Academic literature on the topic 'Advanced nurse competences'

The development of medical science creates new challenges for nurses to acquire new skills. Thanks to legal changes in Poland, nurses have gained the opportunity to independently provide health services in many areas, including consultations for patients. The aim of the survey is to analyze nurses’ opinions on the expansion of competences in their profession. This is a cross-sectional, descriptive study conducted among 798 nurses using the survey technique. The majority (65.48%) of the respondents believed that they were adequately prepared to take up new competences. Most of the respondents believed that the new competence would improve the efficiency of the healthcare system in Poland (71.06%) and facilitate patients’ access to health services (65.29%). According to the nurses, the scope of nursing advice will mainly concern the promotion of health education, wound treatment and prescribing medications. Age, seniority and education level significantly influenced the nurses’ opinions on the scope of nursing advice. The Mann–Whitney test and the Kruskal–Wallis test were used. A correlation between two quantitative variables was assessed with the Spearman’s rho coefficient. The significance level of p < 0.05 was assumed. The extension of the professional competences of nurses will increase the prestige of the profession and is another step toward introducing the role of Advanced Practice Nurse in Poland.

Nursing around the world is developing very dynamically and nurses are undertaking increasingly complex tasks. The extension of entitlements for nurses in Poland in the area of writing prescriptions and referrals for diagnostic tests seems to be a response to the development and changes occurring in this profession. This will improve the standards of patient care, increase access to medical services and improve the professional status of this group. The aim of this study was to analyze the opinions of nurses regarding their preparedness for administering prescriptions and referrals for diagnostic tests depending on their sense of life satisfaction and the level of occupational burnout. The study was conducted among primary care nurses using a survey technique, using a standardized scale of life satisfaction and a scale to measure burnout. In addition, this study used a proprietary survey questionnaire containing questions regarding the self-assessment of preparedness for new competences. The results showed that nurses do not feel well prepared for new tasks. The levels of life satisfaction and burnout of the nurses surveyed significantly influenced confidence regarding their preparedness for writing prescriptions and referrals for diagnostic tests. Polish nurses have a very cautious attitude towards new competences. However, this is a breakthrough and the first step towards approving the role of an advanced practice nurse in our country.

Aims: The European Society of Cardiology (ESC) guidelines state that heart failure nurse specialists (heart-failure nurses) with specific competences are essential for a successful heart-failure-management programme. Thus, the Heart Failure Association (HFA) of the ESC developed the heart failure nurse curriculum (HFA curriculum). Several ESC member states developed cardiovascular education programmes to enable nurses to deliver high specialist care, but little is known of whether these curricula are in line with the HFA curriculum. Therefore, this paper describes the extent to which cardiovascular education programmes in Belgium, The Netherlands and Germany correspond to the HFA curriculum. Methods and results: A case study approach was adopted to obtain an in-depth understanding of the programme contents in relation to the HFA curriculum. For this purpose, representatives of the educational programmes and/or delegates of the national cardiovascular nursing organization shared their educational curricula. All of the studied cardiovascular education programmes aim to provide heart failure and/or cardiovascular nurses with essential competences for implementation of evidence based and guideline derived care. However, every cardiovascular education programme has a different focus/area of attention. Cardiovascular education in Belgium discusses aspects of all core-learning objectives of the HFA curriculum and emphasizes mostly knowledge aspects of these. Learning objectives in cardiovascular education in The Netherlands focus on chronic diseases in general and on learning objectives concerning patient education, support in self-care and management of device and pharmacological therapy. Cardiovascular education in Germany discusses most learning objectives; however, not all learning objectives receive equal attention. Conclusions: Although local cardiovascular education programmes adopt certain aspects of the HF curriculum, the curriculum as a whole is not adopted.

Abstract Introduction. An independent prescribing certain drugs, including issuing prescriptions, as well as an entitlement to refer patients for certain diagnostic tests, constitute the key competences of an advanced nurse/midwife practice. Aim. To analyze knowledge and attitudes of departmental nurses (DN) towards extending professional powers of nurses and midwives. Material and methods. The sample involved 23 DN (women: 100%) working in the Independent Public Children’s Teaching Hospital in Warsaw. The mean age was 49 years (mode and median: 50; min. 31, max. 61, SD=7.95). The mean of professional experience was 30 years (mode: 25, median: 30, min. 17, max. 40, SD=6.38). A voluntary and anonymous questionnaire with 10 questions referring to knowledge and 32 statements concerning attitudes evaluated in the Likert scale was conducted. Results. Almost all DN knew that prescribing drugs is a right and not an obligation. Nearly half of the DN knew when the new regulations shall enter into force. DN believed that the new regulations shall improve patient care and increase patient’s comfort and access to services. DN concern about preparation of nurses and midwives for new competences. Conclusions. 1. The study group’s level of knowledge about the new competences was insufficient and requires supplementing. 2. The attitudes of the study group towards the new competences were not unambiguous. It should, however, be noted that the study was conducted in a specialized children’s teaching hospital, where the application of the amended regulations is limited. 3. Although the nursing management staff supports the legislative changes, they object to the process of introducing them. This applies particularly to the necessity of an adequate preparation of nurses and midwives. 4. The study should be continued among a representative group of nurses with a similar level of education, professional experience, and place of work, with particular consideration of nurses working in the outpatient health care.

