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

Spiritual Well-being, Faith, Hope, Anxiety and Loneliness in Oncology Patients: A Descriptive Correlational Study

Purpose: To test theorized relationships in the newly developed Faith-Hope-Love Model of Spiritual Wellness (FHLMSW). The research questions were: 1) do measures of faith, hope and love correlate with or predict spirituality as defined by FHLMSW in a palliative care population; and 2) do relationships exist between measures of spirituality and physical symptoms and distress among the same palliative care population. Patients and Methods: This was a descriptive correlational study, which included 21 participants with a stage III or IV cancer diagnosis that were receiving palliative care at a community oncology practice, that took place between January 2015 to March 2015. Each participant completed a 46-item survey that measured five concepts: spiritual well-being (SWB), hope, faith, anxiety, and loneliness. Results: Hope and faith were the best predictors of SWB, accounting for 77.3% and 81% of the variance respectively, and showed strong correlations with SWB (R = .882, p = .000, equal values). Anxiety (fear) negatively correlated with SWB (R = -.523, p = .026). The subscales of the loneliness measure negatively correlated with SWB (p \u3e .10) with the strongest in the Romantic subscale (R = .123). Conclusion: This is the first study where spiritual needs were conceptually and operationally defined, measured, and correlated with each other and with a reliable and valid measure of SWB. Relevance to clinical practice: Palliative care patients at the end of life expect nurses to provide spiritual care. Researchers have reported multifaceted benefits associated with support of spiritual needs. If the FHLMSW is found to be valid, this may help nurses provide more effective spiritual care at the end of life

Self-Management Education in Hispanic Women with Gestational Diabetes Mellitus (GDM)

The purpose of this Practice Inquiry Project was to develop, implement, and evaluate the effectiveness of a diabetes self-management education intervention in a population of Hispanic women at risk for gestational diabetes mellitus within a CenteringPregnancy(R) model of care

Orthopedic Nurse Practitioner as a Subspecialty: A Case Study

Purpose: The overall purpose of this study was to describe the ONP role by exploring how and why NPs are utilized in orthopedic health care settings. Two problems associated with the evolving ONP role were addressed: the concomitant decrease in the supply of and increased demand for orthopedic patient care services and the nursing profession’s unmet challenge to keep pace with that increased demand and protection of the public and nursing profession through credentialing of ONPs and programs providing certification and training for ONPs. Approach: This study employed a single-embedded case study research approach to answer the research questions and interpret the results through analysis of interview data, participant observations, and document surveys. Findings and Conclusions: The analysis of the ONP role through the lens of Style’s conceptual model, Nursing as a Social System, and the PEPPA-Plus framework revealed the ONP role lacks the maturity required for long-term sustainability, thereby threatening the viability of the role. Highly specialized knowledge and skill are required for the ONP role and currently the means for supplying adequately trained and/or experienced ONP job applicants is ineffective. The development of the ONP role is contingent upon trusting professional relationships with individuals or groups of orthopedic surgeons, a necessary component of the ONP role. The highly specialized ONP role varies significantly from the general NP role in which it emerged suggesting new methods for training and evaluation may be indicated. Lastly, environmental conditions contribute to the decisions by orthopedic surgeons and health care organizations to employ ONPs. This study identified environmental conditions consistent with those in both Style’s and the PEPPA-Plus models suggesting these models are useful frameworks for ONP-role analysis. Relevance: Findings from this study may influence and inform policy makers to improve and enhance the orthopedic-patient care provided by ONPs and theory development regarding the role and utilization of sub-specialty NPs. This in turn may influence the eventual establishment of evidence-based standards for orthopedic education, training programs, and fellowship accreditation

Use of Standardized Test Results by Faculty and Students for Advanced Practice Nurse Certification Success

The utilization of standardized testing as a recognized educational strategy to measure pre-professional readiness in Advanced Practice Nursing (APN) graduate programs has increased. Research supports such use for predicting licensure success for undergraduate education, however when related to the use in graduate nursing education, it is limited. Teaching and learning practices of APN faculty and students have not been comprehensively explored. This study examined the use of standardized testing results by faculty and students in APN graduate education that contributes to student national certification success. The Reconceptualization of Vygotsky’s Theory of Zone of Proximal Development (RVZPD) underpins the study. An original descriptive correlational research design was implemented with a sample from a multi-state APN graduate program. Low participant response yielded insufficient data. An amendment to the original study was approved and a qualitative study was implemented to better understand the participants’ perspectives on their use of standardized test results. Responses from participants were categorized into four themes: Concurring, Divergent, Student, and Faculty-specific. Standardized testing is a tool to measure new knowledge and skills was a concurring theme. Students agreed test results reflect their knowledge, while faculty disagreed they reflect their teaching. Advanced Practice Education Associates (APEA) predictor test results informed students of areas of weakness to focus on for test success, while informing faculty of areas needing in-depth teaching. This qualitative data from graduate nursing students and faculty indicate that standardized testing has potential to serve as a meaningful educational component for both teaching and learning practices that lead to APN national certification success

Managing Patients at High-risk for Breast Cancer: An eLearning Module for Primary Care Providers

Women at high-risk of developing breast cancer must be screened appropriately and educated about breast cancer reduction strategies much earlier than those of average risk. The National Comprehensive Cancer Network (NCCN) (2017) has identified guidelines for the care of this group. This project focused on the development of education for providers, specifically an eLearning module, to help translate guidelines into practice. Providers of adult primary care (including internal medicine and family practice) from four clinics in Snohomish County, Washington, were asked to participate in an eLearning module regarding the care of patients at high-risk for breast cancer. Repeated measures surveys using a Likert Scale were presented to the PCP participants, as well as questions regarding demographics and current practices. The surveys assessed the four components of learning according to the Kirkpatrick Model including reaction, knowledge, behavior and results. Paired t-tests were used to evaluate learning regarding knowledge and behavior, showing statistically significant improvement (sig. \u3c 0.05) between pretest and posttest for questions about understanding current evidence-based recommendations, use of a screening tool, and referrals to a breast care specialist, supporting that learning occurred and participants believed this learning would impact their behaviors. High-risk breast education is needed for the PCP to engage in shared decision-making with their patients about high risk care. The NCCN (2016) has created evidence-based guidelines for the support and monitoring of patients who are found to be at high-risk; however, this evidence continues to be slowly disseminated

