Credentialling Australian critical care nurses: the pilot study.

In October 1998, the Australian College of Critical Care Nurses (ACCCN) launched a model to credential specialist level critical care nurses. This model was 'road tested' during a pilot study, when experienced critical care nurses were invited to apply to become the first Australian credentialled critical care nurses. The pilot study was designed to ensure all individuals taking part in the process were surveyed regarding adequacy of the credentialling package and the credentialling process. Applicants were required to provide evidence of practise at the specialist level, as described in the Competency Standards for Specialist Level Critical Care Nurses. Evidence was presented via curriculum vitae, professional journal and supported by three peer reviewers and two referees. Each application was sent to a three-person assessor panel, which assessed the evidence in the application against the Competency Standards for Specialist Level Critical Care Nurses. A total of six applications from five states and one territory were received by April 1999. Five of the applicants were assessed to have met the Competency Standards and were awarded the credential, Australia Credentialled Critical Care Nurse (ACCN), which they will hold for a period of 3 years. Feedback from assessors, applicants, peer reviewers and referees involved in the pilot study has resulted in the further refinement of the credentialling package and processes. Australian critical care nurses will now have the opportunity to seek to be credentialled four times per year.     

Is heart failure nursing practice at the level of a clinical nurse specialist or advanced nurse practitioner? The Irish experience.

Since 2000 there has been a significant increase of Heart Failure Nursing positions in the Irish health service. The background to these positions has been based on the model established at St. Vincent's University Hospital, Dublin since 1998. Recognition of nursing practice in Ireland has also transformed with the introduction of Clinical Nurse Specialist and Advance Nurse Practitioner positions. To date Clinical Nurse Specialists coordinate and manage heart failure programmes, however it remains to be seen whether current practices are within the scope of practice of these nurses. Advanced Nurse Practitioner is a new position in Irish Nursing from examining guidelines and education this may be the way forward for Heart Failure Nursing in Ireland.     

The emerging role of the breast care nurse in Australia

It is well documented that educated breast care nurses can provide essential support and information to empower a woman with breast cancer to participate in treatment decisions and take more control over her health and life. An evaluation of Breast Cancer Support Services, a dynamic unit within the Anti-Cancer Council of Victoria, Australia, conducted in 1994, recommended that breast cancer support service nurses should increase their knowledge of breast cancer treatment and management throughout the whole continuum from diagnosis to death. Greater knowledge would enhance the nurse's role as a vital member of a multidisciplinary team and a resource to women experiencing breast cancer at any stage in their journey. Acting on these recommendations, the Anti-Cancer Council of Victoria, in conjunction with La Trobe University, designed and developed the first national, tertiary-level training program for breast care nurses. The Breast Cancer Distance Education program, which has graduates from all states in Australia, has been accredited by the Royal College of Nursing and positively evaluated by the Centre for Behavioural Research in Cancer. The evaluation found that students rated the course highly, and many planned to change their nursing practice as a result of taking the course. Accredited breast care nurses are taught to use accurate and up-to-date information in combination with advanced communication skills. They do not hesitate to confer with other members of the multidisciplinary team to ensure that women with breast cancer receive the individualized support and continuity of care they deserve.     

Nursing informatics and undergraduate nursing curricula: A scoping review protocol

AimThis scoping review aims to review contemporary published literature on Nursing Informatics education in undergraduate nursing education.IntroductionNursing is the largest workforce in health care and nurses are increasingly required to work with digital information systems. The need for nurses to understand and embrace information technology is closely linked with the ability to function in the contemporary healthcare workplace. However, despite the early adoption of Nursing Informatics in Australia in the 1980 s, there remain barriers to Nursing Informatics engagement and proficiency, including poor computer literacy, limited professional development and a lack of undergraduate informatics education.DesignThis scoping review will be developed in adherence with the JBI Manual for Evidence Synthesis: Scoping Reviews and the PRISMA-ScR Checklist.MethodsTo be included in this scoping review, papers need to include Nursing Informatics education for undergraduate nursing students in a Bachelor of Nursing program. Undergraduate nursing students are defined as individuals enrolled in a recognised nursing program leading to registration as a Nurse. To meet the requirements for registration as a Registered Nurse, in Australia, individuals are required to complete a Bachelor of Nursing program at a university (Australian Qualifications Framework Level 7) For the purpose of this scoping review, undergraduate nursing students are defined as those individuals undertaking a three year Bachelor of Nursing program at a university. Equivalent international definitions will be also used in the scoping review procedure. Sources of information will be included if they were published between 2015 and 2022 and describe curriculum recommendations (including barriers to implementing Nursing Informatics education). The purpose of the identified timespan is to reflect the rapidly evolving nature of health informatics and digital technologies. The requirement for curriculum recommendations is to reflect the purpose of the scoping review as the basis for a Delphi study, where Nursing Informatics and its integration into Bachelor of Nursing curricula will be explored and described in collaboration with domain experts.Ethics and disseminationEthics approval has been obtained for this scoping review (Project ID: 2156) from the Flinders University’s Human Research Ethics Committee and has been determined to be low risk.     