Summary. Advanced research and assessment of the patient's health status plays a key role in the practice of a nurse. As autonomous, independent health care providers, nurses perform health assessments to evaluate patient needs and determine the best treatments. Advanced health assessment is a systematic process for evaluating the physical, mental and functional aspects of patient health. Mastering this diagnostic tool is vital to nurse`s practice because health assessment forms the basis of patient care The aim of the study – to describe and analyze the academic program of the course Advanced Physical Assessment, branch of knowledge – 22 HEALTH CARE, specialty “223 NURSING”, training program “NURSING”, degree of higher education – Second (Master) level of higher education in the international students’ faculty of I. Horbachevsky TNMU. Materials and Methods. It was described and analyzed both the training program and the academic program of the course of studies “Advanced Physical Assessment”, available for students of the second degree of higher education in the Institute of Nursing, I. Horbachevsky Ternopil National Medical University. Results. The course of studies “Advanced Physical Assessment”, which was developed according to the requirements of the training program is aimed at development of systemic knowledge and understanding of conceptual foundations by students utilizing systematic history taking and the knowledge of therapeutic communication to elicit subjective data; collecting objective data; validating, analyzing and documentation of those data. This course ensures the acquisition of the appropriate competences and program learning outcomes, consists of lectures, training sessions and student`s independent work. It presents an overview of the full and comprehensive health assessment of patients across the life span. It emphasizes multiple aspects of advanced health assessment, including physical, functional and mental health assessment along with transcultural variations. Conclusions. According to the requirements of the training program “Nursing” the course of studies “Advanced Physical Assessment” is available for students of the second (master) degree of higher education. The course of studies “Advanced Physical Assessment” consists of lectures (24 hours), training sessions (30 hours) and student’s independent work (126 hours). The course of studies “Advanced Physical Assessment” ensures the acquisition of the appropriate competences and program learning outcomes in accordance with the training program “Nursing”. The assessment of students` performance is evaluated using the criteria for assessment of students’ knowledge and skills.

Abstract Many publications have focused on quality improvement interventions in nursing homes but the self-initiated daily involvement of nursing homes in quality improvement activities has rarely been investigated (e.g., conducting surveys, using data to set quality aims and track quality of care over time, conducting quality improvement projects). Such activities can be carried out by nurses in expanded roles with competences beyond those of regular registered nurses (e.g., advanced studies, Bachelor/Master’s degree), but evidence is lacking. We aimed to described the involvement of nursing homes and of nurses working in expanded roles in quality improvement activities in Swiss nursing homes. A cross-sectional multi-center study (2018-2019) using survey data from a convenience sample of 115 Swiss nursing homes and 104 nurses in expanded roles was used and descriptive statistics applied. Most nursing homes reported carrying several quality improvement activities (median = 8 activities out of 10 surveyed). The group of nursing homes working with a nurse in an expanded role (n = 83) were more engaged in quality improvement than the other group (median = 8 versus 6.5) Higher-educated nurses participated more in a majority of quality improvement activities than lower-educated nurses (Bachelor/Master-educated nurses: median of 13 out of 17 activities surveyed, versus diploma-educated nurses: 10), except for clinical teaching. This study provides insights into nursing homes’ involvement in daily quality improvement and suggests that, depending on the targeted quality improvement needs, nursing homes use different profiles and education levels of nurses in expanded roles.

Constantly changing environment and constantly growing needs and requirements of patients, make nursing define its competences, look for place in the health care system, plan tasks and create nursing development strategies. It tries to meet the requirements, becoming at the same time a key link in the health care system and a fully autonomous profession but with an unchangeable mission which is to save human life and care for the patient. Permanent changes in health care, in society as well as in the structures in medical professions cause that nursing constantly strives for its development and tries to engage substantive dialogue with those responsible for health policy, in order to outline the framework of the profession in the actual reality and its future. A review of selected national strategies for nursing development, the circumstances in which they developed and key assumptions allow to conclude about their positive impact on public health in a given country and on the quality of patient care. What connects individual strategies is the priority treatment of multisectoral cooperation in health care, aspects related to the promotion of the profession, education of nurses and the definition of new roles and new competences in the context of the requirements and needs of a given country. An example may be prescribing, providing nursing advice or introducing the role of an advanced practice nurse. A great achievement for nursing in Poland is the initiative of creation Strategy of Development for nursing. It is a planning document that defines the directions of activities ensuring high quality, safety and access to nursing care of patients.

OBJECTIVE: To identify the competencies of nurses to health promotion in psychiatric and mental health context. METHODS: Integrative review of literature performed through search using the keywords: "mental health" and "professional competence", in the databases SciELO, LILACS, CINAHL, PubMed, Scopus and Cochrane, in the period of 2003 to 2011. 215 studies were identified, of these, six followed the inclusion criteria. RESULTS: Based on the National Panel for Psychiatric Mental Health NP Competencies, the competencies were identified on the evaluated studies: Monitoring and ensuring the quality of health care practice, management of patient health/illness status, cultural competence, managing and negotiating health care delivery systems, the nurse practitioner-patient relationship. CONCLUSION: The studies analysis evidenced the need for education and training so that nurses may develop the competencies of health promotion in diverse psychiatric care and mental health contexts, in order to broaden knowledge and skills.

