% formed a committee, and 37% gathered patient materials or financial resources (22%). Participants also reported new policies (30%), in-service education (37%), new patient education materials (26%), a patient navigator role (28%), and workplace collaborations with reproductive specialists (46%). ENRICH improved nurses' knowledge and involvement in activities addressing fertility needs of oncology patients. Our study provides a readily accessible model to prepare oncology nurses to integrate American Society of Clinical Oncology guidelines and improve Quality Oncology Practice Initiative measures related to fertility. Nurses will be better prepared to discuss important survivorship issues related to fertility and reproductive health, leading to improved quality of life outcomes for AYAs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Evaluation of a compassion fatigue resiliency program for oncology nurses.

    PubMed

    Potter, Patricia; Deshields, Teresa; Berger, Julia Allen; Clarke, Marty; Olsen, Sarah; Chen, Ling

    2013-03-01

    To evaluate a resiliency program designed to educate oncology nurses about compassion fatigue. Descriptive pilot study. A National Cancer Institute-designated comprehensive cancer center in the midwestern United States. 13 oncology nurses employed in an outpatient infusion center. Nurses attended a five-week program involving five 90-minute sessions on compassion fatigue resiliency. A pre- and post-test design, using repeated measures, was conducted over six months. Scores on the Professional Quality of Life (ProQOL) IV, Maslach Burnout Inventory-Human Services Survey, Impact of Event Scale-Revised (IES-R), and the Nursing Job Satisfaction Scale. Long-term benefits were realized from the program. Secondary traumatization scores on the ProQOL IV declined immediately after the program, remained down at three months, and then dropped again at six months, with a statistically significant mean difference compared with baseline. The average IES-R total scores improved significantly overall and for each of the three postintervention time points. Participants evaluated the program positively with respect to their ability to apply and benefit from resiliency techniques. This is the first reported study to show benefits gained from a compassion fatigue intervention program. Participants received useful strategies for managing stress at work and home. Compassion fatigue is a prevalent condition among healthcare providers. Development of resiliency to compassion fatigue may improve decision making, clarity of communication, and patient and nurse satisfaction. Self-regulation offers an approach to reduce stress during a perceived threat. Working by intention reduces reactivity in the workplace and makes communication more intentional and, therefore, effective.

  15. Cost-effectiveness of a nurse practitioner-family physician model of care in a nursing home: controlled before and after study.

    PubMed

    Lacny, Sarah; Zarrabi, Mahmood; Martin-Misener, Ruth; Donald, Faith; Sketris, Ingrid; Murphy, Andrea L; DiCenso, Alba; Marshall, Deborah A

    2016-09-01

    To examine the cost-effectiveness of a nurse practitioner-family physician model of care compared with family physician-only care in a Canadian nursing home. As demand for long-term care increases, alternative care models including nurse practitioners are being explored. Cost-effectiveness analysis using a controlled before-after design. The study included an 18-month 'before' period (2005-2006) and a 21-month 'after' time period (2007-2009). Data were abstracted from charts from 2008-2010. We calculated incremental cost-effectiveness ratios comparing the intervention (nurse practitioner-family physician model; n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician-only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person-month. We assessed joint uncertainty around costs and effects using non-parametric bootstrapping and cost-effectiveness acceptability curves. Point estimates of the incremental cost-effectiveness ratio demonstrated the nurse practitioner-family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person-month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness-to-pay threshold of $1000 CAD/emergency department transfer, the probability the intervention was cost-effective compared with the internal, external and combined control groups was 26%, 21% and 25%. Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost-effectiveness of the nurse practitioner-family physician model; however, these results suggest benefits that could be confirmed in a larger study. © 2016 John Wiley & Sons Ltd.

  16. Does Contact by a Family Nurse Practitioner Decrease Early School Absence?

    ERIC Educational Resources Information Center

    Kerr, Jill; Price, Marva; Kotch, Jonathan; Willis, Stephanie; Fisher, Michael; Silva, Susan

    2012-01-01

    Chronic early school absence (preschool through third grade) is associated with school failure. The presence of school nurses may lead to fewer absences, and nurse practitioners in school-based health centers (SBHCs) can facilitate a healthier population resulting in improved attendance. Efforts to get students back to school are unexplored in…

  17. The Business Management Preceptorship within the Nurse Practitioner Program.

    ERIC Educational Resources Information Center

    Wing, Donna Marie

    1998-01-01

    A nurse practitioner business preceptorship provides students with knowledge of basic business, accounting, finance, economics, marketing, and reimbursement. A lack of qualified faculty can be offset with adjunct business faculty. Selection of placement sites should provide challenging management experiences. (SK)

  18. What do surgical oncology staff nurses know about colorectal cancer ostomy care?

    PubMed

    Gemmill, Robin; Kravits, Kathy; Ortiz, Mildred; Anderson, Casandra; Lai, Lily; Grant, Marcia

    2011-02-01

    For most patients diagnosed with colorectal cancer, dealing with the adjustment and rehabilitation after treatment can be overwhelming. There is a significant need for expert educational and counseling support, especially for the patient with a new ostomy. This pilot study describes acute care oncology staff nurses' knowledge about and attitudes toward providing direct ostomy care support and education. This study is part of a larger project assessing gaps in education and services in support of patients with colorectal cancer. The Survey on Ostomy Care questionnaire designed to assess nurses' knowledge about and attitudes toward ostomy care was administered to oncology staff nurses at a comprehensive cancer center. Only 30% of staff nurses surveyed strongly agreed or agreed with the statement, "I care for ostomy patients often enough to keep up my skills in ostomy care." Maintaining staff nurses' ability to teach and demonstrate to patients complex care such as ostomy care depends on the ability to practice both education and hands-on skills. Staff nurses identify that lack of opportunity to care for the new ostomy patient influences their ability to maintain skill expertise. The results show the need to explore the provision of ongoing staff education for low-volume patient populations using creative teaching strategies, such as clinical simulation and short videos. Copyright 2011, SLACK Incorporated.

  19. Nurse Practitioners, Physician Assistants, and Certified Nurse-Midwives: A Policy Analysis. Health Technology Case Study 37.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This case study was conducted to analyze the cost-effectiveness of nurse practitioners (NPs), physicians' assistants (PAs), and certified nurse midwives (CNMs) by examining (1) the contributions of each group in meeting health-care needs; (2) the effect of changing the method of payment for their services on the health-care delivery system; and…

  20. Factors influencing oncology nurses' approaches to accommodating cultural needs in palliative care.

    PubMed

    Huang, Ya-Ling; Yates, Patsy; Prior, Deborah

    2009-12-01

    The purpose of this study is to explore the social construction of cultural issues in palliative care amongst oncology nurses. Australia is a nation composed of people from different cultural origins with diverse linguistic, spiritual, religious and social backgrounds. The challenge of working with an increasingly culturally diverse population is a common theme expressed by many healthcare professionals from a variety of countries. Grounded theory was used to investigate the processes by which nurses provide nursing care to cancer patients from diverse cultural backgrounds. Semi-structured interviews with seven Australian oncology nurses provided the data for the study; the data was analysed using grounded theory data analysis techniques. The core category emerging from the study was that of accommodating cultural needs. This paper focuses on describing the series of subcategories that were identified as factors which could influence the process by which nurses would accommodate cultural needs. These factors included nurses' views and understandings of culture and cultural mores, their philosophy of cultural care, nurses' previous experiences with people from other cultures and organisational approaches to culture and cultural care. This study demonstrated that previous experiences with people from other cultures and organisational approaches to culture and cultural care often influenced nurses' views and understandings of culture and cultural mores and their beliefs, attitudes and behaviours in providing cultural care. Relevance to clinical practice. It is imperative to appreciate how nurses' experiences with people from other cultures can be recognised and built upon or, if necessary, challenged. Furthermore, nurses' cultural competence and experiences with people from other cultures need to be further investigated in clinical practice.

  1. Physician Assistant and Nurse Practitioner Prescribing: 1997-2002

    ERIC Educational Resources Information Center

    Hooker, Roderick S.; Cipher, Daisha J.

    2005-01-01

    Context: Physician assistants (PAs) and nurse practitioners (NPs) have licensure to practice in all states and they have prescriptive authority in 47 and 40 states, respectively. However, there have been no published studies from a national standpoint comparing urban and rural settings. Purpose: The objective of this study was to describe the…

  2. Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest – intervention – posttest study

    PubMed Central

    Dauer, Lawrence T; Kelvin, Joanne F; Horan, Christopher L; St Germain, Jean

    2006-01-01

    Background Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. Methods A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. Results As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. Conclusion The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses. PMID:16762060

  3. A new assessment model and tool for pediatric nurse practitioners.

    PubMed

    Burns, C

    1992-01-01

    This article presents a comprehensive assessment model for pediatric nurse practitioner (PNP) practice that integrates familiar elements of the classical medical history, Gordon's Functional Health Patterns, and developmental fields into one system. This model drives the diagnostic reasoning process toward consideration of a broad range of disease, daily living (nursing diagnosis), and developmental diagnoses, which represents PNP practice better than the medical model does.

  4. Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)

    PubMed Central

    Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan

    2014-01-01

    Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring

  5. A Study of Family Nurse Practitioners: Perceived Competencies and Some of Their Implications for Nursing Education.

    ERIC Educational Resources Information Center

    Ward, Mary Jane Morrow

    This study was designed to determine the most common health needs and problems that family nurse practitioners (FNP) deal with, to determine how competent FNPs judge themselves to be, to determine what sources in nursing education FNPs judge to be most valuable, and to determine whether or not there were significant differences in the level of…

  6. Current Directions in Family Nurse Practitioner Curricula. Proceedings of a National Conference of Representatives from Family Nurse Practitioner Programs (Chapel Hill, North Carolina, January 29-31, 1976)

    ERIC Educational Resources Information Center

    Pickard, C. Glenn, Jr., Ed.; Watkins, Julia D., Ed.

    The conference reported here was held for nurse faculty and physicians from twenty-five family nurse practitioner (FNP) programs based in twenty-one states to provide the participants with an opportunity to consider their common curriculum problems and successes in FNP education. The first half of this booklet contains five paper presentations…

  7. Establishing an Australian nurse practitioner-led colorectal cancer screening clinic.

    PubMed

    Morcom, Joylene; Dunn, Sandra V; Luxford, Yoni

    2005-01-01

    In Australia, colorectal cancer is the most commonly occurring internal cancer affecting both men and women, and the second most common cause of cancer-related death. Flexible sigmoidoscopy has not been commonly used as a screening tool in Australia due primarily to lack of resources. Until now, people at average risk of developing bowel cancer frequently undergo colonoscopy after referral to a specialist. To fill an identified need, a nurse practitioner-led colorectal screening service providing fecal occult blood testing and flexible sigmoidoscopy, health education and promotion, patient counseling, information and a referral point for general practitioners, and a referral service for above average-risk patients was established in a South Australian metropolitan teaching hospital. Establishment of this clinic required advanced and extended theoretical and clinical preparation for the nurse practitioner, as well as development of interdisciplinary relationships, referral processes, clinical infrastructure, and a marketing strategy. An audit of the first 100 flexible sigmoidoscopy patients revealed service and procedural outcomes that compared favorably with other colorectal screening services as well as a high level of patient satisfaction.

  8. The Family Meeting in Palliative Care: Role of the Oncology Nurse.

    PubMed

    Glajchen, Myra; Goehring, Anna

    2017-12-01

    To describe the family meeting in palliative and end-of-life care, highlighting the role of the oncology nurse. Specific strategies will be provided for pre-meeting preparation, communication, and follow-up activities. A conceptual framework drawn from family and communication theory, and best practices from the clinical, research, nursing, and palliative care literature. Working with patients and families is complex, but the family meeting is a promising tool and a potential quality indicator in palliative care. The nurse is well positioned to participate fully in every aspect of the family meeting. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

    PubMed

    Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H

    2014-04-07

    Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

  10. Virtual Learning Environment in Continuing Education for Nursing in Oncology: an Experimental Study.

    PubMed

    das Graças Silva Matsubara, Maria; De Domenico, Edvane Birelo Lopes

    2016-12-01

    Nurses working in oncology require continuing education and nowadays distance education is a possibility. To compare learning outcomes of the professionals participating in classroom learning versus distance learning; describing the sociodemographic characteristics and digital fluency of participants; comparing learning outcomes with independent variables; assessing the adequacy of educational practices in Virtual Environment Moodle Learning through the constructivist online learning environment survey. An experimental, randomized controlled study; conducted at the A C Camargo Cancer Center, located in São Paulo, SP, Brazil. The study included 97 nurses, with average training of 1 to 2 years. A control group (n = 44) had face to face training and the experiment group (n = 53) had training by distance learning, both with identical program content. The dependent variable was the result of learning, measured by applying a pre-assessment questionnaire and post-intervention for both groups. The sociodemographic and digital fluency data were uniform among the groups. The performance of both groups was statistically significant (p 0.005), and the control group had a greater advantage (40.4 %). Distance education has proven to be an effective alternative for training nurses, especially when they have more complex knowledge, more experience in the area and institutional time. Distance Education may be a possibility for the training of nurses for work in oncology. The association of age, training time and the institution, and the experience in Oncology interfered in the performance of both groups.

  11. Estimating the Net Career Income of a Geriatrician and a Nurse Practitioner: Still Want to Be a Doctor?

    PubMed

    Golden, Adam G; Xu, Peixin; Wan, Thomas T H; Issenberg, Saul Barry

    2016-07-01

    With a continual shortage of geriatricians, adult-gerontology primary care nurse practitioners have assumed a greater role in the delivery of outpatient care for older adults. Given the long duration of physician training, the high cost of medical school, and the lower salaries compared with subspecialists, the financial advantage of a career as a geriatrician as opposed to a nurse practitioner is uncertain. This study compares the estimated career earnings of a geriatrician and an adult-gerontology primary care nurse practitioner. We used a synthetic model of estimated net earnings during a 43-year career span for a 22-year old person embarking on a career as a geriatrician versus a career as an adult-gerontology primary care nurse practitioner. We estimated annual net income and net retirement savings using different annual compound rates and calculated the financial impact of forgiving medical student loans, shortening the duration of physician training, and reinstituting the practice pathway for geriatric medicine certification. Career net incomes for the geriatrician did not match the nurse practitioner until almost age 40. At 65 years of age, the difference between the geriatrician and nurse practitioner was 30.6%. A higher annual compound rate was associated with an even smaller percentage difference. Combining all three health policy interventions lowered the break-even age to 28 and more than doubled the difference in career earnings. Small estimated differences in net career earnings exist between geriatricians and adult-gerontology primary care nurse practitioners. Health policy interventions had a dramatic positive effect on geriatricians' lifetime net earnings in calculated estimates.

  12. Reflections on 50 Years of Neuroscience Nursing: Neuro-Oncology, Moving Forward by Looking Back.

    PubMed

    Reed, Marilyn E; Anthony, Patricia P; Rosenfeld, Priscilla B; Ligon, Brandi L; Doris, Estelle M; Fox, Sherry W

    2018-06-01

    During the past 50 years, there have been more than 100 articles published in the Journal of Neuroscience Nursing covering the topic of neuro-oncology. This article will explore the historical implications and milestones from these articles. The analysis highlights the scope and depth of the many articles as they relate to the advancements in neuro-oncology.

  13. Processes in healthcare teams that include nurse practitioners: what do patients and families perceive to be effective?

    PubMed

    Kilpatrick, Kelley; Jabbour, Mira; Fortin, Chantal

    2016-03-01

    To explore patient and family perceptions of team effectiveness of teams those include nurse practitioners in acute and primary care. Nurse practitioners provide safe and effective care. Patients are satisfied with the care provided by nurse practitioners. Research examining patient and family perceptions of team effectiveness following the implementation of nurse practitioners in teams is lacking. A descriptive qualitative design was used. We used purposeful sampling to identify participants in four clinical specialties. We collected data from March 2014-January 2015 using semi-structured interviews and demographic questionnaires. Content analysis was used. Descriptive statistics were generated. Participants (n = 49) believed that the teams were more effective after the implementation of a nurse practitioner and this was important to them. They described processes that teams with nurse practitioners used to effectively provide care. These processes included improved communication, involvement in decision-making, cohesion, care coordination, problem-solving, and a focus on the needs of patients and families. Participants highlighted the importance of interpersonal team dynamics. A human approach, trust, being open to discussion, listening to patient and family concerns and respect were particularly valued by participants. Different processes emerged as priorities when data were examined by speciality. However, communication, trust and taking the time to provide care were the most important processes. The study provides new insights into the views of patients and families and micro-level processes in teams with nurse practitioners. The relative importance of each process varied according to the patient's health condition. Patients and providers identified similar team processes. Future research is needed to identify how team processes influence care outcomes. The findings can support patients, clinicians and decision-makers to determine the processes to focus on to

  14. Online Faculty Mentoring and Transition Balance in Family Nurse Practitioner Students

    ERIC Educational Resources Information Center

    Poronsky, Cathlin B.

    2011-01-01

    The purpose of this study was to examine the effect of online faculty mentoring on Registered Nurse (RN) to Family Nurse Practitioner (FNP) role transition balance during graduate education. Making the transition from RN to an FNP can seem daunting and there is limited information in the literature about RN to FNP role transition during graduate…

  15. New Hampshire Nurse Practitioners Take the Lead in Forming an Accountable Care Organization.

    PubMed

    Wright, Wendy L

    In 2012, New Hampshire nurse practitioners (NPs), along with Anthem Blue Cross/Blue Shield, formed the first Patient Centered Shared Savings Program in the nation, composed of patients managed by nurse practitioners employed within NP-owned and operated clinics. In this accountable care organization (ACO), NP-attributed patients were grouped into one risk pool. Data from the ACO and the NP risk pool, now in its third year, have produced compelling statistics. Nurse practitioners participating in this program have met or exceeded the minimum scores for 29 quality metrics along with a demonstrated cost-savings in the first 2 years of the program. Hospitalization rates for NP-managed patients are among the lowest in the state. Cost of care for NP-managed patients is $66.85 less per member per month than the participating physician-managed patients. Data from this ACO provide evidence that NPs provide cost-effective, quality health care and are integral to the formation and sustainability of any ACO.

  16. Expanding the role of the nurse practitioner in the deployed setting.

    PubMed

    Dargis, Julie; Horne, Theresa; Tillman-Ortiz, Sophie; Scherr, Diane; Yackel, Edward E

    2006-08-01

    Today's military is experiencing rapid advances in technology and in manpower utilization. The Army Medical Department is redesigning the structure and function of deployable hospital systems as part of this effort. The transformation of deployable hospital systems requires that a critical analysis of manpower utilization be undertaken to optimize the employment of soldier-medics. The objective of this article was to describe the use of nurse practitioners as primary care providers during deployment. The lived experiences of five nurse practitioners deployed to Operation Iraqi Freedom are presented. Data gathered during the deployment and an analysis of the literature clearly support expanded and legitimized roles for these health care professionals in future conflicts and peacekeeping operations.

  17. Estimating the Net Career Income of a Geriatrician and a Nurse Practitioner: Still Want to Be a Doctor?

    PubMed Central

    Golden, Adam G.; Xu, Peixin; Wan, Thomas T.H.; Issenberg, S. Barry

    2016-01-01

    Objectives With a continual shortage of geriatricians, adult-gerontology primary care nurse practitioners have assumed a greater role in the delivery of outpatient care for older adults. Given the long duration of physician training, the high cost of medical school, and the lower salaries compared with subspecialists, the financial advantage of a career as a geriatrician as opposed to a nurse practitioner is uncertain. This study compares the estimated career earnings of a geriatrician and an adult-gerontology primary care nurse practitioner. Methods We used a synthetic model of estimated net earnings during a 43-year career span for a 22-year old person embarking on a career as a geriatrician versus a career as an adult-gerontology primary care nurse practitioner. We estimated annual net income and net retirement savings using different annual compound rates and calculated the financial impact of forgiving medical student loans, shortening the duration of physician training, and reinstituting the practice pathway for geriatric medicine certification. Results Career net incomes for the geriatrician did not match the nurse practitioner until almost age 40. At 65 years of age, the difference between the geriatrician and nurse practitioner was 30.6%. A higher annual compound rate was associated with an even smaller percentage difference. Combining all three health policy interventions lowered the break-even age to 28 and more than doubled the difference in career earnings. Conclusions Small estimated differences in net career earnings exist between geriatricians and adult-gerontology primary care nurse practitioners. Health policy interventions had a dramatic positive effect on geriatricians’ lifetime net earnings in calculated estimates. PMID:27364024

  18. Mary Grant Seacole: the first nurse practitioner.

    PubMed

    Messmer, P R; Parchment, Y

    1998-01-01

    Mary Grant Seacole was born in 1805, in Kingston, Jamaica, to a Jamaican doctress (medicine woman) and a Scottish naval officer. Later Seacole became a doctress, nursing British soldiers during epidemics of cholera, dysentery, and yellow fever in Jamaica, Cuba, and Panama. After refusals by both the British government and Florence Nightingale to be allowed to practice in Scutari, she financed her own way to the scene of the Crimean War and then established the British Hotel to serve both the comfort and medical needs of the wounded soldiers. At night, Seacole worked side by side with Nightingale at Scutari as a volunteer nurse. Seacole's fame grew proportionately after she was seen helping wounded soldiers on the battlefields even while the battles were still raging. Seacole died on May 14, 1881, in London. One hundred years later, many members of the London black community, a few members of the Nurses Association of Jamaica and the Friends of Mary Seacole marched to her grave, honoring her as one of the greatest women of all times. Mary Grant Seacole rose above the barriers of racial prejudice and demonstrated the determinism, compassion, and caring that have became the hallmark of nurse practitioners.

  19. Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

    PubMed

    van der Plas, Annicka G M; Onwuteaka-Philipsen, Bregje D; Vissers, Kris C; Deliens, Luc; Jansen, Wim J J; Francke, Anneke L

    2016-01-01

    To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case management are associated with this view. For sustainable palliative care in an ageing society, basic palliative care is provided by generalists and specialist palliative care is reserved for complex situations. Acceptance of and cooperation with specialist palliative care providers by the general practitioner and community nurse is pivotal. Cross-sectional questionnaire study. Questionnaire data from 168 general practitioners and 125 community nurses were analysed using chi-square tests, univariate and multivariate logistic regression. Data were gathered between March 2011-December 2013. Of general practitioners, 46% rated the case manager as helpful in realizing care that is appropriate for the patient; for community nurses this was 49%. The case manager did not hinder the process of care and had added value for patients, according to the general practitioners and community nurses. The tasks of the case manager were associated with whether or not the case manager was helpful in realizing appropriate care, whereas patient characteristics and the number of contacts with the case manager were not. General practitioners and community nurses are moderately positive about the support from the case manager. To improve cooperation further, case managers should invest in contact with general practitioners and community nurses. © 2015 John Wiley & Sons Ltd.

  20. The role of resilience and mindful leadership in oncology nursing.

    PubMed

    Rishel, Cindy J

    2015-03-01

    When oncology nurses think of the word resilient, they often describe the term in the context of the patients and families they care for each day. When patients face a diagnosis of cancer, their lives have suddenly been altered in a frightening manner. Everything changes, and they must find a way to navigate the troubled waters ahead. 
.

  1. The implementation and evaluation of a communication skills training program for oncology nurses.

    PubMed

    Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Penn, Stacey; Gallegos, Tess E; Zaider, Talia; Krueger, Carol A; Bialer, Philip A; Bylund, Carma L; Parker, Patricia A

    2017-09-01

    Many nurses express difficulty in communicating with their patients, especially in oncology settings where there are numerous challenges and high-stake decisions during the course of diagnosis and treatment. Providing specific training in communication skills is one way to enhance the communication between nurses and their patients. We developed and implemented a communication skills training program for nurses, consisting of three teaching modules: responding empathically to patients; discussing death, dying, and end-of-life goals of care; and responding to challenging interactions with families. Training included didactic and experiential small group role plays. This paper presents results on program evaluation, self-efficacy, and behavioral demonstration of learned communication skills. Three hundred forty-two inpatient oncology nurses participated in a 1-day communication skills training program and completed course evaluations, self-reports, and pre- and post-standardized patient assessments. Participants rated the training favorably, and they reported significant gains in self-efficacy in their ability to communicate with patients in various contexts. Participants also demonstrated significant improvement in several empathic skills, as well as in clarifying skill. Our work demonstrates that implementation of a nurse communication skills training program at a major cancer center is feasible and acceptable and has a significant impact on participants' self-efficacy and uptake of communication skills.

  2. Oncology Nursing Support for Safe and Effective Use of Eribulin in Metastatic Breast Cancer

    PubMed Central

    Donovan, Diana; Urquhart, Laura; Hopkins, Una; Knight, Sandra; Moore, Laura

    2014-01-01

    Nurse practitioners play important roles in breast cancer prevention, early detection, therapeutic efficacy, and surveillance. Assessment of a patient’s health status is part of the nine nurse practitioner core competencies updated in 2012 by the National Organization of Nurse Practitioner Faculties. Although adverse events are common in treatment for metastatic breast cancer (MBC), proactive management strategies can limit the number and/or severity of adverse events. Additionally, knowledge of common metastatic sites and clinical signs/symptoms of recurrence provides one of the first-line strategies for successful treatment. We review five case studies of women with MBC who were managed successfully with eribulin mesylate in late lines of therapy after at least two chemotherapeutic regimens for advanced breast cancer that included both an anthracycline and a taxane in either the adjuvant or metastatic setting. PMID:24855406

  3. How important are autonomy and work setting to nurse practitioners' job satisfaction?

    PubMed

    Athey, Erin K; Leslie, Mayri Sagady; Briggs, Linda A; Park, Jeongyoung; Falk, Nancy L; Pericak, Arlene; El-Banna, Majeda M; Greene, Jessica

    2016-06-01

    Nurse practitioners (NPs) have reported aspects of their jobs that they are more and less satisfied with. However, few studies have examined the factors that predict overall job satisfaction. This study uses a large national sample to examine the extent to which autonomy and work setting predict job satisfaction. The 2012 National Sample Survey of Nurse Practitioners (n = 8311) was used to examine bivariate and multivariate relationships between work setting and three autonomy variables (independent billing practices, having one's NP skills fully utilized, and relationship with physician), and job satisfaction. NPs working in primary care reported the highest levels of autonomy across all three autonomy measures, while those working in hospital surgical settings reported the lowest levels. Autonomy, specifically feeling one's NP skills were fully utilized, was the factor most predictive of satisfaction. In multivariate analyses, those who strongly agreed their skills were being fully utilized had satisfaction scores almost one point higher than those who strongly disagreed. Work setting was only marginally related to job satisfaction. In order to attract and retain NPs in the future, healthcare organizations should ensure that NPs' skills are being fully utilized. ©2015 American Association of Nurse Practitioners.

  4. A Multi-Institutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners.

    PubMed

    Brown, Kristen M; Mudd, Shawna S; Hunt, Elizabeth A; Perretta, Julianne S; Shilkofski, Nicole A; Diddle, J Wesley; Yurasek, Gregory; Bembea, Melania; Duval-Arnould, Jordan; Nelson McMillan, Kristen

    2018-06-01

    Assess the effect of a simulation "boot camp" on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training. Prospective pre/post interventional pilot study. University simulation center. Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America. We conducted an expert opinion survey to guide curriculum development. The curriculum included didactic sessions, case studies, and high-fidelity simulation, based on high-complexity cases, congenital heart disease benchmark procedures, and a mix of lesion-specific postoperative complications. To cover multiple, high-complexity cases, we implemented Rapid Cycle Deliberate Practice method of teaching for selected simulation scenarios using an expert driven checklist. Knowledge was assessed with a pre-/posttest format (maximum score, 100%). A paired-sample t test showed a statistically significant increase in the posttest scores (mean [SD], pre test, 36.8% [14.3%] vs post test, 56.0% [15.8%]; p < 0.001). Time to recognize and treat an acute deterioration was evaluated through the use of selected high-fidelity simulation. Median time improved overall "time to task" across these scenarios. There was a significant increase in the proportion of clinically time-sensitive tasks completed within 5 minutes (pre, 60% [30/50] vs post, 86% [43/50]; p = 0.003] Confidence and satisfaction were evaluated with a validated tool ("Student Satisfaction and Self-Confidence in Learning"). Using a five-point Likert scale, the participants reported a high level of satisfaction (4.7 ± 0.30) and performance confidence (4.8 ± 0.31) with the simulation experience. Although simulation boot camps have been used effectively for training physicians and educating critical care providers, this was a novel

  5. A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis.

    PubMed

    Contandriopoulos, Damien; Brousselle, Astrid; Dubois, Carl-Ardy; Perroux, Mélanie; Beaulieu, Marie-Dominique; Brault, Isabelle; Kilpatrick, Kelley; D'Amour, Danielle; Sansgter-Gormley, Esther

    2015-02-27

    Integrating Nurse Practitioners into primary care teams is a process that involves significant challenges. To be successful, nurse practitioner integration into primary care teams requires, among other things, a redefinition of professional boundaries, in particular those of medicine and nursing, a coherent model of inter- and intra- professional collaboration, and team-based work processes that make the best use of the subsidiarity principle. There have been numerous studies on nurse practitioner integration, and the literature provides a comprehensive list of barriers to, and facilitators of, integration. However, this literature is much less prolific in discussing the operational level implications of those barriers and facilitators and in offering practical recommendations. In the context of a large-scale research project on the introduction of nurse practitioners in Quebec (Canada) we relied on a logic-analysis approach based, on the one hand on a realist review of the literature and, on the other hand, on qualitative case-studies in 6 primary healthcare teams in rural and urban area of Quebec. Five core themes that need to be taken into account when integrating nurse practitioners into primary care teams were identified. Those themes are: planning, role definition, practice model, collaboration, and team support. The present paper has two objectives: to present the methods used to develop the themes, and to discuss an integrative model of nurse practitioner integration support centered around these themes. It concludes with a discussion of how this framework contributes to existing knowledge and some ideas for future avenues of study.

