Legal issues for nurses. Navigating the Board of Nurse Examiner's disciplinary process.
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Humans↗
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Implementing the role of patient-navigator nurse at a university hospital centre.
A profile of the role and functions of an oncology patient-navigator nurse (OPN) and the preliminary phases to implementing this role within a team specializing in oncology are first presented. This is followed by a qualitative study that provides a descriptive assessment for implementing an initial OPN in the head and neck oncology area of a university hospital centre (UHC) with a supraregional model for oncology. Three groups of stakeholders (individuals with cancer and families, caregivers, network partners) were interviewed on three occasions: before, during and after implementation. The results show that this new role can be integrated within a team specializing in oncology. The beneficial effects of this role on the process of adaptation to illness, interdisciplinary work and continuity of care are described. Several recommendations are formulated, one being the importance of situating the implementation process from an organizational change perspective.
Adaptation, Psychological↗
Hyperlinked Lexicon in Nursing Informatics--a tool for navigating through Nursing Informatics Terminology.
The Evolution of Information Technology is rapid. Electronic circuits substitute mental activities and new Technology invades to all aspects of life. Nursing, which is like all the other Health related professions information-intensive, could use the new Technology to be facilitated. The implementation of Informatics to Nursing was supported by the growing information that Nursing has to manage. The definition of Nursing Informatics was put on 1980 and since then a lot attempts to define Nursing Informatics have followed. The applications of Nursing Informatics are focused on four fields of Nursing: Administration of Nursing, Clinical Practice, Education, and Research. The first applications of Nursing Informatics made visible the need for the development of a Unified Language System. The efforts, today, are focused on two fields: to establish a standard definition of the terms of or related to Nursing Informatics, to establish standard definitions and Classification Schemes for the Nursing Phenomena and Practice so that they can be processed by Nursing Informatics. In solving these problems important role plays the study of Linguistics. Another important factor that should be taken into account is the Development of International Standards of general acceptance that enhances communication aspects. Apart from the International Standardisation Organisations, other non-profit organisations have constituted Special Groups that are dealing with the promotion of Nursing Informatics. Final Nursing Informatics should follow the previous attempts of Nursing to establish a Unified Language System. All the steps of the development of the application are described. In particular subjects that are covered are: the scope of the application, the collection of the material, the designing and building up of the Database, the development of a User Interface and the characteristics of the Application.
Databases as Topic↗
Navigating a nursing curriculum: bridges and barriers.
As increasing numbers of students from non-traditional sources enter the baccalaureate nursing program, retention of these educationally, socially, and economically disadvantaged and older students have become important to a nursing program's continued viability. To retain these students, nurse educators need to become more sensitive to the educational needs of these students. Through focus groups used to survey sophomore, junior, and senior nursing students, researchers identified academic and non-academic resources cited by successful traditional and non-traditional students. A telephone survey of local nursing programs, by a third researcher, identified student resources at other statewide baccalaureate nursing programs. Participating students cited curriculum resources most often, with emotional support and academic resources of next importance. Students also expressed frustration regarding accessing resources (e.g., class time, office support, parking). The long term goal was to develop a resource program for non-traditional nursing students.
Adolescent↗
Multicenter randomized effectiveness/implementation trial of a digital self-management support tool to improve the quality of life during adjuvant hormonal therapy for patients with early breast cancer: The HOPE trial.
BACKGROUND: For patients with hormone receptor (HR) positive early breast cancer (BC), adjuvant endocrine therapy (ET) represents the cornerstone of treatment. However, 75% of patients experience ET-related symptoms that negatively affect their quality of life (QOL). Despite their high prevalence, these symptoms are often underestimated and under-addressed during consultations. As a result, non-adherence to ET is common and remains a major barrier for optimal disease and survival outcomes. METHODS: National, prospective, randomized, open-label hybrid type 1 effectiveness/implementation trial conducted in France comparing a personalized digital health pathway plus standard of care (SoC) vs. SoC alone in patients with HR+ early BC reporting ET-related symptoms. 180 patients will be randomized 1:1 to receive either 12 weeks of the digital health pathway or 12 weeks of SoC. The intervention is anchored by the Resilience© digital companion including remote symptom and needs assessment, an introductory nurse-navigator phone call, and access to personalized, symptom-specific online educational and self-management programs (physical activity, yoga, meditation or cognitive behavioral therapy). In both arms, patients will be invited to wear a wearable device to objectively monitor behavioral parameters. The primary endpoint is the ET symptoms scale of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR45 over 12-weeks. Secondary endpoints include other QOL domains, self-reported ET adherence, eHealth literacy, self-efficacy, and evaluation of the implementation process. DISCUSSION: This study should provide evidence on the effectiveness and real-world implementation of a personalized digital health pathway to improve QOL in patients experiencing ET-related symptoms. TRIAL REGISTRATION: ClinicalTrials.gov NCT06781996; Protocol version 3.0.