Scientific advances in genetics and genomics are rapidly redefining our understanding of health and illness and creating a significant shift in practice for all health care disciplines. Nurses educated at the graduate level are well-prepared to assume clinical and leadership roles in health care systems and must also be prepared to assume similar roles related to genetic/genomic health care. This chapter describes the processes used to create a consensus document identifying the genetic/genomic competencies essential for nurses prepared at the graduate level. Three groups were involved in the competency development; a steering committee provided leadership and used qualitative methods to review and analyze pertinent source documents and create an initial competency draft; an advisory board evaluated and revised the draft, and a consensus panel refined and validated the final set of competencies. The concensus process resulted in 38 competencies organized under the following categories: Risk Assessment and Interpretation; Genetic Education, Counseling, Testing and Results Interpretation; Clinical Management; Ethical, Legal, and Social Implications; Professional Role; Leadership, and Research. These competencies apply to all individuals functioning at the graduate level in nursing, including but not limited to advanced practice registered nurses, clinical nurse leaders, nurse educators, nurse administrators, and nurse scientists and are intended to inform and guide their practice.

Background: Specialists were asked to describe the most essential palliative and end-of-life care competencies needed in their working units, in order to deepen the understanding of the phenomenon. Aim: To describe the most essential competencies of palliative-care nurses and physicians. Methods: The data was collected using an open-ended question in a survey sent to registered nurses (n=129) working within palliative care and to physicians (n=64) with a special competency in palliative care. The data was analysed using content analysis. Results: The description of the most essential competencies included 16 main categories and 63 subcategories in total. The three strongest main categories were ‘clinical competence’, ‘competence in social interactions’ and ‘competence in giving support’. Eleven main categories were based on both nurses' and physicians' data, while five main categories were created from nurses’ data only. Conclusion: Interprofessional palliative-care education is recommended for the undergraduate and postgraduate education of nurses and physicians.

Background: Graduate nursing academic faculty rely heavily on clinical preceptors for mentorship and clinical practicum experiences for BSN-DNP degree-seeking family nurse practitioner (FNP) students. Thus, it is important that preceptors have documented clinical competencies to assure the delivery of quality, evidence-based practice that meets regulatory requirements prior to precepting students.Objectives: The objectives of this quality improvement project were to develop and implement APRN competency validation tools (CVTs) in nurse-led clinic settings.Methods: Rapid Cycle Quality Improvement (RCQI) strategies were used to develop and implement APRN CVTs.Results: Three APRN CVTs were successfully developed, tested, refined, and implemented in four nurse-led clinics in rural east Tennessee. With one exception, the APRN preceptors had documentation of clinical competency prior to approval as a SPADES preceptor. Graduate academic faculty, preceptors, and students reported satisfaction with the SPADES project.Conclusion: CVTs are feasible tools for documentation of validated clinical APRN preceptors’ competency in nurse-led clinics. The CVTs and the medical record review checklist are available upon request from the primary author.Implications for Nursing: Use of APRN CVTs provides documentation that the preceptor uses evidence-based practice in the clinic setting prior to precepting students.

Andelen äldre personer ökar i Sverige och världen vilket innebär att efterfrågan av vård ökar, men all vård behöver inte ske på sjukhus. Insatser som kan förhindra undvikbar slutenvård bör vara viktiga att arbeta fram dels ur ett hållbarhetsperspektiv, men även viktigt för att minska den påfrestning, förvirring och försämrad hälsostatus en sjukhusvistelse kan innebära för den äldre sköra patienten. Mobila närsjuksvårdsteam som utgår från sjukhusen är en relativt ny vårdform i Sverige och introducerades i Västra Götalandsregionen för ungefär 10 år sedan. Mobila närsjukvårdsteam gör insatser för sköra patienter med komplexa behov i hemmet och i teamen arbetar bland annat sjuksköterskor. Inom sjuksköterskans kompetensområde ingår att självständigt kunna ansvara för omvårdnad av patienter, inneha förmågan att se hela patientens livsvärld samt arbeta för en säker vård.  Syftet med den här studien är att belysa sjuksköterskans arbete med sköra patienter i mobila närsjukvårdsteam. Denna studie har genomförts som kvalitativ metod med induktiv ansats och bygger på intervjuer som datainsamlingsmetod. Vi har intervjuat sjuksköterskor verksamma på tre olika mobila närsjukvårdsteam. Resultatet av vår studie har visat att sjuksköterskan i mobila närsjukvårdsteam har en viktig roll då de utför avancerad vård i hemmet genom samverkan i team och med andra vårdaktörer. Sjuksköterskan har ett helhetsperspektiv med patienten i fokus och på så sätt kan andelen onödiga sjukhusinläggningar minska. Vår studie visar att snabb uppföljning i hemmet av sköra patienter som skrivs ut från sjukhus skapar trygghet samt minskar återinläggningar. Dessutom är rätt vård av sköra äldre patienter en organisatorisk fråga och vården behöver bedrivas av rätt kompetens. Sjuksköterskans arbete i mobila närsjukvårdsteam innebär att arbeta med hållbar utveckling genom att konsumtion av slutenvård minskar.
The proportion of older people is increasing in Sweden and the world, which means that the demand for care is increasing, but all care need not executed in hospitals. Efforts that can prevent avoidable outpatient care should be important to work on from a sustainability perspective, but also important to reduce the stress, confusion and deteriorating health status a hospital stay can cause for the older fragile patient. Mobile local health care teams executed from the local hospital are a relatively new form of care in Sweden. Mobile local health care teams were introduced in the Västra Götaland region about 10 years ago. Mobile local health care teams makes efforts for fragile patients with complex needs in their home.  The registered nurse’s expertise includes being able to independently be responsible for the care of patients, having the ability to see the entire patient's needs and working for patient's safety. The aim of this study is to illustrate the nurse's work with fragile older patients in mobile local health care teams. This study has been conducted as a qualitative method with an inductive approach and is based on interviews as a data collection method. We have interviewed nurses working on three different mobile local health care teams. The result has shown that the registered nurse in mobile local health care teams plays an important role as they carry out advanced care in the home through collaboration in teams and with other healthcare players. The registered nurse has a holistic perspective with the patient in focus, unnecessary hospitalizations and re-admission can be reduced. This study shows that fast follow-up in the home of fragile patients who are discharged from hospitals creates security and reduces re-admissions. In addition, proper care of fragile elderly patients is an organizational issue and care needs to be conducted by the right expertise. Registered nurse's work in mobile local health care teams means working with sustainable development by reducing the consumption of inpatient care.