  6. Use of the consultation satisfaction questionnaire to examine patients' satisfaction with general practitioners and community nurses: reliability, replicability and discriminant validity.

    PubMed Central

    Poulton, B C

    1996-01-01

    BACKGROUND: Primary health care services are the most frequently used in the health care system. Consumer feedback on these services is important. Research in this area relates mainly to doctor-patient relationships which fails to reflect the multidisciplinary nature of primary health care. AIM: A pilot study aimed to examine the feasibility of using a patient satisfaction questionnaire designed for use with general practitioner consultations as an instrument for measuring patient satisfaction with community nurses. METHOD: The questionnaire measuring patient satisfaction with general practitioner consultations was adapted for measuring satisfaction with contacts with a nurse practitioner, district nurses, practice nurses and health visitors. A total of 1575 patients in three practices consulting general practitioners or community nurses were invited to complete a questionnaire. Data were subjected to principal components analysis and the dimensions identified were tested for internal reliability and replicability. To establish discriminant validity, patients' mean satisfaction scores for consultations with general practitioners, the nurse practitioner, health visitors and nurses (district and practice nurses) were compared. RESULTS: Questionnaires were returned relating to 400 general practitioner, 54 nurse practitioner, 191 district/practice nurse and 83 health visitor consultations (overall response rate 46%). Principal components analysis demonstrated a factor structure similar to that found in an earlier study of the consultation satisfaction questionnaire. Three dimensions of patient satisfaction were identified: professional care, depth of relationship and perceived time spent with the health professional. The dimensions were found to have acceptable levels of reliability. Factor structures obtained from data relating to general practitioner and community nurse consultations were found to correlate significantly. Comparison between health professionals

  7. An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

    PubMed

    Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

    2011-12-01

    The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  8. [Intervention study of compassion fatigue of oncology nurses in Balint group activities].

    PubMed

    Yao, L Y; Xiang, M L; Ye, Z H; Qian, Y; Lu, Q; Yan, L J; Jiang, L Y; Zhong, H B

    2017-12-20

    Objective: To explore the effectiveness of Balint group on compassion fatigue among oncology nurses. Methods: From January to December 2016, 35 oncology nurses from one general hospital were enrolled. 18 cases were allocated in the observation group and 17 cases in the control group by computer randomization. Nurses in the observation group were received a total of 8 times Balint Group activities, with 2 times a month and 1.5 hours each time, which is aiming to discuss difficult cases encountered in the clinic to help nurses have a deeper experience and a better understanding of the emotions and behaviors, fantasies and needs between nurse-patient interaction. Nurses in the control group without intervention. All the Participants were requested to complete the survey of the Professional Quality of Life (ProQOL) , the Jefferson Scale of Empathy-Health Professionals (JSE-HP) , and the General Health Questionnaire (GHQ) at pre and post intervention. Results: Before intervention, two group of nurses in age, working years, marriage, and education were not statistically significant ( P >0.05). There was no difference in the scores of empathy, compassion satisfaction, secondary traumatic stress, and General health ( P >0.05). After intervention, the scores of JSE-HP and its three dimensions of perspective taking, emotional care, and trans-positional consideration in the observation group had significantly higher than the control group ( P <0.05). The level of compassion satisfaction in the observation group was higher, and the general health status was lower ( P <0.05). There was no statistically difference in the level of burnout and secondary traumatic stress between two groups ( P >0.05) . Conclusion: Balint group has a positive role in promoting nurses'empathetic skills, compassion satisfaction and mental health.

  9. Perceptions of Burnout, Its Prevention, and Its Effect on Patient Care as Described by Oncology Nurses in the Hospital Setting
.

    PubMed

    Russell, Kimberly

    2016-01-01

    To identify overall perceptions of burnout within the inpatient oncology nursing population, how they perceived that burnout affected the care they provided, and how they perceived that burnout could be decreased.
. A quantitative descriptive study using questionnaires to describe perceptions of burnout.
. A university-affiliated hospital using inpatient oncology nurses from three nursing units at University of Pittsburgh Medical Center Presbyterian in Pennsylvania.
. A convenience sample of 61 nurses. 
. Two instruments were used to investigate various aspects about perceptions of burnout among inpatient oncology nurses. Nurses participated on an anonymous voluntary basis by completing these instruments. 
. Perceived burnout, perception of how burnout affects care provided to patients, and strategies to relieve burnout.
. Inpatient oncology nurses report a moderate level of perceived burnout. In addition, this nursing population perceived that this burnout had a negative impact on the care they provided. Nurses believed they experienced burnout because of increased nurse-patient ratios and skipped or shortened lunches or breaks. However, they perceived that burnout could be prevented when adequate resources, collaboration, teamwork, and the support of family and friends existed. 
. As a result of the level of care needed by inpatients with cancer, the association between burnout experienced by nurses and how it can affect care is important to recognize. One such association identified was that a relationship existed between the nurses' interactions with patients' family, friends, or visitors and increased perceptions of burnout and depersonalization. As a result, nurses can experience increased burnout and act in a manner that lacks compassion because of emotional detachment.
. With extremely ill inpatients with cancer, nurses need to be able to manage high levels of demands from patients and their family members to provide quality and

  10. Autonomy of nurse practitioners in primary care: An integrative review.

    PubMed

    Choi, Min; De Gagne, Jennie C

    2016-03-01

    This integrative review of the existing literature was conducted to identify dimensions related to nurse practitioner (NP) autonomy and to recommend future areas of research related to the important topic of NP autonomy in this era of cost-conscious healthcare reform. Articles were identified from the following databases: CINAHL, MEDLINE, PubMed, Ovid, Scopus, Google Scholar, and EBSCO. Over 24 articles were found; 12 peer-reviewed articles met the inclusion criteria of research conducted with NPs, physicians, and patients. The results revealed three categories of association with regard to NP autonomy: job satisfaction, patient satisfaction, and physician-NP collaboration. This review was undertaken to advance understanding of autonomy among NPs and the dynamics involved in their delivery of care. Further research into the associations between NP autonomy and its dimensions are necessary to indicate a future direction to the NP role. ©2015 American Association of Nurse Practitioners.

  11. Knowledge and motivation: two elements of health literacy that remain low with regard to nurse practitioners in Australia.

    PubMed

    Cashin, Andrew; Heartfield, Marie; Cox, Darlene; Dunn, Sandra; Stasa, Helen

    2015-09-01

    This paper presents analysis of consumer focus groups that were undertaken as a part of the project to develop the now current Nursing and Midwifery Board of Australia's Nurse Practitioner Standards for Practice. Six focus groups were conducted with consumers around Australia, including urban and remote areas. One purpose for these groups was to explore what was known of nurse practitioners and whether consumers could articulate the difference between the regulated titles of enrolled nurse, registered nurse and nurse practitioner. Consumers' knowledge of nurses' roles in the Australian primary healthcare system, and hence system literacy (particularly in terms of navigating the system), was low. Of perhaps greatest importance is the fact that those consumers with low health systems literacy also exhibited a low level of motivation to seek new knowledge. Many consumers relied on the medical profession to direct care. The low levels of health literacy raise questions of how to meaningfully include health consumers in innovative health-related policy work.

  12. Discussing Death, Dying, and End-of-Life Goals of Care: A Communication Skills Training Module for Oncology Nurses.

    PubMed

    Coyle, Nessa; Manna, Ruth; Shen, Megan; Banerjee, Smita C; Penn, Stacey; Pehrson, Cassandra; Krueger, Carol A; Maloney, Erin K; Zaider, Talia; Bylund, Carma L

    2015-12-01

    Effective communication, particularly at the end of life, is an essential skill for oncology nurses, but few receive formal training in this area. The aim of this article is to adapt an end-of-life care communication skills training (CST) module, originally developed for oncologists, for oncology nurses and to evaluate participants' confidence in using the communication skills learned and their satisfaction with the module. The adapted end-of-life care module consisted of a 45-minute didactic, exemplary video and 90 minutes of small group interaction and experiential role play with a simulated patient. Using a five-point Likert-type scale, 247 inpatient oncology nurses completed pre-/post-workshop surveys rating their confidence in discussing death, dying, and end-of-life goals of care with patients, as well as overall satisfaction with the module. Nurses' confidence in discussing death, dying, and end-of-life goals of care increased significantly after attending the workshop. Nurse participants indicated satisfaction with the module by agreeing or strongly agreeing to all six items assessing satisfaction 90%-98% of the time. Nurses' CST in discussing death, dying, and end-of-life care showed feasibility, acceptability, and potential benefit at improving confidence in having end-of-life care discussions.

  13. Nursing diagnoses (NANDA-I) in hematology-oncology: a Delphi-study.

    PubMed

    Speksnijder, Herma T; Mank, Arno P; van Achterberg, Theo

    2011-01-01

    To identify NANDA-I diagnoses that are most relevant to hematology-oncology nursing in Europe. In a two-round, electronic, quantitative Delphi study, 28 experts from nine European countries assessed the relevance of NANDA-I diagnoses and health problems. This study identified 64 relevant diagnoses and three health problems. All experts listed 11 diagnoses: "imbalanced nutrition: less than body requirements,"diarrhea,"fatigue,"risk for bleeding,"risk for infection,"impaired oral mucous membrane,"risk for impaired skin integrity,"impaired skin integrity,"hyperthermia,"nausea,"acute pain," and the health problem "pruritis." The "NANDA-I classification 2009-2011" describes, in almost all disease- and treatment-related problems, nursing diagnoses as relevant to the adult patient with hematological malignancy. These diagnoses are therefore recommended. © 2011, The Authors. International Journal of Nursing Terminologies and Classifications © 2011, NANDA International.

  14. [The relationships between the general practitioner and the oncological radiotherapist. A preliminary study by telephone interviews].

    PubMed

    Baio, A; Cavallini Francolini, D; Corbella, F; De Vecchi, P; Ragone, L; Tinelli, C; Franchini, P

    1999-11-01

    We addressed the issue of the relationship between the general practitioner (GP) and the radiotherapist to improve the quality of care of cancer patients. The study consisted in evaluating medical requests and phone interviews, with a questionnaire with yes/no and multiple choice answers to the following 5 questions: 1) Do you think a cancer diagnosis is always a hopeless death sentence? 2) Is it professionally rewarding to cure a cancer patient? 3) Are you satisfied with your relationship, as a general practitioner, with oncologic reference centers? 4) Is it more wearing for a general practitioner to manage a cancer than a noncancer patient? 5) Would you answer a questionnaire about the relationship between the general practitioner, the cancer patient and the oncologist? We evaluated 1590 medical requests and made 401 phone interviews; 255 colleagues (70%) answered the questionnaire. Medical requests were correctly and completely formulated by GPs in 45% of cases. A cancer diagnosis was not considered a hopeless death sentence in 90.9% of cases and 76% of GPs considered it professionally rewarding to cure a cancer patient. 75.6% of GPs considered it more wearing to manage a cancer than a noncancer patient, and female GPs felt this more strongly than their male counterparts. Irrespective of gender, GPs over 50 years of age tend to consider cancer a hopeless and fatal disease. The relationship with oncologic centers was considered satisfactory in 86.2% of cases. However, since cancer patients need greater medical care, GPs would like a closer cooperation with oncologists. The great interest GPs took in this study encourages further investigation through a more in depth questionnaire designed with the help of GPs themselves and interested statisticians.

  15. The role of psychological factors in oncology nurses' burnout and compassion fatigue symptoms.

    PubMed

    Duarte, Joana; Pinto-Gouveia, José

    2017-06-01

    This study explored the role of several psychological factors in professional quality of life in nurses. Specifically, we tried to clarify the relationships between several dimensions of empathy, self-compassion, and psychological inflexibility, and positive (compassion satisfaction) and negative (burnout and compassion fatigue) domains of professional quality of life. Using a cross-sectional design, a convenience sample of 221 oncology nurses recruited from several public hospitals filling out a battery of self-report measures. Results suggested that nurses that benefit more from their work of helping and assisting others (compassion satisfaction) seem to have more empathic feelings and sensibility towards others in distress and make an effort to see things from others' perspective. Also, they are less disturbed by negative feelings associated with seeing others' suffering and are more self-compassionate. Nurses more prone to experience the negative consequences associated with care-providing (burnout and compassion fatigue) are more self-judgmental and have more psychological inflexibility. In addition, they experience more personal feelings of distress when seeing others in suffering and less feelings of empathy and sensibility to others' suffering. Psychological factors explained 26% of compassion satisfaction, 29% of burnout and 18% of compassion fatigue. We discuss the results in terms of the importance of taking into account the role of these psychological factors in oncology nurses' professional quality of life, and of designing nursing education training and interventions aimed at targeting such factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Complementary and Alternative Medicine: Core Competencies for Family Nurse Practitioners.

    ERIC Educational Resources Information Center

    Burman, Mary E.

    2003-01-01

    Directors of family nurse practitioner education programs (n=141) reported inclusion of some complementary/alternative medicine content (CAM), most commonly interviewing patients about CAM, critical thinking, evidence-based medicine, laws, ethics, and spiritual/cultural beliefs. Definition of CAM was medically, not holistically based. More faculty…

  17. Illness prevention and health promotion services provided by nurse practitioners: predicting potential consumers.

    PubMed Central

    Pender, N J; Pender, A R

    1980-01-01

    A cross-sectional survey of 388 residents of a northern Illinois county explored the relationships between psychosocial and behavioral characteristics of the population and intentions to use illness prevention and health promotion services provided by nurse practitioners. Results of the study indicated that 61 per cent of the respondents intended to use one or more of the nurse-provided services when they became available within the community. The best predictors of intention to use the services were: expressed interest in use of prevention and health promotion services for direct pay, education beyond high school, and a low level of life stress. Intentions to use the services did not differ significantly between individuals with a regular personal physician and those without a regular physician. These data were interpreted as indicating a need within the community for nurse practitioners to provide prevention and health promotion care. The findings also supported the complementary roles of nurses and physicians in providing health care to ambulatory populations. PMID:7416338

  18. Evaluating an australian emergency nurse practitioner candidate training program.

    PubMed

    Plath, Sharyn J; Wright, Mary; Hocking, Julia

    2017-11-01

    Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate. The training team defined milestones for Semesters one and two, and developed a case review form to assess application of the candidate's knowledge in new clinical situations, as well as check for gaps in understanding. A clinical skills guide was developed for the candidate to work toward, and a comprehensive assessment was carried out at two time points in the training program. Feedback was obtained from the mentors and the candidate at the end point of the training program, and has been used to refine the program for 2017. This in-house training program provided specialised, evidence-based training for the emergency department environment, resulting in development of the nurse practitioner candidate as a high functioning team member. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

  19. Physician Assistant and Nurse Practitioner Malpractice Trends.

    PubMed

    Brock, Douglas M; Nicholson, Jeffrey G; Hooker, Roderick S

    2017-10-01

    Trends in malpractice awards and adverse actions (e.g., revocation of provider license) following an act or omission constituting medical error or negligence were examined. The National Practitioner Data Bank was used to compare rates of malpractice reports and adverse actions for physicians, physician assistants (PAs), and nurse practitioners (NPs). During 2005 through 2014, there ranged from 11.2 to 19.0 malpractice payment reports per 1,000 physicians, 1.4 to 2.4 per 1,000 PAs, and 1.1 to 1.4 per 1,000 NPs. Physician median payments ranged from 1.3 to 2.3 times higher than PAs or NPs. Diagnosis-related malpractice allegations varied by provider type, with physicians having significantly fewer reports (31.9%) than PAs (52.8%) or NPs (40.6%) over the observation period. Trends in malpractice payment reports may reflect policy enactments to decrease liability.

  20. Perceived Quality of Work Life and Risk for Compassion Fatigue Among Oncology Nurses: A Mixed-Methods Study.

    PubMed

    Denigris, Jami; Fisher, Kathleen; Maley, MaryKay; Nolan, Elizabeth

    2016-05-01

    To examine factors that influenced the nurse's perceived quality of work life and risk for compassion fatigue (CF). The specific aims of the study were to describe the (a) relationship among nurse characteristics and perceived quality of work life, (b) relationship between personal life stress and perceived quality of work life, and (c) the nurse's beliefs about his or her risk for CF.
. A descriptive, mixed-methods study.
. A hematology-oncology unit in a large urban teaching hospital in Pennsylvania.
. 20 oncology nurses. 
. Descriptive study using questionnaires and in-depth interviews. The variables were nurse characteristics, personal life stress, and quality of work life. Data were analyzed descriptively and thematically. Scores on the self-report questionnaires were compared to themes.
. Personal life stressors, measured by combining the Impact of Events Scale and Life Events Scale, identified powerful or severe impacts on well-being for 30% of nurse respondents in this study, theoretically placing them at risk for CF. However, qualitative data did not complement the results of the Life Events Scale, and 55% of the nurses described their overall work experiences as "life-affirming and rewarding." The participants provided multiple sources of their work-related stress, including subcategories of communication breakdown, work environment/institution, and care-driven factors. 
. Overall, oncology nurses experienced positive reinforcement at work and they had little concern about individual or organizational effectiveness. Positive experiences offset the negative and balanced out the risk for CF.
. The identification of personal and social contributors, as well as solutions to work-related stress, supports the philosophical premises (i.e., conceptual model) that the circumstances that place a nurse at risk for CF are socially constructed. Nurses can achieve greater empathy through self-understanding and translate this learning to patient care.

  1. International practice settings, interventions and outcomes of nurse practitioners in geriatric care: A scoping review.

    PubMed

    Chavez, Krista S; Dwyer, Andrew A; Ramelet, Anne-Sylvie

    2018-02-01

    To identify and summarize the common clinical settings, interventions, and outcomes of nurse practitioner care specific to older people. Scoping review of the international published and grey literature. A structured literature search was conducted of CINAHL, EMBASE, MEDLINE, Google Scholar, and Cochrane Collaboration and Joanna Briggs Institute databases. Following the Arksey and O'Malley framework, randomized controlled and quasi-experimental studies of Masters-prepared nurse practitioners providing care for patients over 65 years were included. Studies were reviewed independently by two investigators. Data were extracted, collated by setting, summarized in tables and synthesized for analysis. In total, 56 primary research studies from four countries and 23 systematic reviews were identified. Primary studies were conducted in primary care (n=13), home care (n=14), long-term care (n=10), acute/hospital care (n=9), and transitional care (n=10). Nurse practitioner interventions included substitutive as well as a supplementation NP role elements to meet specific unmet patient care needs. Studies examined six main outcome measures: service utilization (n=41), cost (n=24), length of stay (n=14), health indices (n=44), satisfaction (n=14) and quality of life (n=7). Cumulatively, nurse practitioners demonstrated enhanced results in 83/144 (58%) of outcomes compared to physician-only or usual care. The most commonly measured financial-related outcome was service utilization (n=41) and benefits were frequently reported in home care (8/9, 89%) and long-term care (7/10, 70%) settings. Among patient and care-related outcomes health indices were most frequently measured (n=44). Primary care most frequently reported improved health indices (11/13, 85%). Transitional care reported improved outcomes across all measures, except for service utilization. This review demonstrates improved or non-inferiority results of nurse practitioner care in older people across settings. More well

  2. Evaluating Cultural Competence of Pediatric Oncology Nurses at a Teaching Hospital: A Pilot Study.

    PubMed

    Eche, Ijeoma Julie; Aronowitz, Teri

    This cross-sectional descriptive study evaluated registered nurses' self-ratings of cultural competence on the hematology/oncology unit at a large Northeastern urban children's hospital. The Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals was used to measure 5 constructs of cultural competence. The study findings show that there were significant correlations between the knowledge and skill subscales (ρ = .57, P < .001) and the knowledge and desire subscales (ρ = .42, P < .05). The highest mean among the 5 subscales was cultural desire (mean = 15.5), indicating that nurses were motivated to engage in the process of becoming culturally competent. The lowest mean among the 5 subscales was cultural knowledge (mean = 11.2), followed by cultural skill (mean = 11.8), indicating that nurses did not perceive themselves to be well informed in these areas. The findings from this pilot study suggest that nurses on this pediatric oncology unit are most likely to possess cultural desire and cultural awareness, but there is certainly opportunity to engage and educate the staff. Targeted interventions to improve cultural competence on this inpatient unit are being explored and a larger scale study is being planned to assess the cultural competence of nurses across the hospital.

  3. A case study of nurse practitioner role implementation in primary care: what happens when new roles are introduced?

    PubMed Central

    2013-01-01

    Background At the time of this study (2009) the role of the nurse practitioner was new to the province of British Columbia. The provincial government gave the responsibility for implementing the role to health authorities. Managers of health authorities, many of whom were unfamiliar with the role, were responsible for identifying the need for the NP role, determining how the NP would function, and gaining team members’ acceptance for the new role. Method The purpose of the study was to explain the process of nurse practitioner role implementation as it was occurring and to identify factors that could enhance the implementation process. An explanatory, single case study with embedded units of analysis was used. The technique of explanation building was used in data analysis. Three primary health care settings in one health authority in British Columbia were purposively selected. Data sources included semi-structured interviews with participants (n=16) and key documents. Results The results demonstrate the complexity of implementing a new role in settings unfamiliar with it. The findings suggest that early in the implementation process and after the nurse practitioner was hired, team members needed to clarify intentions for the role and they looked to senior health authority managers for assistance. Acceptance of the nurse practitioner was facilitated by team members’ prior knowledge of either the role or the individual nurse practitioner. Community health care providers needed to be involved in the implementation process and their acceptance developed as they gained knowledge and understanding of the role. Conclusion The findings suggest that the interconnectedness of the concepts of intention, involvement and acceptance influences the implementation process and how the nurse practitioner is able to function in the setting. Without any one of the three concepts not only is implementation difficult, but it is also challenging for the nurse practitioner to fulfill

  4. Expanding rural access to mental health care through online postgraduate nurse practitioner education.

    PubMed

    Kverno, Karan; Kozeniewski, Kate

    2016-12-01

    Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services. ©2016 American Association of Nurse Practitioners.

  5. Novice nurse practitioner workforce transition and turnover intention in primary care.

    PubMed

    Faraz, Asefeh

    2017-01-01

    Little is known about the workforce transition and turnover intention of novice nurse practitioners (NPs) in primary care (PC). This research aimed to describe the individual characteristics, role acquisition and job satisfaction of novice NPs, and identify factors associated with their successful transition and turnover intention in the first year of PC practice. A descriptive, cross-sectional study was conducted via online survey administered to a national sample of 177 NPs who graduated from an accredited NP program and were practicing in a PC setting for 3-12 months. This study demonstrated that greater professional autonomy in the workplace is a critical factor in turnover intention in novice NPs in the PC setting. Further research is needed regarding the novice NP workforce transition to provide adequate professional autonomy and support during this critical period. ©2016 American Association of Nurse Practitioners.

  6. A comparative study on the clinical decision-making processes of nurse practitioners vs. medical doctors using scenarios in a secondary care environment.

    PubMed

    Thompson, Stephen; Moorley, Calvin; Barratt, Julian

    2017-05-01

    To investigate the decision-making skills of secondary care nurse practitioners compared with those of medical doctors. A literature review was conducted, searching for articles published from 1990 - 2012. The review found that nurse practitioners are key to the modernization of the National Health Service. Studies have shown that compared with doctors, nurse practitioners can be efficient and cost-effective in consultations. Qualitative research design. The information processing theory and think aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality and they were compared using a structured scenario-based interview. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment. This study was conducted from May 2012 - January 2013. The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took 3 minutes longer to complete the scenarios. This study suggests that nurse practitioner consultations are comparable to those of medical doctors in a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes. © 2016 John Wiley & Sons Ltd.

  7. Grants for nurse practitioner traineeship programs--PHS. Interim final regulations.

    PubMed

    1984-08-01

    These regulations set forth requirements for grants to schools of nursing, medicine, and public health, to public or nonprofit private hospitals, and to other public or nonprofit private entities to meet the costs of traineeships for training nurse practitioners. A trainee must sign a commitment with the Secretary to practice full-time as a nurse practitioner in a primary medical care health manpower shortage area, designated under section 332 of the Public Health Service Act (the Act), for a period equal to 1 month for each month of traineeship support, after completion of the training. If this obligation is not fulfilled, a trainee must pay back traineeship support. The purpose of these regulations is to respond to the comments on the 1980 interim final regulations and to conform 42 CFR Part 57, Subpart AA, with the Paperwork Reduction Act of 1980, Pub. L. 96-511, and with the Omnibus Budget Reconciliation Act of 1981, Pub. L. 97-35, which requires, among other provisions, that the Secretary provide, by regulation, for the waiver or suspension of the repayment obligation under certain conditions. In addition, other minor changes have been made and Office of Management and Budget (OMB) numbers are cited in those sections which have approved reporting and recordkeeping requirements.

  8. Working in a 'third space': a closer look at the hybridity, identity and agency of nurse practitioners.

    PubMed

    Chulach, Teresa; Gagnon, Marilou

    2016-03-01

    Nurse practitioners (NPs), as advanced practice nurses, have evolved over the years to become recognized as an important and growing trend in Canada and worldwide. In spite of sound evidence as to the effectiveness of NPs in primary care and other care settings, role implementation and integration continue to pose significant challenges. This article utilizes postcolonial theory, as articulated by Homi Bhabha, to examine and challenge traditional ideologies and structures that have shaped the development, implementation and integration of the NP role to this day. Specifically, we utilize Bhabha's concepts of third space, hybridity, identity and agency in order to further conceptualize the nurse practitioner role, to examine how the role challenges some of the inherent assumptions within the healthcare system and to explore how development of each to these concepts may prove useful in integration of nurse practitioners within the healthcare system. Our analysis casts light on the importance of a broader, power structure analysis and illustrates how colonial assumptions operating within our current healthcare system entrench, expand and re-invent, as well as mask the structures and practices that serve to impede nurse practitioner full integration and contributions. Suggestions are made for future analysis and research. © 2015 John Wiley & Sons Ltd.

  9. Biosimilars: Considerations for Oncology Nurses
.

    PubMed

    Vizgirda, Vida; Jacobs, Ira

    2017-04-01

    Biosimilars are developed to be highly similar to and treat the same conditions as licensed biologics. As they are approved and their use becomes more widespread, oncology nurses should be aware of their development and unique considerations. This article reviews properties of biosimilars; their regulation and approval process; the ways in which their quality, safety, and efficacy are evaluated; their postmarketing safety monitoring; and their significance to oncology nurses and oncology nursing.
. A search of PubMed and regulatory agency websites was conducted for references related to the development and use of biosimilars in oncology. 
. Because biologics are large, structurally complex molecules, biosimilars cannot be considered generic equivalents to licensed biologic products. Consequently, regulatory approval for biosimilars is different from approval for small-molecule generics. Oncology nurses are in a unique position to educate themselves, other clinicians, and patients and their families about biosimilars to ensure accurate understanding, as well as optimal and safe use, of biosimilars.

  10. Reproductive Health in the Adolescent and Young Adult Cancer Patient: An Innovative Training Program for Oncology Nurses

    PubMed Central

    Vadaparampil, Susan T.; Hutchins, Nicole M.; Quinn, Gwendolyn P.