Nurse Practitioner preparation: is it time to move beyond masters level entry in Australia?

Nurse Practitioner education in Australia currently requires a post graduate qualification at masters level for endorsement by national registration bodies and entry into practice. This paper reviews the evidence and debate in America that saw the education of Nurse Practitioners advance to the doctoral level in 2004. Consideration will then be given to the similarities between the American and Australian context, in order to open the debate about whether it is timely for Australian universities to consider the need to advance Australia Nurse Practitioner education to the Doctor of Nursing Practice.     

The first Australian nurse practitioner census: A protocol to guide standardized collection of information about an emergent professional group

Middleton S, Gardner G, Gardner A, Della P, Gibb M, Millar L. International Journal of Nursing Practice 2010; 16 : 517–524
The first Australian nurse practitioner census: A protocol to guide standardized collection of information about an emergent professional group Internationally, collection of reliable data on new and evolving health‐care roles is crucial. We describe a protocol for design and administration of a national census of an emergent health‐care role, namely nurse practitioners in Australia using databases held by regulatory authorities. A questionnaire was developed to obtain data on the role and scope of practice of Australian nurse practitioners. Our tool comprised five sections and included a total of 56 questions, using 28existing items from the National Nursing and Midwifery Labour Force Census and nine items recommended in the Nurse Practitioner Workforce Planning Minimum Data Set. Australian Nurse Registering Authorities (n = 6) distributed the survey on our behalf. This paper outlines our instrument and methods. The survey was administered to 238 authorized Australian nurse practitioners (85% response rate). Rigorous collection of standardized items will ensure health policy is informed by reliable and valid data. We will re‐administer the survey 2 years following the first survey to measure change over time.     

Developing case managers for chronically ill children: Florida's registered nurse specialist program

This article describes the Florida Health and Rehabilitative Services/Children's Medical Services Nurse Specialist Program. This program is a statewide training and service delivery system designed to prepare selected nurses to provide comprehensive, family-centered case management services to children with special health care needs, within the home and community settings.     

Sexual assault nurse examiner and sexual assault response team (SANE/SART) program

Guided by the Center for Advanced Nursing Practice Evidence-Based Practice Model, under the leadership of a Clinical Nurse Specialist for Women's Health, in response to focused community needs assessment, a SANE/SART program was developed, implemented, and evaluated. The SANE/SART program brings quality improvement across the entire women's health program. Currently, the program scope is expanding to include the pediatric population and is extending into rural communities throughout the state. The model will continue to be the catalyst for future program initiatives and advancing best practice.     

Integrating gerontology competencies into graduate nursing programs.

Current demographic and health care utilization trends strongly indicate a rapidly increasing demand for nurses who are well qualified to care for older adults. Advanced practice nurses are positioned to assume leadership roles in geriatric nursing care; however, they must first acquire adequate preparatory education. This article describes two graduate nursing schools' curricular innovations that were funded by The John A. Hartford Foundation, in collaboration with the American Association of Colleges of Nursing (AACN), through the Geriatric Nursing Education Project: Enhancing Gerontological/Geriatric Nursing for Advanced Practice Nursing. These programs at University of North Carolina at Greensboro and Pennsylvania State University incorporated techniques to translate the Nurse Practitioner and Clinical Nurse Specialist Competencies for Older Adult Care [American Association of Colleges of Nursing. (2004). Nurse practitioner and clinical nurse specialist competencies for older adult care. Washington, DC: AACN] into an advanced practice curriculum and developed strategies to sustain curricular innovations. Finally, lessons learned from these two projects are discussed and recommendations are made for integrating geriatric nursing competencies into graduate programs.     