Objectifs: Etudier l'évolution de l'introduction du rôle de l'IPA et proposer des recommandations pour les études ultérieures.Méthodes: Une revue de la littérature française et internationale concernant l'IPA. Participation à un groupe de travail national concernant l'avancement de ce rôle et les réformes éducationnelles. Une étude rétrospective comparant la prise en charge de patients hypoglycémiques en milieu pré-hospitalier par infirmiers et physiciens. Un questionnaire étudiant les perceptions des premiers étudiants en cursus IPA.Résultats: Différents niveaux de transferts de compétence et de collaboration médecin/infirmière existent déjà en France. Dans l'étude rétrospective, la qualité de soin des infirmières a été similaire à celle des médecins. Dans l'étude sur l'IPA, la majorité des étudiants a indiqué que les autres infirmières et docteurs ne sont pas au courant du rôle de l'IPA, et que des barrières bloquent son développement.Conclusions: La création du rôle d'IPA et le développement de la formation des infirmières en France peuvent répondre aux défis de santé publique, telle l'incidence croissante des maladies chroniques et la pénurie de médecins. Les recommandations suivantes furent proposées pour le développement du rôle de l'IPA : définir et faire reconnaître le rôle de la pratique infirmière avancée et ses compétences, promouvoir le rôle plus largement dans les disciplines médicales, soutenir les efforts de communication entre l'état et les professionnels de santé, développer des programmes au niveau master et doctorat, et promouvoir des travaux de recherche infirmiers et interdisciplinaires
Background: In the context of public health challenges and health care reforms in France, the evolving advanced practice nurse (APN) role may be a solution. Objectives: To study the introduction of the ANP role and provide evidence-based recommendations for future research.Methods: A review of the international and French APN literature was performed. Participation in a national task force concerned advancement of the role and education reforms. In a retrospective study, nurses and physicians were compared in the pre-hospital management of hypoglycemic patients. Finally, a survey was administered to the first French APN Master's students to identify their perceptions of the APN role.Results: Variables levels of skill transfer and doctor-nurse collaboration currently exist in France. In the retrospective study, the pre-hospital quality of care of nurses was comparable to that of doctors. In the APN student survey, the majority indicated that other nurses and doctors were not aware of the APN role, and that barriers exist in role development. Conclusions: Creation of the APN role and advancement of nursing education in France can respond to public health challenges including the rising incidence of chronic diseases and an impending physician shortage. The following recommendations were proposed for APN role development: to define and recognize the advanced practice nurse role and related competencies, promote the role in a wider range of medical disciplines, facilitate clear communication between government and health care professionals, develop nursing Master's and Doctorate programs, and promote nursing and interdisciplinary research