Humans↗
Breast cancer: so much more than just a perioperative experience.
This paper's focus is the various types of breast cancer, the predisposing factors for the disease, treatment options, treatment modalities, conventional and unconventional therapies, surgical reconstruction, genetics and hormone replacement. The treatment of breast cancer is regarded as a team effort requiring the dedication and expertise of all of the members of the care team to ensure a favorable patient outcome. Within this team the author recommends an expanded new role for the perioperative nurse, that of the nurse navigator.
Breast Neoplasms↗
Accelerating Lung Cancer Management Through Previsit Liquid Biopsy: Results From the LUNG-FAST Pilot Study.
BACKGROUND: Timely molecular profiling is essential for treatment selection in non-small cell lung cancer (NSCLC), yet delays in biomarker testing remain common. We evaluated the feasibility and early clinical impact of a nurse navigator-driven workflow to initiate liquid biopsy before the initial oncology visit. METHODS: LUNG-FAST (Liquid Biopsy for Urgent Neoplastic Genomic Profiling Focused Accelerated Stratification and Testing) was a 4-month prospective pilot at a tertiary cancer center. Intake nurse navigators identified eligible patients with suspected or newly diagnosed lung cancer and facilitated previsit liquid biopsy ordering. Feasibility, turnaround times, genomic findings, and early clinical outcomes were assessed. RESULTS: Among 64 patients, intake nurse navigators identified 94% (60/64) of eligible cases. Liquid biopsy was ordered in 58 patients, with 62% (36/58) placed before the initial oncology visit. Median turnaround time from blood draw to results was 8.5 days for commercial testing and 12.5 days for institutional testing. FDA-actionable genomic alterations were identified in 34% (22/64) of patients, while an additional 11% (7/64) harbored clinically relevant, non-FDA-actionable alterations. Overall, FDA-actionable or clinically relevant alterations were identified in 45% (29/64), with 22% detected by liquid biopsy and an additional 23% by tissue-only profiling. Median time from new patient visit to systemic therapy was 26 days. CONCLUSIONS: A nurse navigator-driven workflow enabling previsit liquid biopsy is feasible and identifies actionable genomic alterations in a substantial proportion of patients with lung cancer. Plasma and tissue profiling are complementary, and earlier plasma-based testing may expedite treatment decision-making while highlighting opportunities to optimize biomarker testing workflows.
Humans↗
Nursing retention in the era of a nursing shortage: Norton Navigators.
Norton Healthcare has launched Norton Navigators, an 18-month mentoring program that matches recent nursing school graduates with experienced nurses. The program has improved Norton Healthcare's retention rate of new nurses and reduced the overall turnover rate for new graduates. Other benefits include saving 40,000 dollars per retained nurse, higher patient satisfaction, and an increase in recruitment.
Attitude of Health Personnel↗
Navigating towards a moral horizon: a multisite qualitative study of ethical practice in nursing.
This paper reports the results of a qualitative study of nurses' ethical decision-making. Focus groups of nurses in diverse practice contexts were used as a means to explore the meaning of ethics and the enactment of ethical practice. The findings centre on the metaphor of a moral horizon--the horizon representing "the good" towards which the nurses were navigating. The findings suggest that currents within the moral climate of nurses' work significantly influence nurses' progress towards their moral horizon. All too often, the nurses found themselves navigating against a current characterized by the privileging of biomedicine and a corporate ethos. Conversely, a current of supportive colleagues as well as professional guidelines and standards and ethics education helped them to move towards their horizon. The implications for nursing practice and for our understanding of ethical decision-making are discussed.
Decision Making↗
Navigating in a complex nursing world.
The recent findings emerging from the new science of complexity are altering our view of unpredicted behavior. In many cases, natural laws hidden deep within the complex processes of healthcare systems may be exerting a powerful influence over our ability to control outcomes. The author explores the concept of complexity and how nurse administrators may use these new theories to navigate through an increasingly unpredictable world.
Humans↗
The N-CODES project moves to user testing.
