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Article
Publication date: 11 December 2008

Julia Halpin, Patricia Wain and Peter Nolan

This paper reports on a study undertaken in one mental health NHS foundation trust in the UK, which sought to examine to what extent advanced practice nursing could contribute to…

158

Abstract

This paper reports on a study undertaken in one mental health NHS foundation trust in the UK, which sought to examine to what extent advanced practice nursing could contribute to advancing new ways of working in the future. The literature on advanced nursing in the UK is critically discussed and where availability permits, reference is made to international literature. The findings of a survey of nurses with a Masters degree or acting at advanced level are reported and discussed. Though the data reported here are largely confirmed by similar studies, nevertheless the insights provided should alert organisations to the complexity of introducing new roles during a time of radical change in the health care system. Despite the efforts of a highly motivated trust, respondents identified barriers and obstacles that were of such significance that some were forced to rethink their readiness to embrace the role. It is hoped that the recommendations derived from this study may assist other organisations at a similar stage of implementing advanced nursing practice roles.

Details

The Journal of Mental Health Training, Education and Practice, vol. 3 no. 4
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 9 August 2022

Seham Mansour Alyousef and Sami Abdullrahman Alhamidi

Research supports the value of clinical supervision as an essential aspect of mental health nursing. Despite the need for this, there appears to be a deficit in qualified…

Abstract

Purpose

Research supports the value of clinical supervision as an essential aspect of mental health nursing. Despite the need for this, there appears to be a deficit in qualified supervision in the mental health field, although efforts have been made toward advanced mental health practitioner nursing. This study aims to characterize the ideas that advanced mental health nurse practitioners hold about supervision in practice and to consider what is required to support changes to advanced mental health nursing in Saudi Arabia.

Design/methodology/approach

This study adopted a qualitative exploratory design that applied a phenomenological approach as the research method. Twelve postgraduate mental health nurses were recruited through purposive sampling.

Findings

The data analysis generated the central theme, which indicates the attributes of a competent supervisor of advanced mental health nurse practitioners. The components of a supervisor’s competence had the following three main themes: nursing competencies, professional characteristics and communication.

Research limitations/implications

A limitation of this study is that the data was collected from practicing advanced care mental health practitioners in Saudi Arabia. Further research conducted in different geographical areas and with different categories of staff is warranted. The results of those studies could be compared against the results presented here.

Practical implications

Best practice measures indicated that mental health nurse practitioners working in mental health settings and private practice should receive supervision to help them reflect upon their daily nursing practice challenges.

Originality/value

The findings of this study indicate that to support mental health practitioners and advanced mental health practitioners working in private practice, competent supervisors need to be on hand and willing to invest in creating a supportive culture in practice.

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

Article
Publication date: 30 October 2018

Tara Officer, Jackie Cumming and Karen McBride-Henry

The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on mechanisms…

1203

Abstract

Purpose

The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on mechanisms occurring across policy creation and in practice leading to successful role development.

Design/methodology/approach

The authors applied a realist approach involving interviews, document review and field log observations to create refined theories explaining how successful development occurs.

Findings

Three final mechanisms were found to influence successful advanced practitioner role development: engagement in planning and integrating roles; establishing opportunities as part of a well-defined career pathway; and championing role uptake and work to full scopes of practice.

Research limitations/implications

This research focuses on one snapshot in time only; it illustrates the importance of actively managing health workforce change. Future investigations should involve the continued and systematic evaluation of advanced practitioner development.

Practical implications

The successful development of advanced practitioner roles in a complex system necessitates recognising how to trigger mechanisms occurring at times well beyond their introduction.

Social implications

Potential candidates for new roles should expect roadblocks in their development journey. Successfully situating these roles into practice through having a sustainable and stable workforce supply provides patients with access to a wider range of services.

Originality/value

This is the first time a realist evaluation has been undertaken, in New Zealand, of similar programmes operating across multiple sites. The paper brings insights into the process of developing new health programmes within an already established system.

Details

Journal of Health Organization and Management, vol. 33 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 12 October 2012

John Howard and Katie Barnes

The purpose of this paper is to show how competency models can be used to govern the increased autonomy of advanced practitioners in nursing, and to assist in workforce…

1431

Abstract

Purpose

The purpose of this paper is to show how competency models can be used to govern the increased autonomy of advanced practitioners in nursing, and to assist in workforce development.

