Lack of full practice authority (FPA) for advanced practice registered nurses (APRNs) is a barrier to the provision of efficient, cost-effective, high-quality, and comprehensive health care services for some of our most vulnerable citizens ( Agency for Healthcare Research and Quality, 2014 , Buerhaus et al., 2015 , Pohl et al., 2010a , Seibert et al., 2004 ). APRNs have the education, knowledge, skills, and experience necessary to provide basic and comprehensive primary care services; they are a ready workforce, ideally positioned to improve access to care, contribute to health disparities reduction efforts, and lower the cost of providing such care ( National Center for Workforce Analysis 2013 , Perloff et al., 2016 ). However, barriers at the state and national levels continue to prevent these highly qualified health care providers from practicing to the full extent to which their education and training have prepared them. It is the position of the American Academy of Nursing (academy) that FPA of APRNs is essential to achieving health equity.

The purpose of this case study is to demonstrate the effectiveness of an Advanced Practice Nurse in providing spiritual and nursing care within a faith community setting. The study will describe the process of developing a Parish Nurse program using a Nurse Practitioner to offer wholistic health care to parishioners. It will also illustrate the collaborative process of developing a free health center within a faith based organization, using the Nurse Practitioner to manage the health center and deliver health care services. In order to demonstrate the need for parish nurse care, the case study used an anonymous survey to provide insight into the health status of the congregation, as well as to determine perceived needs of parishioners. Excerpts from the researcher's journal and audio-taped interviews of parishioners and key leaders within the community was used to express congregants' experiences of receiving parish nurse care, and to convey the need for a free community health center in the target population. A utilization review was conducted to demonstrate the profile of the patients who have accessed the services of the health center. The findings revealed three commons themes of parish nurse care; presence, spiritual support, and health care liaison. The study also revealed parishioners had an expedited referral process and improved patient provider relationships. Additional findings determined that the free health center was able to be operated by many of the members of the faith based organization, and was effective in managing chronic conditions such as hypertension and diabetes. Advanced Practice Nurses who are Parish Nurses have an opportunity to practice in a more wholistic manner, and offer advanced level care to parishioners and the community at large to improve health outcomes.

No description available.

No / There is limited evidence of the impact of radiographers working in advanced roles beyond task substitution. This study reviews the contribution of advanced (and consultant) practitioner radiographers to service delivery whilst reporting radiographs and demonstrates the impact this has on patients and staff, both internal and external to the imaging department. The study was a prospective exploratory study using activity diaries to allow interval sampling when individuals were rostered to report. Data was coded using a compiled list of activities and recorded in 15-min intervals over the period of one week. Thirteen radiographers who independently report radiographs participated across 6 locations in a busy multisite English National Health Service (NHS) Trust. Radiographers reported the majority of the examinations during the study period (n = 4512/5671; 79.6%). The total number of coded activities recorded over the study period was 1527, equating to 380.5 relative hours. The majority of available time was spent reporting, including dictating and verifying the reports of colleagues or trainees, although 69.5% of reporting time was interrupted. Based upon the hours of reporting there was an average of 19.3 reports (patient episodes) produced per hour. Direct patient care tasks and support for staff in decision making were regularly documented. Supplementary tasks included administrative activity, amendments to rotas, preparing presentations and documenting incidents identified during reporting. This study has demonstrated the breadth and complexity of the activities performed by advanced practice radiographers. The findings confirm their role in supporting service delivery beyond image interpretation.