    2012-01-01

    In 2008, approximately 69,200 AYAs were diagnosed with cancer, second only to heart disease for males in this age group. Despite recent guidelines from professional organizations and clinical research that AYA oncology patients want information about reproductive health topics and physician support for nurses to address these issues with patients, existing research finds few oncology nurses discuss this topic with patients due to barriers such as lack of training. This article describes an innovative eLearning training program, entitled Educating Nurses about Reproductive Issues in Cancer Healthcare (ENRICH). The threefold purpose of this article is to: (1) highlight major reproductive health concerns relevant to cancer patients, (2) describe the current status of reproductive health and oncology communication and the target audience for the training, and (3) present a systematic approach to curriculum development, including the content analysis and design stages as well as the utilization of feedback from a panel of experts. The resulting 10-week curriculum contains a broad-based approach to reproductive health communication aimed at creating individual- and practice-level change. PMID:23225072

  11. Job Satisfaction Among Family Nurse Practitioners in the United States Air Force

    DTIC Science & Technology

    1999-05-01

    role, attitude of health personnel, Herzberg, workplace, organizational culture, personnel management , workload. vi JOB SATISFACTION AMONG FAMILY NURSE...find assistance through USUHS or from the functional manager of the Family Nurse Practitioner Program. We wish you success with your research and with...Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington

  12. Nurse practitioners, certified nurse midwives, and physician assistants in physician offices.

    PubMed

    Park, Melissa; Cherry, Donald; Decker, Sandra L

    2011-08-01

    The expansion of health insurance coverage through health care reform, along with the aging of the population, are expected to strain the capacity for providing health care. Projections of the future physician workforce predict declines in the supply of physicians and decreasing physician work hours for primary care. An expansion of care delivered by nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs) is often cited as a solution to the predicted surge in demand for health care services and calls for an examination of current reliance on these providers. Using a nationally based physician survey, we have described the employment of NPs, CNMs, and PAs among office-based physicians by selected physician and practice characteristics. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  13. Does clinical experience help oncology nursing staff to deal with patient pain better than nurses from other displines? Knowledge and attitudes survey amongst nurses in a tertiary care in Malaysia.

    PubMed

    Yaakup, Hayati; Eng, Tan Chai; Shah, Shamsul Azhar

    2014-01-01

    Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers. The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this. This cross-sectional research study used a modified version of the Nurses' Knowledge and Attitudes Survey (NKAS) regarding pain. Basic demographic data were obtained for further correlation with the level of pain knowledge. A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of 42.7±10.9 (range: 5-92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years (6.6±4.45). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was 58.6±9.58, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards (63.52±9.27, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03). The present findings give further support for the universal concern about poor knowledge and attitudes among nurses related to the optimal management of pain. The results indicated that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helps to improve attitudes and knowledge concerning better pain management.

  14. Balancing health care needs in a changing context: nursing highlights from the 2016 European Oncology Nursing Society Congress (EONS10), 17–18 October 2016, Dublin, Ireland

    PubMed Central

    Lichosik, Danuta; Caruso, Rosario

    2017-01-01

    European cancer nurses have to face many challenges as a result of the rapidly changing economic and political context in which balancing health care needs has become strategic for healthcare delivery. Currently, cancer nurses must overcome many obstacles arising from clinical, organisational, and educational issues. Within this scenario, the European Oncology Nursing Society (EONS) shaped its tenth congress programme to boost discussion and reflections, to share experiences and research, and to see how cancer nurses try to anticipate and embrace changes. The aim of this was to promote innovative solutions and to address the many issues involved with cancer care. EONS10 was held on 17–18 October in Dublin, Ireland. The congress was attended by more than 500 delegates. The programme covered the following themes: caring for families and carers, inequalities and access to cancer care, caring for patients with haematological cancers, palliative care, communication and information exchange, community cancer care (i.e. parallel sessions), roles and responsibility for advanced nursing practice, International Psycho-Oncology Society (IPOS)-Academy workshops (i.e. workshops), cancer survivorship, clinical leadership and new roles, oncology nursing research, symptom experiences and management, palliative care (i.e. proffered papers), poster presentations, and satellite symposia. The aim of this paper is to highlight and discuss the contents of the EONS10 congress. PMID:28144284

  15. A qualitative study of advanced nurse practitioners' use of physical assessment skills in the community: shifting skills across professional boundaries.

    PubMed

    Raleigh, Mary; Allan, Helen

    2017-07-01

    To explore multiple perspectives on the use of physical assessment skills by advanced nurse practitioners in the UK. Physical assessment skills practices are embedded in advanced nursing practice roles in the UK. There is little evidence on how these skills are used by advanced nurse practitioners in the community. Case study. A qualitative interpretative single-embedded case study of 22 participants from South of England. A framework method analysed interview data collected by the researcher between March-August 2013. Participants included nurses, doctors, nurse educators and managers. Physical assessment skills education at universities is part of a policy shift to develop a flexible workforce in the UK. Shared physical assessment practices are less to do with role substitution and more about preparing practitioners with skills that are fit for purpose. Competence, capability and performance with physical assessment skills are an expectation of advanced nursing practice. These skills are used successfully by community advanced nurse practitioners to deliver a wide range of services in response to changing patient need. The introduction of physical assessment skills education to undergraduate professional preparation would create a firm foundation to develop these skills in postgraduate education. Physical assessment education prepares nurses with the clinical competencies to carry out healthcare reforms in the UK. Shared sets of clinical assessment competencies between disciplines have better outcomes for patients. Levels of assessment competence can depend on the professional attributes of individual practitioners. Unsupportive learning cultures can hinder professional development of advanced nursing practice. © 2016 John Wiley & Sons Ltd.

  16. A clinical trial of nurse practitioner care in residential aged care facilities.

    PubMed

    Arendts, Glenn; Deans, Pamela; O'Brien, Keith; Etherton-Beer, Christopher; Howard, Kirsten; Lewin, Gill; Sim, Moira

    2018-05-04

    Optimising quality of life and reducing hospitalisation for people living in residential aged care facilities (RACF) are important health policy goals. A cluster controlled clinical trial of nurse practitioner care in RACF. Six facilities were included: three randomly allocated to intervention where nurse practitioners working with general practitioners and using a best practice guide were responsible for care, and three control. Participants were followed up for a minimum of 12 months unless dead or transferred to another facility. We enrolled two hundred patients (101 intervention and 99 control) with a mean (SD) follow up of 604 (276) days. There were 98 ED visits by intervention participants, resulting in 56 hospitalisations, compared with 121 ED visits and 70 hospitalisations for controls (risk reduction = 8%, 95% CI = -1% -17%, p = 0.10). For the pre-specified secondary outcomes of transfers within the first 12 months of enrolment, the number of residents making at least one visit (46 in each study arm) and rate of ED attendance (0.66 visits per intervention resident versus 0.70 visits per control resident) was not affected by the intervention. After adjusting for dependency and comorbidity, the intervention group had non-significantly lower transfers (OR 0.7, 95% CI 0.3-1.5, p = 0.34). There was a reduction in the rate of decline in the quality of life of intervention compared to control residents. Nurse practitioner care coordination resulted in no statistically significant change in rates of ED transfer or health care utilisation, but better maintained resident quality of life. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. A triadic interplay between academics, practitioners and students in the nursing theory and practice dialectic.

    PubMed

    Chan, Engle Angela; Chan, Kitty; Liu, Yat Wa Justina

    2012-05-01

      This article is a report of a descriptive study of the effectiveness of classroom teaching by clinical nurse specialists on students' transfer of theory into practice.   Ongoing concern about a theory-practice merger in nursing has led to collaborative initiatives between academics and practitioners globally. There are different forms of collaborative efforts, but information on their evaluation is scarce and inconclusive. Integration of theory and practice is important for an outcome-based approach, which emphasizes students' clinical competence as the measure of success. The limited nursing discussion on theory and practice collaboration in education was our impetus for the study.   Between 2007 and 2008, focus group interviews were held, first with 75 and then with 35 from the same group of first-year students, regarding their learning experience from the lectures of the two clinical nurse specialists in diabetes and colostomy care, respectively, prior to and after their clinical placements. Six of their clinical instructors and the two clinical nurse specialists were also interviewed. The audiotaped interviews were transcribed verbatim and analysed using content analysis.   Three themes were identified: impact of students' vicarious learning from clinical nurse specialists' stories of experience; improving the collaboration between clinical nurse specialists and subject lecturers for junior students' learning experience; continuity in the clinical integration of theory-practice as dialectic through an interplay between academics, practitioners and students.   The theory and practice issue is best addressed as a triadic paradigm in a community of practice with the collaboration among academics, practitioners and students. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  18. Protection behaviors for cytotoxic drugs in oncology nurses of chemotherapy centers in Shiraz hospitals, South of Iran.

    PubMed

    Abbasi, Khadijeh; Hazrati, Maryam; Mohammadbeigi, Abolfazl; Ansari, Jasem; Sajadi, Mahboubeh; Hosseinnazzhad, Azam; Moshiri, Esmail

    2016-01-01

    The use of antineoplastic agents for the treatment of cancer is an increasingly common practice in hospitals. As a result, workers involved with handling antineoplastic drugs may be accidentally exposed to these agents, placing them at potential risk for long-term adverse effects. This study aimed to determine the occupational protection status of clinical nursing staff exposed to cytotoxic drugs. The study was designed as an analytic descriptive survey. The research settings took place in six centers of chemotherapy in Shiraz, Iran. The participants were 86 nurses who worked in oncology units and administered cytotoxic drugs. Data were collected using a questionnaire and a checklist which was developed by the investigators to determine occupational protection status of clinical nursing staff exposed to cytotoxic drugs. Percentage calculations and the independent samples t -test were used to see the general distribution and analysis of data. To statistically analyze of the data, SPSS software (version 16) was applied. The mean age of participants was 30.52 ± 6.50 years and 66.27% of the nurses worked on inpatient oncology wards. The mean practice score was 21.1 ± 3.76 that ranged from 12.5 to 31. The independent samples t -test showed the outpatient nurses were weaker in practice (17.2 ± 2.52) in comparison with university hospitals (23.35 ± 3.02, P < 0.001). Occupational protection status of clinical nursing staff exposed to cytotoxic drugs especially during administration and disposal of medicines was poor and rarely trained with this subject and was observed under the standard conditions. There is deficiency in the understanding and related protection practices of clinical nursing staff vocationally exposed to cytotoxic drugs. It is recommended that all clinical nursing staff should receive full occupational protection training about these matters and the authorities provide standard conditions of oncology wards.

  19. Effect of systematic review of medication by general practitioner on drug consumption among nursing-home residents.

    PubMed

    Khunti, K; Kinsella, B

    2000-09-01

    nursing-home patients usually have many medical problems and often take many drugs. They are therefore at risk from drug side effects and interactions. to evaluate the impact of a visit by a general practitioner and a comprehensive repeat prescribing review on the consumption of inappropriate drugs in nursing homes. two general practitioners made one comprehensive visit to four randomly selected nursing homes. In each home we discussed all patients in detail with a senior member of staff. We reviewed the prescribing record of each patient and stopped items if we considered them inappropriately prescribed or unnecessary. repeat prescriptions were altered in 65% of patients: 51% had an item stopped and 26% had an item changed to a cheaper alternative or the dose reduced. There was a reduction in the mean number of repeat prescriptions prescribed. a single visit by a general practitioner to a nursing home and a comprehensive repeat prescribing review can lead to a reduction in the number of items prescribed and to substantial savings for the health service. Further rigorous, cost-effectiveness studies are needed.

  20. Alcohol Abuse Curriculum Guide for Nurse Practitioner Faculty. Health Professions Education Curriculum Resources Series. Nursing 3.

    ERIC Educational Resources Information Center

    Hasselblad, Judith

    The format for this curriculum guide, written for nurse practitioner faculty, consists of learning objectives, content outline, teaching methodology suggestions, references and recommended readings. Part 1 of the guide, Recognition of Early and Chronic Alcoholism, deals with features of alcoholism such as epidemiological data and theories,…

  1. Nurse practitioners' work hours and overtime: How much, and under what working conditions?

    PubMed

    Bae, Sung-Heui; Champion, Jane Dimmitt

    2016-03-01

    To explore the nature and prevalence of nurse practitioner (NP) overtime, work hours, and their relationship to practice within NP work conditions. A secondary analysis of data extracted from the 2012 National Sample Survey of Nurse Practitioners. The focus in this study was on data from NPs in active practice in clinical settings. The final analytic sample consisted of 9010 NPs. NPs working in hospitals and long-term care settings tended to work more than 40 h/week (p < .001). When healthcare facilities used electronic health records (p < .001) or had recently adopted electronic health records (p = .002), NPs were found to work more hours per week than those who did not. Regarding the type of relationships with physicians, NPs who worked more than 40 h/week either had hierarchical relationships with them (p < 0.001), or relationships in which the physician examined and signed off on patients whom the NP had examined (p < .001). These analyses provide a preliminary description of the nature and prevalence of NP work hours/overtime and work conditions related to longer work hours. Further study is indicated to assess the potential impact of work hours/overtime on NP roles and patient outcomes. ©2015 American Association of Nurse Practitioners.

  2. Education and referral criteria: impact on oncology referrals to palliative care.

    PubMed

    Reville, Barbara; Reifsnyder, JoAnne; McGuire, Deborah B; Kaiser, Karen; Santana, Abbie J

    2013-07-01

    To describe a quality improvement project involving education and referral criteria to influence oncology provider referrals to a palliative care service. A single group post-test only quasi-experimental design was used to evaluate palliative care service (PCS) referrals following an intervention consisting of a didactic presentation, education outreach visits (EOV) to key providers, and referral criteria. Data on patient demographics, cancer types, consult volume, reasons for referral, pre-consult length of stay, overall hospital stay, and discharge disposition were collected pre-intervention, then post-intervention for 7.5 months and compared. Attending oncologists, nurse practitioner, and house staff from the solid tumor division at a 700-bed urban teaching hospital participated in the project. Two geriatricians, a palliative care nurse practitioner, and rotating geriatric fellows staffed the PCS. The percentage of oncology referrals to PCS increased significantly following the intervention (χ(2) = 6.108, p = .013). 24.9% (390) patients were referred in the 4.6 years pre-intervention and 31.5% (106) patients were referred during 7.5 months post-intervention. The proportion of consults for pain management was significantly greater post-intervention (χ(2) = 5.378, p = .02), compared to pre-intervention, when most referrals were related to end-of-life issues. Lung, pancreatic, and colon were the most common cancer types at both periods, and there were no significant differences in patient demographics, pre-referral length of hospitalization or overall hospital days. There was a trend toward more patients being discharged alive following the intervention. A quality improvement project supported the use of education and referral criteria to influence both the frequency and reasons for palliative care referral by oncology providers.

  3. The role of the neonatal nurse practitioner in the community hospital level I nursery.

    PubMed

    Hatch, Julie

    2012-01-01

    Neonatal nurse practitioners (NNPs) have played a significant role in providing medical coverage to many of the country's Level III neonatal intensive care units (NICUs). Extensive education and experience are required for a nurse practitioner (NP) to become competent in caring for these critically ill newborns. The NNP can take this competence and experience and expand her role out into the community Level I nurseries. Clinical care of the infants and close communication with parents, pediatricians, and the area tertiary center provide a community service with the goal of keeping parents and babies together in the community hospital without compromising the health of the baby. The NNP service, with 24-hour nursery and delivery coverage, supports an ongoing obstetric service to the community hospital. The NNP's experience enables her to provide a neonatal service that encompasses a multitude of advanced practice nursing roles.

  4. Nurse practitioners in aged care: documentary analysis of successful project proposals.

    PubMed

    Clark, Shannon J; Parker, Rhian M; Davey, Rachel

    2014-11-01

    Meeting the primary health care needs of an aging population is an increasing challenge for many Western nations. In Australia, the federal government introduced a program to develop, test, and evaluate nurse practitioner models in aged care settings. In this article, we present a documentary analysis of 32 project proposals awarded funding under the Nurse Practitioner-Aged Care Models of Practice Program. Successfully funded models were diverse and were operated by a range of organizations across Australia. We identified three key priorities as underlying the proposed models: "The right care," "in the right place," and "at the right time." In this article, we explore how these priorities were presented by different applicants in different ways. Through the presentation of their models, the program's applicants identified and proposed to address current gaps in health services. Applicants contrasted their proposed models with available services to create persuasive and competitive applications for funding. © The Author(s) 2014.

  5. Use of Joint Commission International Standards to Evaluate and Improve Pediatric Oncology Nursing Care in Guatemala

    PubMed Central

    Day, Sara W.; McKeon, Leslie M.; Garcia, Jose; Wilimas, Judith A.; Carty, Rita M.; de Alarcon, Pedro; Antillon, Federico; Howard, Scott C.

    2017-01-01

    Background Inadequate nursing care is a major impediment to development of effective programs for treatment of childhood cancer in low-income countries. When the International Outreach Program at St. Jude Children’s Research Hospital established partner sites in low-income countries, few nurses had pediatric oncology skills or experience. A comprehensive nursing program was developed to promote the provision of quality nursing care, and in this manuscript we describe the program’s impact on 20 selected Joint Commission International (JCI) quality standards at the National Pediatric Oncology Unit in Guatemala. We utilized JCI standards to focus the nursing evaluation and implementation of improvements. These standards were developed to assess public hospitals in low-income countries and are recognized as the gold standard of international quality evaluation. Methods We compared the number of JCI standards met before and after the nursing program was implemented using direct observation of nursing care; review of medical records, policies, procedures, and job descriptions; and interviews with staff. Results In 2006, only 1 of the 20 standards was met fully, 2 partially, and 17 not met. In 2009, 16 were met fully, 1 partially, and 3 not met. Several factors contributed to the improvement. The pre-program quality evaluation provided objective and credible findings and an organizational framework for implementing change. The medical, administrative, and nursing staff worked together to improve nursing standards. Conclusion A systematic approach and involvement of all hospital disciplines led to significant improvement in nursing care that was reflected by fully meeting 16 of 20 standards. PMID:23015363

  6. The case for renewed investment in the district nursing specialist practitioner qualification.

    PubMed

    Longstaff, Fiona

    2013-09-01

    District nursing as a profession has been under significant threat over the last few years due to a lack of foresight and funding, resulting in an undervalued and underinvested workforce. The once-heralded specialist practitioner programme was slowly decommissioned in all but a handful of universities, leaving no alternative but for community trusts to employ staff nurses in team leader roles without the development the added qualification gave them. In light of the renewed focus on the fundamental advancement of district nurses and recent Government publications clearly reinforcing the district nurse's role, this article argues for the need for educational commissioners and workforce planners to commit to continued investment in this vital profession.

  7. Resurfacing the care in nursing by telephone: lessons from ambulatory oncology.

    PubMed

    Wilson, Rosemary; Hubert, John

    2002-01-01

    The practice of providing telephone mediated advice and assistance is often described as "telephone triage" in relevant literature. The decision-making processes required for priority-setting and the provision of advice have been found to be complex and multifaceted. Conceptualization of this valuable patient care activity as a linear "triage" function serves to make invisible the nursing care provided. This article explores the current practice of providing telephone mediated advice and assistance in the following 2 distinct nursing care settings: emergency departments and ambulatory oncology centers. Examination of this activity in these 2 settings provides a forum to discuss and critique legally and fiscally driven prescriptive protocol use to inform decision-making. The effectiveness of experiential knowledge coupled with the strengths of nurse-patient relationships suggests that a need exists to highlight the caring aspects of telephone mediated assistance.

  8. Doctors' and nurses' perceptions of interdisciplinary collaboration in the NICU, and the impact of a neonatal nurse practitioner model of practice.

    PubMed

    Copnell, Beverley; Johnston, Linda; Harrison, Denise; Wilson, Anita; Robson, Anne; Mulcahy, Caroline; Ramudu, Louisa; McDonnell, Geraldine; Best, Christine

    2004-01-01

    The importance of interdisciplinary collaboration has been attested to by a number of authors. Some have suggested that Nurse Practitioners (NPs) may be able to improve collaboration between doctors and nurses, but this assertion does not appear to have been researched. To investigate doctors' and nurses' perceptions of interdisciplinary collaboration in two neonatal intensive care units, and to assess the impact of a Neonatal Nurse Practitioner (NNP) practice model on these perceptions. The study was conducted as part of a larger project to develop a NNP model of practice. Survey, pre- and post-intervention. Medical and nursing staff in both units were surveyed before and after introduction of the NP model of practice. The instrument consisted of 25 statements relating to nurse-doctor interactions, with which respondents indicated their level of agreement on a five-point Likert scale. The Mann-Whitney U-test was used to compare scores for individual items and for overall collaboration between various groups of staff, and between the first and second surveys. Significant differences between the responses of nurses and doctors were found on both surveys. Areas of disagreement chiefly concerned doctors' behaviour and their attitudes towards nurses, rather than nurses' behaviour or environmental factors. Doctors consistently reported a higher degree of collaboration than did nurses. Few differences were found between first and second surveys. Results suggest that problems in nurse-physician interactions exist in both units. No impact of the NNP role, as established in this project, on interdisciplinary collaboration could be demonstrated. Further research in this area is warranted.

  9. The importance of social support for people with type 2 diabetes - a qualitative study with general practitioners, practice nurses and patients.

    PubMed

    Goetz, Katja; Szecsenyi, Joachim; Campbell, Stephen; Rosemann, Thomas; Rueter, Gernot; Raum, Elke; Brenner, Herrmann; Miksch, Antje

    2012-01-01

    Social support is an important element of family medicine within a primary care setting, delivered by general practitioners and practice nurses in addition to usual clinical care. The aim of the study was to explore general practitioner's, practice nurse's and people with type 2 diabetes' views, experiences and perspectives of the importance of social support in caring for people with type 2 diabetes and their role in providing social support. Interviews with general practitioners (n=10) and focus groups with practice nurses (n=10) and people with diabetes (n=9). All data were audio-recorded, fully transcribed and thematically analysed using qualitative content analysis by Mayring. All participants emphasized the importance of the concept of social support and its impacts on well-being of people with type 2 diabetes. Social support is perceived helpful for people with diabetes in order to improve diabetes control and give support for changes in lifestyle habits (physical activity and dietary changes). General practitioners identified a lack of information about facilities in the community like sports or self-help groups. Practice nurses emphasized that they need more training, such as in dietary counselling. Social support given by general practitioners and practice nurses plays a crucial role for people with type 2 diabetes and is an additional component of social care. However there is a need for an increased awareness by general practitioners and practice nurses about the influence social support could have on the individual's diabetes management.

  10. Collaboration, not competition: cost analysis of neonatal nurse practitioner plus neonatologist versus neonatologist-only care models.

    PubMed

    Bosque, Elena

    2015-04-01

    Although advanced practice in neonatal nursing is accepted and supported by the American Academy of Pediatrics and National Association of Neonatal Nurse Practitioners, less than one-half of all states allow independent prescriptive authority by advanced practice nurse practitioners. The purpose of this study was to compare costs of a collaborative practice model that includes neonatal nurse practitioner (NNP) plus neonatologist (Neo) versus a neonatologist only (Neo-Only) practice in Washington state. Published Internet median salary figures from 3 sources were averaged to produce mean ± SD provider salaries, and costs for each care model were calculated in this descriptive, comparative study. Median NNP versus Neo salaries were $99,773 ± $5206 versus $228,871 ± $9654, respectively (P < .0001). The NNP + Neo (5 NNP/3 Neo full-time equivalents [FTEs]) cost $1,185,475 versus Neo-Only (8 Neo FTEs) cost $1,830,960. The NNP + Neo practice model with 8 FTEs suggests a cost savings, with assumed equivalent reimbursement, of $645,485/year. These results may provide the impetus for more states to adopt broader scope of practice licensure for NNPs. These data may provide rationale for analysis of actual costs and outcomes of collaborative practice.

  11. Emergency nurse practitioners: a three part study in clinical and cost effectiveness

    PubMed Central

    Sakr, M; Kendall, R; Angus, J; Saunders, A; Nicholl, J; Wardrope, J

    2003-01-01

    Aims: To compare the clinical effectiveness and costs of minor injury services provided by nurse practitioners with minor injury care provided by an accident and emergency (A&E) department. Methods: A three part prospective study in a city where an A&E department was closing and being replaced by a nurse led minor injury unit (MIU). The first part of the study took a sample of patients attending the A&E department. The second part of the study was a sample of patients from a nurse led MIU that had replaced the A&E department. In each of these samples the clinical effectiveness was judged by comparing the "gold standard" of a research assessment with the clinical assessment. Primary outcome measures were the number of errors in clinical assessment, treatment, and disposal. The third part of the study used routine data whose collection had been prospectively configured to assess the costs and cost consequences of both models of care. Results: The minor injury unit produced a safe service where the total package of care was equal to or in some cases better than the A&E care. Significant process errors were made in 191 of 1447 (13.2%) patients treated by medical staff in the A&E department and 126 of 1313 (9.6%) of patients treated by nurse practitioners in the MIU. Very significant errors were rare (one error). Waiting times were much better at the MIU (mean MIU 19 minutes, A&E department 56.4 minutes). The revenue costs were greater in the MIU (MIU £41.1, A&E department £40.01) and there was a great difference in the rates of follow up and with the nurses referring 47% of patients for follow up and the A&E department referring only 27%. Thus the costs and cost consequences were greater for MIU care compared with A&E care (MIU £12.7 per minor injury case, A&E department £9.66 per minor injury case). Conclusion: A nurse practitioner minor injury service can provide a safe and effective service for the treatment of minor injury. However, the costs of such a service

  12. Physician Assistants and Nurse Practitioners as a Usual Source of Care

    ERIC Educational Resources Information Center

    Everett, Christine M.; Schumacher, Jessica R.; Wright, Alexandra; Smith, Maureen A.

    2009-01-01

    Purpose: To identify characteristics and outcomes of patients who use physician assistants and nurse practitioners (PA/NPs) as a usual source of care. Methods: Cross sectional analysis using the telephone and mail surveys of the Wisconsin Longitudinal Study (WLS), a prospective cohort study of Wisconsin high school graduates and selected siblings…

  13. A focus group study of the use of video-recorded simulated objective structured clinical examinations in nurse practitioner education.

    PubMed

    Barratt, Julian

    2010-05-01

    The objective structured clinical examination (OSCE) is a common method of clinical skills assessment used for advanced nurse practitioner students across the United Kingdom. The purpose of an advanced nursing OSCE is to assess a nurse practitioner student's competence and safety in the performance of commonly used advanced clinical practice skills. Students often feel nervous when preparing for and participating in an OSCE. Consideration of these identified anxieties led to the development of an alternative method of meeting students' OSCE learning and preparation needs; namely video-recorded simulated OSCEs. Video-recording was appealing for the following reasons: it provides a flexible usage of staff resources and time; OSCE performance mistakes can be rectified; it is possible to use the same video-recordings with multiple cohorts of students, and the recordings can be made conveniently available for students with video streaming on internet-based video-sharing sites or virtual learning environments. The aim of the study was to explore the value of using such recordings amongst nurse practitioner students, via online and face-to-face focus groups, to see if they are a suitable OSCE educational preparation technique. The study findings indicate that simulated OSCE video-recordings are an effective method for supporting nurse practitioner educational development. Copyright 2009 Elsevier Ltd. All rights reserved.

  14. Personal digital assistant use by nurse practitioners: a descriptive study.

    PubMed

    Stroud, Sally D; Smith, Carol A; Erkel, Elizabeth A

    2009-01-01

    We sought to describe the prevalence and patterns of use of personal digital assistants (PDAs) among active nurse practitioners (NPs). A descriptive correlational survey was conducted among NPs in the United States (N = 126). Participants were randomly selected from members of the American Academy of Nurse Practitioners who had listed a practice site on their application. Sixty-four percent of participants used PDAs. A drug reference was reported to be the most useful and frequently installed application. A large majority of PDA users believed that PDA use supported clinical decision making (91%), promoted patient safety (89%), and increased productivity (75%). Sixty-two percent predicted that PDA use would change their practice within the next 5 years. As innovative PDA applications with potential to improve patient outcomes become increasingly available, handheld computer skills will be a fundamental practice competency. To prevent errors in clinical decision making with quick access to PDA reference materials, NPs must critically evaluate the legitimacy and worth of PDA software programs. There is a critical need to evaluate the effectiveness of PDA use in clinical settings and develop an evidence base to guide use of the PDA in solving clinical problems.

