Background: Due to arduous demands of graduate education, advanced practice nursing (APN) students who are classified as adult learners are at risk for suffering sleep deprivation. Factors contributing to sleep deprivation include stress, expected academic challenges, and everyday life stressors. Purpose: This study investigated if APN students’ grade-point average (GPA), gender, and employment status predicted levels of daytime sleepiness. Theoretical Framework. The psychological well-being model selected for this study was consistent with the theory that sleep is a resource essential to well-being; adequate sleep is the resource needed to optimally manage stressful life demands. Methods. Bivariate and multiple regression were employed to examine the relationship between GPA, gender, and employment status with daytime sleepiness on a sample of APN students (N = 123) in their second academic year. The Epworth Sleepiness Scale and a demographic questionnaire were used to record data on GPA, gender, and employment status. Results. Results showed ESS and GPA were negatively correlated and statistically significant (r = -.24, p < .05). This indicates that as the tendency for sleepiness increased, GPA decreased, thereby supporting the alternative hypothesis. Although not statistically significant, employed participants reported greater daytime sleepiness, as did women. Conclusions: When GPA, gender, and employment were combined, multiple correlation showed a statistically significant shared variance of 8% with daytime sleepiness, due primarily to the correlation between GPA and daytime sleepiness. The effect size of shared variance was between small and medium with respect to magnitude of importance.

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.

Yes / Background: The education of first contact practitioners (FCPs) working in musculoskeletal practice in primary care is guided by an NHS England framework: the Roadmap to Practice. This includes a portfolio route to recognise the skills and capabilities of experienced physiotherapists. Aim: To review the portfolio route for evidencing the capabilities expected of the roadmap through the experience of practitioners. Method: An online survey and interviews were conducted of FCPs and supervisors from early-implementer sites. Results: While participants largely supported the need for assurance of their capabilities, their personal perceptions of completing the portfolio were strongly influenced by their career stage, clinical experience and length of time in their FCP role. Individuals often had limited planned time for portfolio development and competing clinical priorities. Conclusion: The portfolio route was acknowledged as a valuable way to evidence capability within practice. The volume of evidence required and the limited guidance given were overwhelming for many participants. / Funding for this project was provided by Health Education England.