Knowledge gaps in prostate cancer treatment between physicians and clinical nurse specialists

Delphi consultations, a method of gaining consensus by gathering expert opinion, were conducted in order to understand the role of degarelix as a treatment option for advanced hormone‐dependent prostate cancer. During the Delphi consultations, differences were identified between physicians and clinical nurse specialists in terms of their knowledge of therapeutic developments. We argue that disparities in knowledge between physicians and nurse specialists could limit the effectiveness of multi‐disciplinary teams in providing optimal patient care. When such situations arise, communication between patients and nurse specialists, often the patient's primary point of contact, may conflict with information they have received from the physician. This could lead to confusion and uncertainty among patients about whether they are receiving the best possible care. Time and resources should be provided to address the continuing educational needs of nurses, which will ultimately result in the improved care and experience of patients.     

影响成为临床护理专家的因素及对策

目的 :为了解在临床工作的护士对临床护理专家的了解程度 ,及影响成为CNS的因素 ,进行调查与分析。方法 :对外科临床工作的 5 2名护士采用问卷式调查 ,调查表为笔者自行设计 ,共有 10项内容 ,采用单项选择法 ,按每项的积累人次计算出百分比。结果 :影响护士成为CNS的主要原因为工作忙累、学习时间少、工作压力大等。结论 :解决护士工学矛盾 ;缓解压力 ;充分利用时间进行理论与实践的充实、不断更新知识 ,加速护理人才的培养 ,使之成为CNS。     

多专业专科护士联合义诊的实践及效果

目的 探讨多专业专科护士联合义诊的可行性及效果.方法 组织10个专业的共24名专科护士联合义诊,记录义诊工作量并发放患者问卷,了解患者的满意度、患者对专科护士的了解并对义诊效果进行评价.结果 共发放调查问卷82份,回收问卷82份,患者对义诊满意度总得分为（59.14 ±0.47）分,49名（59.76％）应诊者对专科护士完全不了解,患者通过咨询对疾病有深刻了解,得分为（9.67 ±0.94）.结论 可通过组织专科护士义诊等活动拓宽专科护士的服务范围,树立专科护士的教育者角色,并提高其影响力.     

我国临床护理专家的培养现状与分析

临床护理专家(CNS)经过近一个世纪的不断发展,目前在一些发达国家已形成比较系统、完善、成熟的制度,而我国尚处于摸索阶段,各方面机制还不完善.分析我国CNS的培养现状进行初步探讨,并就相关问题提出见解及对策.     

The impact of expanding the numbers of clinical nurse specialists in cancer care: a United Kingdom case study

In the last few years there has been an increase in the number of clinical nurse specialists (CNSs) working in cancer care throughout the UK. This paper examines the issues raised by the proliferation of site-specific cancer CNS posts, developed to give a 'nursing lead' for a particular tumour type. The issues common to all CNS posts are exacerbated when a number of specialists are involved in the cancer journey, causing potential fragmentation and confusion. Key issues need to be addressed if the role is to remain credible, and ensure clarity for patients and the multiprofessional team. These include role clarification, sensitive integration, interface with other cancer CNSs and the multiprofessional team, evaluation, cost, education and training, recruitment and succession planning and the 'career cul-de-sac'. Cancer nursing's response to these challenges will set the professional agenda for education, training and future models of service delivery.     

The specialist nursing workforce caring for men with prostate cancer in the UK

Prostate cancer is the most common cancer in men in the UK accounting for 25% of all new cases of cancer. It is predicted to become the most common cancer overall by 2030. A national survey of the specialist nursing workforce caring for men with prostate cancer was completed across the four countries of the UK during June and July 2014. In total 302 specialist nurses completed the survey and data from 285 was used in the analysis. This is the biggest whole population survey of this workforce in recent years. The most common job title was clinical nurse specialist (185) and the most common band was agenda for change band 7 (174). However in Scotland 50% of the respondents stated that they were paid on band 6. Over half the group (158) had worked in prostate cancer care for more than 10 years. Few (48) had come into specialist posts from a specific specialist nurse development role. There is wide geographic variation in the provision of specialist nursing for men with prostate cancer. This is reflected in available hours and caseload sizes. The respondents reported frozen and vacant posts across the UK. This equated to 58·3 full time equivalents. The work of specialist nurses caring for men with prostate cancer is clinically complex and appears to cover most key times in the cancer journey. However workload appears to be limiting the care that the nurses are able to provide with over half the respondents (163) saying that they left work undone for patients.     

Clinical role clarification: using the Delphi method to establish similarities and differences between nurse practitioners and clinical nurse specialists

This article is based on the Department of Health's (England) funded pluralistic evaluation of Nurse Practitioner preparation, 'Realizing Specialist & Advanced Nursing Practice: establishing the parameters of and identifying competencies for "Nurse Practitioner" roles and evaluating programmes of preparation' (RSANP). During this 27-month project, which began in 1996, one of the research methods used, the Delphi study, was aimed at reaching a consensus of views amongst nurses in clinical practice, educators, purchasers, providers and representatives of statutory and professional bodies on the parameters and competencies desirable for the Nurse Practitioner role. The agreed competencies were then used as one measure of the appropriateness of various programmes used to prepare Nurse Practitioners. Of the competencies required for the role, the majority are 'nursing' competencies and are the same as those required for the Clinical Nurse Specialist role. However, for both Clinical Nurse Specialists and Nurse Practitioners, these are practised at a 'higher level'. Other competencies needed for the Nurse Practitioner role relate to the knowledge and skills required to assess, diagnose and determine nursing and medical management of a patient and to evaluate that management. Data indicated, however, that even these competencies were being used by some Clinical Nurse Specialists. Final analysis enabled the identification of the two roles with the use of a 'Typology of Named Clinical Nursing Roles'.     