  15. A national survey of the primary and acute care pediatric nurse practitioner educational preparation.

    PubMed

    Hawkins-Walsh, Elizabeth; Berg, Mary; Docherty, Sharron; Lindeke, Linda; Gaylord, Nan; Osborn, Kristen

    2011-01-01

    The past decade has been marked by a gradual expansion of the traditional primary care role of the pediatric nurse practitioner (PNP) into practice arenas that call for more acute and critical care of children. The purpose of the study was to explore the educational programming needs of dual (combined) track PNP programs that prepare graduates to provide care to children and adolescents across the continuum of health and illness. A two-phase, exploratory, mixed method design was utilized. An electronic survey was completed by 65% of PNP program directors in the country. Semi-structured telephone interviews were conducted with hospital-based PNPs who were practicing in roles that met a range of health care needs across the primary and acute care continuum. Primary care and acute care programs have more common than unique elements, and the vast majority of clinical competencies are common to both types of program. Only three competencies appear to be unique to acute care programs. The Association of Faculties of Pediatric Nurse Practitioner Programs should utilize existing evidence and develop guidelines for dual PNP programs that focus on the provision of care to children across a wide continuum of health and illness. Copyright © 2011 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  16. Workforce characteristics of privately practicing nurse practitioners in Australia: Results from a national survey.

    PubMed

    Currie, Jane; Chiarella, Mary; Buckley, Thomas

    2016-10-01

    Australian private practice nurse practitioner (PPNP) services have grown since legislative changes in 2010 enabled eligible nurse practitioners (NPs) to access reimbursement for care delivered through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS). This article provides data from a national survey on the workforce characteristics of PPNPs in Australia. PPNPs in Australia were invited to complete an electronic survey. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. There were 73 completed surveys. One of the intentions of expanding access to MBS and PBS for patients treated by NPs was to increase patients' access to health care through greater flexibility in the healthcare workforce. The results of this survey confirm that the workforce characteristics of PPNPs provide a potentially untapped resource to meet current primary healthcare demand. The findings of this study allow us to understand the characteristics of PPNP services, which are significant for workforce planning. The focus of PPNP practice is toward primary health care with PPNPs working predominantly in general practice settings. The largest age group of PPNPs is over 50 years and means a proportion will be retiring in the next 15 years. ©2016 American Association of Nurse Practitioners.

  17. Preparation and Evolving Role of the Acute Care Nurse Practitioner.

    PubMed

    Hoffman, Leslie A; Guttendorf, Jane

    2017-12-01

    Acute care nurse practitioners (ACNPs) are increasingly being employed as members of critical care teams, an outcome driven by increasing demand for intensive care services, a mandated reduction in house officer hours, and evidence supporting the ability of ACNPs to provide high-quality care as collaborative members of critical care teams. Integration of adult ACNPs into critical care teams is most likely to be successful when practitioners have appropriate training, supervision, and mentoring to facilitate their ability to practice efficiently and effectively. Accomplishing this goal requires understanding the educational preparation and skill set potential hires bring to the position as well as the development of an orientation program designed to integrate the practitioner into the critical care team. Pediatric ACNPs are also commonly employed in critical care settings; however, this commentary focuses on the adult ACNP role. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  18. Developing the Evidence Base in Pediatric Oncology Nursing Practice for Promoting Health-Related Quality of Life in Pediatric Oncology Patients.

    PubMed

    Cantrell, Mary Ann; Conte, Teresa M; Hudson, Melissa M; Ruble, Kathy; Herth, Kaye; Shad, Aziza; Canino, Alyssa

    Research has shown that self-esteem and hopefulness are positively related among female childhood cancer survivors (CCS) and contribute to their health-related quality of life (HRQOL). HRQOL remains a significant outcome of treatment for CCS. This study examined the relationships among self-esteem, hopefulness, and HRQOL in young adult female CCS to inform the development of evidence-based practice guidelines for pediatric oncology nursing practice. An online survey was conducted with a sample of young adult female CCS from 58 treatment centers across the United States at 4 time points: at baseline and at 6 weeks, 3 months, and 6 months after initial measurement time. The relationships between self-esteem, hopefulness, and HRQOL were statistically significant (Time 1, P = .05; Times 2, 3, and 4, P = .01) across all measurement times. These findings identify hopefulness and self-esteem as determinants of HRQOL and suggest that caring practices among pediatric oncology nurses that support psychosocial adjustment through promoting self-esteem and hopefulness have the potential to support HRQOL among young adult female CCS. These outcomes support the development of evidence-based practice guidelines to influence HRQOL outcomes among these survivors.

  19. Evolution of a Family Nurse Practitioner Program to Improve Primary Care Distribution

    ERIC Educational Resources Information Center

    Andrus, Len Hughes; Fenley, Mary D.

    1976-01-01

    Describes a Family Nurse Practitioner Program that has effectively improved the distribution of primary health care manpower in rural areas. Program characteristics include selection of personnel from areas of need, decentralization of clinical and didactic training sites, competency-based portable curriculum, and circuit-riding institutionally…

  20. Conceptual Issues Surrounding Quality of Life in Oncology Nursing.

    PubMed

    Flannery, Marie

    2017-05-01

    Quality of life (QOL) is a critical, prevalent, and enduring concept in oncology nursing research and practice. QOL is a paramount issue in the consideration of treatment, goal planning, and decision making for individuals with cancer, their families, and their care providers. Journals, well-developed valid and reliable instruments, and multiple conceptual models and frameworks are devoted to QOL. This column will review two broad conceptual aspects to consider in relation to QOL. First, conceptual considerations will be discussed for the definition and measurement of QOL. Second, conceptual issues related to QOL as an outcome will be discussed.

  1. Mentoring Nurse Practitioners in a Hospital Setting.

    PubMed

    Pop, Rodica S

    2017-08-01

    Nursing philosophy is the foundation of nurse practitioner (NP) training. However, NP practice is based on the medical care model. Thus, the necessity of mediating between these two approaches is often problematic for new NPs who are transitioning into their new roles. Mentoring has been used successfully to facilitate role transition and role understanding for nurses, NPs, and physicians. However, mentoring has been rarely studied in NPs. The purpose of this study was to develop a theory of mentoring for new NPs in a hospital setting. Grounded theory methodology was used. The sampling approach was initially purposive and was then shifted to theoretical to ensure the collection of meaningful data. Semistructuredinterviews were recorded and transcribed into Word documents for analysis. The three-phase analysis developed by Corbin and Strauss was initiated after the second interview. Sixteen participants (eight mentors and eight mentees) were interviewed between February and June 2011. The core category that emerged from the data was "defining self," and the main categories were forming the relationship, developing the relationship, and mentoring outcomes. A well-designed formal mentoring program may greatly improve the transition of NPs into a new role. The theory generated by the data from these study participants provides clearly defined categories that may be operationally defined and utilized to develop evaluation tools for mentoring programs.

  2. Long-term care legislation: an issue of concern for nurse practitioners.

    PubMed

    Jennings, J P

    1989-01-01

    Comprehensive long-term care policy has many hurdles to overcome before it becomes a reality. The biggest hurdle is the price tag! Estimates range from $6 billion (Pepper's home-care bill) to $46 billion (Stark's long-term care coverage bill). Congressional insiders predict that federal long-term care coverage must contain "pay-as-you-go" financing to win congressional passage. The medicare catastrophic health care act is cited by many in the Congress as establishing the precedent for self-financing of new federal benefits. In a pay-as-you-go era in public spending, any new program can only come from trimming existing programs and shifting those funds to new programs or from generating new revenues. The latter could result from increased beneficiary cost-sharing, an increase in the medicare payroll tax, or by eliminating the $45,000 cap on income exposed to the current 1.45% medicare payroll tax. Federal proposals to date build on existing medicare and medicaid programs. In them, quality assurance measures have been strengthened, consumer input encouraged, and a new layer of bureaucracy established to screen potential clients and provide case-management services. The scope of services is broad in most of the current proposals, and reimbursement is provided for respite care to allow family care givers relief and assistance. Access to nurse practitioners' services is an important feature of Kennedy's Lifecare proposal and is the focus of lobbying efforts for all public and private proposals. It is time for nurse practitioners to become involved in long-term care legislation. This may be initiated by reviewing current proposals and long-term care packages offered by major insurance companies. Any future long-term care benefit should bear the imprint of the nurse practitioner's professional perspective and the profession's commitment to humane, caring health policy.

  3. Training Nurse Practitioners and Physician Assistants. How Important Is State Financing?

    ERIC Educational Resources Information Center

    Henderson, Tim M.; Fox-Grage, Wendy

    This report identifies issues in state financing of programs to train nurse practitioners and physician assistants and presents findings of a national survey of 51 such training programs. An introductory chapter gives the main arguments for increased use of nonphysician providers of primary health care; this is followed by a chapter on barriers to…

  4. Variations in Missed Care Across Oncology Nursing Specialty Units.

    PubMed

    Villamin, Colleen; Anderson, Jacqueline; Fellman, Bryan; Urbauer, Diana; Brassil, Kelly

    2018-04-19

    An opportunity was identified to compare perceptions of the occurrence and types of missed care at a comprehensive cancer center. The purpose was to evaluate the difference in perceived occurrence and types of missed care between medical, surgical, and hematologic oncology units in the context of a newly implemented patient care delivery system, Primary Team Nursing (PTN). A descriptive, repeated-measures design was used. The MISSCARE survey was distributed electronically to 580 staff members across 6 inpatient units. Frequently perceived elements of missed nursing care were ambulation, turning every 2 hours, and care conference attendance. At the time of study implementation, surgical units reported 0.24 higher scores than medical units (P = .017); hematology units reported 0.26 lower scores than surgical units (P = .005). PTN status did not affect MISSCARE scores (P = .525). Study findings suggest that perceived missed care in a comprehensive cancer center is similar to that in other hospital settings.

  5. Integration of Early Specialist Palliative Care in Cancer Care: Survey of Oncologists, Oncology Nurses, and Patients.

    PubMed

    Salins, Naveen; Patra, Lipika; Usha Rani, M R; Lohitashva, S O; Rao, Raghavendra; Ramanjulu, Raghavendra; Vallath, Nandini

    2016-01-01

    Palliative care is usually delivered late in the course of illness trajectory. This precludes patients on active disease modifying treatment from receiving the benefit of palliative care intervention. A survey was conducted to know the opinion of oncologists, oncology nurses, and patients about the role of early specialist palliative care in cancer. A nonrandomized descriptive cross-sectional study was conducted at a tertiary cancer care center in India. Thirty oncologists, sixty oncology nurses, and sixty patients were surveyed. Improvement in symptom control was appreciated by oncologists, oncology nurses, and patients with respect to pain (Z = -4.10, P = 0.001), (Z = -5.84, P = 0.001), (Z = -6.20, P = 0.001); nausea and vomiting (Z = -3.75, P = 0.001), (Z = -5.3, P = 0.001), (Z = -5.1, P = 0.001); constipation (Z = -3.29, P = 0.001), (Z = -4.96, P = 0.001), (Z = -4.49, P = 0.001); breathlessness (Z = -3.57, P = 0.001), (Z = -5.03, P = 0.001), (Z = -4.99, P = 0.001); and restlessness (Z = -3.68, P = 0.001), (Z = -5.23, P = 0.001), (Z = -3.22, P = 0.001). Improvement in end-of-life care management was appreciated by oncologists and oncology nurses with respect to communication of prognosis (Z = -4.04, P = 0.001), (Z = -5.20, P = 0.001); discussion on limitation of life-sustaining treatment (Z = -3.68, P = 0.001), (Z = -4.53, P = 0.001); end-of-life symptom management (Z = -4.17, P = 0.001), (Z = -4.59, P = 0.001); perimortem care (Z = -3.86, P = 0.001), (Z = -4.80, P = 0.001); and bereavement support (Z = -3-80, P = 0.001), (Z = -4.95, P = 0.001). Improvement in health-related communication was appreciated by oncologists, oncology nurses, and patients with respect to communicating health related information in a sensitive manner (Z = -3.74, P = 0.001), (Z = -5.47, P = 0.001), (Z = -6.12, P = 0.001); conducting family meeting (Z = -3.12, P = 0.002), (Z = -4.60, P = 0.001), (Z = -5.90, P = 0.001); discussing goals of care (Z = -3.43, P = 0.001), (Z = -5.49, P = 0

  6. Robot-assisted preparation of oncology drugs: the role of nurses.

    PubMed

    Palma, Elisabetta; Bufarini, Celestino

    2012-12-15

    Since 2007, the preparation of cancer drugs at the Pharmacy of the University Hospital of Ancona has been progressively robotized. Currently, the process of preparation of intravenous cancer drugs is almost totally automated (95%). At present, the Cytotoxic laboratory of Ancona is the sole, in Europe, that can count on two robots. The robots handle 56 oncology molecules, which correspond to more than 160 different vials. The production rate in 2011 exceeded 19,000 preparations. The quality of compounding and the sterility controls are satisfactory, every step of the process is traceable. The nursing staff played a fundamental role in the robot development process. The nursing staff and the pharmacists are still collaborating with the robotic engineers in order to increase efficiency, ergonomics and user-friendliness of the robots. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Chronic kidney disease in an Aboriginal population: A nurse practitioner-led approach to management.

    PubMed

    Barrett, Elizabeth; Salem, Lesley; Wilson, Sue; O'Neill, Claire; Davis, Kathleen; Bagnulo, Sharif

    2015-12-01

    Chronic kidney disease (CKD) is a significant health problem impacting Australia's Aboriginal and Torres Strait Islander population. After age adjustment, the prevalence of kidney disease is 3.7 times higher in Aboriginal people and 7.3 times higher for end-stage kidney disease compared with the wider population. Yet at an Aboriginal Community Controlled Health Service (ACCHS) with a significant patient population, fewer than expected numbers of Aboriginal patients were identified with CKD. The ACCHS engaged a nurse practitioner to lead a systematic approach to the identification and treatment of CKD. This nurse practitioner-led approach to CKD was developed and implemented at a rural NSW ACCHS, with the support of a partnership formed between the nurse practitioner, the ACCHS, a nephrologist from a referral hospital and a statewide NGO. The primary measure for improvement has been to identify and stage patients with CKD and establish management plans as appropriate. This nurse-led project was established to: (i) identify patients with CKD; (ii) provide access for CKD patients to appropriate services; (iii) commence pharmacological and non-pharmacological strategies that enable remission or regression of CKD; and (iv) educate practice GPs and other staff members on CKD clinical guidelines and best practice. The CKD project has improved access to essential health care for vulnerable and at-risk populations, with 187 patients to date having been identified with kidney disease and staged for its severity. The need for strong multi-disciplinary teamwork has been demonstrated with good communication strategies implemented. © 2015 National Rural Health Alliance Inc.

  8. Pilot survey of NICU nurses' interest in the neonatal nurse practitioner role.

    PubMed

    Rasmussen, Lynn B; Vargo, Lyn E; Reavey, Daphne A; Hunter, Kim S

    2005-02-01

    This descriptive, qualitative pilot study explored the interest and perceptions of neonatal intensive care unit (NICU) nurses regarding the neonatal nurse practitioner (NNP) role. Motivating factors to become an NNP, challenges facing NNPs, and rewards of the NNP role from the perspectives of NICU nurses were explored. The convenience sample was obtained using 2 survey techniques. The first sample group included nurses who were employed in Level III NICUs located within 2 major Midwestern cities. In order to confirm the data and to expand the scope, the second sample group was recruited from NICU nurses who were attending a regional educational conference. All participants were currently employed NICU nurses and were therefore potential NNP students. Combining the participants of both enrollment techniques resulted in a potential of 696 subjects. A simple self-administered survey was used to collect data. Narrative data were qualitatively analyzed. Demographic data and categorical items were quantified. This study achieved a total 30% response rate (n = 209). Of the total participants, only 32% of Level III NICU nurses were interested in becoming an NNP. Analysis of the data revealed 6 major categories (themes) of reasons why nurses were not interested in the NNP role. The themes most often mentioned by the participants were (1) obligations to family and/or work (46%) and (2) too much responsibility in the NNP role (30%). The data also revealed several different rewards and challenges for those in the NNP role as well as factors that may motivate nurses to become an NNP. Given the current NNP shortage, an increase in the supply of NNPs for the workforce is imperative. Current enrollment in NNP academic programs does not appear to be meeting the demand. Exploring the factors that influence enrollment in NNP programs from the perspective of potential NNP students is the first step towards increasing the supply of NNPs. The majority of participants were not interested

  9. The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

    PubMed

    Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

    2015-01-01

    To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an

  10. An evaluation of the quality of Emergency Nurse Practitioner services for patients presenting with minor injuries to one rural urgent care centre in the UK: a descriptive study.

    PubMed

    McDevitt, Joe; Melby, Vidar

    2015-02-01

    To evaluate the quality of the emergency nurse practitioner service provided to people presenting to a rural urgent care centre with minor injuries. The three objectives that were focused were an evaluation of the safety and effectiveness of the emergency nurse practitioner service, an assessment of patients' satisfaction with the emergency nurse practitioner service and a determination of factors that may enhance the quality of the emergency nurse practitioner service. Urgent care centres have become increasingly prevalent across the UK. Emergency nurse practitioner services at these rural urgent care centres remain largely unevaluated. This study attempts to redress this deficit by evaluating the quality of an emergency nurse practitioner service in relation to the care of patients presenting with minor injuries to a rural urgent care centre. This descriptive study used a case-note review and a survey design with one open-ended exploratory question. Patient views were collected using a self-completed questionnaire and a data extraction tool to survey patients' case notes retrospectively. Despite comparatively low total length-of-stay times, most patients felt they had enough time to discuss things fully with the emergency nurse practitioner. Although emergency nurse practitioners routinely impart injury advice, feedback from some patients suggests a need for the provision of more in-depth information regarding their injury. The vast majority (97·3%) of patients felt that the quality of the emergency nurse practitioner service was of a high standard. Contrary to some other studies, the findings in this study indicate that patient satisfaction is not influenced by waiting times. Emergency nurse practitioners in rural urgent care centres have the potential to deliver a safe and effective quality service that is reflected in high levels of patient satisfaction. This study provides some evidence to support the continued expansion of the emergency nurse practitioner

  11. Obstacles to preventive care for individuals with disability: Implications for nurse practitioners.

    PubMed

    Marrocco, Anna; Krouse, Helene J

    2017-05-01

    Individuals with disabilities have been identified as a population with a significantly lower usage of preventive services. Nurse practitioners (NPs) provide a key access point in the healthcare delivery system for preventive services for vulnerable populations such as those with disabilities. It is essential to understand existing barriers that prohibit access to effective preventive care for this vulnerable population. Systematic search and review of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Google Scholar, and government reports and World Health Organizations reports. Twenty-six articles were included in the review. This literature review confirmed previous notions that people with disabilities are receiving much fewer preventive services than the general population. The studies reviewed identified four major barriers that contributed to the lack of preventive care. These barriers included physical environment and system, transportation, provider knowledge and attitude, and financial. Recognition of the obstacles that this subpopulation faces in accessing preventive care services is the first step to effectively remedying this problem. Preventive services have been identified as one of the cornerstones to improving health and quality of life. By understanding the circumstances that restrict those with disabilities from accessing preventive services, NPs can provide meaningful and effective solutions. ©2017 American Association of Nurse Practitioners.

  12. Improving neuro-oncological patients care: basic and practical concepts for nurse specialist in neuro-rehabilitation

    PubMed Central

    2012-01-01

    Background Neuro-oncological population well expresses the complexity of neurological disability due to the multiple neurological deficits that affect these patients. Moreover, due to the therapeutical opportunities survival times for patients with brain tumor have increased and more of these patients require rehabilitation care. The figure of nurse in the interdisciplinary specialty of neurorehabilitation is not clearly defined, even if their role in this setting is recognized as being critical and is expanding. The purpose of the study is to identify the standard competencies for neurorehabilitation nurses that could be taught by means of a specialization course. Methods A literature review was conducted with preference given to works published between January 2000 and December 2008 in English. The search strategy identified 523 non-duplicated references of which 271 titles were considered relevant. After reviewing the abstracts, 147 papers were selected and made available to a group of healthcare professionals who were requested to classify them in few conceptual main areas defining the relative topics. Results The following five main areas were identified: clinical aspects of nursing; nursing techniques; nursing methodology; relational and organisational models; legal aspects of nursing. The relative topics were included within each area. As educational method a structured course based on lectures and practical sessions was designed. Also multi-choices questions were developed in order to evaluate the participants’ level of knowledge, while a semi-structured interview was prepared to investigate students’ satisfaction. Conclusions Literature shows that the development of rehabilitation depends on the improvement of scientific and practical knowledge of health care professionals. This structured training course could be incorporated into undergraduate nursing education programmes and also be inserted into continuing education programmes for graduate nurses

  13. Integration of the Nurse Practitioner Into Your Child Abuse Team.

    PubMed

    Herold, Beth; St Claire, Karen; Snider, Scott; Narayan, Aditee

    Child maltreatment is a leading cause of childhood morbidity in the United States, often leading to lifelong adverse health consequences. Currently, there is a nationwide shortage of child abuse pediatricians (CAPs), resulting in many unfilled child abuse positions throughout the United States. In addition, the number of future CAPs currently in fellowship training will meet neither the current need for CAPs nor provide replacements for the senior CAPs who will be retiring in the next 5 to 10 years. Although it is recognized that pediatric nurse practitioners (PNPs) play an important role in the care of maltreated children, there are few available data on the impact of the PNP as an integral member of the child abuse team. Using the outcomes logic model, we present a systematic process through which the PNP can be effectively integrated into a medical child abuse team. The outcomes from this process show that the addition of PNPs to the child abuse team not only provides immediate relief to the nationwide CAP shortage but also significantly augments the diverse clinical skills and expertise available to the child abuse team. Copyright © 2018 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  14. Physical Activity of Nurse Clinical Practitioners and Managers.

    PubMed

    Jirathananuwat, Areeya; Pongpirul, Krit

    2017-11-01

    This study was aimed (1) to compare the level of physical activity (PA) between working and nonworking hours and (2) to compare the level of PA during working hours of nurse clinical practitioners (NCPs) with that of nurse managers (NMs). This cross-sectional survey was conducted at a Thai university hospital from October 2015 to March 2016. All randomly selected participants wore an activity tracker on their hip for 5 days, except during bathing and sleeping periods, to record step counts and time points. Of 884 nurses, 289 (142 NCPs and 147 NMs) were randomly selected. The average age was 35.87 years. They spent 9.76 and 6.01 hours on work and nonwork activities, respectively. Daily steps per hour were significantly lower during work than nonwork periods (P < .001). An NCP had significantly higher overall hourly PA (P = .002). The number of steps per hour during work period of NCP was significantly higher than that of NM even after adjusting for age, work experience, and body mass index (P = .034). NCP had higher overall PA than NM, which was partly contributed by work-related PA. Level of PA for a professional with variation of actual work hours should be measured on hourly basis.

  15. Factors Influencing Successful Use of Information Retrieval Systems by Nurse Practitioner Students

    PubMed Central

    Rose, Linda; Crabtree, Katherine; Hersh, William

    1998-01-01

    This study examined whether a relationship exists between selected Nurse Practitioner students' attributes and successful information retrieval as demonstrated by correctly answering clinical questions using an information retrieval system (Medline). One predictor variable, attitude toward current computer technology, was significantly correlated (r =0.43, p ≤ .05) with successful literature searching.

  16. Assistant practitioners: lessons learned from licensed practical nurses.

    PubMed

    Whittingham, Katrina

    The role of the assistant practitioner (AP) needs to be defined so they have clear career pathways and opportunities for professional development. The author sought to learn from other countries where a sustained effort had been made to support practitioners fulfilling this intermediate role. The equivalent of an AP in Canada is the licensed practical nurse (LPN); LPNs are subject to clear regulation and practice within their remit of their license. The author travelled to Alberta, Canada, and performed a qualitative study to investigate the role of the LPN. LPNs undertake a 2-year diploma-level course and have the opportunity to enhance their careers through specialist courses or to train as a RN. LPNs benefit from careful regulation, enabling them to have a clear scope of practice, a career structure with opportunities for development and consistent ethical standards. Lessons can be learned from the LPN model and put in practice in the UK; APs need a consistent education programme, a career pathway that promotes development and effective regulation.

  17. Impact and management of chemotherapy/radiotherapy-induced nausea and vomiting and the perceptual gap between oncologists/oncology nurses and patients: a cross-sectional multinational survey.

    PubMed

    Vidall, Cheryl; Fernández-Ortega, Paz; Cortinovis, Diego; Jahn, Patrick; Amlani, Bharat; Scotté, Florian

    2015-11-01

    Chemotherapy/radiotherapy-induced nausea and vomiting (CINV/RINV) can affect half of oncology patients, significantly impacting daily life. Nausea without vomiting has only recently been thought of as a condition in its own right. As such, the incidence of nausea is often underestimated. This survey investigated the incidence and impact of CINV/RINV in patients compared with estimations of physicians/oncology nurses to determine if there is a perceptual gap between healthcare professionals and patients. An online research survey of physicians, oncology nurses and patients was conducted across five European countries. Participants had to have experience prescribing/recommending or have received anti-emetic medication for CINV/RINV treatment. Questionnaires assessed the incidence and impact of CINV/RINV, anti-emetic usage and compliance, and attribute importance of anti-emetic medication. A total of 947 (375 physicians, 186 oncology nurses and 386 patients) participated in this survey. The incidence of nausea was greater than vomiting: 60 % of patients reported nausea alone, whereas 18 % reported vomiting. Physicians and oncology nurses overestimated the incidence of CINV/RINV but underestimated its impact on patients' daily lives. Only 38 % of patients reported full compliance with physicians'/oncology nurses' guidelines when self-administering anti-emetic medication. Leading factors for poor compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting. There is a perceptual gap between healthcare professionals and patients in terms of the incidence and impact of CINV/RINV. This may lead to sub-optimal prescription of anti-emetics and therefore management of CINV/RINV. Minimising the pill burden and eliminating the requirement to swallow medication could improve poor patient compliance with anti-emetic regimens.

  18. Financial savvy: the value of business acumen in oncology nursing.

    PubMed

    Rishel, Cindy J

    2014-05-01

    Have you given serious thought to your individual ability to affect the high cost of health care? If so, you may have determined that the opportunity to have any meaningful effect on cost of services for patients with cancer is limited. You may believe that budgets are the responsibility of nursing leadership. Indeed, the development of the unit or department budget is an activity that many of us have no direct (or even indirect) role in completing. Once the budget is finalized, we are frequently given directives to control our costs and improve the financial bottom line for our employers. One could argue that this is a particularly difficult missive for oncology nurses with the soaring costs of chemotherapy and biotherapy drugs, the expenses incurred to provide supportive care needed by patients with cancer, and the need to provide services to the increasing number of cancer survivors.

  19. Recruitment of oncology nurses for Internet research: issues and future directions.

    PubMed

    Im, Eun-Ok; Chee, Wonshik; Lim, Hyun Ju; Bender, Melinda; Tsai, Hsiu-Min; Yang, Soon-Ok; Lee, Hungsa

    2006-11-03

    To provide future directions for Internet research based on issues raised during the recruitment process of an Internet survey of oncology nurses. Throughout the research process, the research staff recorded issues as they arose and wrote memos regarding recruitment issues and possible reasons for the issues. Weekly group discussions were conducted, and written records of the discussions were kept. The written memos and records were reviewed, and the content was analyzed. The recruitment issues included flexibility required, mutual trust, changing Internet dynamics, and potential selection bias. As the issues indicated, recruiting nurses for the study only through the Internet did not work well. For future Internet research, the authors suggest using multiple Internet and real settings for recruitment, a variety of strategies, the quota sampling method, and creative motivation strategies.

  20. Development and psychometric testing of the Nurse Practitioner Primary Care Organizational Climate Questionnaire.

    PubMed

    Poghosyan, Lusine; Nannini, Angela; Finkelstein, Stacey R; Mason, Emanuel; Shaffer, Jonathan A

    2013-01-01

    Policy makers and healthcare organizations are calling for expansion of the nurse practitioner (NP) workforce in primary care settings to assure timely access and high-quality care for the American public. However, many barriers, including those at the organizational level, exist that may undermine NP workforce expansion and their optimal utilization in primary care. This study developed a new NP-specific survey instrument, Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), to measure organizational climate in primary care settings and conducted its psychometric testing. Using instrument development design, the organizational climate domain pertinent for primary care NPs was identified. Items were generated from the evidence and qualitative data. Face and content validity were established through two expert meetings. Content validity index was computed. The 86-item pool was reduced to 55 items, which was pilot tested with 81 NPs using mailed surveys and then field-tested with 278 NPs in New York State. SPSS 18 and Mplus software were used for item analysis, reliability testing, and maximum likelihood exploratory factor analysis. Nurse Practitioner Primary Care Organizational Climate Questionnaire had face and content validity. The content validity index was .90. Twenty-nine items loaded on four subscale factors: professional visibility, NP-administration relations, NP-physician relations, and independent practice and support. The subscales had high internal consistency reliability. Cronbach's alphas ranged from.87 to .95. Having a strong instrument is important to promote future research. Also, administrators can use it to assess organizational climate in their clinics and propose interventions to improve it, thus promoting NP practice and the expansion of NP workforce.

