Stakeholder Engagement in Nursing Curriculum Development and Renewal Initiatives: A Review of the Literature

Stakeholder engagement remains a critical endeavour in nursing curriculum development and renewal. Engaging stakeholders such as patients and families, students, and frontline clinicians in the development process is necessary to ensure that curricula meet the current needs of patients and are responsive to a changing healthcare environment. To inform strategies for effective stakeholder engagement a literature review was conducted to identify: 1) common roles and functions of stakeholders across nursing curricular projects, and 2) factors that promote positive stakeholder engagement in nursing curriculum development or renewal. Twelve papers were included in this review. Texts were analyzed using qualitative thematic analysis. Common roles and functions were classified according to formalized leadership roles or on an informal, as needed basis, with varying levels of engagement. Four themes emerged pertaining to factors that promote positive stakeholder engagement: positive leadership, empowerment, sense of ownership, and a culture of equality. Optimizing stakeholder contributions to nursing curricular projects can be fostered by an understanding of strategies to positively engage these partners and identifying productive and meaningful stakeholder roles. Résumé La mobilisation des parties prenantes demeure une étape cruciale du processus d’élaboration et de renouvellement des programmes d’études en sciences infirmières. Il est nécessaire de mobiliser les parties prenantes, comme les patients et les familles, les étudiantes et les cliniciennes de première ligne pour veiller à ce que les programmes d’études respectent les besoins actuels des patients et tiennent compte de l’environnement changeant des soins de santé. Pour orienter les stratégies en matière de mobilisation des parties prenantes, nous avons réalisé une recension des écrits afin d’identifier : 1) les fonctions et les rôles courants des parties prenantes dans l’ensemble des projets de programmes d’études en sciences infirmières, et 2) les facteurs qui favorisent une mobilisation positive des parties prenantes dans le processus d’élaboration ou de renouvellement des programmes d’études en sciences infirmières. Douze articles ont fait l’objet d’une analyse thématique qualitative dans le cadre de cette étude. Les fonctions et les rôles courants ont été classés selon qu’ils soient officiels et décisionnels ou de façon informelle, selon les besoins, menant à divers degrés de mobilisation. Quatre thèmes se sont dégagés relativement aux facteurs qui favorisent une mobilisation active des parties prenantes : un leadership positif, une habilitation, un sentiment d’appartenance et une culture d’égalité. Pour encourager l’optimisation des contributions des parties prenantes aux projets de programmes d’études en sciences infirmières, il est important de comprendre les stratégies qui permettent de mobiliser positivement ces partenaires et de cerner des rôles productifs et significatifs pour eux

Advanced Practice Nurses and Their Roles in Swiss Cancer Care: A Cross-Sectional Study.

OBJECTIVES To examine the advanced practice nurse workforce in Swiss cancer care and how their roles are being implemented (eg, role structures, processes) to achieve optimal outcomes for patients and their families, care organizations, and the broader health care system. METHODS A cross-sectional study was conducted. The sample included master-prepared advanced practice nurses in cancer care, who completed an online questionnaire from December 2021 to January 2022. Thirty-nine items assessed structures (eg, role characteristics, utilization), processes (eg, role activities, interventions), and perceived outcomes (eg, for patients, the health care system) of advanced practice nurses in Swiss cancer care. Data from closed questions were analyzed using descriptive statistics. Data from open-ended questions were organized and summarized into categories related to domains of advanced practice nursing and its reported frequency by the advanced practice nurses. RESULTS The participating advanced practice nurses (n = 53), worked in half of the 26 Swiss cantons. Interventions were identified within nine categories, of which most were targeted to patients and their families (n = 7), followed by health care professionals (n = 2). Perceived positive outcomes were patient symptom management, length of hospital stay, and health care costs. Participants felt less confident in cancer care (eg, autonomous practice) and reported 15 professional development needs (eg, medical interventions, teaching). CONCLUSIONS This study provides a comprehensive examination of 53 advanced practice nurses, detailing the characteristics of their roles and utilization across various jurisdictions and health care settings. The results highlight the diverse dimensions of advanced practice nursing and its potential to enhance cancer services and outcomes in Switzerland. Opportunities for role development support and expansion are identified. IMPLICATIONS FOR NURSING PRACTICE More systematic health human resource planning is needed to expand the deployment of advanced practice nurses across jurisdictions, practice settings, and more diverse patient populations. Role development needs show the desire for specialized educational preparation in cancer care

Enfermagem com prática avançada : uma estratégia para atingir cobertura universal de saúde e acesso universal à saúde