军队医院专科护士的培养与管理

目的探讨军队医院专科护士培养模式与管理方法。方法分析专科护士的发展现状,结合军队医院专科护士的特点提出其培养模式和管理方法。结果军队医院专科护士的培养和管理方法包括拓宽培训渠道,利用军队文职人员政策引进地方专科护士的培养方法和途径,以及建立管理架构、工作评价制度和个人档案,设立岗位津贴和专项奖励制度等。结论加强专科护士的使用与管理,可有效提升军队专科护士的质量,发挥专科护士作用,进一步提高军队医院护理队伍的人才建设。     

The Fife hormone service for prostate cancer patients: a cost‐effective and patient‐centric model

Injectable hormone therapy is a key element of treatment for many patients with prostate cancer. In the UK, it is typically administered in primary care. In 2003, National Health Service (NHS) Fife rolled out an innovative service for these patients, in which responsibility was moved from primary care to a specialist nurse‐led service in secondary care. The initial rationale was based on cost savings, but a significant number of other advantages have subsequently been demonstrated. These include a simpler patient journey, improved continuity of care and reduced use of consultant time. Standards of care have also improved, with fewer missed appointments, better provision of patient support and rapid access to specialist physician care when needed. An audit of 377 of 542 patients currently treated within the service has provided supportive evidence for many of these advantages. The Fife service offers a cost‐effective model for locally provided nurse‐led care that could be applied to hormone therapy services for prostate cancer elsewhere in the UK, and to services for other cancers with large numbers of patients requiring long‐term management.     

专科护士在护理专业中的角色和地位

对“专科护士”(CNS)的概念和执业标准 ,CNS的工作内容、角色作用和在实践中遇到的问题 ,以及CNS在护理专业发展中的意义作了简要的介绍和分析。CNS是在护理专业化进程中产生的 ,是高级临床护理工作者。在一些国家的卫生保健系统中 ,CNS活跃在各种护理服务场所 ,可有其专门的工作岗位和相应的岗位职责 ,为服务对象提供常规的医疗护理工作未能提供或未能系统地提供的专门化护理服务。多年来 ,CNS所做的工作体现了护理工作在卫生保健事业中的独特作用和价值 ,丰富了护理学知识体系 ,对护理学科的发展做出了贡献。我国CNS的培养和使用尚处于起步阶段 ,其发展是符合卫生保健事业的需求的 ,也给临床护士在专业上的发展展示了一个全新的领域     

临床护理专家对高职护理教育的看法与建议

目的调查临床护理专家对高职护理教育的看法和建议,为构建基于岗位胜任力的高职护理课程体系提供依据。方法应用行为事件访谈法,对浙江省8所三级甲等医院的15名临床护理专家进行访谈。结果专家认为毕业1⁵年的低年资护士存在工作责任心不强、主动学习意识欠缺、专科护理知识缺乏等问题。与本科生相比,高职护理毕业生的优点是操作技能强、培养成本低,但理论知识不强、可持续发展能力不足。临床护理专家从师资队伍建设、教学内容、教学方法和考核方法等方面对护理教育提出了建议。结论临床护理专家对护理教育的意见和建议不仅为高职护理专业课程体系设置提供了依据,对护理教育教学改革也具有借鉴意义。     

临床护理专家的发展及现状

临床护理专家是指在某专科或专病具有较高水平的护理人才，其主要角色功能包括临床实践、护理研究、护理教学、护理会诊以及护理管理五大基本职能和社会心理治疗以及高级医疗、护理技能等方面的特殊职能。为了适应患者、患者家属、医疗机构及社区需求的复杂性和变化性，临床护理专家与护理开业者的角色进行合并是未来发展的必然趋势。本文综述了临床护理专家的发展现状，包括含义、分类、职能、管理、教育以及认证等，并对其发展趋势进行展望。     

我国临床护理专家的培养现状与分析

临床护理专家(CNS)经过近一个世纪的不断发展,目前在一些发达国家已形成比较系统、完善、成熟的制度,而我国尚处于摸索阶段,各方面机制还不完善.分析我国CNS的培养现状进行初步探讨,并就相关问题提出见解及对策.     

我国临床护理专家的培养现状与分析

临床护理专家(CNS)经过近一个世纪的不断发展,目前在一些发达国家已形成比较系统、完善、成熟的制度,而我国尚处于摸索阶段,各方面机制还不完善.分析我国CNS的培养现状进行初步探讨,并就相关问题提出见解及对策.     

The evolving role of the clinical nurse specialist within the comprehensive breast cancer centre

• ? The collaborative functioning of a specialist multidisciplinary team is a fundamental prerequisite in the establishment of designated breast cancer units throughout the UK. It is, therefore, opportune for clinical nurse specialists to examine carefully their unique contribution to the care of women with breast disease.
• ? This article explores the contemporary developments in service provision and identifies potential areas for nursing development.
• ? It is only when the role of the breast care nurse is explicitly defined can research begin to determine the effectiveness of nursing practice in terms of women's health.