  1. MASTERPLAN: study of the role of nurse practitioners in a multifactorial intervention to reduce cardiovascular risk in chronic kidney disease patients.

    PubMed

    Van Zuilen, Arjan D; Wetzels, Jack F M; Bots, Michiel L; Van Blankestijn, Peter J

    2008-01-01

    Moderate to severe chronic kidney disease (CKD) is associated with increased cardiovascular risk. Usually nephrologists are primarily responsible for the care of CKD patients. However, in many cases treatment goals, as formulated in guidelines, are not met. The addition of a nurse practitioner might improve the quality of care. The Multifactorial Approach and Superior Treatment Efficacy in Renal Patients with the Aid of Nurse Practitioners (MASTERPLAN) study is a randomized controlled multicenter trial, aimed at investigating whether a multifactorial approach in patients with moderate to severe CKD (stage 3 and 4) to achieving treatment goals using both a polydrug strategy and lifestyle treatment either with or without the addition of a nurse practitioner will reduce cardiovascular risk and slow the decline of kidney function. Patients (n=793) have been randomized to nurse care or physician care. In the nurse-care arm of the study, nurse practitioners use flowcharts to address risk factors requiring drug and/or lifestyle modification. They have been trained to coach patients by motivational interviewing with the aim of improving patient self-management. At baseline, both treatment groups show equal distributions with regard to key variables in the study. Moreover, in only 1 patient were all risk factors within the limits as defined in various guidelines, which underscores the relevance of our initiative.

  2. Integration of Early Specialist Palliative Care in Cancer Care: Survey of Oncologists, Oncology Nurses, and Patients

    PubMed Central

    Salins, Naveen; Patra, Lipika; Usha Rani, MR; Lohitashva, SO; Rao, Raghavendra; Ramanjulu, Raghavendra; Vallath, Nandini

    2016-01-01

    Introduction: Palliative care is usually delivered late in the course of illness trajectory. This precludes patients on active disease modifying treatment from receiving the benefit of palliative care intervention. A survey was conducted to know the opinion of oncologists, oncology nurses, and patients about the role of early specialist palliative care in cancer. Methods: A nonrandomized descriptive cross-sectional study was conducted at a tertiary cancer care center in India. Thirty oncologists, sixty oncology nurses, and sixty patients were surveyed. Results: Improvement in symptom control was appreciated by oncologists, oncology nurses, and patients with respect to pain (Z = −4.10, P = 0.001), (Z = −5.84, P = 0.001), (Z = −6.20, P = 0.001); nausea and vomiting (Z = −3.75, P = 0.001), (Z = −5.3, P = 0.001), (Z = −5.1, P = 0.001); constipation (Z = −3.29, P = 0.001), (Z = −4.96, P = 0.001), (Z = −4.49, P = 0.001); breathlessness (Z = −3.57, P = 0.001), (Z = −5.03, P = 0.001), (Z = −4.99, P = 0.001); and restlessness (Z = −3.68, P = 0.001), (Z = −5.23, P = 0.001), (Z = −3.22, P = 0.001). Improvement in end-of-life care management was appreciated by oncologists and oncology nurses with respect to communication of prognosis (Z = −4.04, P = 0.001), (Z = −5.20, P = 0.001); discussion on limitation of life-sustaining treatment (Z = −3.68, P = 0.001), (Z = −4.53, P = 0.001); end-of-life symptom management (Z = −4.17, P = 0.001), (Z = −4.59, P = 0.001); perimortem care (Z = −3.86, P = 0.001), (Z = −4.80, P = 0.001); and bereavement support (Z = −3-80, P = 0.001), (Z = −4.95, P = 0.001). Improvement in health-related communication was appreciated by oncologists, oncology nurses, and patients with respect to communicating health related information in a sensitive manner (Z = −3.74, P = 0.001), (Z = −5.47, P = 0.001), (Z = −6.12, P = 0.001); conducting family meeting (Z = −3.12, P = 0.002), (Z = −4.60, P = 0

  3. The quality of oncology nursing care: A cross sectional survey in three countries in Europe.

    PubMed

    Charalambous, Andreas; Adamakidou, Theodoula; Cloconi, Constantina; Charalambous, Melanie; Tsitsi, Theologia; Vondráčková, Lucie; Bužgová, Radka

    2017-04-01

    The increase in patients diagnosed with and living with cancer calls for the provision of quality nursing care within this paradigm, one that can reflect the complex needs of the patient that cancer and its treatments induce. The study aimed to evaluate the quality of oncology nursing care, as perceived, by hospitalized cancer patients in three European countries. This was a cross-sectional descriptive study. In-patients diagnosed with cancer were selected based on explicit inclusion and exclusion criteria. Data was collected with the Quality of Oncology Nursing Care Scale- QONCS, comprising of 34 items grouped in 5 domains. Sociodemographic data was also retrieved. The sample included 610 patients receiving care in 2 hospitals in Cyprus (n = 274), 1 hospital in Greece (n = 144) and 2 hospitals in the Czech Republic (n = 192). Statistically significant differences were found between the three countries and across all domains of the QONCS, with the exception of the spiritual and religious care (p = 0.136). Age and days of treatment produced statistically significant differences across all the domains of the QONCS, whilst gender did not produced any statistically significant differences (p ranged from (0.136-0.369). This is one of the first studies that provide evidence on the Quality of Nursing Care delivered to patients diagnosed with cancer in various European countries. Discrepancies were found between the participating countries. However, the provision of spiritual and religious care by the nurses received the lowest scores across the three participating countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Trends in Nurse Practitioner and Physician Assistant Practice in Nursing Homes, 2000-2010.

    PubMed

    Intrator, Orna; Miller, Edward Alan; Gadbois, Emily; Acquah, Joseph Kofi; Makineni, Rajesh; Tyler, Denise

    2015-12-01

    To examine nurse practitioner (NP) and physician assistant (PA) practice in nursing homes (NHs) during 2000-2010. Data were derived from the Online Survey Certification and Reporting system and Medicare Part B claims (20 percent sample). NP/PA state average employment, visit per bed year (VPBY), and providers per NH were examined. State fixed-effect models examined the association between state regulations and NP/PA use. NHs using any NPs/PAs increased from 20.4 to 35.0 percent during 2000-2010. Average NP/PA VPBY increased from 1.0/0.3 to 3.0/0.6 during 2000-2010. Average number of NPs/PAs per NH increased from 0.2/0.09 to 0.5/0.14 during 2000-2010. The impact of state scope-of-practice regulations was mixed. NP and PA scope-of-practice regulations impact their practice in NHs, not always as intended. © Health Research and Educational Trust.

  5. Open Mouth, Open Mind: Expanding the Role of Primary Care Nurse Practitioners.

    PubMed

    Clark, Carol A; Kent, Kathleen A; Jackson, Richard D

    2016-01-01

    Oral health is essential to overall health at any age, although in children it is particularly important because poor oral health can have a deleterious effect on deciduous and permanent dentition. For decades, oral health providers have urged primary care providers to incorporate oral health assessment, risk factor identification, parent education, and preventive therapy into routine well-child visits. Despite recommendations from various professional associations and governmental organizations, the incidence of dental disease in young children remains relatively unchanged. Although the literature has clearly demonstrated that preventive care treatments, such as the application of fluoride varnish performed in the primary care setting, improve oral health in children, very few primary care providers include oral health services in their well-child visits. The purpose of this article is to reduce the barriers and knowledge gaps identified in recent pediatric oral health research and educate primary care nurse practitioners on the application of fluoride varnish to reduce the risk of the development of dental caries in young children. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  6. Diabetes Mellitus Care Provided by Nurse Practitioners vs Primary Care Physicians.

    PubMed

    Kuo, Yong-Fang; Goodwin, James S; Chen, Nai-Wei; Lwin, Kyaw K; Baillargeon, Jacques; Raji, Mukaila A

    2015-10-01

    To compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). Retrospective cohort study. Primary care in communities. Individuals with a diagnosis of diabetes mellitus in 2009 who received all their primary care from NPs or PCPs were selected from a national sample of Medicare beneficiaries (N = 64,354). Propensity score matching within each state was used to compare these two cohorts with regard to rate of eye examinations, low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (HbA1C) testing, nephropathy monitoring, specialist consultation, and Medicare costs. The two groups were also compared regarding medication adherence and use of statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (for individuals with a diagnosis of hypertension), and potentially inappropriate medications (PIMs). Nurse practitioners and PCPs had similar rates of LDL-C testing (odds ratio (OR) = 1.01, 95% confidence interval (CI) = 0.94-1.09) and nephropathy monitoring (OR = 1.05, 95% CI = 0.98-1.03), but NPs had lower rates of eye examinations (OR = 0.89, 95% CI = 0.84-0.93) and HbA1C testing (OR = 0.88, 95% CI = 0.79-0.98). NPs were more likely to have consulted cardiologists (OR = 1.29, 95% CI = 1.21-1.37), endocrinologists (OR = 1.64, 95% CI = 1.48-1.82), and nephrologists (OR = 1.90, 95% CI = 1.67-2.17) and more likely to have prescribed PIMs (OR = 1.07, 95% CI = 1.01-1.12). There was no statistically significant difference in adjusted Medicare spending between the two groups (P = .56). Nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline-concordant care. NPs used specialist consultations more often but had similar overall costs of care to PCPs. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  7. Financial viability, benefits and challenges of employing a nurse practitioner in general practice.

    PubMed

    Helms, Christopher; Crookes, Jo; Bailey, David

    2015-04-01

    This case study examines the financial viability, benefits and challenges of employing a primary healthcare (PHC) nurse practitioner (NP) in a bulk-billing healthcare cooperative in the Australian Capital Territory. There are few empirical case reports in the Australian literature that demonstrate financial sustainability of this type of healthcare professional in primary healthcare. This case study demonstrates that the costs of employing a PHC-NP in general practice are offset by direct and indirect Medicare billings generated by the PHC-NP, resulting in a cost-neutral healthcare practitioner. The success of this model relies on bidirectional collaborative working relationships amongst general practitioners and NPs. PHC-NPs should have a generalist scope of practice and specialist expertise in order to maximise their utility within the general practice environment.

  8. [International collaboration to develop a nurse practitioner master's program].

    PubMed

    Tang, Woung-Ru

    2007-12-01

    Because of the shortage of resident doctors and in order to raise standards, hospitals and medical centers have trained their own nurse practitioners (NPs). Given the absence of standard training criteria and an unevenness of faculty quality, however, many NPs play the role of medical substitute, which is far from the independent role performed by NPs in foreign countries. It is therefore necessary to include NP training within higher education. The Graduate Institute of Nursing at Chang Gung University established the first NP in-service training program in 2003 through international collaboration, with the purpose of cultivating advanced clinical nursing talents. The program emphasizes the importance of clinical reasoning and practical training, in order to enable students to perform the multiple roles of treatment and caring undertaken by NPs. Experts in advanced nursing and clinical medicine from Taiwan and abroad were invited to serve as lecturers. The students also had the opportunity to take NP courses at Oregon Health and Science University (USA) and participate in clinical visits. The results have been widely praised. International collaboration is built upon the mutual trust of the parties, and its success is determined by the measures that it involves, as well as by the global vision and competence of participants. This paper shares the advantages and disadvantages of the NP master's program through international collaboration.

  9. Factors which influence nurse practitioners ability to carry out physical examination skills in the clinical area after a degree level module--an electronic Delphi study.

    PubMed

    McElhinney, Evelyn

    2010-11-01

    The aim of the study was to identify the factors that influence nurse practitioners ability to practice physical examination skills in the clinical area. The changing health care needs of the population require new ways of working for many health professionals. Physical examination (core skills of inspection, palpation, percussion and auscultation) of patients is a fairly new role for nurses in secondary care in the United Kingdom. However, implementing new roles in the clinical area can be challenging for the practitioners involved, and several factors have been identified which are seen to help or hinder their success. A Delphi study was undertaken using blind copy email over six weeks in 2008. The participants included a purposive sample of 21 nurses from 10 clinical areas who had completed a degree level module in physical examination as part of a nurse practitioner pathway. This study generated valuable opinion of factors that can help or hinder the ability of nurses to practice physical examination in the clinical area. The results highlight the importance of individual self-confidence, role clarity, effective educational preparation and support from other disciplines to the nurse practitioners ability to carry out this new role. Several factors reported by the participants concur and add to factors reported in previous studies of new role implementation. There appears to be a continued need for clear job descriptions, role clarity, authority and autonomy to practice for nurse practitioners undertaking physical examination. Physical examination knowledge and skills are part of the role of nurse practitioners. This study highlights several factors which need to be addressed to ensure practitioners are able to carry out this new role on return to the clinical area. © 2010 Blackwell Publishing Ltd.

  10. Palliative care knowledge and attitudes among oncology nurses in Qatar.

    PubMed

    Al-Kindi, Sadeer G; Zeinah, Ghaith F Abu; Hassan, Azza Adel

    2014-08-01

    Formal palliative care (PC) education is lacking in the middle eastern state of Qatar. This study was done to assess the need for PC education among oncology nurses in Qatar. In March 2012, a self-constructed questionnaire was distributed to 115 nurses at the Qatar National Center for Cancer Care and Research. A total of 115 nurses responded to the questionnaire. The majority (87.8%) were female. Although 60% had more than 10 years of work experience, only 31% had received formal training in PC, with only 6.1% having completed postgraduate training. The majority (63%) of responders attributed this issue to unavailability of PC courses rather than lack of time, interest, or financial issues. Currently, only 16.7% did not express interest in the field, with 56% showing some kind of interest. In terms of knowledge, 54% of the responders were familiar with the World Health Organization ladder for pain relief. Only 43.6% know about Palliative Performance Scale, and half of the nurses know the Edmonton Symptom Assessment System. Overall, 56% of the nurses indicated a need for training in more than 1 aspect. These aspects included training in care of the dying patients (14.6%), communication strategies (22%), caregiver support (10.6%), psychosocial care (15%), pain management (10.2%), other symptom management (13%), and other ethical/spiritual issues (14.2%). There is a clear deficiency in formal PC education among the nurses at the National Center for Cancer Care and Research, in Qatar. This is reflected by their lack of experience and exposure to PC and their mediocre knowledge in the field. This could be attributed to the fact that formal PC service was established only recently in Qatar (2008). Formal training courses in PC nursing are required. © The Author(s) 2013.

  11. The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments

    PubMed Central

    2012-01-01

    Background The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments. Methods A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes. Results The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care. Conclusions ICT is a

  12. The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments.

    PubMed

    Li, Julie; Westbrook, Johanna; Callen, Joanne; Georgiou, Andrew

    2012-04-02

    The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments. A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes. The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care. ICT is a facilitator through which the disruptive

  13. A randomised controlled crossover trial of nurse practitioner versus doctor led outpatient care in a bronchiectasis clinic

    PubMed Central

    Sharples, L; Edmunds, J; Bilton, D; Hollingworth, W; Caine, N; Keogan, M; Exley, A

    2002-01-01

    Background: With the decrease in junior doctor hours, the advent of specialist registrars, and the availability of highly trained and experienced nursing personnel, the service needs of patients with chronic respiratory diseases attending routine outpatient clinics may be better provided by appropriately trained nurse practitioners. Methods: A randomised controlled crossover trial was used to compare nurse practitioner led care with doctor led care in a bronchiectasis outpatient clinic. Eighty patients were recruited and randomised to receive 1 year of nurse led care and 1 year of doctor led care in random order. Patients were followed up for 2 years to ensure patient safety and acceptability and to assess differences in lung function. Outcome measures were forced expiratory volume in 1 second (FEV1), 12 minute walk test, health related quality of life, and resource use. Results: The mean difference in FEV1 was 0.2% predicted (95% confidence interval –1.6 to 2.0%, p=0.83). There were no significant differences in the other clinical or health related quality of life measures. Nurse led care resulted in significantly increased resource use compared with doctor led care (mean difference £1497, 95% confidence interval £688 to £2674, p<0.001), a large part of which resulted from the number and duration of hospital admissions. The mean difference in resource use was greater in the first year (£2625) than in the second year (£411). Conclusions: Nurse practitioner led care for stable patients within a chronic chest clinic is safe and is as effective as doctor led care, but may use more resources. PMID:12149523

  14. The effect of nurses’ preparedness and nurse practitioner status on triage call management in primary care: A secondary analysis of cross-sectional data from the ESTEEM trial

    PubMed Central

    Varley, Anna; Warren, Fiona C.; Richards, Suzanne H.; Calitri, Raff; Chaplin, Katherine; Fletcher, Emily; Holt, Tim A.; Lattimer, Valerie; Murdoch, Jamie; Richards, David A.; Campbell, John

    2016-01-01

    Background Nurse-led telephone triage is increasingly used to manage demand for general practitioner consultations in UK general practice. Previous studies are equivocal about the relationship between clinical experience and the call outcomes of nurse triage. Most research is limited to investigating nurse telephone triage in out-of-hours settings. Objective To investigate whether the professional characteristics of primary care nurses undertaking computer decision supported software telephone triage are related to call disposition. Design Questionnaire survey of nurses delivering the nurse intervention arm of the ESTEEM trial, to capture role type (practice nurse or nurse practitioner), prescriber status, number of years’ nursing experience, graduate status, previous experience of triage, and perceived preparedness for triage. Our main outcome was the proportion of triaged patients recommended for follow-up within the practice (call disposition), including all contact types (face-to-face, telephone or home visit), by a general practitioner or nurse. Settings 15 general practices and 7012 patients receiving the nurse triage intervention in four regions of the UK. Participants 45 nurse practitioners and practice nurse trained in the use of clinical decision support software. Methods We investigated the associations between nursing characteristics and triage call disposition for patient ‘same-day’ appointment requests in general practice using multivariable logistic regression modelling. Results Valid responses from 35 nurses (78%) from 14 practices: 31/35 (89%) had ≥10 years’ experience with 24/35 (69%) having ≥20 years. Most patient contacts (3842/4605; 86%) were recommended for follow-up within the practice. Nurse practitioners were less likely to recommend patients for follow-up odds ratio 0.19, 95% confidence interval 0.07; 0.49 than practice nurses. Nurses who reported that their previous experience had prepared them less well for triage were more

  15. The Development of an HIV Training Program for Nurse Practitioners.

    PubMed

    McGee, Kara S; Relf, Michael; Harmon, James L

    2016-01-01

    Responding to a national need for a new workforce of HIV care providers as the first generation of providers decrease their practices or retire, the Duke University School of Nursing, with funding from the Health Resources and Services Administration, developed and implemented a program to train nurse practitioners (NP) to assume the full spectrum of primary care services needed by people living with HIV infection and various co-morbidities. The 12-credit program includes course work in HIV-related epidemiology; pathogenesis; psychosocial, political, ethical, and legal issues; and pharmacology and clinical management. Students complete 392 hours of HIV-specific clinical practice in addition to clinical hours required of all NP students. The program is the only distance-based program of its kind in the United States. Online didactic instruction is complemented by campus-based sessions with interprofessional faculty. We describe the 5 overarching goals that frame the program, and challenges and progress toward achieving those goals. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  16. Nurse practitioners' role perception, stress, satisfaction, and intent to stay at a Midwestern academic medical center.

    PubMed

    Brom, Heather M; Melnyk, Bernadette M; Szalacha, Laura A; Graham, Margaret

    2016-05-01

    There is a growing demand for nurse practitioners (NPs) within academic medical centers (AMCs) because of physician shortages and increased need for access to care. In order to retain these NPs, it is important to assess their role perception and satisfaction. The purpose of this study was to evaluate these concepts and their relationships to stress and intent to stay. A 90-item descriptive survey, including a new role perception scale and the Misener Nurse Practitioner Job Satisfaction Scale, was administered to all NPs at a Midwestern AMC. The response rate was 62.4% (n = 181). Overall, the NPs had moderate role perception (M = 4.30, SD = 1.23) and were somewhat satisfied (M = 4.23, SD = 0.74). Over a third (39.4%) reported they were unsure about staying or did not intend to stay in their position. Intent to stay and stress were moderately correlated with overall satisfaction and weakly correlated with role perception. There were significant differences in the intrapractice and professional aspects of job satisfaction based on their supervisor. With increased NP needs, it is crucial for AMCs and NP supervisors to assess role perception, satisfaction, and stress among NPs in order to ensure a stable, satisfied, and productive workforce. ©2015 American Association of Nurse Practitioners.

  17. Oncology nurses' perceptions of barriers to discussion of fertility preservation with patients with cancer.

    PubMed

    King, Lindsey; Quinn, Gwendolyn P; Vadaparampil, Susan T; Gwede, Clement K; Miree, Cheryl A; Wilson, Crystal; Clayton, Heather; Perrin, Karen

    2008-06-01

    Infertility is a common result of cancer treatment; however, opportunities exist for patients to preserve fertility prior to treatment. Recent evidence suggests that healthcare providers, including nurses, do not consistently discuss fertility preservation (FP) with patients. This qualitative, cross-sectional pilot study used a focus group and in-depth interviews to explore knowledge, attitudes, and practice behaviors related to nurses' discussion of FP with patients with cancer. Results indicate that only half of the nurses discuss FP methods with patients, even though most believe that having discussions with patients about fertility is part of their role. Factors associated with the discussion of FP among nurses included (a) knowledge (FP procedures, fertility institutes and clinics, resources for patients, and practice guidelines), (b) attitudes (difficulty finding facilities, time constraints, role, comfort level, ethical issues, financial considerations, and patient characteristics), and (c) behaviors (patient initiation, physician behaviors, patient characteristics, and timing). Discussion should be stimulated among nurses about the role of nurses in the FP discussion, and educational interventions and practice guidelines should be developed that are aimed at oncology nurses to help facilitate discussions with patients.

  18. Neonatal nurse practitioners: distribution, roles and scope of practice.

    PubMed

    Freed, Gary L; Dunham, Kelly M; Lamarand, Kara E; Loveland-Cherry, Carol; Martyn, Kristy K

    2010-11-01

    We sought to determine the distribution and scope of practice of the neonatal nurse practitioner (NNP) workforce across the United States. To determine distribution, we used counts of certified NNPs from the National Certification Corp (Chicago, IL). We calculated state NNP/child population ratios as the number of NNPs divided by the state population 0 to 17 years of age. We calculated NNP/NICU bed ratios as the number of NNPs divided by the total number of NICU beds per state. To characterize roles and scope of practice, we conducted a mail survey of a random national sample of 300 NNPs in states that license nurse practitioners to practice independently and 350 NNPs in states that require physician involvement. The greatest concentrations of NNPs per capita were in the Midwest, South, and Mid-Atlantic region. Thirty-one states had <100 total NNPs. The survey response rate was 77.1%. More than one-half of NNP respondents (54% [n = 211]) reported that they spent the majority of their time in a community hospital, whereas more than one-third (37% [n = 144]) were in an academic health center. Only 2% (n = 7) reported that they engaged in independent practice. As with many health care professionals, the supply of NNPs may not be distributed according to need. With increasing concern regarding the availability of NNPs, comprehensive studies that examine the demand for NNPs and the roles of other clinicians in the NICU should provide a greater understanding of appropriate NICU workforce capacity and needs.

  19. Professional online community membership and participation among healthcare providers: An extension to nurse practitioners and physician assistants.

    PubMed

    Betts, Kevin R; O'Donoghue, Amie C; Aikin, Kathryn J; Kelly, Bridget J; Boudewyns, Vanessa

    2016-12-01

    Professional online communities allow healthcare providers to exchange ideas with their colleagues about best practices for patient care. Research on this topic has focused almost exclusively on primary care physicians and specialists, to the exclusion of advanced practice providers such as nurse practitioners and physician assistants. We expand this literature by examining membership and participation on these websites among each of these provider groups. Participants (N = 2008; approximately 500 per provider group) responded to an Internet-based survey in which they were asked if they use professional online communities to dialogue with colleagues and if so, what their motivation is for doing so. Nearly half of the participants in our sample reported utilizing professional online communities. Select differences were observed between provider groups, but overall, similar patterns emerged in their membership and participation on these websites. Nurse practitioners and physician assistants utilize professional online communities in similar proportion to primary care physicians and specialists. Providers should be cognizant of the impact this use may have for both themselves and their patients. Researchers are urged to take into account the various professional roles within the healthcare community while developing research on this topic. ©2016 American Association of Nurse Practitioners.

  20. [Strategies for improving care of oncologic patients: SHARE Project results].

    PubMed

    Reñones Crego, María de la Concepción; Fernández Pérez, Dolores; Vena Fernández, Carmen; Zamudio Sánchez, Antonio

    2016-01-01

    Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  1. Organizational climate in primary care settings: implications for nurse practitioner practice.

    PubMed

    Poghosyan, Lusine; Nannini, Angela; Clarke, Sean

    2013-03-01

    The purpose of this review is to investigate literature related to organizational climate, define organizational climate, and identify its domains for nurse practitioner (NP) practice in primary care settings. A search was conducted using MEDLINE, PubMed, HealthSTAR/Ovid, ISI Web of Science, and several other health policy and nursingy databases. In primary care settings, organizational climate for NPs is a set of organizational attributes, which are perceived by NPs about their practice setting, emerge from the way the organization interacts with NPs, and affect NP behaviors and outcomes. Autonomy, NP-physician relations, and professional visibility were identified as organizational climate domains. NPs should be encouraged to assess organizational climate in their workplace and choose organizations that promote autonomy, collegiality between NPs and physicians, and encourage professional visibility. Organizational and NP awareness of qualities that foster NP practice will be a first step for developing strategies to creating an optimal organizational climate for NPs to deliver high-quality care. More research is needed to develop a comprehensive conceptual framework for organizational climate and develop new instruments to accurately measure organizational climate and link it to NP and patient outcomes. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  2. Nurse practitioners and controlled substances prescriptive authority: improving access to care.

    PubMed

    Ambrose, Michelle A; Tarlier, Denise S

    2013-03-01

    In 2007, Health Canada proposed a new framework to regulate prescriptive authority for controlled substances, titled New Classes of Practitioners Regulations (NCPR). The new regulatory framework was passed in November 2012; it gives nurse practitioners (NPs), midwives and podiatrists the authority to prescribe controlled medications under the Controlled Drugs and Substances Act. It is expected that authorizing NPs to write prescriptions for certain controlled substances commonly used in primary care will enhance flexibility and timeliness in primary care service delivery. Studies from the United States have shown positive outcomes in primary care access, decreased healthcare costs and the evolution and advancement of the NP role when prescriptive authority was expanded to include controlled substances. The purpose of this paper is to examine how NPs' prescriptive authority for controlled substances affects access to primary care and NP role development. Three key issues identified from the experience of one group of NPs in the United States (access to care, professional autonomy and prescriber knowledge) offer insight into the practice changes that may be anticipated for NPs in Canada now that they have acquired prescriptive authority for controlled substances. Recommendations are offered to assist nurse leaders and educators to best support NPs as they take on this new and important role responsibility.

  3. The Oncology Nursing Society Leadership Competency project: developing a road map to professional excellence.

    PubMed

    Day, Donald D; Hand, Mikel W; Jones, Ann R; Harrington, Nancy Kay; Best, Robyn; LeFebvre, Kristine B

    2014-08-01

    Combining the recommendations of the Institute of Medicine's report on the future of nursing, an Oncology Nursing Society (ONS) leadership think tank, and current evidence, the ONS Leadership Competencies were developed to provide all nurses with a pathway to advance their leadership skills and abilities. Generated through a systematic approach of literature review, data synthesis, and peer and expert review, the ONS Leadership Competencies are divided into five domains: vision, knowledge, interpersonal effectiveness, systems thinking, and personal mastery. Each of the competencies can be measured at the individual, group, and governance levels. They serve as a means of self-assessment, growth, future planning, and professional development. This article describes the process used to develop the ONS Leadership Competencies and offers examples of how they may be used in practice.

  4. Cross-Cultural Communication in Oncology: Challenges and Training Interests.

    PubMed

    Weber, Orest; Sulstarova, Brikela; Singy, Pascal

    2016-01-01

    To survey oncology nurses and oncologists about difficulties in taking care of culturally and linguistically diverse patients and about interests in cross-cultural training.
. Descriptive, cross-sectional.
. Web-based survey.
. 108 oncology nurses and 44 oncologists. 
. 31-item questionnaire derived from preexisting surveys in the United States and Switzerland.
. Self-rated difficulties in taking care of culturally and linguistically diverse patients and self-rated interests in cross-cultural training.
. All respondents reported communication difficulties in encounters with culturally and linguistically diverse patients. Respondents considered the absence of written materials in other languages, absence of a shared common language with patients, and sensitive subjects (e.g., end of life, sexuality) to be particularly problematic. Respondents also expressed a high level of interest in all aspects of cross-cultural training (task-oriented skills, background knowledge, reflexivity, and attitudes). Nurses perceived several difficulties related to care of migrants as more problematic than physicians did and were more interested in all aspects of cross-cultural training. 
. The need for cross-cultural training is high among oncology clinicians, particularly among nurses.
. The results reported in the current study may help nurses in decision-making positions and educators in introducing elements of cross-cultural education into oncology curricula for nurses. Cross-cultural training should be offered to oncology nurses.

