-
Nursing Management Sep 2019This article provides an overview of artificial intelligence (AI), including how AI algorithms and robots are altering the nurse's role and the challenges facing the... (Review)
Review
This article provides an overview of artificial intelligence (AI), including how AI algorithms and robots are altering the nurse's role and the challenges facing the nursing profession as AI is integrated into healthcare delivery.
Topics: Artificial Intelligence; Humans; Nursing
PubMed: 31425440
DOI: 10.1097/01.NUMA.0000578988.56622.21 -
Revista Brasileira de Enfermagem 2020To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. (Review)
Review
OBJECTIVE
To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing.
METHOD
Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles.
RESULTS
All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews.
FINAL CONSIDERATIONS
The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.
Topics: Humans; Nursing; Nursing Theory; Translational Research, Biomedical
PubMed: 32049218
DOI: 10.1590/0034-7167-2017-0893 -
Seminars in Oncology Nursing Aug 2018To examine nurse communication in cancer care and offer communication strategies for quality palliative care nursing. (Review)
Review
OBJECTIVES
To examine nurse communication in cancer care and offer communication strategies for quality palliative care nursing.
DATA SOURCES
Communication strategies offered are based on the COMFORT Communication curriculum, an evidence-based communication training program.
CONCLUSION
Whole-patient assessment, a major component of palliative care, involves communication that includes eliciting the patient's story, addressing health literacy needs, being mindful of burnout, and relating to the patient and family.
IMPLICATIONS FOR NURSING PRACTICE
Quality communication skills are essential to oncology nursing, especially given their vital role in cancer care.
Topics: Communication; Comprehensive Health Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Nurse's Role; Nurse-Patient Relations; Oncology Nursing; Palliative Care; Quality of Health Care
PubMed: 30100368
DOI: 10.1016/j.soncn.2018.06.007 -
Journal of Medical Internet Research Apr 2017Information and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Information and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their practice, modifying the ways in which they plan, provide, document, and review clinical care.
OBJECTIVE
An overview of systematic reviews was conducted to develop a broad picture of the dimensions and indicators of nursing care that have the potential to be influenced by the use of ICTs.
METHODS
Quantitative, mixed-method, and qualitative reviews that aimed to evaluate the influence of four eHealth domains (eg, management, computerized decision support systems [CDSSs], communication, and information systems) on nursing care were included. We used the nursing care performance framework (NCPF) as an extraction grid and analytical tool. This model illustrates how the interplay between nursing resources and the nursing services can produce changes in patient conditions. The primary outcomes included nurses' practice environment, nursing processes, professional satisfaction, and nursing-sensitive outcomes. The secondary outcomes included satisfaction or dissatisfaction with ICTs according to nurses' and patients' perspectives. Reviews published in English, French, or Spanish from January 1, 1995 to January 15, 2015, were considered.
RESULTS
A total of 5515 titles or abstracts were assessed for eligibility and full-text papers of 72 articles were retrieved for detailed evaluation. It was found that 22 reviews published between 2002 and 2015 met the eligibility criteria. Many nursing care themes (ie, indicators) were influenced by the use of ICTs, including time management; time spent on patient care; documentation time; information quality and access; quality of documentation; knowledge updating and utilization; nurse autonomy; intra and interprofessional collaboration; nurses' competencies and skills; nurse-patient relationship; assessment, care planning, and evaluation; teaching of patients and families; communication and care coordination; perspectives of the quality of care provided; nurses and patients satisfaction or dissatisfaction with ICTs; patient comfort and quality of life related to care; empowerment; and functional status.
CONCLUSIONS
The findings led to the identification of 19 indicators related to nursing care that are impacted by the use of ICTs. To the best of our knowledge, this was the first attempt to apply NCPF in the ICTs' context. This broad representation could be kept in mind when it will be the time to plan and to implement emerging ICTs in health care settings.
TRIAL REGISTRATION
PROSPERO International Prospective Register of Systematic Reviews: CRD42014014762; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014014762 (Archived by WebCite at http://www.webcitation.org/6pIhMLBZh).
Topics: Decision Support Systems, Clinical; Humans; Nursing; Patient Care Planning; Quality of Health Care; Quality of Life; Review Literature as Topic; Telemedicine
PubMed: 28442454
DOI: 10.2196/jmir.6686 -
Seminars in Oncology Nursing Aug 2018To highlight the importance, challenges, and evolution of advance care planning for patients with cancer. (Review)
Review
OBJECTIVE
To highlight the importance, challenges, and evolution of advance care planning for patients with cancer.