Il progetto ha indagato l importanza delle competenze infermieristiche avanzate in medicina dei disastri prendendo in considerazione una formazione standardizzata finalizzata alla costituzione di un percorso formativo dedicato La medicina delle catastrofi si è imposta all’attenzione del mondo culturale e scientifico negli ultimi vent’anni, per gli addetti ai lavori l’interesse per l’argomento ha conosciuto un crescendo esponenziale in ragione del contesto politico e sociale dei nostri giorni. Gli attentati verificatisi a New York, Madrid e Londra hanno rappresentato la spinta propulsiva verso un argomento fino ad allora ritenuto di scarso interesse per coloro, che nella quotidianità, erano deputati alla gestione dell’emergenza sanitaria sia in ambito ospedaliero che extraospedaliero. Dopo la tragedia dell'11 settembre 2001, sono stati ideati e realizzati un gran numero di corsi di istruzione e formazione in Medicina dei Disastri . In Italia il Ministero della Salute e la Prefettura ( Ministero della Difesa ) si rivolgono al Servizio di Emergenza Territoriale 118 per intervenire in caso di “Disastro”. In Italia gli infermieri che lavorano presso i Servizi di Emergenza Territoriale 118, spesso, non possiedono competenze certificate ma si avvalgono dell’esperienza per affrontare tali emergenze. Da questo quesito nasce l’idea di un progetto formativo dedicato, che fornisca agli infermieri competenze avanzate e standardizzate in materia di medicina dei disastri Formazione e organizzazione rappresentano i cardini della medicina dei disastri e si pongono come obiettivi primari su cui investire risorse umane e materiali. OBIETTIVO GENERALE: costituire, attraverso un metodo validato, una “nurse core competencies” standardizzata, relativa alla Medicina dei Disastri, su cui progettare un percorso didattico professionalizzante per infermieri, relativo, alla Medicina dei Disastri OBIETTIVI SPECIFICI: - Valutare, utilizzando il Dreyfus ' Ability Scale / livelli di competenza di P. Benner (11), la percezione degli infermieri dei servizi di emergenza territoriale 118 in Italia relativa alle competenze possedute per rispondere ai disastri e agli incidenti casuali di massa facendo riferimento al “National Standardized All-Hazard Disaster Core Competencies Task Force” di Shultz e Koenig (1° Survey) (12). - Attribuire un valore di importanza, in base alle competenze certificate possedute e all’esperienza nel campo della medicina dei disastri, alle attività contenute nella core competence “National Standardized All-Hazard Disaster Core Competencies Task Force” di Shultz e Koenig (2°Survey). - L’ obiettivo del focus group è quello di indagare l’importanza di una formazione specifica in medicina dei disastri ed individuare possibili criticità dovute ad una ipotetica carenza di percorsi didattici dedicati e l’eventuale gap formativo. Contesto e popolazione L’indagine multicentrica si è rivolta ai Servizi di emergenza 118. Per quanto riguarda la prima indagine agli infermieri era richiesta l’appartanenza ad un Servizio di Area Critica, per quanto concerne la seconda survey,la popolazione è stata selezionata in base a requisiti specifici: prestare Servizio presso il Servizio di emergenza territoriale 118, possedere competenze certificate in medicina dei disastri ed esperienza nel campo Materiali e metodi Lo studio del progetto prevede una ricerca di tipo quantitativo attraverso la somministrazione di due survey , costruite sulla base degli strumenti validati elencati sopra e compilati in tempi diversi ed una ricerca di tipo qualitativo attraverso il focus group. Strumenti - Standardized National All-Hazard Disaster Core Competencies of Koenig and Schultz - Dreyfus' Ability Scale - Scala Likert - Griglia di osservazione di Bales (20) (scala degli atteggiamenti IPA- Interaction Process Analysis Per lavorare al questionario da somministrare agli infermieri dei servizi territoriali 118 in Italia è stato necessario tradurre dall’inglese all’italiano il primo strumento. Il processo di traduzione1 si è svolto secondo le linee guida del QCER (Quadro Comune Europeo di Riferimento per le Lingue) e a tal proposito è stato costituito un gruppo di lavoro multidisciplinare. L’obiettivo generale del progetto di dottorato era quello di costruire, attraverso un metodo validato, una “nurse core competencies” relativa alla medicina dei Disastri, su cui costruire un percorso didattico, professionalizzante, per infermieri. Il lavoro è iniziato conducendo una revisione della letteratura internazionale finalizzata alla ricerca di uno strumento validato, pertinente, all’ipotesi di ricerca. Lo stato dell’arte ha confermato una carente offerta di percorsi didattici, completi, fruibili da infermieri, tranne corsi di pochi giorni che non forniscono sufficienti competenze in merito. E’ emerso, inoltre, un gap formativo che spesso viene colmato dall’esperienza sul campo ma non supportata da competenze certificate ed inoltre, alla luce della nuova normativa, inerente le competenze avanzate dell’infermiere, è necessario istituire percorsi formativi specialistici. Per il progetto di studio è stata condotta una ricerca di tipo quantitativo e qualitativo e rispettivamente sono state somministrate due survey, attraverso uno studio multicentrico, ed è stato organizzato un focus group. Per quanto concerne i dati statistici è stata svolta un’analisi monovariata e bivariata con il software SPSS: l’attendibilità dei questionari è stata valutata calcolando il livello di coerenza interna, relativa od ogni costrutto, ossia l’alpha di Cronbach che ha dato un risultato di 0,98 e 0.99, pertanto molto soddisfacente; per il focus group è stata individuata la posizione di massima efficacia della dinamica di gruppo attraverso la griglia osservazionale di Bales (scala degli atteggiamenti IPA- Interaction Process Analysis. Dal primo questionario emerge, tra i rispondenti. un’anzianità di servizio molto elevata pertanto l’esperienza è molta e sarebbe utile poiché l’80% non è mai intervenuto in disastri ma il 70% non possiede formazione in materia di medicina dei disastri pertanto è fondamentale avere competenze certificate e una formazione che comprenda simulazioni in scala reale. Le competenze maggiori sono possedute in materia di Triage e una minore conoscenza invece è emersa, nei confronti di impianti e sistemi sanitari in grado di fronteggiare rapidamente un disastro e l'aumento spropositato della domanda di soccorso rispetto alle risorse disponibili: personale adeguato, forniture, attrezzature, strutture e spazi adeguati per la cura del paziente. Questi argomenti riassunti in surge capacity e surge capability sono i cardini della medicina dei disastri, è rilevante che sia emerso questo dato come competenza maggiormente carente. Ma soprattutto una carenza formativa si è evidenziata per quanto concerne i principi etici e problemi psicosociali, in medicina dei disastri che hanno un impatto, non da poco, sulla popolazione colpita ed il personale chiamato ad intervenire. In un disastro è fondamentale avere anche una preparazione in merito, basti pensare agli aspetti etici del Triage: “non tutti possono essere salvati” e ai problemi psicosociali che ne derivano: traumi psicologici in bambini, anziani, disabili, donne in gravidanza ma anche tra gli operatori chiamati ad intervenire. Gli input psicologici negativi sono molteplici. La motivazione dei rispondenti è stata molto elevata poiché il lavoro è stato ritenuto molto rilevante per il 45% e rilevante/mediamente rilevante il 49,2%, un dato molto significativo che evidenzia una cultura intellettuale sull’argomento La seconda intervista ha preso in considerazione, come contesto, i Servizi di emergenza territoriale, per quanto concerne la popolazione, sono stati fissati due requisiti di reclutamento: esperienza sul campo e competenze certificate in materia di medicina dei disastri. Lo strumento utilizzato è lo stesso inserito nella prima survey ma in questo caso è stato richiesto ai rispondenti di esprimere un parere di inclusione o esclusione sugli obiettivi di performance estrapolati dall’elenco di competenze della core presa in considerazione, nell’ottica di inserirli o meno in un programma didattico, specifico, in medicina dei disastri. Nonostante la survey fosse impegnativa dal punto di vista della compilazione (circa 10 minuti circa per l’intera compilazione), i questionari sono stati compilati per intero ed inoltre sono state inserite numerose osservazioni, tutte positive e costruttive. Si percepiscono pertanto motivazione ed interesse per l’argomento proposto ed è proprio stato specificato che il lavoro e l’argomento sono molto interessanti ed è forte e sentita la necessità di formazione specifica, nell’ambito della medicina dei disastri. Il triage è emerso nuovamente come prima attività riconosciuta dagli infermieri come la più importante, nel primo questionario era ritenuta la competenza posseduta maggiormente. Dalle annotazioni libere, predisposte nel questionario, viene evidenziata carenza di formazione e la necessità che vengano istituiti corsi completi. Viene inoltre annotato l’importanza di argomenti etici e psicologici nonché l’importanza di una formazione multi professionale e in collaborazione con altri enti. Anche questi dati concordano con il primo questionario dove veniva espresso il bisogno di formazione in tal senso. Il focus group è stato organizzato con l’obiettivo di indagare l’importanza di una formazione specifica in medicina dei disastri ed individuare possibili criticità dovute ad una ipotetica carenza di percorsi didattici dedicati e l’eventuale gap formativo. La posizione di massima efficacia della dinamica di gruppo ha trovato collocazione nell’area dei comportamenti socio emozionali positivi e nell’area di orientamento al compito (ambito conoscitivo). Nel corso della conversazione non sono mai emersi comportamenti e atteggiamenti socio emozionali negativi.E’ indubbio che il focus abbia messo in evidenza il bisogno di formazione e la necessità di istituire un corso completo e multidisciplinare che conferisca agli infermieri competenze avanzate certificate e quindi riconoscibili, a livello formale, in ambito lavorativo e didattico. In ultimo, ma non meno importante, è emersa la carenza di una cultura intellettuale di base. relativa alla medicina dei disastri. A tal proposito si auspica che questo lavoro abbia contribuito ad accrescere questa cultura, e continui a farlo, attraverso gli infermieri che hanno partecipato a questa indagine, con il loro preziosissimo contributo, poiché hanno dimostrato molto interesse e motivazione sull’argomento. Questo progetto di dottorato non può considerarsi terminato e lascia spazio quindi ad altre ipotesi future e ad approfondimenti, come del resto il lavoro di ricerca prevede. Sicuramente i limiti maggiori sono dovuti al numero del campione che può risultare rappresentativo ma sicuramente può essere ampliato, inoltre si sono incontrati molti ostacoli per reperire indirizzi per diffondere i questionari: la situazione dei Servizi 118 in Italia è disomogenea e sempre soggetta a cambiamenti strutturali, organizzativi ed economici