  5. Reflections on independence in nurse practitioner practice.

    PubMed

    Weiland, Sandra A

    2008-07-01

    To examine factors that influence the ability of nurse practitioners (NPs) to practice as independent primary care providers. Extensive literature search on CINAHL, OVID, MEDLINE, Internet journal sources, and professional association Web sites. The legal authority for NPs to practice independently is recognized; however, the ability to put that authority into practice is undermined by the historical failure of political, professional, and social entities to recognize NPs as providers capable of providing primary care autonomously. Nonrecognition is responsible for complex reimbursement policies (both federal and state) that economically and professionally restrain the NP role; hence, NPs remain in a financially dependent relationship despite 40 years of proven safe practice. NPs must articulate their independence as practitioners more vociferously in order to meet society's healthcare requirements, as well as to attain professional fulfillment and forge collegial relationships. NPs will never be seen as members of a profession by either themselves or others without the practicality of independence and autonomy. Although legal independence is a fact, real practice independence in the pragmatic sense is contingent upon reimbursement. Without fiscal sustainability, practice independence is an impossibility. And, without professional autonomy, NPs will have only an employee's voice in the dynamic healthcare system in which they are really key players in providing healthcare services to the poor and undeserved populations.

  6. Oncologists' and oncology nurses' attitudes and practices towards family involvement in cancer consultations.

    PubMed

    Laidsaar-Powell, R; Butow, P; Bu, S; Fisher, A; Juraskova, I

    2017-01-01

    Family members (FMs) regularly attend cancer consultations with patients, may assume an array of roles (e.g. emotional, informational) and their involvement may result in benefits and/or challenges. Little is currently known about how oncology health professionals (HPs) view FMs who accompany a patient in consultations. This study aimed to explore the attitudes and practices of Australian oncologists and oncology nurses regarding family involvement in consultations. Eleven oncologists and 10 nurses from a range of subspecialties and tumour streams participated in semi-structured interviews. Interviews were transcribed and qualitatively analysed using framework analysis methods. Five relevant themes were identified: (1) the varied and dynamic nature of family roles during consultations; (2) positivity towards FMs; (3) the benefits of family involvement to the FM themselves; (4) current HP practices to facilitate positive family involvement; and (5) the challenges of family involvement in consultations and HP practices to manage them. Overall, participants held mostly positive attitudes towards family involvement. Although they identified a number of challenges which can arise when family are involved, many noted these situations are the exception, that there are strategies which can help to overcome the challenges, and that the benefits of family involvement typically outweigh the costs. © 2016 John Wiley & Sons Ltd.

  7. The Relationship of Genetics, Nursing Practice, and Informatics Tools in 6-Mercaptopurine Dosing in Pediatric Oncology [Formula: see text].

    PubMed

    Haylett, Wendy J

    An antileukemic agent prescribed for pediatric oncology patients during the maintenance phase of therapy for acute lymphoblastic leukemia, 6-mercaptopurine (6-MP), is highly influenced by genetic variations in the thiopurine S-methyltransferase enzyme. As such, 6-MP must be dosed so that patients with 1 or 2 inactive thiopurine S-methyltransferase alleles will not incur an increased risk for myelosuppression or other toxicities. Informatics tools such as clinical decision support systems are useful for the application of this and similar pharmacogenetics information to the realm of nursing and clinical practice for safe and effective patient care. This article will discuss pharmacogenetics and the associated use of 6-MP; present implications for nursing practice; identify informatics tools such as clinical decision support systems, which can greatly enhance the care of patients whose treatment is based on critical genetic information; and examine the relationship of genetics, nursing practice, and informatics for 6-MP dosing in pediatric oncology.

  8. Communication During Palliative Care and End of Life: Perceptions of Experienced Pediatric Oncology Nurses.

    PubMed

    Montgomery, Kathleen E; Sawin, Kathleen J; Hendricks-Ferguson, Verna

    Communication between patients, families, and healthcare providers is a central component of end-of-life care. Nurse communication during palliative care (PC) and end of life (EOL) is a phenomenon with limited research. It is unclear how the level of nursing experience influences the perspectives of nurses communicating during EOL. The aim of this study is to describe the commonalities of experienced nurses' perceptions of communicating during PC and EOL and perceptions of barriers and facilitators to effective communication. This study was part of a larger multisite study that used a qualitative, empirical phenomenology design and represents focus group data gathered from pediatric oncology nurses with more than 5 years of experience or who were advanced practice nurses not involved in the direct evaluation of other nurses. Five core themes with corresponding themes and subthemes were identified. The core themes included (a) Evolution of PC/EOL, (b) Skill of Knowing, (c) Expanded Essence of Caring, (d) Experienced Nurse as Committed Advocate, and (e) Valuing Individual Response to Grief. Findings reflect how the concept of experience transcended the 5 core themes and captured how experience provided nurses the know-how to fulfill the roles of communication, caring, and advocacy for children and families. Enhancing nurse communication skills during EOL requires opportunities to gain experience coupled with clinical strategies, such as standardized curricula, simulation, competency-based orientation programs, mentorship, and peer support.

  9. Shifting patterns of practice: nurse practitioners in a managed care environment.

    PubMed

    Johnson, Rosemary

    2005-01-01

    The purpose of this qualitative study was to uncover patterns across nurse practitioner (NP) experiences that contribute to understanding their perceptions of managed care, how it affects daily practice, and how NPs respond to a changing managed care workplace. In-depth interviews were conducted with 14 NPs representing primary care, specialty, and independent practices. Over an 18-month period, data collection and analysis occurred simultaneously using standard methods of purposive sampling, constant comparison, memoing, and member checks. This study illuminates the tension NPs experience between a business and a professional ethic and the strategies they use to reconcile this difference with core nursing values. Type of setting, workplace dynamics, and length of time in practice contributed to variation in NP perspectives.

  10. [Reflection on the Differences and Similarities of Mental Health Care in Virginia and Taiwan: Geography, History, Culture, and Nurse Practitioners].

    PubMed

    Lu, Chueh-Fen; Tung, Ching-Chuan; Ely, Linda

    2016-12-01

    Sponsored by the pilot overseas internships project of the Ministry of Education, Taiwan, the authors and ten undergraduate students from Taiwan visited several mental health facilities in Virginia for one month. These facilities included the Catawba State Hospital, Salem Veteran Affairs Medical Center, Carilion Saint Albans Behavioral Health (New River Valley Medical Center), Warm Hearth Village, Adult & Child Family Counseling private outpatient clinic, the Free Clinic of the New River Valley, New Life Clubhouse, and Self-Government Program for Assertive Community Treatment. In-depth dialogue and participation in nursing care under the supervision of registered nurses facilitated the authors' reflection on mental health care and the roles and functions of Taiwanese nurse practitioners. The present article adopts a macro view in order to compare the related issues between Taiwan and Virginia, including: geographic features, history, culture of health-seeking behavior, healthcare insurance, and the relationships among various professionals. How these issues relate to social-cultural background and how the overall healthcare environment impacts upon the roles of nurse practitioners in Taiwan are rarely discussed in literature. We expect that this cross-cultural contrast and reflection will elicit a better understanding of how these factors have shaped and affected the roles of Taiwanese nurse practitioners. Further, suggestions about how to improve the nursing profession in Taiwan are presented.

  11. Consumer perspectives on nurse practitioners and independent practice.

    PubMed

    Brown, Deonne J

    2007-10-01

    The purposes of this study were to report the results of a survey for determining the feasibility and sustainability of independently managed nurse practitioner (NP) practices, to identify the characteristics of consumers who would likely choose an independent NP practice, to assess consumer needs, and to define a target market for competitively positioning NPs. An anonymous electronic survey of 1000 employees (response rate = 21%) at a large nonprofit organization in King County, Washington. This organization employs persons in a wide range of socioeconomic and vocational situations. Descriptive statistics and chi-square analyses were applied to determine associations between demographic characteristics and having used an NP or having the intent to use an independent NP practice. Most respondents knew about NPs, and the majority had seen an NP for their care. Most were satisfied or very satisfied with NP care. A much larger percentage (90%) than previous studies knew about NPs; 58% had seen an NP for their care, making NPs the most used practitioner alternative to physicians. Evidence suggests that NP users are more likely to be female and younger. Eighty-two percent of NP users were satisfied or very satisfied with the care they had received compared to a 70% satisfaction rate for current providers. Women, relatively younger respondents, those who had seen a physician assistant or NP, and those who considered NPs to provide quality and more personalized care were significantly more likely to indicate that they would choose an independent NP practice in their community. Based on a standard marketing formula, 30% of the sample in this study would be expected to change their health care to such a practice. This is the first descriptive study to suggest widespread acceptance of NPs as independent practitioners. Compared to a 1985 study of Seattle residents, consumers are far more likely to know about NPs. Consumer studies such as this one identify the characteristics

  12. Exploring conceptual and theoretical frameworks for nurse practitioner education: a scoping review protocol.

    PubMed

    Wilson, Rosemary; Godfrey, Christina M; Sears, Kim; Medves, Jennifer; Ross-White, Amanda; Lambert, Natalie

    2015-10-01

    The objective of this review is to examine conceptual and/or theoretical frameworks that are relevant to nurse practitioner education.The specific review question is: What conceptual and/or theoretical frameworks are available that are relevant to the structuring of nurse practitioner education? The use of conceptual and theoretical frameworks to organize the educational curriculum of nursing programs is essential to protect and preserve the focus and clarity of nursing's distinct contribution to health care. Conceptual frameworks of nursing provide a means to look at nursing in relationship to external factors, thereby assigning meaning to the practice. Graduate level nursing education in the preparation of Nurse Practitioners (NPs) specifically and Advanced Practice Nurses (APNs) in general, is significantly compromised by the tendency to conceptualize the learning in these complex programs as being primarily related to skills-based tasks and competencies alone. According to Baumann, advanced nursing education must focus on the uniqueness of the NP position, in contrast to other health care professions. To do this, Baumann suggests using a conceptual nursing model and nursing theory as opposed to a strictly biomedical model. This allows NPs to interpret information in a way that differs from the strict biomedical model, providing opportunities for the NPs to be truly present in the lives of their patients.Canadian Nurse Practitioner (NP) practice competency documents are based primarily on the Canadian Nurses Association (CNA) Nurse Practitioner (NP) Core Competency Framework. This document defines the core set of entry-level competencies required for all NPs to practice in all Canadian jurisdictions, settings and client populations. The Core Competencies in the CNA NP Framework are organized within four main categories: professional role, responsibility and accountability; health assessment and diagnosis; therapeutic management; and health promotion and

  13. Culture Care Theory: a proposed practice theory guide for nurse practitioners in primary care settings.

    PubMed

    McFarland, Marilyn M; Eipperle, Marilyn K

    2008-04-01

    Leininger's Theory of Culture Care Diversity and Universality is presented as a foundational basis for the educational preparation, primary care contextual practice, and outcomes-focused research endeavours of advanced practice nursing. Discussion emphasises the value of care and caring as the essence of advanced practice nursing through the use of three modes of care, use of the Sunrise and other enablers, and the ethnonursing method. Education, research, practice, and key concepts of the theory are connected as essential components toward the provision of culturally congruent care to meet the healthcare needs of diverse individuals, families, groups, and communities by family nurse practitioners.

  14. Developing and implementing a complex Complementary and Alternative (CAM) nursing intervention for breast and gynecologic cancer patients undergoing chemotherapy--report from the CONGO (complementary nursing in gynecologic oncology) study.

    PubMed

    Klafke, Nadja; Mahler, Cornelia; von Hagens, Cornelia; Blaser, Gisela; Bentner, Martina; Joos, Stefanie

    2016-05-01

    The purpose of this study was to develop a complex nursing intervention including complementary and alternative medicine (CAM) for breast and gynecologic cancer patients during chemotherapy to improve quality of life. Data sources Theoretical framework and concepts, practical nursing knowledge, and evidence-based studies were compiled in interprofessional meetings. Data synthesis The final complex intervention consists of three autonomous, but interacting components: (1) CAM nursing package, (2) resource-oriented counseling, and (3) evidence-based information material on CAM. CAM interventions include acupressure, aromatherapy, compress, and massage, targeting 14 clinically relevant symptoms during chemotherapy. Participants receive these interventions during chemotherapy with instructions for self care. During a counseling interview, the patient's needs and preferences are assessed by trained nurses. Furthermore, participants are equipped with evidence-based information material (booklet and DVD). Prior to study start, nurses attended training modules for administering CAM therapies and for communicating and counseling within the salutogenic approach. It was possible to design a multimodal CAM nursing intervention based on a theoretical concept, evidence-based studies, and practical nursing experience targeting the prevention or relief of side-effects women suffer during chemotherapy. The systematic analysis of the CONGO study will contribute to evidence-based CAM nursing care within supportive cancer care. Oncology nurses play an important role in supportive CAM care of breast and gynecologic cancer patients in daily clinical practice. Within oncology outpatient services, the implementation of evidence-based CAM nursing interventions and counseling may contribute to understand the impact of nursing on patient quality of life and symptom relief. This can lead to a new understanding of the nurse's professional role.

  15. Corporate culture assessments in integrative oncology: a qualitative case study of two integrative oncology centers.

    PubMed

    Mittring, Nadine; Pérard, Marion; Witt, Claudia M

    2013-01-01

    The offer of "integrative oncology" is one option for clinics to provide safe and evidence-based complementary medicine treatments to cancer patients. As known from merger theories, corporate culture and integration models have a strong influence on the success of such integration. To identify relevant corporate culture aspects that might influence the success in two highly visible integrative oncology clinics, we interviewed physicians, nurses, practitioners, and managers. All interviews (11 in a German breast cancer clinic and 9 in an integrative medicine cancer service in the USA) were audio-recorded, transcribed and analyzed with content analysis. According to the theoretical framework of mergers, each clinic selected a different integration type ("best of both worlds" and "linking"). Nonetheless, each developed a similar corporate culture that has a strong focus on research and safe and evidence-based treatments, and fosters a holistic and patient-centered approach. Structured communication within the team and with other departments had high relevance. Research was highlighted as a way to open doors and to facilitate a more general acceptance within the hospital. Conventional physicians felt unburdened by the provision of integrative medicine service but also saw problems in the time required for scheduled treatments, which often resulted in long waiting lists.

  16. An investigation of the international literature on nurse practitioner private practice models.

    PubMed

    Currie, J; Chiarella, M; Buckley, T

    2013-12-01

    To investigate and synthesize the international literature surrounding nurse practitioner (NP) private practice models in order to provide an exposition of commonalities and differences. NP models of service delivery have been established internationally and most are based in the public healthcare system. In recent years, opportunities for the establishment of NP private practice models have evolved, facilitated by changes in legislation and driven by identification of potential patient need. To date, NP private practice models have received less attention in the literature and, to the authors' knowledge, this is the first international investigation of NP private practice models. Integrative literature review. A literature search was undertaken in October 2012. Database sources utilized included Medical Literature Analyses and Retrieval (MEDLINE), the Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Scopus and the Cochrane Database of Systematic Reviews (CDSR). The grey literature was also searched. The following Medical Subject Headings (MeSH) and search terms used both individually and in combination included nurse practitioners; private practice; joint practice; collaboration; and insurance, health and reimbursement. Once literature had been identified, a thematic analysis was undertaken to extract themes. Thirty manuscripts and five publications from the grey literature were included in the final review. Private practice NP roles were identified in five countries, with the majority of the literature emanating from the USA. The thematic analysis resulted in the identification of five themes: reimbursement, collaborative arrangements, legislation, models of care and acceptability. Proportionally, there are very few NPs engaged in private practice internationally. The most common NP private practice models were community based, with NPs working in clinic settings, either alone or with other health professionals. Challenges in the

  17. Supporting students undertaking the Specialist Practitioner Qualification in District Nursing.

    PubMed

    Ginger, Tracey; Ritchie, Georgina

    2017-11-02

    The ever-evolving role of the Specialist Practitioner Qualified District Nurse (SPQDN) presents an increasing number of challenges for Practice Teachers and mentors in preparing SPQDN students for the elevated level clinical and transformational leadership necessary to ensure high-quality patient care. The daily challenges of clinical practice within the community nursing setting in addition to undertaking educational interventions in the clinical arena demand that a structured approach to supervision and mentorship is crucial. Employing learning plans to assess individual students learning needs, prepare plans for educational developments and interventions and evaluate a student's progress can be a helpful tool in aiding the learning journey for both the SPQDN student and Practice Teacher or mentor. This article examines how and why a structured learning plan may be used in supporting learning and competency in achieving the necessary level of practice to meet the requirements of the SPQDN.

  18. Does certification status of oncology nurses make a difference in patient outcomes?

    PubMed

    Frank-Stromborg, Marilyn; Ward, Sandra; Hughes, Linda; Brown, Karen; Coleman, Ann; Grindel, Cecelia Gatson; Miller Murphy, Cynthia

    2002-05-01

    To test hypotheses that patients cared for by Oncology Certified Nurses (OCNs(r)) have superior outcomes compared to those cared for by noncertified nurses. Descriptive ex post facto. A homecare agency in the midwestern United States. 20 nurses (7 certified and 13 noncertified) and charts for 181 of their patients. Retrospective chart review. Symptom management (i.e., pain and fatigue), adverse events (e.g., infection and decubitus ulcers), and episodic care utilization (e.g., visits to care facilities, admissions to care facilities, unscheduled home visits). Contrary to hypotheses, the two groups did not differ with respect to assessment of pain at admission, number of pain assessments subsequent to admission, assessment of fatigue at admission, number of unplanned visits to care facilities, admissions to care facilities, and number of unscheduled home visits. As hypothesized, the OCNs(r) documented a higher number of postadmission fatigue assessments (p less than 0.05). Contrary to hypotheses, patients of OCNs(r) had a greater number of infections and fewer documented instances of patient teaching regarding infection. Little support was found for the hypothesis that nursing care by OCNs(r) results in superior patient outcomes in comparison to care by noncertified nurses. Further research is needed to examine the dimensions of clinical practice that may demonstrate the benefits of care by OCNs(r).

  19. [Problematizing the multidisciplinary residency in oncology: a practical teaching protocol from the perspective of nurse residents].

    PubMed

    Melo, Myllena Cândida de; Queluci, Gisella de Carvalho; Gouvêa, Mônica Villela

    2014-08-01

    To investigate practical teaching of nurse residents in a multidisciplinary residency in oncology. A qualitative descriptive study grounded in the problematization methodology and its steps, represented by the Maguerez Arch. Data were analyzed using content analysis. Potentiating and limiting elements of the residency guided the design of a practical teaching protocol from the perspective of residents, structured in three stages: Welcoming and ambience; Nursing care for problem situations; and, Evaluation process. Systematization of practical teaching promoted the autonomy of individuals and the approximation of teaching to reality, making residency less strenuous, stressful and distressing.

  20. An Integrated Nurse Practitioner-Run Subspecialty Referral Program for Incontinent Children.

    PubMed

    Jarczyk, Kimberly S; Pieper, Pam; Brodie, Lori; Ezzell, Kelly; D'Alessandro, Tina

    Evidence suggests that urinary and fecal incontinence and abnormal voiding and defecation dynamics are different manifestations of the same syndrome. This article reports the success of an innovative program for care of children with incontinence and dysfunctional elimination. This program is innovative because it is the first to combine subspecialty services (urology, gastroenterology, and psychiatry) in a single point of care for this population and the first reported independent nurse practitioner-run specialty referral practice in a free-standing pediatric ambulatory subspecialty setting. Currently, services for affected children are siloed in the aforementioned subspecialties, fragmenting care. Retrospective data on financial, patient satisfaction, and patient referral base were compiled to assess this program. Analysis indicates that this model is fiscally sound, has similar or higher patient satisfaction scores when measured against physician-run subspecialty clinics, and has an extensive geographic referral base in the absence of marketing. This model has potential transformative significance: (a) the impact of children achieving continence cannot be underestimated, (b) configuration of services that cross traditional subspecialty boundaries may have broader application to other populations, and (c) demonstration of effectiveness of non-physician provider reconfiguration of health care delivery in subspecialty practice may extend to the care of other populations. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  1. A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners.

    PubMed

    Boyle, Eileen; Saunders, Rosemary; Drury, Vicki

    2016-07-01

    To explore patient experiences of type 2 diabetes mellitus care delivered by general practice nurses in collaboration with the general practitioner. Australian general practice nurses are expanding their role in multidisciplinary type 2 diabetes care with limited research on patient perceptions of care provision within this collaborative model. Qualitative interpretive. Purposeful sampling was used to invite the patients (n = 10). Data were collected from semi-structured face-to-face interviews. Braun and Clarke's () inductive coding thematic analysis process was used to interpret the data. All participants experienced their General Practice Nurse consultation as a clinical assessment for their General Practitioner. While they appreciated the extra time with the General Practice Nurse, they were unsure of the purpose of the consultation beyond clinical assessment. They described the ongoing challenge of living with T2DM and identified a need for additional information and advice. The results suggest that the model of general practice nurse type 2 diabetes care has an important role to play in the delivery of effective ongoing care of patients. However, this role requires further development to ensure that it is understood by the patients as a role that not only conducts clinical assessments but also provides relevant education and self-management support as part of a collaborative approach to care delivery with General Practitioners. The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses. © 2016 John Wiley & Sons Ltd.

  2. Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

    PubMed Central

    Duker, Leah I. Stein

    2016-01-01

    Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. PMID:27295001

  3. Exploration of the concept of collaboration within the context of nurse practitioner-physician collaborative practice.

    PubMed

    Bridges, Sharon

    2014-07-01

    Collaboration in the healthcare setting is a multifaceted process that calls for deliberate knowledge sharing and mutual accountability for patient care. The purpose of this analysis is to offer an increased understanding of the concept of collaboration within the context of nurse practitioner (NP)-physician (MD) collaborative practice. The evolutionary method of concept analysis was utilized to explore the concept of collaboration. The process of literature retrieval and data collection was discussed. The search of several nursing and medicine databases resulted in 31 articles, including 17 qualitative and quantitative studies, which met criteria for inclusion in the concept analysis. Collaboration is a complex, sophisticated process that requires commitment of all parties involved. The data analysis identified the surrogate and related terms, antecedents, attributes, and consequences of collaboration within the selected context, which were recognized by major themes presented in the literature and these were discussed. An operational definition was proposed. Increasing collaborative efforts among NPs and MDs may reduce hospital length of stays and healthcare costs, while enhancing professional relationships. Further research is needed to evaluate collaboration and collaborative efforts within the context of NP-MD collaborative practice. ©2013 American Association of Nurse Practitioners.

  4. Prescribing of psychotropic medication for nursing home residents with dementia: a general practitioner survey.

    PubMed

    Cousins, Justin M; Bereznicki, Luke Re; Cooling, Nick B; Peterson, Gregory M

    2017-01-01

    The aim of this study was to identify factors influencing the prescribing of psychotropic medication by general practitioners (GPs) to nursing home residents with dementia. GPs with experience in nursing homes were recruited through professional body newsletter advertising, while 1,000 randomly selected GPs from southeastern Australia were invited to participate, along with a targeted group of GPs in Tasmania. An anonymous survey was used to collect GPs' opinions. A lack of nursing staff and resources was cited as the major barrier to GPs recommending non-pharmacological techniques for behavioral and psychological symptoms of dementia (BPSD; cited by 55%; 78/141), and increasing staff levels at the nursing home ranked as the most important factor to reduce the usage of psychotropic agents (cited by 60%; 76/126). According to GPs, strategies to reduce the reliance on psychotropic medication by nursing home residents should be directed toward improved staffing and resources at the facilities.

  5. Effects of substituting nurse practitioners, physician assistants or nurses for physicians concerning healthcare for the ageing population: a systematic literature review.

    PubMed

    Lovink, Marleen H; Persoon, Anke; Koopmans, Raymond T C M; Van Vught, Anneke J A H; Schoonhoven, Lisette; Laurant, Miranda G H

    2017-09-01

    To evaluate the effects of substituting nurse practitioners, physician assistants or nurses for physicians in long-term care facilities and primary healthcare for the ageing population (primary aim) and to describe what influences the implementation (secondary aim). Healthcare for the ageing population is undergoing major changes and physicians face heavy workloads. A solution to guarantee quality and contain costs might be to substitute nurse practitioners, physician assistants or nurses for physicians. A systematic literature review. PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL, Web of Science; searched January 1995-August 2015. Study selection, data extraction and quality appraisal were conducted independently by two reviewers. Outcomes collected: patient outcomes, care provider outcomes, process of care outcomes, resource use outcomes, costs and descriptions of the implementation. Data synthesis consisted of a narrative summary. Two studies used a randomized design and eight studies used other comparative designs. The evidence of the two randomized controlled trials showed no effect on approximately half of the outcomes and a positive effect on the other half of the outcomes. Results of eight other comparative study designs point towards the same direction. The implementation was influenced by factors on a social, organizational and individual level. Physician substitution in healthcare for the ageing population may achieve at least as good patient outcomes and process of care outcomes compared with care provided by physicians. Evidence about resource use and costs is too limited to draw conclusions. © 2017 John Wiley & Sons Ltd.

  6. Evaluating newly acquired authority of nurse practitioners and physician assistants for reserved medical procedures in the Netherlands: a study protocol

    PubMed Central

    De Bruijn-Geraets, Daisy P; Van Eijk-Hustings, Yvonne JL; Vrijhoef, Hubertus JM

    2014-01-01

    Aim The study protocol is designed to evaluate the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Background Recent (temporarily) enacted legislation in Dutch health care authorizes nurse practitioners and physician assistants to indicate and perform specified medical procedures, i.e. catheterization, cardioversion, defibrillation, endoscopy, injection, puncture, prescribing and simple surgical procedures, independently. Formerly, these procedures were exclusively reserved to physicians, dentists and midwives. Design A triangulation mixed method design is used to collect quantitative (surveys) and qualitative (interviews) data. Methods Outcomes are selected from evidence-based frameworks and models for assessing the impact of advanced nursing on quality of health care. Data are collected in various manners. Surveys are structured around the domains: (i) quality of care; (ii) costs; (iii) healthcare resource use; and (iv) patient centredness. Focus group and expert interviews aim to ascertain facilitators and barriers to the implementation process. Data are collected before the amendment of the law, 1 and 2·5 years thereafter. Groups of patients, nurse practitioners, physician assistants, supervising physicians and policy makers all participate in this national study. The study is supported by a grant from the Dutch Ministry of Health, Welfare and Sport in March 2011. Research Ethics Committee approval was obtained in July 2011. Conclusion This study will provide information about the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Study findings aim to support policy makers and other stakeholders in making related decisions. The study design enables a cross-national comparative analysis. PMID:24684631

  7. Targeting communication interventions to decrease oncology family caregiver burden

    PubMed Central

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Oliver, Debra Parker; Demiris, George; Rankin, Anna

    2012-01-01

    Objectives The goal of this paper was to articulate and describe family communication patterns that give shape to four types of family caregivers: Manager, Carrier, Partner, and Loner. Data Sources Case studies of oncology family caregivers and hospice patients were selected from data collected as part of a larger, randomized controlled trial aimed at assessing family participation in interdisciplinary team meetings. Conclusion Each caregiver type demonstrates essential communication traits with nurses and team members; an ability to recognize these caregiver types will facilitate targeted interventions to decrease family oncology caregiver burden. Implications for Nursing Practice By becoming familiar with caregiver types, oncology nurses will be better able to address family oncology caregiver burden and the conflicts arising from family communication challenges. With an understanding of family communication patterns and its impact on caregiver burden, nurses can aid patient, family, and team to best optimize all quality of life domains for patient as well as the lead family caregiver. PMID:23107184

  8. Customized role play: strategy for development of psychiatric mental health nurse practitioner competencies.

    PubMed

    Hubbard, Grace B

    2014-04-01

    To discuss the teaching/learning strategy of customized role play to enhance psychiatric mental health nurse practitioner (PMHNP) students' entry level competency. Customized role play facilitates application of new content, understanding of the patient's experience, and assessment of skill deficits. New PMHNP graduates have entry level proficiency across the life span with a range of psychotherapeutic interventions. © 2013 Wiley Periodicals, Inc.