DATA SOURCES
Peer-reviewed journal articles and clinical guidelines.
CONCLUSION
Advance care planning is fundamental to support the personhood of patients with advanced cancer. Patients must be encouraged by physicians and nurses to articulate what matters and provides meaning to them as they live, cope, and receive treatment for their cancer.
IMPLICATIONS FOR NURSING PRACTICE
Nurses can facilitate advance care planning and primary palliative care, to support patients and families to make informed and value-concordant decisions regarding cancer and end-of-life treatments.
Topics: Advance Care Planning; Comprehensive Health Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Nurse-Patient Relations; Oncology Nursing; Pain Management; Palliative Care; Quality of Health Care
PubMed: 30100366
DOI: 10.1016/j.soncn.2018.06.012 -
Journal of Clinical Nursing Apr 2020Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for... (Review)
Review
BACKGROUND
Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for hospitals. Consideration of the current thinking around pressure injury risk must be evaluated to improve risk assessments and subsequent nursing interventions aimed at reducing hospital-acquired pressure injuries.
DESIGN
This is a discursive paper using Walker and Avant's (2005) theory synthesis framework to examine the relevance of existing pressure injury models as they align with the current literature.
METHODS
PubMed and CINAHL indexes were searched, first for conceptual models and then for pressure injury research conducted on hospitalised patients for the years 2006-2016. A synthesis of the searches culminated into a new pressure injury risk model.
CONCLUSIONS
Gaps in previous models include lack of attention to the environment, contributing episode-of-care factors and the dynamic nature of injury risk for patients. Through theory synthesis, the need for a new model representing the full risk for pressure injury was identified. The Pressure Injury Predictive Model is a representation of the complex and dynamic nature of pressure injury risk that builds on previous models and addresses new patient, contextual and episode-of-care process influences. The Pressure Injury Predictive Model (PIPM) provides a more accurate picture of the complexity of contextual and process factors associated with pressure injury development.
RELEVANCE TO CLINICAL PRACTICE
Using the PIPM to determine risk can result in improved risk identification. This information can be used to implement targeted, evidence-based pressure injury prevention interventions specific to the patient risk profile, thus limiting unwarranted and unnecessary care.
Topics: Evidence-Based Nursing; Hospitalization; Humans; Nursing Theory; Pressure Ulcer; Risk Assessment
PubMed: 31889342
DOI: 10.1111/jocn.15171 -
Revista Brasileira de Enfermagem 2020to describe a theoretical model of nursing care for children with obesity in Primary Health Care.
OBJECTIVES
to describe a theoretical model of nursing care for children with obesity in Primary Health Care.
METHODS
Grounded Theory and the theoretical/philosophical framework of Virginia Henderson were used. The research was conducted in Family Basic Health Units and in Specialized Services in the city of Campina Grande, Paraíba, Brazil. A total of 24 participants composed four sample groups. Data were collected through semi-structured interviews, between April and October 2015, and analyzed by the constant comparison method. The analysis occurred by initial coding, construction of diagrams and memos, axial coding, selective coding and reflection on the paradigm and on the emerging theory.
RESULTS
six categories emerged from the data. Nurses worrying about the care of children with obesity as a neglected area in Primary Health Care was the theoretical model.
FINAL CONSIDERATIONS
the phenomenon is related to the individuality of nursing care and the need for shared responsibilities.
Topics: Adult; Brazil; Female; Grounded Theory; Humans; Interviews as Topic; Male; Middle Aged; Nursing Care; Nursing Theory; Pediatric Nursing; Pediatric Obesity; Qualitative Research
PubMed: 32578728
DOI: 10.1590/0034-7167-2018-0881 -
Nurse Education in Practice Jul 2021Management of critically ill patients is changing due a rise in population age, comorbidity and complexity. To accommodate these changes, the demand is increasing for... (Review)
Review
OBJECTIVES
Management of critically ill patients is changing due a rise in population age, comorbidity and complexity. To accommodate these changes, the demand is increasing for advanced practice nurses. More knowledge is needed regarding the role of advanced practice critical care nurses in European countries. The aim of the study was to review the literature describing skills and competencies required for advanced practice critical care nursing in Europe and to investigate related policy.