derivanti da disposizioni normative . Le prospettive future sono rivolte essenzialmente all’implementazione di un programma educativo ed innovativo inerente la medicina dei disastri; per quanto concerne le risorse economiche è possibile sottoporre progetti didattici all’Ente di Protezione Civile che può disporre di finanziamenti europei erogabili, per iniziative che includono anche corsi di formazione, specifici in materia di medicina delle catastrofi. The project investigated the importance of advanced nursing skills in disaster medicine by considering a standardized training aimed at creating a dedicated training path Disaster medicine has attracted attention to the cultural and scientific world in the last twenty years, for the insiders interest in the subject has experienced an exponential growth due to the political and social context of our days. The attacks in New York, Madrid and London represented the driving force towards a topic that until then was considered of little interest to those who, in their daily life, were deputies to the management of the health emergency both in hospital and outside the hospital. After the tragedy of 11 September 2001, a large number of education and training courses in Disaster Medicine have been designed and implemented. In Italy, the Ministry of Health and the Prefecture (Ministry of Defense) turn to the 118 Territorial Emergency Service to intervene in the event of a "disaster". In Italy nurses working at Territorial Emergency Services 118 often do not have certified skills but use the experience to deal with such emergencies. From this question arises the idea of ​​a dedicated training project, which provides nurses with advanced and standardized skills in disaster medicine. Training and organization are the cornerstones of disaster medicine and are set as primary objectives on which to invest human and material resources. GENERAL OBJECTIVE: to establish, through a validated method, a standardized "nurse core competencies", related to Disaster Medicine, on which to plan a professional training course for nurses, relative, to Disaster Medicine SPECIFIC OBJECTIVES: - Evaluate, by using the Dreyfus' Ability Scale / levels of competence of P. Benner (11), the perception of nurses of the territorial emergency services 118 in Italy concerning the skills possessed to respond to disasters and mass casual incidents referring to the "National Standardized All-Hazard Disaster Core Competencies Task Force" by Shultz and Koenig (1st Survey) (12). - Assign a value of importance, based on the certified skills possessed and experience in the field of disaster medicine, to the activities contained in the core competence of the "National Standardized All-Hazard Disaster Core Competencies Task Force" by Shultz and Koenig (2nd Survey ). - The objective of the focus group is to investigate the importance of specific training in disasters and to identify possible critical issues due to a hypothetical lack of dedicated didactic paths and the possible training gap. Context and population The multi-center survey focused on the 118 emergency services. Regarding the first survey of the nurses, the need for a Critical Area Service was required, with regard to the second survey, the population was selected according to specific requirements. : provide service at the Territorial Emergency Service 118, possess certified skills in disaster medicine and experience in the field Materials and methods The study of the project involves a quantitative research through the administration of two surveys, built on the basis of the validated tools listed above and compiled at different times and a qualitative research through the focus group. Instruments - Standardized National All-Hazard Disaster Core Competencies of Koenig and Schultz - Dreyfus' Ability Scale - Likert scale - Bales observation grid (20) (IPA-Interaction Process Analysis attitudes scale) In order to work on the questionnaire to be administered to the nurses of territorial services 118 in Italy, it was necessary to translate the first tool from English into Italian. The translation process1 took place according to the guidelines of the CEFR (Common European Framework of Reference for Languages) and a multidisciplinary working group was set up for this purpose. The general objective of the doctoral project was to build, through a validated method, a "nurse core competencies" related to Disaster medicine, on which to build a didactic, professionalizing path for nurses. The work began by conducting a review of the international literature aimed at finding a validated tool, relevant to the research hypothesis. The state of the art has confirmed a lack of offer of didactic paths, complete, usable by nurses, except courses of a few days that do not provide sufficient skills in this regard. In addition, a training gap has emerged that is often filled by experience in the field but not supported by certified skills and furthermore, in the light of the new legislation, inherent in the advanced skills of the nurse, it is necessary to establish specialized training courses. For the study project a quantitative and qualitative research was conducted and two surveys were administered, through a multicentric study, and a focus group was organized. With regard to the statistical data, a monovariate and bivariate analysis was carried out with the SPSS software: the reliability of the questionnaires was assessed by calculating the level of internal, relative or each construct, ie the Cronbach alpha which gave a result of 0.98 and 0.99, therefore very satisfactory; for the focus group the position of maximum effectiveness of the group dynamics was identified through the observational grid of Bales (IPA-Interaction Process Analysis attitude scale) From the first questionnaire emerges, among the respondents, a very high level of service therefore experience is great and it would be useful as 80% have never intervened in disasters but 70% have no training in disaster medicine so it is essential to have certified skills and training that includes full-scale simulations. they are owned in the field of Triage and less knowledge has instead emerged, with regard to systems and health systems able to cope rapidly with a disaster and the disproportionate increase in the demand for assistance compared to the available resources: adequate personnel, supplies, equipment, facilities and adequate space for patient care. These arguments summarized in surge capacity and surge capability are the cornerstones of disaster medicine, it is important that this data emerged as the most lacking competence. But above all, a lack of training has been highlighted with regard to ethical principles and psychosocial problems, in medicine of disasters that have an impact, not a little, on the population affected and the staff called to intervene. In a disaster it is also important to have a preparation on this, just think of the ethical aspects of the Triage: "not everyone can be saved" and the psychosocial problems that derive: psychological trauma in children, the elderly, the disabled, pregnant women but also between the operators called to intervene. There are many negative psychological inputs. The motivation of the respondents was very high because the work was considered very relevant for 45% and 49.2% is relevant / significant, a very significant figure that highlights an intellectual culture on the subject. The second interview took into account, as context, the Territorial Emergency Services, with regard to the population, two recruitment requirements were set: field experience and certified skills in disaster medicine. The instrument used is the same as in the first survey but in this case respondents were asked to express an opinion of inclusion or exclusion on performance targets extrapolated from the list of core competencies taken into consideration, with a view to inserting them or not in a specific educational program in disasters medicine. Although the survey was demanding from the compilation point of view (about 10 minutes for the entire compilation), the questionnaires were completed in full and also many comments were included, all positive and constructive. We therefore perceive motivation and interest in the proposed topic and it has been specified that the work and the topic are very interesting and the need for specific training in the field of disasters is strong and felt. . The triage has emerged again as the first activity recognized by nurses as the most important, in the first questionnaire was considered the most widely owned competence. From the free annotations, prepared in the questionnaire, there is a lack of training and the need for complete courses to be established. It is also noted the importance of ethical and psychological topics as well as the importance of a multi professional training and in collaboration with other bodies. These data also agree with the first questionnaire where the need for training in this sense was expressed. The focus group was organized with the aim of investigating the importance of specific training in disaster medicine and identifying possible critical issues due to a hypothetical lack of dedicated didactic paths and the possible training gap. The position of maximum effectiveness of the group dynamics has found a place in the area of ​​positive social and emotional behaviors and in the area of ​​orientation to the task (cognitive field). During the conversation, negative social and emotional behaviors and attitudes have never emerged. It is undoubted that the focus highlighted the need for training and the need to establish a complete and multidisciplinary course that gives nurses advanced skills certified and therefore recognizable, at the formal level, in the workplace and teaching. Last but not least, the lack of a basic intellectual culture has emerged. relating to Disaster Medicine. In this regard it is hoped that this work has contributed to increasing this culture, and continues to do so, through the nurses who participated in this survey, with their invaluable contribution, since they have shown much interest and motivation on the subject. This doctoral project can not be considered finished and therefore leaves room for other future hypotheses and in-depth analyzes, as the research work provides. Surely the biggest limits are due to the number of the sample that can be representative but surely it can be expanded, moreover many obstacles have been encountered to find addresses to spread the questionnaires: the situation of the 118 Services in Italy is inhomogeneous and always subject to structural changes, organizational and economic results deriving from regulatory provisions. The future perspectives are essentially aimed at the implementation of an educational and innovative program concerning disaster medicine; as far as economic resources are concerned, it is possible to submit educational projects to the Civil Protection Agency, which may dispose of European funding, for initiatives that also include training courses specific to disaster medicine.