  9. The Dual Rounding Model: Forging Therapeutic Alliances 
in Oncology and Palliative Care.

    PubMed

    Baxley, Carey E

    2016-04-01

    Inpatients with solid tumors at Duke University Hospital in Durham, NC, are cared for in a dynamic integrated care model that incorporates medical oncology and palliative care. This has profound implications for patients, their loved ones, medical and surgical staff, and oncology nurses. As a nurse with less than three years of experience, my participation in a setting that uses the Dual Rounding Model has accelerated my professional and personal development. During a typical shift, I am an oncology nurse, a palliative care nurse, and a hospice nurse.
.

  10. Use of a Shared Mental Model by a Team Composed of Oncology, Palliative Care, and Supportive Care Clinicians to Facilitate Shared Decision Making in a Patient With Advanced Cancer.

    PubMed

    D'Ambruoso, Sarah F; Coscarelli, Anne; Hurvitz, Sara; Wenger, Neil; Coniglio, David; Donaldson, Dusty; Pietras, Christopher; Walling, Anne M

    2016-11-01

    Our case describes the efforts of team members drawn from oncology, palliative care, supportive care, and primary care to assist a woman with advanced cancer in accepting care for her psychosocial distress, integrating prognostic information so that she could share in decisions about treatment planning, involving family in her care, and ultimately transitioning to hospice. Team members in our setting included a medical oncologist, oncology nurse practitioner, palliative care nurse practitioner, oncology social worker, and primary care physician. The core members were the patient and her sister. Our team grew organically as a result of patient need and, in doing so, operationalized an explicitly shared understanding of care priorities. We refer to this shared understanding as a shared mental model for care delivery, which enabled our team to jointly set priorities for care through a series of warm handoffs enabled by the team's close proximity within the same clinic. When care providers outside our integrated team became involved in the case, significant communication gaps exposed the difficulty in extending our shared mental model outside the integrated team framework, leading to inefficiencies in care. Integration of this shared understanding for care and close proximity of team members proved to be key components in facilitating treatment of our patient's burdensome cancer-related distress so that she could more effectively participate in treatment decision making that reflected her goals of care.

  11. Using Simulation in a Psychiatric Mental Health Nurse Practitioner Doctoral Program.

    PubMed

    Calohan, Jess; Pauli, Eric; Combs, Teresa; Creel, Andrea; Convoy, Sean; Owen, Regina

    The use and effectiveness of simulation with standardized patients in undergraduate and graduate nursing education programs is well documented. Simulation has been primarily used to develop health assessment skills. Evidence supports using simulation and standardized patients in psychiatric-mental health nurse practitioner (PMHNP) programs is useful in developing psychosocial assessment skills. These interactions provide individualized and instantaneous clinical feedback to the student from faculty, peers, and standardized patients. Incorporating simulation into advanced practice psychiatric-mental health nursing curriculum allows students to develop the necessary requisite skills and principles needed to safely and effectively provide care to patients. There are no documented standardized processes for using simulation throughout a doctor of nursing practice PMHNP curriculum. The purpose of this article is to describe a framework for using simulation with standardized patients in a PMHNP curriculum. Students report high levels of satisfaction with the simulation experience and believe that they are more prepared for clinical rotations. Faculty feedback indicates that simulated clinical scenarios are a method to ensure that each student experiences demonstrate a minimum standard of competency ahead of clinical rotations with live patients. Initial preceptor feedback indicates that students are more prepared for clinical practice and function more independently than students that did not experience this standardized clinical simulation framework. Published by Elsevier Inc.

  12. Attitudes of Oncologists, Oncology Nurses, and Patients from a Women's Clinic Regarding Medical Decision Making for Older and Younger Breast Cancer Patients.

    ERIC Educational Resources Information Center

    Beisecker, Analee E.; And Others

    1994-01-01

    Administered Beisecker Locus of Authority in Decision Making: Breast Cancer survey to 67 oncologists, 94 oncology nurses, and 288 patients from women's clinic. All groups believed that physicians should have dominant role in decision making. Nurses felt that patients should have more input than patients or physicians felt they should. Physicians…

  13. Women's experiences of nurse case management on a gynaecological oncology unit in a Swiss tertiary hospital. A thematic analysis.

    PubMed

    Grob, Silvia; Bläuer, Cornelia; Frei, Irena Anna

    2017-12-01

    Women with gynaecological cancer face various physical, social and emotional challenges concerning their health. Existing research shows that case management can improve patient satisfaction and reduce readmission rates. Although nurse case management was introduced on a gynaecological oncology unit in a Swiss university hospital in 2013, little is known about the experiences of female patients on a unit that uses this model of care. The aims were to explore women's experiences and to gain deeper understanding about hospital-based nurse case management on a gynaecological oncology unit and to qualitatively evaluate the concept of nurse case management. Sound research knowledge suggests that experiences are best explored with a qualitative research design. Ten participant interviews were conducted and inductively analysed between September 2014 and May 2015 as described by the thematic analysis method. Ethical approval was obtained, and the women signed a consent form. The first theme was named continuous relationship, with the nurse case manager as contact person and trusted partner. Study participants explained that friendliness and being present were essential qualities of nurse case management. Secondly, an essential support for women dealing with the situation of gynaecological cancer was described in the theme sharing information. The organisation of rehabilitation and other services by the nurse case management defined the third theme coordinating care. Trust was seen as the basis of the continuous relationship, marked by friendliness and presence of the nurse case manager. The helpful approach of persons practicing nurse case management made dealing with the situation of illness easier for women with gynaecological cancer. Coordination of information between the nurse case management and other healthcare services could be improved. Further evaluation is suggested to explore effects of the concept on family members. © 2017 Nordic College of Caring Science.

  14. Toward a Broader Role for Occupational Therapy in Supportive Oncology Care.

    PubMed

    Sleight, Alix G; Duker, Leah I Stein

    2016-01-01

    Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  15. Treatment and disease management of multiple sclerosis patients: A review for nurse practitioners.

    PubMed

    Roman, Cortnee; Menning, Kara

    2017-10-01

    This review discusses the role of the nurse practitioner (NP) in evaluating the clinical effects, potential side effects, and monitoring requirements for treatment options in multiple sclerosis (MS) and provides guidance on how to help patients understand these issues. A literature search was conducted on PubMed to identify publications on monitoring and disease management of MS patients. Additional resources included drug information web sites and package inserts. NPs play an active role in the management of MS patients via effective monitoring and communication throughout the patient's treatment regimen and disease course. In the shared decision-making model of MS treatment, NPs ensure that patients understand the implications of their disease-modifying therapies (DMTs). As patients move through treatments during the course of their disease, the importance of this role increases, and it is critical that NPs follow the guidelines in each medication's product label and take into account any potential lingering effects of prior medications. It is critical for NPs to promote patient adherence, to ensure that patients understand treatment side effects and monitoring requirements, and to take sequencing and reversibility implications of DMTs into account when making clinical decisions. ©2017 American Association of Nurse Practitioners.

  16. Pediatric oncology nurses' attitudes related to discussing fertility preservation with pediatric cancer patients and their families.

    PubMed

    Vadaparampil, Susan T; Clayton, Heather; Quinn, Gwendolyn P; King, Lindsey M; Nieder, Michael; Wilson, Crystal

    2007-01-01

    This study explores nurses' attitudes toward the discussion of fertility preservation (FP) with pediatric cancer patients and their families. A cross-sectional survey was administered to attendees of a pediatric oncology conference. Of the 115 nurses who responded and comprised the study sample, most reported discussing risks of infertility or FP nurses to influence discussion of FP are the potential of upsetting patients' families, that boys younger than 18 years should not be given erotic materials during semen collection, and difficulty locating FP facilities. The 3 patient factors most likely to encourage the discussion of FP are the patient being recently married or engaged, the patient asking about FP, and availability of patient education materials. While the results indicate that nurses do not regularly discuss FP with their patients, nurses perceive such discussion as being within their scope of practice. Therefore, with appropriate intervention, nurses may play a key role in facilitating discussions regarding FP with patients and families.

  17. Creating and validating an instrument to identify the workload at an oncology and hematology outpatient service

    PubMed Central

    Martin, Lelia Gonçalves Rocha; Gaidzinski, Raquel Rapone

    2014-01-01

    Objective Construct and to validate an instrument for measuring the time spent by nursing staff in the interventions/activities in Outpatient Oncology and Hematology, interventions based on Nursing Interventions Classification (NIC), for key areas of Pediatric Oncology and Oncology Nursing. Methods Cross-sectional study divided into two steps: (1) construction of an instrument to measure the interventions/Nursing activities and (2) validation of this instrument. Results We selected 32 essential interventions from NIC for Pediatric Oncology and Oncology Nursing areas. The judges agreed with removing 13 and including 6 interventions in the instrument, beyond personal activity. Conclusion The choice of essential interventions from NIC is justified by the gain time on research. PMID:25295454

  18. Outcomes and provider perspectives on geriatric care by a nurse practitioner-led community paramedicine program.

    PubMed

    Kant, Rebecca E; Vejar, Maria; Parnes, Bennett; Mulder, Joy; Daddato, Andrea; Matlock, Daniel D; Lum, Hillary D

    2018-05-03

    This study explores the use of a nurse practitioner-led paramedicine program for acute, home-based care of geriatric patients. This case series describes patients, outcomes, and geriatric primary care provider perspectives related to use of this independent paramedicine program. There were 40 patient visits from August 2016-May 2017. We reviewed patient demographics, medical conditions, healthcare utilization, and communication processes and used semi-structured interviews and content analysis to explore staff perspectives. The most commonly treated diagnoses were respiratory conditions, urinary tract infections, and gastrointestinal concerns. Two patients required an immediate transfer to a higher level of care. Six patients had emergency department visits and five patients were hospitalized within two weeks. Geriatric providers identified three themes including: potential benefits to geriatric patients, importance of enhanced care coordination and communication, and considerations for the specific role of nurse practitioner-led community paramedicine programs for geriatric patient care. Published by Elsevier Inc.

  19. Compassion fatigue and burnout: prevalence among oncology nurses.

    PubMed

    Potter, Patricia; Deshields, Teresa; Divanbeigi, Joyce; Berger, Julie; Cipriano, Doreen; Norris, Lori; Olsen, Sarah

    2010-10-01

    This descriptive, cross-sectional survey was conducted in inpatient nursing units and outpatient clinics in a cancer center in the midwestern United States. The sample of 153 healthcare providers included RNs, medical assistants, and radiology technicians. The fourth revision of the 30-item Professional Quality of Life (ProQOL R-IV) scale was used for measuring compassion fatigue, compassion satisfaction, and burnout. A series of cross tab analyses examined the relationship between participant demographics and three ProQOL R-IV subscales. The study sample scored similarly on compassion satisfaction and burnout when compared with participants who used the ProQOL R-IV in previous studies. Value exists in analyzing the prevalence of burnout and compassion fatigue among oncology healthcare providers. Understanding the needs of distinct demographic groups offers valuable direction for intervention program development. Applying internal evidence in the design of a relevant stress-reduction program will better equip healthcare providers to recognize and manage compassion fatigue and burnout.

  20. Nurse practitioners' focus on health care in terms of cure and care: analysis of graduate theses using the International Classification of Functioning, Disability and Health.

    PubMed

    Stallinga, Hillegonda A; Jansen, Gerard J; Kastermans, Marijke C; Pranger, Albert; Dijkstra, Pieter U; Roodbol, Petrie F

    2016-07-01

    To explore the focus of nurse practitioners on health care in terms of cure and care. Nurse practitioners are expected to act on the intersection of cure and care. However, in clinical practice and education, a clear model covering this area is lacking; therefore, it is unknown to what extent nurse practitioners are focused on this specific area. Graduate theses may reflect the focus of nurse practitioners. Sequential exploratory mixed method. In total, 413 published abstracts of graduate theses of a Dutch Master of Advanced Nursing Practice (2000-2015) were analysed using the International Classification of Functioning, Disability and Health. Data source included aim, question and outcome of each thesis and graduates' characteristics. A qualitative deductive approach was used for the analyses. Theses were classified as focused on cure, care, or on the intersection of cure and care. A small majority of 53% (N = 219) of the graduate theses addressed patient's health status and could be classified in the International Classification of Functioning, Disability and Health. Of the classified theses, 48% were focused on cure, 39% on the intersection of cure and care and 13% on care. While the percentage of theses addressing health status increased significantly over the 15-year period, the percentage of theses focused on cure, care and on the intersection of cure and care remained the same. The graduate theses reflected that nurse practitioners are increasingly oriented towards patients' health status. However, their focus is predominantly on cure rather than on the intersection of cure and care. © 2016 John Wiley & Sons Ltd.

  1. One hand cannot clap-a study of Arab practitioners of traditional and complementary medicine in Israel: identifying barriers to integrative oncology care.

    PubMed

    Popper-Giveon, Ariela; Schiff, Elad; Hatem, David; Samuels, Noah; Ben-Arye, Eran

    2014-01-01

    The integration of complementary medicine is gradually becoming an accepted part of standard care for patients with cancer. In our integrative oncology program, we have encountered difficulties in recruiting Arab patients. In order to understand the special needs of this population, we conducted interviews among Arab practitioners of complementary and traditional medicine (CTM). The characteristics of practitioners and their views regarding the therapeutic process were examined. Semi-structured qualitative interviews were administered to 27 Arab practitioners of CTM whose clientele was comprised primarily of Arab cancer patients. Conventional content analysis of the transcribed interviews and field notes was performed in order to identify key themes. Three groups of CTM practice were identified: Folk-herbal medicine (n = 9), complementary medicine (CM; n = 14), and religious healing (n = 4). Seven factors were identified in the practitioner accounts: the duration and scheduling of treatment sessions, the language of communication, the presence of family members, the appearance of the practitioner, the definition of treatment goals, the discussion of behavioral and lifestyle changes, and finally, the use of tangible elements in treatment. The study of Arab CTM practitioner recommendations may help facilitate a culture-sensitive encounter with Arab patients with cancer. This approach may also have implications for other ethno-culturally unique populations. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Oncology nurses’ communication challenges with patients and families: A qualitative study

    PubMed Central

    Banerjee, Smita C.; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A.; Parker, Patricia A.; Bylund, Carma L.

    2016-01-01

    The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. PMID:26278636

  3. Nurse practitioners: leadership behaviors and organizational climate.

    PubMed

    Jones, L C; Guberski, T D; Soeken, K L

    1990-01-01

    The purpose of this article is to examine the relationships of individual nurse practitioners' perceptions of the leadership climate in their organizations and self-reported formal and informal leadership behaviors. The nine climate dimensions (Structure, Responsibility, Reward, Perceived Support of Risk Taking, Warmth, Support, Standard Setting, Conflict, and Identity) identified by Litwin and Stringer in 1968 were used to predict five leadership dimensions (Meeting Organizational Needs, Managing Resources, Leadership Competence, Task Accomplishment, and Communications). Demographic variables of age, educational level, and percent of time spent performing administrative functions were forced as a first step in each multiple regression analysis and used to explain a significant amount of variance in all but one analysis. All leadership dimensions were predicted by at least one organizational climate dimension: (1) Meeting Organizational Needs by Risk and Reward; (2) Managing Resources by Risk and Structure; (3) Leadership Competence by Risk and Standards; (4) Task Accomplishment by Structure, Risk, and Standards; and (5) Communication by Rewards.

  4. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study

    PubMed Central

    Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke JAH; Schoonhoven, Lisette; Koopmans, Raymond TCM; Laurant, Miranda GH

    2017-01-01

    Introduction In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. Methods and analysis This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context–mechanism–outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. Ethics and dissemination The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. PMID

  5. Perceptions of Emergency Department Physicians Toward Collaborative Practice With Nurse Practitioners in an Emergency Department Setting

    DTIC Science & Technology

    1998-05-01

    questions or they seem to get over their heads they hand it off to the docs. Depending of their training, nurse practitioners in the right situation...conference and explain themselves, it’s just experience, so we just have had a head start there. Years and years of nursing experience isn’t the same...years of medical school is spent in Chemistry and Embryology . I have spent the last 12 years completely dedicated to my career and a physician

  6. Mentoring: Positively Influencing Job Satisfaction and Retention of New Hire Nurse Practitioners.

    PubMed

    Horner, Diane Kostrey

    The purpose of study was to determine whether mentoring based on Watson's Caring Model positively influences nurse practitioner (NP) job satisfaction. This nonexperimental mixed-methods study utilized an online survey, administered through Qualtrics containing demographic and mentoring variables. Job satisfaction results were obtained from the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS). Also, open-ended questions regarding mentoring were reported. There was a 54% response rate in which 37 of the 69 participants responded (n = 37), with statistical significance set at p < .05. All or 100% of participants reported that the mentor experience/relationship positively influenced job satisfaction. Scores from the MNPJSS ranged from 141 to 246, with a mean of 195.26 (SD = 28.29) corresponding to "minimally satisfied" or a mean of 4.44 on the 6-point scale. These results are similar to the MNPJSS score with a mean of 4.39. A mentoring experience can provide a positive environment, which can lead to increased job satisfaction. In turn, a higher level of satisfaction in the work environment can be associated with reduced turnover and improved retention and patient outcomes. Ultimately, a safer health care system will evolve and improve patient care and outcomes. Through Watson's Caring Model, a reciprocal relationship between the mentor and the mentee can provide a new NP hire a sense of community and direct availability. By experiencing a mentor relationship, job satisfaction can improve, which is a key factor in retaining NPs. As E-mentoring is a newer topic in nursing literature, further research is needed. Further studies could also review and develop one-on-one mentoring programs.

  7. Outreach syncope clinic managed by a nurse practitioner: Outcome and cost effectiveness.

    PubMed

    Hamdan, Mohamed H; Walsh, Kathleen E; Brignole, Michele; Key, Jamie

    2017-01-01

    Introduction The purpose of this study was to assess the clinical and financial outcomes of a novel outreach syncope clinic. Methods We compared the clinical outcome of the Faint and Fall Clinic at the American Center (January-June 2016) with that of the University of Wisconsin Health and Clinics Faint and Fall Clinic (January 2013-December 2014). The American Center-Faint and Fall Clinic is run solely by a nurse practitioner, assisted by online faint-decision software and consultancy of a faint specialist through video-conferencing. Results Five hundred and twenty-eight consecutive patients were seen at the University of Wisconsin Hospital and Clinics-Faint and Fall Clinic and 68 patients at the American Center-Faint and Fall Clinic. The patients' clinical characteristics were similar except for a lower age in the American Center patients (45 ± 18 vs 51 ± 22, p = 0.03). Overall, a diagnosis was made within 45 days in 70% (95% confidence interval 66-74%) of the University of Wisconsin Hospital and Clinics patients and 69% (95% confidence interval 58-80%) of the American Center patients, ( p = 0.9). A mean of 3.0 ± 1.6 tests per patient was used in the University of Wisconsin Hospital and Clinics group compared to 1.5 ± 0.8 tests per patient in the American Center group, p = 0.001. Over the six-month study period, the total revenue at the American Center was US$152,597 (contribution margin of US$122,393 plus professional revenue of US$30,204). The total cost of the nurse practitioner including benefits was US$66,662 ((US$98,466 salary/year + 35.4% benefits)/2). Total revenue minus expenses resulted in a net profit of US$85,935. Discussion A nurse practitioner-run outreach syncope-clinic equipped with online faint-decision software and consultancy of a faint specialist through vedio-conferencing is feasible and financially self-sustainable. It allows the dissemination of standardized high-quality syncope care to patients who have

  8. Initial Development of C.A.T.E.S.: A Simulation-Based Competency Assessment Instrument for Neonatal Nurse Practitioners.

    PubMed

    Cates, Leigh Ann; Bishop, Sheryl; Armentrout, Debra; Verklan, Terese; Arnold, Jennifer; Doughty, Cara

    2015-01-01

    Determine content validity of global statements and operational definitions and choose scenarios for Competency, Assessment, Technology, Education, and Simulation (C.A.T.E.S.), instrument in development to evaluate multidimensional competency of neonatal nurse practitioners (NNPs). Real-time Delphi (RTD) method to pursue four specific aims (SAs): (1) identify which cognitive, technical, or behavioral dimension of NNP competency accurately reflects each global statement; (2) map the global statements to the National Association of Neonatal Nurse Practitioners (NANNP) core competency domains; (3) define operational definitions for the novice to expert performance subscales; and (4) determine the essential scenarios to assess NNPs. Twenty-five NNPs and nurses with competency and simulation experience Main outcome variable: One hundred percent of global statements correct for competency dimension and all but two correct for NANNP domain. One hundred percent novice to expert operational definitions and eight scenarios chosen. Content validity determined for global statements and novice to expert definitions and essential scenarios chosen.

  9. Mentoring new nurse practitioners to accelerate their development as primary care providers: a literature review.

    PubMed

    Harrington, Susan

    2011-04-01

    To provide a review of the literature regarding programs for mentoring new nurse practitioners (NPs) to accelerate their development as primary care providers. A search was conducted in PubMed, Ovid, CINAHL, and Cochrane Database of Systematic Reviews. There is currently a critical shortage of primary care providers and an aging population requiring management of chronic medical conditions. Although NPs are trained in health promotion, disease prevention, and medical management and are well equipped to treat patients in primary care, the work can be overwhelming to the novice NP. A mentoring program could help the new NP further develop competencies and capabilities as a provider. However, there is a gap in the literature concerning any mentoring programs for novice NPs. Nonetheless, the literature review has provided a mentoring definition, program models, desired characteristics of nurse mentors, and barriers to mentoring programs. It has also described the benefits, goals and outcomes of a mentoring relationship. These insights from the literature provide a foundation for future mentoring program development. A mentoring program for new NPs working in primary care could accelerate productivity, increase job satisfaction, and provide longevity in the primary care setting. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

  10. Medication errors in chemotherapy preparation and administration: a survey conducted among oncology nurses in Turkey.

    PubMed

    Ulas, Arife; Silay, Kamile; Akinci, Sema; Dede, Didem Sener; Akinci, Muhammed Bulent; Sendur, Mehmet Ali Nahit; Cubukcu, Erdem; Coskun, Hasan Senol; Degirmenci, Mustafa; Utkan, Gungor; Ozdemir, Nuriye; Isikdogan, Abdurrahman; Buyukcelik, Abdullah; Inanc, Mevlude; Bilici, Ahmet; Odabasi, Hatice; Cihan, Sener; Avci, Nilufer; Yalcin, Bulent

    2015-01-01

    Medication errors in oncology may cause severe clinical problems due to low therapeutic indices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errors and underlying factors during chemotherapy preparation and administration based on a systematic survey conducted to reflect oncology nurses experience. This study was conducted in 18 adult chemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators and medication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparation or administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapy units; errors and their estimated monthly number during chemotherapy preparation and administration; and evaluation of the possible factors responsible from ME. The survey was conducted by face to face interview and data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for a comparative analysis of categorical data. Some 83.4% of the 210 nurses reported one or more than one error during chemotherapy preparation and administration. Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%). Our findings suggest that the probability of medication error is very high during chemotherapy preparation and administration, the most common involving prescribing and ordering errors. Further studies must address the strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protective measures

  11. Implementing advanced nurse practitioner roles in acute care: an evaluation of organizational change.

    PubMed

    Cummings, Greta G; Fraser, Kim; Tarlier, Denise S

    2003-03-01

    Medical shortages are seen as the driving force behind the recent implementation of the advanced nurse practitioner (ANP) role in some Canadian hospitals. The authors analyzed the implementation of the ANP role in one tertiary care teaching hospital from the organizational change perspective. Despite successful implementation, issues of role definition, scope of practice boundaries, and staff reactions remain unresolved. Recommendations are discussed for implementing ANP roles in other acute care facilities.

  12. Promoting Postpartum Mental Health in Fathers: Recommendations for Nurse Practitioners

    PubMed Central

    Kumar, Sheena V.; Oliffe, John L.; Kelly, Mary T.

    2017-01-01

    The transition to fatherhood can challenge the mental health of first-time fathers and heighten their risk for postpartum depression (PPD). Paternal PPD not only affects the individual, but relationships with partners and children as well. This scoping review explores paternal PPD, highlighting the factors for and impacts of paternal PPD, the experiences of first-time fathers during the postnatal period, including their knowledge gaps and learning preferences. Drawing on the scoping review findings, recommendations are made for postnatal programs to improve the inclusion of new fathers amid describing how nurse practitioners can promote men’s mental health in the postpartum period. PMID:29183251

  13. Increasing Role of Nurse Practitioners in House Call Programs.

    PubMed

    Yao, Nengliang Aaron; Rose, Karen; LeBaron, Virginia; Camacho, Fabian; Boling, Peter

    2017-04-01

    Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work. An observational study using secondary data. Medicare Provider Utilization and Payment Data. Medicare beneficiaries. Medicare payments for home and domiciliary care visits, the number of residence-based medical visits, provider volume, geographical distribution of full-time house call providers. About 3,300 NPs performed over 1.1 million home and domiciliary care visits in 2013, accounting for 22% of all residential visits to Medicare fee-for-service beneficiaries. A total of 310 NPs individually made more than 1,000 residential visits (defined as a full-time house call provider); among full-time house call providers, including physicians, NPs are now the most common provider type. There are substantial variations in the geographic distribution of full-time house call NPs, internists, and family physicians. Full time NP's service area is about 30% larger than family physicians and internists. Nursing home residents are far more likely to receive NP visits than are homebound persons receiving home visits. NPs are now the largest type of provider delivering residence-based care and NPs provide care over the largest geographical service area. However, the vast majority of frail Americans are more likely to receive NP's care in a nursing facility versus at home. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  14. Near patient testing in general practice: attitudes of general practitioners and practice nurses, and quality assurance procedures carried out.

    PubMed Central

    Hilton, S; Rink, E; Fletcher, J; Sibbald, B; Freeling, P; Szczepura, A; Davies, C; Stilwell, J

    1994-01-01

    BACKGROUND. The evaluation of near patient testing in British general practice has largely been confined to studies examining individual tests or comparing equipment. AIM. This study set out to determine the attitudes of practice staff to near patient testing, and the extent to which staff undertook quality assessment. METHOD. Four types of near patient testing machines were introduced into 12 general practices in two regions of England, south west Thames and west Midlands. General practitioner and practice nurse attitudes to near patient testing were assessed by semi-structured interview before and six months after the introduction of the machines. The extent to which routine quality assurance procedures were carried out within the surgery and as part of local and national schemes was examined. RESULTS. Although 80% of general practitioners anticipated changing patient management with near patient testing, only two fifths reported having done so after six months. Nurses generally were enthusiastic at the outset, although one third were unhappy about incorporating near patient testing into their work schedules. Time pressure was the most important factor restricting uptake of near patient testing. Nurses performed quality control regularly but complete local external quality assurance procedures were established in only half the practices. All the practices participated in a national scheme for cholesterol assays. CONCLUSION. General practitioners in this study did not find near patient testing a very useful addition to their resources. Pressure on nurses' time was the most frequently reported limitation. PMID:7748669

  15. Hospital management of outpatient oncology treatment decisions: a survey to identify strategies and concerns.

    PubMed

    Li, Edward; Schleif, Ron; Edelen, Bruce

    2013-09-01

    Historically, hospitals did not actively restrict or manage outpatient oncology drug use, because treatment options were few, and reimbursement was generous. Recent growth of novel agents coupled with reimbursement challenges may require a strategy change. The extent of hospital engagement in controlling outpatient oncology drug use is currently unknown. Our objective was to describe the extent of hospital outpatient oncology drug management, management strategies employed, and specific drugs/tumor types of most concern for inappropriate use and cost. A multiple choice-question survey assessed management strategies and the drugs/tumors of greatest concern in US hospitals that dispense outpatient chemotherapy. From June to July 2011, the survey was distributed electronically to members of the Hematology-Oncology Pharmacy Association, representing 281 institutions. The survey was completed by 93 respondents (33% institutional response rate). Most institutions (99%) use at least one form of control to manage outpatient oncology drug therapy; 89% establish preferred therapies, and most use a multidisciplinary management team consisting of oncologists, pharmacists, nurses, and other practitioners. Tumor types of most concern for inappropriate drug use and cost were: prostate, breast, non-small-cell lung, melanoma, and colorectal. Fifty-five percent were concerned about drugs used in supportive care management. Drugs most restricted were: cetuximab, bevacizumab, eribulin, panitumumab, and trastuzumab. There is active control, management, and restriction of outpatient oncology drugs by hospitals. A majority of these institutions use a multidisciplinary team with active involvement by an oncologist. Future evaluations of hospital programs should consider monitoring the evolution of how institutions manage outpatient oncology services.