REVIEW METHOD
We performed a scoping review including papers published in 1992-2019 targeting policy and the intersection of advanced practice nursing (level of practice), critical care nursing (specialty area) and Europe (geographical origin).
DESIGN AND DATA SOURCES
Main sources of evidence were PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Library, SweMed+, Scopus, ERIC and Social Sciences Citation Index. We also searched grey literature, webpages, reference lists and performed hand-search.
RESULTS
The search identified 11,478 papers/references of which 42 were included. Four levels of practice were identified with unclear boundaries: professional nurse, specialized nurse, advanced practice nurse and advanced critical care practitioner (nurse or other). Most skills and competencies described in the literature were generic to advanced practice and only few were area specific to critical care. Advanced practice critical care nurses were often unable to fulfil their role because education, supportive policy and legislation were lacking.
CONCLUSIONS
This scoping review informs the policy makers and the INACTIC study of existing advanced practice in critical care nursing in Europe. The advanced role in critical care nursing is characterized by inconsistency regarding policy, education, titles, roles, scope of practice, skills and competencies. Levels of practice and areas of specialization need to be clarified. Most skills and competencies identified were generic for advanced practice nursing and many were generic for any profession. Task-shifting from physician to nurse needs to be more clearly defined and patient outcomes described. Given the scarcity of papers in our target area, we believe it might be too early to conduct a systematic review at this time.
Topics: Advanced Practice Nursing; Critical Care; Critical Care Nursing; Europe; Humans; Policy
PubMed: 34265667
DOI: 10.1016/j.nepr.2021.103142 -
Journal of Nursing Scholarship : An... Mar 2016To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the...
PURPOSE
To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country.
APPROACH
A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined.
FINDINGS
A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified.
CONCLUSIONS
A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations.
CLINICAL RELEVANCE
The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes.
Topics: Advanced Practice Nursing; Evidence-Based Nursing; Humans; Nurse's Role; Nursing Evaluation Research; Switzerland
PubMed: 26869323
DOI: 10.1111/jnu.12199 -
Nurse Education in Practice Jan 2022To provide an overview of assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement and to identify... (Review)
Review
AIM
To provide an overview of assessment methods and tools to evaluate postgraduate critical care nursing students' competence in clinical placement and to identify recommendations for future assessment methods.
BACKGROUND
The purpose of postgraduate critical care nursing education is to educate professional, competent and caring critical care nurses and high-quality assessment strategies in clinical placement are of most importance.
DESIGN
An integrative review following Whittemore and Knafl's framework and Prisma 2020 guidelines for systematic reviews.
METHODS
Systematic searches were performed in June 2020 with an update in April 2021 using the following: Academic Search Premier, British Nursing Index, CINAHL, MEDLINE, SveMed+, Web of Science and the Joanna Briggs Institute databases. The systematic literature search and hand search yielded 380 studies. After screening and checking for eligibility, fifteen studies published between 2005 and 2020 were included in this review. The included studies were critically appraised using the Mixed Methods Appraisal Tool for empirical studies and the Joanna Briggs Institute Critical Appraisal tool for literature reviews.
RESULTS
Four qualitative, six quantitative, three mixed-methods and two literature review studies were included in this review. We identified that competence in postgraduate critical care nursing is a multidimensional concept and it is recommended to use a combination of assessment methods like self-assessment, observation and mentor evaluation. It is necessary to have discussions and reflections between the student, preceptor and lecturer, as well as written self- and mentor evaluation to provide formative and summative feedback to the students. The need to provide consistency and objectivity resulted in the development of competency assessment tools and they were mostly developed and validated as a collaboration between clinical sites and educational institutions. Most of the assessment tools consisted of domains reflecting holistic nursing, including both technical and non-technical skills. Domains reflecting evidence-based nursing practice were less common.
CONCLUSIONS
We need valid and reliable instruments to assess postgraduate critical care nursing student's competence in placement. Innovation and further research regarding effective and accessible assessment methods, such as digital assessment tools, are needed to meet future needs. This may also stimulate collaboration to improve the international inconsistency in critical care nursing educations. We should be working towards common, international educational competence descriptions and assessment tools that are in line with the ever-changing critical care environment, including holistic nursing and continuous learning.
Topics: Clinical Competence; Critical Care Nursing; Evidence-Based Nursing; Humans; Mentors; Students; Students, Nursing; Systematic Reviews as Topic
PubMed: 34847502
DOI: 10.1016/j.nepr.2021.103258