Design/methodology/approach

The study shows how competency frameworks for advanced nurse practitioners (ANPs) have evolved in the UK. It compares the current thinking in the UK to the latest competency models from the USA. The article uses the authors' own adaptation of Benner's novice‐to‐expert framework to derive a framework from the current approaches. The authors then demonstrate how the resulting framework can be deployed to target development of new ANPs to address workforce development and governance issues over ensuring the right skill mix for safe autonomous practice. Finally, they argue for registration of advanced practitioners as a distinct professional group to address medico‐legal concerns over increased autonomy.

Findings

The study shows that there are currently limited numbers of ANPs constraining the development of new nurse‐led services, for example paediatrics. The study argues that current developments in the UK are unhelpful to the development of new nurse‐led initiatives that could flourish under the new commissioning arrangements. The study demonstrates how an enhanced framework can be used to target potential new ANPs for bespoke training, to assure that existing role holders have the correct level of competency for safe autonomous practice, and could form the basis of professional registration of advanced practitioners.

Research limitations/implications

The small numbers of existing ANPs and the early stage of development of nurse‐led services limit the opportunities for evaluation.

Practical implications

This study suggests that competency modelling can contribute to the effectiveness of ANP education, help to address workforce planning issues and provide re‐assurance for commissioners in terms of governance and safety.

Originality/value

Competency modelling for ANPs in the UK is in its infancy, but the lack of a safe and competent workforce is a barrier to innovation for commissioners of services.

Details

Clinical Governance: An International Journal, vol. 17 no. 4
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 15 June 2020

Bryan Mitchell, Graham A. Jackson, Barbara Sharp and Debbie Tolson

This paper reports on an action research study that aimed to collaboratively develop a complementary therapy care intervention to augment palliative care choices available to…

Abstract

Purpose

This paper reports on an action research study that aimed to collaboratively develop a complementary therapy care intervention to augment palliative care choices available to nursing home residents with advanced dementia.

Design/methodology/approach

An action research design was adopted that consisted of a series of action cycles involving collaborative exploration, problem-solving planning, development and evidence gathering. A combination of mixed methods was used when gaining data at the different stages, including face to face delivered questionnaires, observational notes, focus groups, and the objective measure of the Neuropsychiatric Inventory adapted for Nursing Homes (NPI-NH).

Findings

Care home staff and relatives considered the use of Complementary Therapy to be a helpful intervention promoting that it can reduce a sense of loneliness and provide companionship for residents experiencing distress. Analysis of NPI-NH scores showed a reduction in presenting neuropsychiatric behaviours associated with stress and distress.

Research limitations/implications

Differing levels of participant group engagement may affect this study’s findings as it was noted that care home staff provided a fuller contribution to the project in comparison to relatives.

Practical implications

Implementation guidance is needed when implementing complementary therapy within the nursing home practice to promote consistency and successful integration of an intervention that is not provided as routine care.

Originality/value

The findings of this study are encouraging and demonstrate the acceptability of complementary therapies to residents with advanced dementia, where positive impacts on otherwise difficult to address dementia symptoms related to stress and distress are highlighted.

Details

Journal of Integrated Care, vol. 28 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 September 2006

Alyson Kettles and Phil Woods

Forensic nursing is a term applied to nurses working in many different areas of clinical practice, such as high security hospitals, medium secure units, low secure units, acute…

Abstract

Forensic nursing is a term applied to nurses working in many different areas of clinical practice, such as high security hospitals, medium secure units, low secure units, acute mental health wards, specialised private hospitals, psychiatric intensive care units, court liaison schemes, and outpatient, community and rehabilitation services. Rarely is the term defined in the general literature and as a concept it is multifaceted. Concept analysis is a method for exploring and evaluating the meaning of words. It gives precise definitions, both theoretical and operational, for use in theory, clinical practice and research. A concept analysis provides a logical basis for defining terms and helps us to refine and define a concept that derives from practice, research and theory. This paper uses the strategy of concept analysis to explore the term ‘forensic nursing’ and finds a working definition of forensic mental health nursing. The historical background and literature are reviewed using concept analysis to bring the term into focus and to define it more clearly. Forensic nursing is found to derive from forensic practice. A proposed definition of forensic nursing is given.

Details

The British Journal of Forensic Practice, vol. 8 no. 3
Type: Research Article
ISSN: 1463-6646

Keywords

Article
Publication date: 1 February 1993

Paul Moorbath

The nursing journals titles needed to support Project 2000 were considered. In order to reflect the structure of nursing literature as a whole, a citation count from the Citation

Abstract

The nursing journals titles needed to support Project 2000 were considered. In order to reflect the structure of nursing literature as a whole, a citation count from the Citation index for 1990 was undertaken. In order to rank journals in each of the 4 branches of Project 2000, an analysis of the citations in a leading journal representing each branch was undertaken. To reflect student usage a survey of photocopier use and citation in student bibliographies was undertaken. In order to reflect what titles the library ought to have, a questionnaire survey of tutors was undertaken. The ranking of titles in the Citation index was tested for correlation with the ranks obtained from student use and tutor recommendation and the correlation between student use and tutor recommendation was drawn. Finally, a scheme for combining the rankings of journal titles obtained by the methods above was devised in order to produce an overall ranking of the principal titles.