Yes / Objectives: Many organisations struggle to clearly differentiate the radiographer consultant role from advanced or specialist practice, with newly appointed consultant practitioners often illprepared for working at this level. This article discusses the design, implementation and validation of an outcomes framework for benchmarking competencies for trainee or new-in-post consultant radiographers. Methods: Five experienced radiographers from different clinical specialisms were seconded to a twelve month consultant trainee post, guided by a locally-devised outcomes framework. A longitudinal qualitative study explored, from the radiographers' perspective, the impact of the outcomes framework on the transition to consultant practice and beyond. Data collection included semi-structured interviews (months 1, 6 and 12), validation via a focus group (month 18) and a group interview (5 years). Results: Early interactions with framework objectives were mechanistic, but as participants better understood the role more creative approaches emerged. Despite diverse clinical expertise, the framework facilitated parity between participants, promoting transparency and credibility which was important in how the consultant role was perceived. All participants achieved all framework outcomes and were subsequently appointed to substantive consultant radiographer positions. Conclusion This outcomes framework facilitates experienced radiographers to successfully transition into consultant radiographers, enabling them to meet multiple non-clinical targets while continuing to work effectively within a changing clinical environment. It is the first validated benchmarking tool designed to support the transition to radiographer consultant practice. Adoption of the tool will provide a standardised measure of consultant radiographer outcomes that will promote inter-organisational transferability hitherto unseen in the UK. / Mid Yorkshire NHS Trust Hospitals

No / The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. The three key themes from the interviews were variations in service demand, the service user’s expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.

Yes / The aim of this study is to profile the contemporary advanced clinical practitioner (ACP) role through standardized document sets. Documentary analysis of job descriptions (JDs), person specification and advertisements. England based jobs advertised on NHS jobs website from 22 January to 21 April 2021. A toatal of 143 trainee and qualified ACP roles were identified. A wide range of sectors and specialities were represented from across all English regions. The most common roles were urgent care, emergency medicine and primary care. Most qualified roles were agenda for change band 8A, although this did vary across specialities. Many roles were restricted to a small number of professions, notably nursing, physiotherapy and paramedic. Inconsistent role titles were noted. A lack of understanding of regulation across different professions was noted. The ACP role has become an accepted across healthcare providers in England. Implementation remains varied across specialities and organizations. Eligibility criteria may relate to professional bias. ACP roles are expanding but this may be at the detriment to advanced nursing posts. Inconsistency in role eligibility suggests some professional bias exists. This was scoping of ACP roles across England using job advertisements. ACP roles are common across sectors and specialities but eligibility varies. The research will have impact on those looking to recruit to ACP roles as well as those refining JDs. No EQUATOR guideline exists for document analysis. No Patient or Public Contribution. The research relates to organizational human resource information only.

Yes / Prior studies have demonstrated inconsistent development and utilisation of radiographers in the reporting of radiographs, and there is ongoing consideration of the level at which such radiographers should be educated to and operating at. This study aimed to explore and evaluate expectation and utilisation of radiographers currently, or training in, reporting in projection radiography across one integrated care system (ICS). Methods: A multi-method approach was utilised, with document analysis of projection radiography reporting role job descriptions and person specifications and an online survey of managers and clinical leads. A single ICS in the north of England formed the setting for the study. Results: This study demonstrated variation in implementation and utilisation of the role across trusts within the ICS. Inconsistencies in scope, expected underpinning education and role activity were identified. Radiographers autonomously reporting in projection radiography were titled advanced practitioners, however are not expected to achieve national educational standards for such roles and are not empowered to work at this level of practice by their employers. It was acknowledged that staffing pressures hinder appropriate role utilisation and reporting capacity. Conclusion: Inconsistent development and utilisation of radiographers in such roles may hamper collaboration and service delivery across a network. Identifying variation and working towards role standardisation could promote cross-organisational working and improve career progression opportunities. Implications for practice: Scoping the reporting radiographer workforce may assist and guide future imaging service and workforce planning. / The full-text of this article will be released for public view at the end of the publisher embargo on 24 Sep 2024.