Incarceration-Related Stigma and Caring Self-Efficacy Among Long-Term Care Nurses

Background: A silver tsunami is occurring in U.S. prisons because of an unprecedented increase in the older population. Prisons are structurally ill-suited to care for this population and financially burdened with providing the necessary medical and nursing care. States have enacted legislation to afford justice-involved persons parole to manage chronic conditions in community-based long-term care (LTC) facilities. Changes in Medicaid regulations provide a seamless transition from prison to community long-term care for this population. However, it is not known if the stigma of justice involvement impacts the perception of long-term nurses concerning this population. Aims/Purpose: This study examined the effects of a stigmatizing stimulus on the caring efficacy of LTC nurses by testing the following hypotheses: a) knowledge of the older patient’s justice involvement will be associated with lower caring self-efficacy when compared to the control vignette; b) knowledge of a history of sexual offenses will be associated with the lowest caring self-efficacy, when compared to all other vignettes, followed by non-sexual violence and non-violent offenses vignettes; c) justice-involved friend or family member and identifying with a Christian religion will be associated with higher caring self-efficacy for older justice-involved persons when compared to those without; and d) friends or family members working in law enforcement will be associated with a lower caring self-efficacy for older justice-involved persons when compared to those without. Methods: Using a vignette-based experimental design, participants completed the Caring Efficacy Scale after they were randomly assigned to one of four vignettes that mirrored the LTC resident population in age, chronic condition, and behavior, but differed by justice involvement. Data was examined with ANOVA analysis. Additional analyses investigated the effects of demographic variables obtained from participants using the researcher-developed demographic questionnaire. Results: This study suggested that LTC nurses exhibited a higher caring self-efficacy to the resident without justice-involvement as opposed to those residents with justice-involvement. Furthermore, among those residents with justice-involvement, LTC nurses exhibited a lower self-caring efficacy towards the resident with a sex offense history as opposed to the vignette residents with a violent and non-violent history of justice-involvement. The nurse’s identification with a Christian religion, having a friend or relative imprisoned, or having a friend or relative in law enforcement did not significantly affect the nurse’s caring self-efficacy. Furthermore, the nurse’s experience of being victimized or having knowledge of a friend or relative’s victimization did not significantly affect the nurse’s caring self-efficacy. Conclusion: Incarceration-related stigma affects the caring self-efficacy of LTC nurses. The effect may be driven by the nurse’s fear of justice-involved people, the nurse struggles with forgiveness towards those imprisoned for specific offenses, or the nurse may feel that justice-involved people are not deserving of high-quality nursing care. Qualitative research is needed to understand the feelings that LTC nurses experience when working with justice-involved people so that training can be developed

Ensuring The Continuation Of The Public Health Nurses Workforce: Comparison Of Work Outcomes With Nurses In Other Sectors Of Healthcare

ABSTRACT ENSURING THE CONTINUATION OF THE PUBLIC HEALTH NURSES WORKFORCE: COMPARISON OF WORK OUTCOMES WITH NURSES IN OTHER SECTORS OF HEALTHCARE Melissa L. Charlie Linda H. Aiken The Quality Health Outcomes Model (QHOM) is the conceptual model guiding this study (Mitchell, Ferketich, & Jennings, 1998). The specific aims of this study are twofold: (1) compare nurse job outcomes, job dissatisfaction, burnout, and intent to leave, of public health nurses (PHN) with nurses that share historical roots with PHS, specifically school nurses (SN) and home health nurses (HHN); (2) determine the extent to which modifiable features of the work environment, including employment benefits, are associated with favorable nurse outcomes. This dissertation is a secondary analysis of data obtained from the RN4CAST-US, a National Institute of Nursing Research- (NINR-) funded survey of nurses undertaken by the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing in 2015-16. Methods of analysis for this study included descriptive data analysis, tests of difference between groups, measurement of outcomes with logistic regression models, and calculation of predictive probability. The level of analysis was the individual nurse. The sample consisted of 529 PHN, 1208 SN, and 3079 HHN. PHN had the highest percentage (94%) of participation in a retirement plan compared to SN (86%) and HHN (64%); PHN also participated in pension plans at the highest percentage (66%). Regardless of variables added to the logistic regression models, the work environment, measured by the Practice Environment Scale, was significantly associated with reduced odds of high burnout (82%), job dissatisfaction (86%), and intent to leave (72%). The probability of PHN experiencing high burnout was 20%, job dissatisfaction 16%, and intent to leave 16%. SN had the lowest probability of burnout, job dissatisfaction, and intent to leave (15%, 8%, and 7%, respectively). HHN had the highest probability of burnout, job dissatisfaction, and intent to leave (29%, 19%, and 17%, respectively). PHN were dissatisfied with salary, opportunity for advancement, and independence at work. HHN were dissatisfied with their work schedule, retirement, health, and tuition benefits. SN were dissatisfied with their professional status. Additional research is needed focusing on the work environments of PHN, SN, and HHN, and potential development of recruitment and retention strategies to assure continuation of public health nursing

The Hilltop 10-20-1978

This document created through a generous donation of Mr. Paul Cottonhttps://dh.howard.edu/hilltop_197080/1220/thumbnail.jp