Experiences of internationally qualified registered nurses enrolled in a bridging program in Australia: A pilot study

BackgroundThe recruitment of internationally qualified registered nurses (IQNs) is one strategy to meet Australia’s healthcare needs. New Australian Standards require some IQNs to complete an approved bridging program run by an eligible higher education institution in Australia. Little is known about the experiences of the IQNs enrolled in these bridging programs or their intention to remain in the workforce.AimThe aim of this pilot study was to investigate the experiences of IQNs enrolled in an approved bridging program and explore their intention to remain and seek employment in the Australian healthcare system.MethodsStudents enrolled in the Graduate Certificate in Australian Nursing program for internationally qualified registered nurses at a regional Australian university were invited to participate. A longitudinal, mixed-methods, exploratory design was used. Participants completed the Six-dimension Scale of Nursing Performance (Schwirian, 1978) and the Casey-Fink Graduate Nurse Experience Survey (Casey et al., 2004) pre, and post-program, and also participated in post-program focus groups.FindingsThe program met participant expectations, provided confidence in clinical practice and perceived competence, particularly in the leadership domain. However, the cultural differences and expectations in nursing and academia experienced by participants require further investigation and intervention. Over time, the participants experienced stress related to social and financial issues, with the greatest concern around gaining employment. All participants indicated their intention to remain and seek employment in the Australian healthcare system.DiscussionIQNs enrolled in approved bridging programs intend to remain in the workforce. Consideration of how to support IQNs experiencing social and financial stress, and achieve successful employment post program is warranted.ConclusionA transition to professional practice program may support the integration of IQNs into the Australian healthcare workforce.     

Advancing nursing practice for orthopaedic outpatients

Nursing roles in the UK have changed considerably over the last several years. More Nurse Specialists have been appointed and roles developed. Patients are likely to be seen by a Nurse Specialist at some point during their episode of care. This paper describes how one such role was developed, implemented and evaluated for post-operative patients attending orthopaedic outpatients.The process is mapped out to show how a guideline was developed and competency achieved. The benefits of the service are listed. This service has now expanded to incorporate different patient groups and other consultants with greater autonomy for the Nurse Specialist regarding referrals to other PAM’s (professions allied to medicine).     

A competency-based approach to public health nursing performance appraisal

OBJECTIVES: To integrate public health nursing (PHN) competencies into a comprehensive performance review instrument for nurses at multiple practice levels in an urban public health department. DESIGN: Based on thorough review of PHN competency literature, the tool evaluates performance for 5 nursing practice classifications (Staff RN, Public Health Nurse, Nurse Practitioner, Clinical Nurse Specialist, Nursing Supervisor) in eight PHN domains (assessment, policy development/program planning, evaluation, communication, cultural competency, partnership/collaboration, disease prevention/health promotion, leadership/systems thinking). SAMPLE: Tool was piloted with over 50 nurses from PHN workforce (n>400) of Public Health-Seattle & King County (Washington). METHOD: Pilot testing includes all components of the performance appraisal system: Public Health Competency Grid, statement of general workplace expectations, Nursing Performance Appraisal Tool, and supporting documents defining performance elements by job classification. RESULTS: Supervisors find the tool easy to use and report that it provides opportunity for real communication between employee and supervisor. Nurses at all practice levels report that it effectively describes/evaluates their practice. CONCLUSIONS: This tool is an efficient performance appraisal instrument providing meaningful feedback to nursing employees within a framework of PHN competencies. Adopting such tools in PHN practice can help nurses to better understand their role in population-based public health efforts.     

Qualitative insights into the role and practice of Epilepsy Specialist Nurses in England: a focus group study

hopkins j. & Irvine F. (2012)?Qualitative insights into the role and practice of Epilepsy Specialist Nurses in England: a focus group study. Journal of Advanced Nursing68(11), 2443-2453. doi: 10.1111/j.1365-2648.2012.05941.x ABSTRACT: Aim. This article is a report of a study that aimed to explore Epilepsy Specialist Nurses' perceptions of their professional role and the factors that may affect their practice. Background. Previous studies have demonstrated high patient satisfaction with the Epilepsy Specialist Nurse. Although UK national guidelines recommend that all individuals with epilepsy should have access to an epilepsy specialist nurse, many National Health Service trusts disregard these guidelines. The need to introduce cost efficiencies in the National Health Service means that the future of some epilepsy specialist nurses is threatened. Design. A qualitative study using focus groups was designed to elicit a rich understanding of the epilepsy specialist nurse role and its current challenges. Methods. Three focus groups were held with a total of 19 participants in the summer of 2009. Data were subjected to thematic framework analysis. Findings. The work was underpinned by high commitment to nursing values, which helped to define the role. Epilepsy specialist nurses were often the sole providers of expert and personalized care to meet patients' complex needs. Policy and financially driven changes undermined professional identity and led to service diminution. Conclusion. The provision of epilepsy care in England remains variable and access to epilepsy specialist nurses is inequitable. Trusts are being seduced by the cost savings of reducing a specialist service but consequent gaps in service may drive up costs elsewhere. The challenge is for epilepsy specialist nurses to demonstrate their unique place in enhancing patient care and in improving health and well-being.     