Objetivo: examinar el rol de la enfermería con práctica avanzada (EPA) a nivel internacional para informar de su desarrollo en América Latina y el Caribe, en apoyo a la cobertura de salud universal y el acceso universal a la salud. Método: se analizó la literatura relacionada con los roles de la EPA, su despliegue en el mundo y la eficacia de EPA en relación con la cobertura de salud universal y el acceso a la salud. Resultados: dada la evidencia de su eficacia en muchos países, las funciones de la EPA son ideales como parte de una estrategia de recursos humanos de atención primaria de salud en América Latina para mejorar la cobertura de salud universal y el acceso a la salud. Brasil, Chile, Colombia y México están bien posicionados para construir esta fuerza de trabajo. Las barreras a la implementación de estas funciones incluyen: la falta de claridad de su rol, la legislación/regulación, educación, financiamiento, y la resistencia de los médicos. Se necesita un liderazgo fuerte de enfermería para alinear los roles de la EPA con las políticas prioritarias, y trabajar en colaboración con los profesionales de atención primaria y los responsables de las políticas para la implementación exitosa de sus funciones. Conclusiones: teniendo en cuenta la diversidad de los contextos en diferentes naciones, es importante evaluar sistemáticamente las necesidades de salud del país y de la población para introducir la combinación más adecuada y complementaria de los papeles de la EPA y dar un formato a su aplicación. La introducción con éxito del papel de la EPA en América Latina y el Caribe podría proporcionar una hoja de ruta para funciones similares en otros países de bajos/medios ingresos.Objetivo: analisar o papel da enfermagem com prática avançada (EPA) a nível internacional para um relatório do seu desenvolvimento na América Latina e no Caribe, para apoiar a cobertura universal de saúde e o acesso universal à saúde. Método: análise da bibliografia relacionada com os papéis da EPA, sua implantação no mundo e a eficácia da EPA em relação à cobertura universal de saúde e acesso à saúde. Resultados: dada a evidência da sua eficácia em muitos países, as funções da EPA são ideais como parte de uma estratégia de recursos humanos de atenção primária de saúde na América Latina para melhorar a cobertura universal de saúde e o acesso à saúde. Brasil, Chile, Colômbia e México estão bem posicionados para construir esta força de trabalho. Barreiras à implementação destas funções incluem: a falta de clareza do seu papel, a legislação/regulamentação, educação, financiamento, e a resistência médica. Uma liderança forte de enfermagem é necessária para alinhar o papel da EPA com as prioridades políticas e trabalhar em colaboração com os profissionais de atenção primária e os decisores políticos para a implementação bem sucedida das suas funções. Conclusões: dada a diversidade de contextos dos diferentes países, é importante avaliar sistematicamente as necessidades de saúde do país e da população para introduzir a combinação mais adequada e complementar dos papéis da EPA e formatar sua aplicação. A introdução bem sucedida do papel da EPA na América Latina e no Caribe poderia fornecer um roteiro para funções semelhantes noutros países de baixa/média renda.Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries

Optimizing the Nursing Role in Abortion Care: Considerations for Health Equity.

Registered nurses (RNs) provide abortion care in hospitals and clinics and support abortion care through sexual health education and family planning care in sexual health clinics, schools and family practice. Nurse practitioners (NPs) improve access to abortion not only as prescribers of medication abortion but also as primary care providers of counselling, resources about pregnancy options and abortion follow-up care in their communities. There is a need to better understand the current status of and potential scope for optimizing nursing roles in abortion care across Canada. In this article, we describe the leadership of nurses in the provision of accessible, inclusive abortion services and discuss barriers to role optimization. We present key insights from a priority-setting meeting held in 2019 with NPs and RNs engaged in medication abortion practice in their communities. As scopes of practice continue to evolve, optimization of nursing roles in abortion care is an approach to enhancing equitable access to comprehensive abortion care and family planning

Effectiveness of registered nurses on system outcomes in primary care: a systematic review

Background Internationally, policy-makers and health administrators are seeking evidence to inform further integration and optimal utilization of registered nurses (RNs) within primary care teams. Although existing literature provides some information regarding RN contributions, further evidence on the impact of RNs towards quality and cost of care is necessary to demonstrate the contribution of this role on health system outcomes. In this study we synthesize international evidence on the effectiveness of RNs on care delivery and system-level outcomes in primary care. Methods A systematic review was conducted in accordance with Joanna Briggs Institute methodology. Searches were conducted in CINAHL, MEDLINE Complete, PsycINFO, and Embase for published literature and ProQuest Dissertations and Theses and MedNar for unpublished literature between 2019 and 2022 using relevant subject headings and keywords. Additional literature was identified through Google Scholar, websites, and reference lists of included articles. Studies were included if they measured effectiveness of a RN-led intervention (i.e., any care/activity performed by a primary care RN within the context of an independent or interdependent role) and reported outcomes of these interventions. Included studies were published in English; no date or location restrictions were applied. Risk of bias was assessed using the Integrated Quality Criteria for Review of Multiple Study Designs tool. Due to the heterogeneity of included studies, a narrative synthesis was undertaken. Results Seventeen articles were eligible for inclusion, with 11 examining system outcomes (e.g., cost, workload) and 15 reporting on outcomes related to care delivery (e.g., illness management, quality of smoking cessation support). The studies suggest that RN-led care may have an impact on outcomes, specifically in relation to the provision of medication management, patient triage, chronic disease management, sexual health, routine preventative care, health promotion/education, and self-management interventions (e.g. smoking cessation support). Conclusions The findings suggest that primary care RNs impact the delivery of quality primary care, and that RN-led care may complement and potentially enhance primary care delivered by other primary care providers. Ongoing evaluation in this area is important to further refine nursing scope of practice policy, determine the impact of RN-led care on outcomes, and inform improvements to primary care infrastructure and systems management to meet care needs. Protocol registration ID PROSPERO: International prospective register of systematic reviews. 2018. ID= CRD42018090767