For a technology to be implemented successfully, it must be thoroughly tested by the stakeholders who will use it in practice. This article reports on the user testing of the Nurse Computer Decision Support working prototype. Ten acute care nurses with varying levels of education and experience participated in the testing. The study's protocol consisted of a series of tasks requiring the participants to use the system while solving patient problems. Both quantitative and qualitative data on usability, ease of navigation, and nurse satisfaction were collected. The nurses ranked usability and ease of navigation highly. Nurses were excited about the system's clinical potential and felt that it would be useful to all practitioners regardless of experience. Testing the system in an actual clinical setting is the next step, but it is clear that the system has extraordinary potential to improve clinical decision making and patient outcomes.
Acute Disease↗
Navigating specialty certification.
Nurses planning to become certified in their specialty or needing to recertify can visit these Web sites for test locations and schedules. Some sites also offer newsletters.
Certification↗
New skills sets needed to navigate managed care.
Nurse managers in the late 1990s and the 21st century may find themselves working for a managed care organization, and certainly will find themselves employed in a managed health care environment. The roles and opportunities are many for managers who have the right combination of skills and knowledge. Understanding managed care language and strategies in synergy, with a creative leadership approach, enables nurse managers to move successfully from acute care to the new world now unfolding.
Health Knowledge, Attitudes, Practice↗
Developing a succession plan: the North Bronx Healthcare Network.
After 3 years of reorganizing a nursing department, surviving 2 very successful Joint Commission on Accreditation of Healthcare Organizations (JCAHO) visits, developing an outcomes-based leadership program for head nurses, and assisting a large health care network navigate change, a nurse executive stops to think about succession planning. The challenge to develop a plan includes her own history, others' definitions, and finally developing her own definition and plan. Included are the complications of planning within a network that includes long-term and loyal employees. Finally, the steps to achieving that plan are outlined with the goal of having the nursing department continue to flourish and survive in a diverse network system.
Career Mobility↗
[Transition from student nurse to staff nurse].
When new staff nurses leave school and enter the working world they experience a shock that is all the greater because of their limited clinical experience. Difficulty in adjustment and a high attrition rate have been noted among new staff nurses as they navigate this challenging and stressful transition. New staff nurses experience excessive workloads, a shortage of practical and managerial skills, great differences between their educational priorities and the reality of clinical practice, and the feeling of a lack of support. Setting up a preceptorship system to support and guide the professional development, psychological adjustment and career planning of individual nurses would help to foster positive socialization, reduce levels of anxiety and increase job satisfaction among nurses. In turn, if this is accomplished, it will lower work-related stress, reduce attrition rates and stabilize levels of nursing manpower.
Adaptation, Psychological↗
Improving oncology nursing practice through understanding and exploring the Internet.
PURPOSE/OBJECTIVES: To provide an overview of the evolution of computer technology, a brief history of the Internet, and guidelines for searching the Internet. DATA SOURCES: Literature, electronic online sources, and personal experience. DATA SYNTHESIS: Vast collections of resources are available on the Internet that can enhance many aspects of oncology nursing practice. These resources are stored on computers, rarely published as print documents, and only available to those oncology nurses who learn to navigate the Internet. IMPLICATIONS FOR NURSING PRACTICE: Specific Internet-based oncology nursing resources can enhance clinical practice, improve education, and facilitate oncology nursing research. CONCLUSIONS: Because a significant number of valuable resources are available on the Internet, it is critical that oncology nurses understand it, be aware of the resources, and have the skills to access the appropriate information.
Clinical Nursing Research↗
Data as textbook.
Hospital information systems have been collecting patient-related data systematically for years. This article describes a course developed at the Yale University School of Nursing that uses hospital data as "textbook" to teach graduate nursing students to navigate a large hospital data set, enabling a multitude of nursing questions to be addressed. The approach used in this course is easily transferrable to the practice setting as demonstrated by the authors. Through understanding patient-level data, their aggregate patterns, and overall database construction, nurses can expand their contributions to clinical practice and management.
Curriculum↗
Enacting connectedness in nursing education: moving from pockets of rhetoric to reality.
Nursing education research points to lack of faculty support as a factor in nursing students' voluntary or involuntary withdrawal from nursing education programs. Moreover, despite global trends toward educational processes grounded in humanism that foster egalitarian and liberating student-teacher relationships, nursing students continue to report that some nursing faculty struggle to enact the caring philosophy they espouse. This article showcases how a fourth-year nursing student, interviewed for a study of students who experienced failure or its threat in their nursing program, found strength as she navigated her way through nursing faculty abuse. An interpretative analysis of the student's experiences with a group of faculty whom she describes as intent on failing her calls for future research on student-teacher relationships.
Adaptation, Psychological↗