Development and validation of clinical indicators for mental health nursing practice

A national study was undertaken in Australia to develop and validate a set of clinical indicators for mental health nursing. Using survey and action research procedures, the indicators were developed in two stages. During stage one, focus group interviews involving 39 nurses were conducted at national conferences in Australia and New Zealand in order to provide a pool of indicator statements. A Delphi survey of an Australian sample of mental health nurses (n = 33) was then conducted to refine the indicators. In stage two, the refined indicators were tested and validated in selected clinical settings. A total of 1751 mental health nurses employed at 14 sites were involved in the second stage of the study. The resulting data were used to establish the set of national indicators that the Australian and New Zealand College of Mental Health Nurses will use in practice accreditation and benchmarking.     

A perioperative nurse liaison program: CNS interventions for cancer patients and their families

Cancer surgery causes stress and anxiety for families and patients. Knowing that communication between family and health care professionals is traditionally fragmented during the perioperative period, Memorial Sloan-Kettering Cancer Center developed a family-centered program to improve information exchange. This article describes the Perioperative Clinical Nurse Specialist program and the process by which ongoing communication of clinical information and psychosocial support for waiting relatives occurs. Good communication during the preoperative, intraoperative, and postoperative period is characteristic of quality care at a critical time. The subject program serves to bridge the gap in the continuum of perioperative care.     

Contemporary enrolled nursing practice: opportunities and issues

Over the last decade, Australia, as with the rest of the developed world, has experienced a widespread labour market decline in the numbers of nurses in the health workforce. Concurrent with this nursing shortage, the second level nurse has, in many countries, ceased to be recognised as a legitimate nursing role. In Australia, recent research indicates that the enrolled nurse role, though contentious, is consolidating as a core component of the health care workforce. This paper reports on national research that examined the role and function of the enrolled nurse in Australia and reviewed the Australian Nursing Council Inc (ANCI) National Competency Standards for Enrolled Nurses. Specific issues related to the contemporary role and function of enrolled nurses, namely supervision, scope of practice and education, are also discussed.     

Mentoring nursing career pathways: the Maryvale High School Student Nurse Academy.

The health care system faces a critical challenge in recruiting younger and more ethnically diverse students into the nursing profession. The innovative Maryvale High School Student Nurse Academy was developed as a collaborative partnership among the public school system, the community college system, public and private universities, and the hospital industry, with guidance from Arizona Nursing Associations and Sigma Theta Tau. The program provides at-risk, minority teens exposure to the health system, professional nurses in a variety of roles, and employment opportunities that can expand in a number of directions within the health industry. Results of the first year pilot are encouraging, resulting in a 100% completion of the program with high student satisfaction ratings. Students demonstrated an increase in overall grade point average and a decrease in school absence rates.     

A Vanguard Approach to the Design and Delivery of Nurse-Led Survivorship Care

ObjectivesSurvivorship care is an essential component of quality cancer care. Although nurses are uniquely positioned to deliver effective and efficient nurse-led survivorship care, they report that their experiences of survivorship care provision are fragmented, under-resourced, and often distressing for the patient.Data SourcesHere we report the culmination of a 4-year program of research and more than a decade of nurse-led work, to improve the survivorship care experience for men with prostate cancer comprising of: (1) the evolution of a national specialist prostate cancer nursing service; (2) a nursing Delphi study to determine prostate cancer survivorship care experiences and priorities; (3) the development of the Prostate Cancer Survivorship Essentials Framework, which provides a road map for improving quality prostate cancer survivorship care across a variety of settings; and (4) the translation of the framework into nursing practice through the development of My Personal Plan, a person-centered, evidence-informed survivorship care plan.ConclusionThrough the leadership of a national prostate cancer specialist nursing service, the provision of a coordinated, evidence-informed person-centered survivorship care service is now achievable. This program of work has demonstrated that irrespective of the setting or mode of delivery, specialist nurses involved in the care of men with prostate cancer and their families are leading best practice through the translation of evidence into everyday clinical practice.Implications for Nursing PracticeThere is an urgent need to address the significant challenges that a prostate cancer diagnosis can bring, and nurses are at the forefront and lead survivorship care delivery, which includes: (1) routine distress screening and referral to tailored evidence-based psychological care; (2) the provision of person-centered care that connects to effective symptom management; (3) self-management support; and (4) signposting to additional services which extend beyond the acute care setting.