Advancing nursing practice : the emergence of the role of Advanced Practice Nurse in Saudi Arabia

Background: The roots of advanced practice nursing can be traced back to the 1890s, but the Nurse Practitioner (NP) emerged in Western countries during the 1960s in response to the unmet health care needs of populations in rural areas. These early NPs utilized the medical model of care to assess, diagnose and treat. Nursing has since grown as a profession, with its own unique and distinguishable, holistic, science-based knowledge, which is complementary within the multidisciplinary team. Today Advanced Practice Nurses (APNs) demonstrate nursing expertise in clinical practice, education, research and leadership, and are no longer perceived as “physician replacements” or assistants. Saudi Arabia has yet to define, legislate or regulate Advanced Practice Nursing. Aims: This article aims to disseminate information from a Saudi Advanced Practice Nurse thought leadership meeting, to chronicle the history of Advanced Practice Nursing within the Kingdom of Saudi Arabia, while identifying strategies for moving forward. Conclusion: It is important to build an APN model based on Saudi health care culture and patient population needs, while recognizing global historical underpinnings. Ensuring that nursing continues to distinguish itself from other health care professions, while securing a seat at the multidisciplinary health care table will be instrumental in advancing the practice of nursing

Prix de conférence à la mémoire de Helene Hudson 2003 : Les soins infirmiers en oncologie: notre passé est le prologue… Pouvons-nous nous approprier l’avenir?

L’élaboration des Normes de soins, des Rôles infirmiers en oncologie et des Compétences relatives aux rôles a été l’occasion pour les infirmières canadiennes de réexaminer leurs racines professionnelles, de passer en revue et de valider leurs rôles actuels et de réviser ou de réaffirmer leurs rôles futurs. Les Normes de soins aux personnes atteintes de cancer et à leurs proches soulignaient la place centrale de l’individu et de sa famille dans toute interaction infirmière et donnaient voix aux besoins exprimés par les Canadiennes et Canadiens vivant avec le cancer ou à risque de développer la maladie. Pour la toute première fois au Canada, un organisme d’infirmières spécialisées prenait les devants pour définir clairement les rôles infirmiers contemporains et les compétences afférentes. Cette vision nouvelle a capté l’intérêt des infirmières en oncologie. L’ACIO, la profession infirmière, d’autres professionnels de la santé et des décideurs en soins de santé doivent dorénavant envisager la manière d’aborder l’opérationnalisation de cette vision éminente des soins infirmiers en oncologie. Les conférencières ont eu la chance “d’entendre” les histoires des infirmières en oncologie du Canada et leurs expériences dans leur cheminement vers l’excellence dans la pratique. Ces histoires font ressortir les données probantes sur lesquelles s’appuient les normes des soins infirmiers en oncologie. Elles dégagent également les défis et les facteurs favorisant l’atteinte de l’excellence dans la pratique des soins infirmiers en oncologie. De ces histoires se dessine l’avenir du développement de la pratique de notre discipline et de l’opérationnalisation des nouvelles Normes de soins

The 2003 Helene Hudson Memorial Lecture: Oncology nursing: Our past is the prologue... Can we author the future?

The development of the standards of care, roles in oncology nursing, and role competencies was an opportunity for Canadian nurses to revisit their professional roots, review and validate their present roles, and revise or reaffirm their future roles. The standards of care for individuals with cancer and their families affirmed the centrality of the individual and family in any nursing interaction and gave voice to the stated needs of Canadians at risk for, or living with cancer. For the first time in Canada, a specialty nursing organization has taken the lead to clearly define contemporary nursing roles and competencies. This new vision has captured the interest of oncology nurses. CANO, the nursing profession, other health care professionals, and health care decision-makers must now also consider how this enlightened view of oncology nursing can be operationalized. The presenters have had the opportunity to “hear” the stories of Canadian oncology nurses and their experiences in striving for excellence in their practice. These stories highlight the evidence supporting the standards of oncology nursing. In addition, the challenges and facilitators for achieving excellence in oncology nursing practice are identified. Through these stories, the future for the development of oncology practice and operationalization of the new standards of care emerges

The supportive care needs of family members of men with advanced prostate cancer

This exploratory study identified the supportive care needs of family members of men with advanced hormone-sensitive (HS) and hormonerefractory (HR) prostate cancer. In focus groups and individual interviews, we asked eight family members of men with HS disease and 11 family members of men with HR disease to identify their supportive care needs and recommend strategies for improving care to meet these needs. Unmet needs common to both groups were lack of information and uncertainty about the future. Unmet needs specific to family members affected by HR prostate cancer related to caregiver burden, practical assistance, and isolation. Implications for practice to improve supportive care services for families affected by APC are provided