ABSTRACT Nurses’ Cardiopulmonary resuscitation (CPR) competence has been a subject of many research studies. The need for nurses to be competent in CPR is not debatable, because nurses are expected to preserve and promote life. This study assessed and compared CPR competence between two groups of Advanced Student Nurses in a Kenyan Medical Training College. The study used a descriptive comparative design. The participants were assigned to two groups based on the CPR training they had received. Group I had Advanced Life Support (ALS) training n=23 (comprised ICU advanced nursing students) and group II had Basic Life Support (BLS) training n=48 (comprised Midwifery, Ophthalmic, Community and Psychiatric advanced nursing students). The study sample constituted 71 participants of whom 28.2% were males and 71.8 % were females. Out of the 71 students who took part in the study only five attained the competence score, the remaining 66 failed the competence test. The five who passed the competence score were from the ALS group. The null hypothesis tested in the study was subjected to paired t-test and a p-value of p= 0.0001 was obtained. The null hypothesis was thus rejected based on this finding. The study confirmed previous findings that nurses CPR competence is below the expectation and the difference in training for the two groups of Advanced Student Nurses.

The nursing implications of burn injuries extend beyond the immediate health concerns over the loss of skin integrity, the presence of scarring, and the psychological impacts on patients due to disfigurement. Non-fatal burns may lead to long-term disabilities, hence advanced nursing care may be required to prevent such outcomes. In Hong Kong, advances have been made to ensure that sophisticated nursing services and care are in place for affected patients. This chapter discusses how burn injuries are managed at different levels within a publicly funded acute care framework, explains how professional competencies regarding burn care are developed among burn care nurses, delineates the roles of medical technology in supporting wound assessment, explains the application of novel dressing materials for various burn wound conditions, and outlines how the establishment of nurse-led clinics can promote the continuity of care for patients with burn injuries. Written with an international perspective with the authors’ practice experiences in Hong Kong (China), this chapter provides evidence-based reference for registered nurses in general, specialty nurses, nurse practitioners, and nurse consultants worldwide.