Bakgrund: I dagens läge finns det kunskapsluckor om hur den perioperativa omvårdnadsprocessen uppfattas ur operationssjuksköterskans synvinkel. För att operationssjuksköterskan ska kunna ge god vård till patienten utifrån dennes önskningar och behov är det viktigt att operationssjuksköterskan får en bra kontakt med patienten. Får operationssjuksköterskan dela patientens värld d.v.s. om patienten både vill och är förmögen till att dela med sig av sina tankar och önskemål, då blir det lättare att ge en personcentrerad vård. Syfte: Syftet med föreliggande litteraturstudien är att undersöka hur operationssjuksköterskan uppfattar den vårdande relationen ur ett perioperativt synsätt. Metod: Det är en litteraturstudie med elva artiklar som har en kvalitativ ansats och en artikel som har en kvantitativ ansats. Föreliggande studien har en kvalitativ ansats då fokus är att beskriva och tolka operationssjuksköterskans upplevelser av omvårdnadsprocessen. Resultat: Generellt sett hade operationssjuksköterskorna en positiv inställning till den perioperativa processen. Operationssjuksköterskorna upplevde att den perioperativa processen  bidrog till ökad kontinuitet och ökad trygghet hos patienterna men framförallt också hos dem själva. Operationssjuksköterskorna utvecklades i sin yrkesroll men också som individer. De kände att deras arbete var meningsfullt och att det fanns en vårdande relation mellan patienten och operationssjuksköterskan. Slutsats: Föreliggande studie lyfter fram att arbetet för operationssjuksköterskor skulle bli effektivare, säkrare vård, få mer kontinuitet och gynna både sjuksköterskorna och patienterna om den perioperativa processen användes i större utsträckning. Det skulle bli lättare att uppnå välmående och god omvårdnad i slutändan. / Background: At present, there are gaps in the knowledge of how the perioperative process is seen from the point of view of the operating room nurse. When it comes to the operating theater nurse to provide quality care to the patient, it is important that the operating theater nurse gets a good contact with the patient. The operating room nurse has to share the patients’ world. Then, it will be easier to give a patient-centered care. Aim: The purpose of this study is to investigate how the operating theater nurse experienced the perioperative process from her/his point of view. Method: This study is a literature review of eleven articles that have a qualitative approach and one article which has a quantitative approach. This study has a more qualitative approach. Its focus is describing and interpreting the surgery nurses’ experience of the perioperative process. Result: The surgical nurses had, to a large extent, a favorable attitude to the perioperative process. Surgical nurses felt that the perioperative process contributed to increased continuity and increased safety for patients, but above all for themselves. Surgical nurses developed professionally, but also as individuals, they felt that their work was meaningful and that there was a caring relationship between the patient and the surgical nurse. Conclusion: This paper emphasizes that if the perioperative process would be used on a larger scale, the work for operative nurses would be more efficient, provide a more secure care, give more continuity and be very favourable to nurses as well as patients. The result for the patients would be a good care and well-being.

Information technology is ubiquitous in society and industry; however, healthcare is just beginning to explore how health information technology (HIT) can be optimized to support quality care. HIT can assist with standardizing care delivery, increasing access to evidence-based medicine, improving accuracy and ease of documentation, and assisting with patient education. Advanced Practice Registered Nurses (APRNs), specifically nurse practitioners (NPs) and certified nurse midwives (CNMs), play a pivotal role in the healthcare delivery system. To be effective practitioners, providers must manage, integrate, and assimilate a multitude of knowledge with each patient encounter. HIT can serve as the channel through which the NP and CNM provides cost-effective, efficient, and quality care. However, healthcare providers have been slow to adopt and implement HIT resources. We know that adoption of HIT by healthcare providers is varied among provider and practice settings. However, few studies have examined the impact on and utilization of information technology by APRNs, specifically nurse practitioners and certified nurse midwives.The purpose of this research was to investigate the utilization and influence of HIT on the clinical decision making of Kentucky nurse practitioners and nurse midwives (Kentucky APRNs). A descriptive cross-sectional design using survey methodology and convenience sampling was employed. Participants were asked to complete an author-modified, web-based survey tool that was based on current research. The 40-question tool was designed to explore providers' attitudes and perceptions of technology, determine their knowledge and utilization of various electronic and traditional print medical resources, and assess the penetration of and daily usage of HIT in practice.This study revealed information related to Kentucky APRN's utilization and influence of HIT on clinical decision making. Establishing exploratory Kentucky APRN findings will assist in evaluating further HIT utilization in Kentucky. Findings suggested that APRNs in Kentucky are beginning to explore the benefits of HIT; however, additional research will be required to identify the true penetration and utilization of technology in Kentucky. Although additional research is needed, HIT appears to be having an overall impact on the clinical practice of Kentucky APRNs.