  16. The influence of registered nurses and nurse practitioners on patient experience with primary care: results from the Canadian QUALICO-PC study.

    PubMed

    Ammi, Mehdi; Ambrose, Sarah; Hogg, Bill; Wong, Sabrina

    2017-12-01

    Nurses, whether registered nurses (RNs) or nurse practitioners (NPs), are becoming key providers of primary care services. While evidence for the influence of NPs on patient experience in primary care is mounting, this is less so for RNs. We use the Canadian component of the international Quality and Costs of Primary Care 2013/14 survey to investigate the mechanisms by which nurses can affect patients' experience in primary care, focusing on accessibility and appropriateness of care. The data allow us to distinguish between family practice RNs, specialised RNs and NPs, and covers all types of patients visiting a primary care clinic in a variety of contexts in all Canadian provinces. In addition to the types of nurses and full-time equivalent (FTE) numbers, we explore the role of nurse autonomy and collaboration. Our regression results show that one of the most important predictors of patient experience is the collaboration between health professionals, whereas nurse staffing in terms of FTE numbers has little influence by itself. Different types of nurses influence different dimensions of accessibility, and the association between patient experience and nurse staffing depends on the number of physicians in the clinic. Our results can inform decision-makers on how to strengthen primary care provision, and particularly in Canadian context, the adaptation of the recently implemented interprofessional primary care teams. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Effective use of interpreters by family nurse practitioner students: is didactic curriculum enough?

    PubMed

    Phillips, Susanne J; Lie, Desiree; Encinas, Jennifer; Ahearn, Carol Sue; Tiso, Susan

    2011-05-01

    Nurse practitioners (NPs) care for patients with limited English proficiency (LEP). However, NP education for improving communication in interpreted encounters is not well reported. We report a single school study using standardized encounters within a clinical practice examination (CPX) to assess the adequacy of current curriculum. Entering family NP (FNP) students (n=26) participated in a baseline CPX case. They were assessed by standardized patients using the validated Interpreter Impact Rating Scale (IIRS) and Physician-Patient Interaction (PPI) scale, and by interpreters using the Interpreter Scale (IS).The case was re-administered to 31 graduating students following completion of existing curriculum. Primary outcome was aggregate change in skills comprising global IIRS, PPI and IS scores. Pre- and post-performance data were available for one class of 10 students. Secondary outcome was change in skill scores for this class. Mean aggregate global scores showed no significant improvement between scores at entry and graduation. For 10 students with pre- and post-performance data, there was no improvement in skill scores for any measure. Skill assessed on one measure worsened. FNP students show no improvement in skills in working with interpreters with the current curriculum. An enhanced curriculum is needed. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

  18. Electronic access to scientific nursing knowledge: the Virginia Henderson International Nursing Library.

    PubMed

    Graves, J R

    2001-02-01

    To inform oncology nurses about the electronic knowledge resources offered by the Sigma Theta Tau International Virginia Henderson International Nursing Library. Published articles and research studies. Clinical nursing research dissemination has been seriously affected by publication bias. The Virginia Henderson International Nursing Library has introduced both a new publishing paradigm for research and a new knowledge indexing strategy for improving electronic access to research knowledge (findings). The ability of oncology nursing to evolve, as an evidence-based practice, is largely dependent on access to research findings.

  19. Team science of nursing, engineering, statistics, and practitioner in the development of a robotic reflexology device.

    PubMed

    Wyatt, Gwen; Sikorskii, Alla; Bush, Tamara Reid; Mukherjee, Ranjan

    2010-01-01

    The purpose of this article is to share the lessons learned in forming an interdisciplinary team that implements a team science approach to integrative medicine (IM) research. The disciplines of nursing, statistics, and engineering, along with consultants and a reflexology practitioner, formed this university-based team to conceptualize and develop a prototype robotic device for reflexology for breast cancer patients. The nurse investigator contributed the intervention background and access to the population; the statistician guided the team thinking on factors that needed to be controlled for; the engineers provided the expertise in device design and development; consultants facilitated the team's thinking in new directions; and the reflexology practitioner prescribed the protocol. We discuss the contributions and achievements of each discipline, as well as the challenges, and share the team experiences with the intent to help guide the formation of new IM teams that promote a conducive atmosphere for carrying out cutting-edge IM research and advancing the science.

  20. Expanding the Role of Nurse Practitioners: Effects on Rural Access to Care for Injured Workers

    ERIC Educational Resources Information Center

    Sears, Jeanne M.; Wickizer, Thomas M.; Franklin, Gary M.; Cheadle, Allen D.; Berkowitz, Bobbie

    2008-01-01

    Context: A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending…

  1. The role of nurse practitioners in health sector reform in Iran (2011).

    PubMed

    Vatankhah, Soudabe; Khalesi, Nader; Ebadifardazar, Farbod; Ferdousi, Masoud; Naji, Homayon; Farahabadi, Seyed Mohammad Ehsaan

    2013-09-01

    Most countries use educated nurses called "nurse practitioners" (NPs) besides the family physicians for diagnosis, treatment, and specifically health education of the family. The main goal of this study was to redefine the role of NPs for better use of their capabilities in the so-called "family physician reform" in Iran. This is a qualitative and comparative study carried out in three stages (triangulation method) in 2011. In the first stage, we conducted a literature review to design a conceptual framework. The second stage was a comparative study on four countries. In this study, we focused on the role of NPs, which in turn helped to redefine this role in the health sector reform of Iran. In the third stage, two expert panels were involved and the suggested roles were confirmed. In the United States, NPs are licensed by the state in which they practice and have a national board certification. In Canada, nurses involved in clinics should participate in specific training course of diagnosis and management of health care after registration. In Austria, nurses in Nursing homes and maternity do some of the medical procedures under the supervision of the physicians. In the United Kingdom, NPs increasingly substitute for GPs in the care of minor illness and routine management of chronic diseases. There is still debate in nursing and medical circles about what the focus of the NP roles should be. In Iran, whereas a noticeable reform toward "family physician" is ongoing, redefining the nurses' role is essential. They can perform more active roles in associating with GPs in the clinics of family physicians, both in urban and rural areas, even with higher degrees of autonomy.

  2. Responding empathically to patients: Development, implementation, and evaluation of a communication skills training module for oncology nurses.

    PubMed

    Pehrson, Cassandra; Banerjee, Smita C; Manna, Ruth; Shen, Megan Johnson; Hammonds, Stacey; Coyle, Nessa; Krueger, Carol A; Maloney, Erin; Zaider, Talia; Bylund, Carma L

    2016-04-01

    The purpose of this paper is to report on the development, implementation, and evaluation of a Communication Skills Training (CST) module for inpatient oncology nurses on how to respond empathically to patients. 248 nurses from a USA cancer center participated in a CST module on responding empathically to patients. Nurses completed pre- and post-training Standardized Patient Assessments (SPAs), a survey on their confidence in and intent to utilize skills taught, and a six-month post-training survey of self-reported use of skills. Results indicate that nurses were satisfied with the module, reporting that agreement or strong agreement to 5 out of 6 items assessing satisfaction 96.7%-98.0% of the time. Nurses' self-efficacy in responding empathically significantly increased pre- to post-training. Additionally, nurses showed empathy skill improvement in the post-SPAs. Finally, 88.2% of nurses reported feeling confident in using the skills they learned post-training and reported an increase of 42-63% in the use of specific empathic skills. A CST module for nurses in responding empathically to patients showed feasibility, acceptability, and improvement in self-efficacy as well as skill uptake. This CST module provides an easily targeted intervention for improving nurse-patient communication and patient-centered care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Tips for starting your own nurse practitioner practice.

    PubMed

    Calmelat, A

    1993-04-01

    The decision to open a nurse practitioner practice is often difficult to make. Success depends on the possession of specific resources, such as adequate skills, finances, emotional support and the desire to be one's own boss. These skills will be critical as the NP develops a business plan and a budget, and makes important decisions, such as the form the business will take: sole proprietorship, partnership or corporation. Using external resources such as attorneys and accountants is also useful, especially when tackling issues of licenses, taxes and insurance. Start-up costs can be kept to a minimum with creativity and used equipment. In-house laboratories and reference laboratories must conform to strict regulations. A practice without established patients will need to market services aggressively through a successful mix of product, price, place and promotion. Patients' acceptance of the NP office will be enhanced by smooth patient flow, adequate space and cleanliness.

  4. Beyond the physical examination: the nurse practitioner's role in adolescent risk reduction and resiliency building in a school-based health center.

    PubMed

    Davis, Teresa K

    2005-12-01

    School-based health centers in high schools provide a unique setting in which to deliver risk-reduction and resilience-building services to adolescents. The traditional health care system operating in the United States focuses on the treatment of illness and disease rather than on preventing problems originating from health risk behaviors. Nurse practitioners can promote healthy behavior in adolescents through linkages to parents, schools, and community organizations; by conducting individual risk assessments; and by providing health education and access to creative health programs that build resilience and promote protective factors. With a focus on wellness, nurse practitioners as advanced practice nurses and specialists in disease prevention and health promotion can establish students' health priorities in the context of the primary health care they deliver on a daily basis.

  5. [Chronic surplus of Japanese cardiac surgeon--ideal nurse practitioner for cardiac surgery, cardiac surgeon's attitude toward the future].

    PubMed

    Ikegami, Hirohisa

    2014-03-01

    It is chronically surplus of doctors in the world of cardiac surgery. There are too many cardiac surgeons because cardiac surgery requires a large amount of manpower resources to provide adequate medical services. Many Japanese cardiac surgeons do not have enough opportunity to perform cardiac surgery operations, and many Japanese cardiac surgery residents do not have enough opportunity to learn cardiac surgery operations. There are physician assistants and nurse practitioners in the US. Because they provide a part of medical care to cardiac surgery patients, American cardiac surgeons can focus more energy on operative procedures. Introduction of cardiac surgery specialized nurse practitioner is essential to deliver a high quality medical service as well as to solve chronic problems that Japanese cardiac surgery has had for a long time.

  6. The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study.

    PubMed

    Schutte, Tim; van Eekeren, Rike; Richir, Milan; van Staveren, Jojanneke; van Puijenbroek, Eugène; Tichelaar, Jelle; van Agtmael, Michiel

    2018-01-01

    In a new prescribing qualification course for specialist oncology nurses, we thought that it is important to emphasize pharmacovigilance and adverse drug reaction (ADR) reporting. We aimed to develop and evaluate an ADR reporting assignment for specialist oncology nurses. The quality of report documentation was assessed with the "Clinical Documentation tool to assess Individual Case Safety Reports" (ClinDoc). The relevance of the reports was evaluated in terms of ADR seriousness, the listing for additional monitoring of the drug by European Medicines Agency (EMA), and lack of labelling information about the ADR. Nurses' opinions of the assignment were evaluated using an E-survey. Thirty-three ADRs were reported, 32 (97%) of which were well documented according to ClinDoc. Thirteen ADRs (39%) were "serious" according to CIOMS criteria. In five cases (15%), the suspect drugs were listed for additional monitoring by EMA and in seven cases (21%), the ADR was not mentioned in the Summary of Product Characteristics. Twenty-five (78.1%) of the 32 enrolled nurses completed the E-survey. Most were > 45 years of age (68%), female (92%) and had extensive clinical experience (6-33 years). All agreed or completely agreed that the reporting assignment was useful, that it fitted in daily practice and that it increased their attention for medication/patient safety. A large majority (84.0%) agreed the assignment changed how they dealt with ADRs. Specialist oncology nurses are capable of reporting ADRs, and they considered the assignment useful. The assignment yielded valuable, relevant, and well-documented ADR reports for pharmacovigilance practice.

  7. Skill mix change between general practitioners, nurse practitioners, physician assistants and nurses in primary healthcare for older people: a qualitative study.

    PubMed

    Lovink, Marleen H; van Vught, Anneke J A H; Persoon, Anke; Schoonhoven, Lisette; Koopmans, Raymond T C M; Laurant, Miranda G H

    2018-05-02

    More and more older adults desire to and are enabled to grow old in their own home, regardless of their physical and mental capabilities. This change, together with the growing number of older adults, increases the demand for general practitioners (GPs). However, care for older people lacks prestige among medical students and few medical students are interested in a career in care for older people. Innovative solutions are needed to reduce the demand for GPs, to guarantee quality of healthcare and to contain costs. A solution might be found in skill mix change by introducing nurse practitioners (NPs), physician assistants (PAs) or registered nurses (RNs). The aim of this study was to describe how skill mix change is organised in daily practice, what influences it and what the effects are of introducing NPs, PAs or RNs into primary healthcare for older people. In total, 34 care providers working in primary healthcare in the Netherlands were interviewed: GPs (n = 9), NPs (n = 10), PAs (n = 5) and RNs (n = 10). Five focus groups and 14 individual interviews were conducted. Analysis consisted of open coding, creating categories and abstraction. In most cases, healthcare for older people was only a small part of the tasks of NPs, PAs and RNs; they did not solely focus on older people. The tasks they performed and their responsibilities in healthcare for older people differed between, as well as within, professions. Although the interviewees debated the usefulness of proactive structural screening on frailty in the older population, when implemented, it was also unclear who should perform the geriatric assessment. Interviewees considered NPs, PAs and RNs an added value, and it was stated that the role of the GP changed with the introduction of NPs, PAs or RNs. The roles and responsibilities of NPs, PAs and RNs for the care of older people living at home are still not established. Nonetheless, these examples show the potential of these professionals. The

  8. Negotiating an acute care nurse practitioner position.

    PubMed

    Selph, A K

    1998-05-01

    Acute care nurse practitioners (ACNPs) entering the current job market or relocating must be able to sell their personal and professional attributes to potential employers. In many areas, health care providers may be unfamiliar with the scope of practice and competencies of an ACNP. As a result, ACNPs will be required to educate potential employers as they simultaneously negotiate for a position. A well-prepared proposal is one tool the ACNP can use to educate the health care team and to build a strong base for negotiations. Successful negotiations also depend on the attitude projected by the ACNP. An attitude that projects an unwavering belief in the value and benefits of the ACNP can enhance the negotiator's position and improve the chances for success. Creating the proposal and developing attitudes for success can be accomplished through an organized process of preparing for negotiations. The purpose of this article is to describe the attitude needed for success, the steps in preparing for negotiation, and the development of an ACNP proposal.

  9. [Nursing cares in constipation of the oncology patient].

    PubMed

    Cordero-Ponce, Montserrat; Romero-Sánchez, Isabel María

    2008-01-01

    The importance of constipation lies in its frequency, even among the healthy. The incidence of constipation in oncological patients is 70-80% in the final stage, 40-50% in advanced disease, and 90% in patients with aggressive cancer. This disorder is not only uncomfortable for the patient but also causes complications. Prolonged constipation can cause abdominal pain and even increase the pain caused by the tumor and stronger pain relief can be required when the constipation is unresolved. Among the complications that can occur are intestinal obstruction, diarrhea by spillage, urinary dysfunction, anorexia, nausea and vomiting, restlessness, malaise, and confusion. When analyzing this problem, we aim to unify criteria and nursing interventions, emphasize the importance of prevention, and solve the problem. Health education of both the patient and the main caregiver aid control of this disorder after discharge. The patient will be able to identify the appearance of constipation, its causes and symptoms and will be familiar with the treatment and when and where to go to review it.

  10. Nurse-driven protocols for febrile pediatric oncology patients.

    PubMed

    Dobrasz, Gina; Hatfield, Marianne; Jones, Laura Masak; Berdis, Jennifer Joan; Miller, Erin Elizabeth; Entrekin, Melanie Smith

    2013-05-01

    Infection is a frequent complication experienced by many children with cancer, with potentially life-threatening consequences that may result in hospitalization, prolonged length of stay, and increased mortality. The need for prompt assessment and early intervention for infection is widely recognized by ED staff as best practice; however, the average length of time to antibiotic administration varies widely in published studies. An interdisciplinary quality improvement initiative including physician, nursing, and pharmacy leaders was created to streamline the identification and treatment for this high-risk population. Based on published evidence for best practice and national recognition of the need for rapid treatment, the goal was set for administration of antibiotic therapy to less than 60 minutes after ED arrival. This project was conducted at 2 emergency departments in a pediatric health care system with 520 beds and a level I and level II trauma designation. Approximately 154,000 patients are seen annually. In the emergency departments, 271 staff members, including registered nurses, paramedics, and patient care technicians, required education about using the newly designed process. Records from all patients with fever and a known history of pediatric cancer who presented to the emergency departments were included in the retrospective review, including patients with solid tumors, acute lymphoblastic leukemia, acute myeloid leukemia, and chronic myelogenous leukemia. Exclusion criteria included patients in known remission, those with prior antibiotic therapy at another facility, congenital neutropenia, or parental concern or objection to treatment. A retrospective medical record review of febrile oncology patients treated from September 2008 until May 2012 was conducted to evaluate the impact of this evidence-based practice change to streamline the "door to drug" process. The average length of time until antibiotic administration, nurses' compliance initiating

  11. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study.

    PubMed

    Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke J A H; Schoonhoven, Lisette; Koopmans, Raymond T C M; Laurant, Miranda G H

    2017-06-08

    In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context-mechanism-outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. © Article author(s) (or their employer(s) unless otherwise stated

  12. Air Force family nurse practitioner and family physician perception of the family nurse practitioner role in military operations other than war.

    PubMed

    Houlihan, S A

    2001-09-01

    The inevitable result of changing world events and defense requirements is that the family nurse practitioner (FNP) will take on a more active role in the deployed setting, especially in military operations other than war. What is the perception of the FNP and family physician of the role of the FNP in these missions? Because of the collaborative role between these two provider groups, it is important to compare these perceptions to ensure quality collaborative care. Respondents were requested to rate their perceptions regarding the ability of the FNP to treat 65 categories of patients. Analysis revealed that there was a significant difference among the providers concerning the FNP role. Several perceived barriers were also identified. Because of this difference, the FNP may not be fully utilized. In addition, this study provides insight regarding the training needs perceived to adequately prepare FNPs for their deployment role.

  13. Exploring the evidence in pediatric hematology and oncology nursing through the "article of the month".

    PubMed

    Linder, Lauri

    2010-01-01

    As the scope of pediatric hematology and oncology nursing expands, nurses are challenged with staying current in the evidence guiding their practice. Nurse-reported barriers to accessing and utilizing research include lack of time as well as difficulty in accessing, understanding, and synthesizing findings. Journal clubs provide a process to guide nurses in the review of current literature related to their practice and promote utilization of research and evidence-based practice among nurses. This article describes the transition of an in-person journal club to an electronically delivered "Article of the Month." The "Article of the Month" is offered six times each year and is posted on the service line's password-protected intranet website. Oversight of the "Article of the Month" is provided by the service line clinical nurse specialist who selects articles based on an annual learning needs assessment and develops a quiz to assess learning and promote critical thinking among nursing staff. Outcomes include anecdotal reports of increased staff confidence in managing emergent patient care needs and greater appreciation of nursing care issues for children with cancer. Areas for future development include exploring options for increasing in-person discussion of issues addressed in the "Article of the Month" among staff members, extending the "Article of the Month" to nurses in other service areas who care for children with cancer, and increasing staff participation in article selection and quiz item development. An ultimate goal is to develop formal evaluation strategies to link this educational strategy to clinical outcomes.

  14. The costs of training a nurse practitioner in primary care: the importance of allowing for the cost of education and training when making decisions about changing the professional-mix.

    PubMed

    Curtis, Lesley; Netten, Ann

    2007-05-01

    What is already known on this topic * Cost containment through the most effective mix of staff achievable within available resources and organisational priorities is of increasing importance in most health systems. However, there is a dearth of information about the full economic implications of changing skill mix. * In the UK a major shift in the primary care workforce is likely in response to the rapidly developing role of nurse practitioners and policies aimed to encourage GP practices to transfer some of their responsibilities to other, less costly, professionals. * Previous research has developed an approach to incorporating the costs of qualifications, and thus the investment required to develop a skilled workforce, for a variety of health service professionals including GPs. What this study adds * This paper describes a methodology of costing nurse practitioners that incorporates the human capital cost implications of developing a skilled nurse practitioner workforce. With appropriate sources of data the method could be adapted for use internationally. * Including the full cost of qualifications results in nearly a 24 per cent increase in the unit cost of a Nurse Practitioner. * Allowing for all investment costs and adjusting for length of consultation, the cost of a GP consultation was nearly 60 per cent higher than that of a Nurse Practitioner.

  15. Neonatal nurse practitioner role transition: the process of reattaining expert status.

    PubMed

    Cusson, Regina M; Strange, Sally Nelson

    2008-01-01

    Neonatal nurse practitioners (NNPs) have managed care for high-risk hospitalized infants in the United States for over 30 years. The journey from being expert nurse to being novice NNP and then finally to being expert NNP is fraught with many challenges. This study used a qualitative descriptive design to describe advanced practice role transition among 70 NNPs. The data consisted of participants' written responses to open-ended questions. Four themes emerged that depicted a linear progression of the transition process from school preparation to beginning feelings in the new role and then development into a more confident practice. Theme 1: First impressions emphasized the ambivalence novice NNPs experienced regarding their preparedness for the role during a stressful and exciting adjustment period. Theme 2: The transition demonstrated the overwhelmingly similar feelings of anxiety, insecurity, exhaustion, and lack of confidence that plagued decision making. Theme 3: Making it as a real NNP indicated that the 1-year mark was a consistent, significant timeframe for feeling like a real NNP. Theme 4: The helpers and hinderers revealed the vulnerability of the novice NNPs to harsh criticism as well as the importance of support, especially from nurse colleagues. NNPs are a valuable resource; thus, enhancing transition is a worthy goal.

  16. Are nurse-led chemotherapy clinics really nurse-led? An ethnographic study.

    PubMed

    Farrell, Carole; Walshe, Catherine; Molassiotis, Alex

    2017-04-01

    The number of patients requiring ambulatory chemotherapy is increasing year on year, creating problems with capacity in outpatient clinics and chemotherapy units. Although nurse-led chemotherapy clinics have been set up to address this, there is a lack of evaluation of their effectiveness. Despite a rapid expansion in the development of nursing roles and responsibilities in oncology, there is little understanding of the operational aspects of nurses' roles in nurse-led clinics. To explore nurses' roles within nurse-led chemotherapy clinics. A focused ethnographic study of nurses' roles in nurse-led chemotherapy clinics, including semi-structured interviews with nurses. Four chemotherapy units/cancer centres in the UK PARTICIPANTS: Purposive sampling was used to select four cancer centres/units in different geographical areas within the UK operating nurse-led chemotherapy clinics. Participants were 13 nurses working within nurse-led chemotherapy clinics at the chosen locations. Non-participant observation of nurse-led chemotherapy clinics, semi-structured interviews with nurse participants, review of clinic protocols and associated documentation. 61 nurse-patient consultations were observed with 13 nurses; of these 13, interviews were conducted with 11 nurses. Despite similarities in clinical skills training and prescribing, there were great disparities between clinics run by chemotherapy nurses and those run by advanced nurse practitioners. This included the number of patients seen within each clinic, operational aspects, nurses' autonomy, scope of practice and clinical decision-making abilities. The differences highlighted four different levels of nurse-led chemotherapy clinics, based on nurses' autonomy and scope of clinical practice. However, this was heavily influenced by medical consultants. Several nurses perceived they were undertaking holistic assessments, however they were using medical models/consultation styles, indicating medicalization of nurses' roles

  17. The effectiveness of emergency nurse practitioner service in the management of patients presenting to rural hospitals with chest pain: a multisite prospective longitudinal nested cohort study.

    PubMed

    Roche, Tina E; Gardner, Glenn; Jack, Leanne

    2017-06-27

    Health reforms in service improvement have included the use of nurse practitioners. In rural emergency departments, nurse practitioners work to the full scope of their expanded role across all patient acuities including those presenting with undifferentiated chest pain. Currently, there is a paucity of evidence regarding the effectiveness of emergency nurse practitioner service in rural emergency departments. Inquiry into the safety and quality of the service, particularly regarding the management of complex conditions is a priority to ensure that this service improvement model meets health care needs of rural communities. This study used a prospective, longitudinal nested cohort study of rural emergency departments in Queensland, Australia. Sixty-one consecutive adult patients with chest pain who presented between November 2014 and February 2016 were recruited into the study cohort. A nested cohort of 41 participants with suspected or confirmed acute coronary syndrome were identified. The primary outcome was adherence to guidelines and diagnostic accuracy of electrocardiograph interpretation for the nested cohort. Secondary outcomes included service indicators of waiting times, diagnostic accuracy as measured by unplanned representation rates, satisfaction with care, quality-of-life, and functional status. Data were examined and compared for differences for participants managed by emergency nurse practitioners and those managed in the standard model of care. The median waiting time was 8.0 min (IQR 20) and length-of-stay was 100.0 min (IQR 64). Participants were 2.4 times more likely to have an unplanned representation if managed by the standard service model. The majority of participants (91.5%) were highly satisfied with the care that they received, which was maintained at 30-day follow-up measurement. In the evaluation of quality of life and functional status, summary scores for the SF-12 were comparable with previous studies. No differences were

  18. Are regulations more consumer-friendly when boards of nursing are the sole regulators of nurse practitioners?

    PubMed

    Rudner Lugo, Nancy; O'Grady, Eileen T; Hodnicki, Donna; Hanson, Charlene

    2010-01-01

    The widely varied regulations in the 50 states often limit consumer access to nurse practitioners (NPs). In 22 states, the Board of Nursing (BON) must share NP regulatory authority with another profession, usually physicians. This study examines the relationship between the BON as the sole authority regulating NPs or sharing that authority with another profession and the NP regulatory environment. Independent t tests compared the NP regulatory environments for consumer access and choice in states with sole BON regulation with those in states with involvement of another profession. The states' NP regulatory environments were quantified with an 11-measure tool assessing domains of consumer access to NPs, NP patients' access to service, and NP patients' access to prescription medications. BON-regulated states were less restrictive (P < .01, effect size 1.02) and supported NP professional autonomy. Entry into practice regulations did not differ in the two groups of states. Having another profession involved in regulation correlates with more restrictions on consumer access to NPs and more restrictions to the full deployment of NPs. Copyright 2010 Elsevier Inc. All rights reserved.

  19. Innovations and issues in the delivery of continuing education to nurse practitioners in rural and northern communities.

    PubMed

    Tilleczek, Kate; Pong, Raymond; Caty, Suzanne

    2005-03-01

    This paper addresses the need to provide rural nurse practitioners (NPs) with the distance education that is considered vital to the upgrading of their professional skills. The method of delivering the courses is a critical aspect of their success. The authors trace and describe the innovative delivery of the Rural Ontario Nurse Practitioner Continuing Education Initiative, from the initial needs assessment study through to the implementation and evaluation study. In each study, a multi-method action research model was used. The respondents showed a preference for face-to-face modalities that were perceived to be constrained by barriers. These barriers were subsequently addressed by the pilot project. Those living in rural areas recognized the benefits of information technologies. Implementation was effectively weighted on multiple modes of online course delivery and the use of constructivist pedagogy. The findings suggest that the delivery of continuing education to rural and remote NPs is still wrought with challenges.

  20. The effect of learning via module versus lecture teaching methods on the knowledge and practice of oncology nurses about safety standards with cytotoxic drugs in Shiraz University of Medical Sciences.

    PubMed

    Abbasi, Khadijeh; Hazrati, Maryam; Mohamadi, Nasrin Pourali; Rajaeefard, Abdolreza

    2013-11-01

    Several studies have established that all nurses need continuing education, especially those who are working in oncology wards. In the current programs, there are just two general patterns for teaching: Teacher-centered and student-centered patterns. In this study, the effect of teacher-centered (lecture) and student-centered (module) teaching methods in relation to safety standards with cytotoxic drugs on the knowledge and practice of oncology nurses was compared. This research was a quasi-experimental study with two intervention groups (module and lecture) and a control group. In this study, 86 nurses in Shiraz, Fars province in 2011, who participated in the prescription of cytotoxic drugs to patients were selected and randomly divided into three groups. The module group used a self-directed module, the lecture group was taught by an experienced lecturer in the classroom and the control group did not receive any intervention. Data in relation to knowledge and practice of oncology nurses in the three groups were collected before and 8 weeks after the intervention by using a questionnaire and checklist. To analyze the data paired-samples t-test and one way ANOVA analysis were used. Knowledge and practice scores increased significantly from baseline in both intervention groups, but there was no significant difference between the scores of the two groups. No considerable changes were observed in the control group. Both module and lecture methods have similar effects on improving the knowledge and practice of nurses in oncology wards. Therefore, considering the advantages of student-centered educational methods, the work load of nurses and the sensitivity of their jobs, we suggest using module.

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