Nursing has embraced flexible online advanced education as a means of increasing the supply of nurse professionals. Virtual simulation and other adaptive learning technologies enhance learning efficiency and student outcomes. A simulated electronic health record (DocuCare) was adopted in an online graduate nursing informatics course. An assignment using DocuCare to learn core concepts of nursing informatics was developed for graduate students enrolled in a nursing informatics course. A validated standard informatics survey instrument was used to measure three individual domains (basic computer skills, roles, and advanced computer skills (clinical informatics)) as well as the combined informatics competency level. Overall, the nursing informatics competency level was between competent and proficient; basic computer skills and roles were above proficient; and advanced computer skills (clinical informatics) fell between competence and proficient levels.

As health professionals, nurses are responsible not only for staying abreast of current professional knowledge to provide effective care but also for managing their own career, professional growth and development. Nurse educators have acknowledged that eportfolios provide a means through which nurses can record and provide evidence of skills, achievements, experience, professional development and, on-going learning, not only for themselves, but for the information and scrutiny of registration boards, employers, managers and peers. Recognising that practices to support these activities that foster 21st century learning should ideally start during their student years, the authors explored eportfolios as a valuable learning device for on-going personal and professional development for fostering students’lifelong learning and enhancing continuous personal and professional development. This paper describes the critical success factors for successful implementation of the Google Sites Practice eportfolio embedded in the three-year BSc(Hons) Nursing Programme in Malta. Evidence-based practice of successful eportfolio implementors was examined and their methods adapted to ensure the initiative had a sound foundation and fit for purpose.The authors argue that to be successful, eportfolio implementation must primarily be strategic, holistic, supported and have senior management buy-in and secondarily, have a robust tool, good pedagogy, and skilled and enthusiastic staff. Keywords:nursing;competency;implementation;eportfolio;Malta;Nurse Education