Details

Aslib Proceedings, vol. 45 no. 2
Type: Research Article
ISSN: 0001-253X

Article
Publication date: 15 September 2010

Rebecca Dawber

Alcohol‐related brain damage (ARBD) is an increasing challenge for service providers working with older people and adults. It has a complex aetiology and does not progress in the…

Abstract

Alcohol‐related brain damage (ARBD) is an increasing challenge for service providers working with older people and adults. It has a complex aetiology and does not progress in the same way as other causes of dementia. The devastating effects of ARBD undermine a person's ability to lead an independent life, yet it is thought that with the right interventions, a degree of recovery can be seen in 75% of sufferers. People with ARBD do not neatly fit into an existing category of care; they ‘fall through the net’ at multiple points in the care pathway. Using a patient synopsis drawn from clinical practice the author illustrates the impact of an advanced practice role in relation to the nursing care of patients with ARBD, as well as making suggestions for the provision of education and support for mainstream services.

Details

The Journal of Mental Health Training, Education and Practice, vol. 5 no. 3
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 26 April 2013

Carina Furåker and Nilsson Agneta

The aim of this paper is to describe registered nurses' (RNs') ways of working and their views on what competence they require, make use of and wish to develop when caring for…

1005

Abstract

Purpose

The aim of this paper is to describe registered nurses' (RNs') ways of working and their views on what competence they require, make use of and wish to develop when caring for older people at residential facilities.

Design/methodology/approach

The participants comprised 23 RNs, trained after 1993 and working at seven residential facilities. The data collection consists of group interviews during spring 2009. The group interviews were subjected to content analysis.

Findings

Three main categories and six sub‐categories were identified. The findings show that the majority of RNs work in a consultative way although they are responsible for basic care as well as advanced nursing care. They must rely on the staff's competence. They compare the residential facilities to a “mini‐hospital” and they are often frustrated by the staff's incompetence. Attitudes to research findings and to the use of evidence‐based knowledge were limited.

Research limitations/implications

RNs require extensive theoretical, technical and medical knowledge as well as knowledge related to persons with dementia conditions and psychiatric disorders and how to lead, teach and supervise.

Practical implications

Social and professional isolation influences competence development and working situation and the differences in leadership influence the quality of nursing care. RNs do not critically reflect on what knowledge they require and make use of and how to search for scientific knowledge and this will have a negative influence on the attitude to the competence.

Originality/value

There is a need of extensive and varied knowledge in evidence‐based nursing as well as in leadership and teaching to be able to work independently.

Details

Leadership in Health Services, vol. 26 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Book part
Publication date: 12 October 2015

Baiba Zarins and Lorraine Carter

Nipissing University in North Bay, Ontario, Canada, working in partnership with leading health science centers in Toronto, Ontario, has developed a unique second-degree entry…

Abstract

Nipissing University in North Bay, Ontario, Canada, working in partnership with leading health science centers in Toronto, Ontario, has developed a unique second-degree entry Bachelor of Science in Nursing (BScN) program called the Scholar Practitioner Program. This program is a response to the increasing demand for nursing programs which builds on prior university learning.

The program uses an educational model based on narrative inquiry and cognitive apprentice pedagogies. Narrative inquiry pedagogy is the overarching philosophical framework of the program, which embraces values that connect teachers and learners. A spirit of inquiry is cultivated in every student and a research culture embedded in the student’s practice.

The six-semester two-year full-time program occurs in a learner-driven environment which shapes how specific semester program objectives are met. A strong emphasis is placed on experiential learning within the Toronto-based academic health sciences centers.

A continuous interactive process involving teachers and learners encourages self-directed learning and participant accountability. Application of knowledge and skills in a professional, caring, and holistic manner is expected. This type of undergraduate learning environment which includes immersion in the employment milieu enables the future scholar practitioner to be relevant in the evolving profession of nursing.

Details

Inquiry-Based Learning for Science, Technology, Engineering, and Math (Stem) Programs: A Conceptual and Practical Resource for Educators
Type: Book
ISBN: 978-1-78441-850-2

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