Advanced Nurses Research Articles

Informing the clinical reasoning of advanced practice students with nursing theories

This article examines the integration of a Clinical Nurse Reasoning (CNR) model into advanced nursing practice training to develop the clinical reasoning skills of advanced practice nurses. The article explores the contribution of Callista Roy's conceptual model of adaptation and presents a global analysis of a complex care situation that justifies the introduction of an CNR model paired with nursing knowledge to ensure comprehensive, quality nursing care.

Awareness of radiation hazards and knowledge of radioprotective measures among radiologists and non-radiology staff: a cross-sectional survey

BackgroundIonizing radiation has become increasingly utilized in medical practice. Consequently, healthcare workers must be aware of radiation hazards and apply the necessary countermeasures to reduce occupational exposure. This study assessed the awareness of radiation hazards and knowledge of radiation protection measures among radiologists and non-radiologists. These findings may improve the application of various safety measures during medical interventions involving radiation.MethodsWe conducted a cross-sectional questionnaire-based study among 200 medical personnel, including consultant surgeons, physicians, radiologists, nurses, and radiographers, across five hospitals in Jordan between November 2022 and February 2023. The questionnaire collected data on demographic characteristics, awareness of radiation hazards, and knowledge of radioprotective techniques.ResultsOverall, the knowledge of radiation protection and awareness of radiation hazards among the participants were poor (51.55% and 37.17%, respectively). No significant difference was detected between the medical disciplines in terms of the level of knowledge of radiation protection; however, radiographers were significantly more aware of radiation hazards.ConclusionsAccording to our findings, medical personnel generally have poor awareness of radiation hazards and radiation protection protocols. However, this understanding can be enhanced through periodic in-service training and regular monitoring of occupational radiation exposure by health professionals.

Improving Throughput and Length of Stay Using Nurse Consultation in the Acute Adult Physical Rehabilitation Unit.

Improving Throughput and Length of Stay Using Nurse Consultation in the Acute Adult Physical Rehabilitation Unit.

Advanced practice nurses’ experiences of patient safety: a focus group study

Background: Patient harm from unsafe care is an increasingly global phenomenon leading to death or disability. Drawing on their expertise, Advanced Practice Nurses provide the opportunity to improve care quality and safety. Aim: To explore Nurse Practitioners and Clinical Nurse Consultants’ experiences in patient safety. Design: A qualitative design was used involving six audio-visually recorded focus group interviews. Participants working in an acute or community adult nursing speciality were involved. Methods: Twenty-eight Advanced Practice Nurses (female 82.1%, mean age 47.5 ± 10 years) were recruited by convenience and snowball sampling. After transcription of interview data, qualitative content analysis was conducted. Results: Six categories were identified: patient safety as the highest priority (1), special contribution to patient safety (2), patients/relatives role in safety (3), multidisciplinary team approach (4), government regulation in safety (5), and further needs to improve safety (6). Advanced Practice Nurses saw themselves as role models and leaders for other healthcare staff through their expertise and professional experience and thus able to see the bigger picture in health. They identified as change agents at the system-level due to their decision-making ability and multi-professional team connectivity. Conclusions: This study emphasises the key position of extended nursing roles and the need for future development of patient safety strategies in hospitals and community care. As influential leaders, Advanced Practice Nurses are best placed to identify improvements. They play a central role in guiding the multi-professional team, the patient and their family, educating nursing staff, and identifying and addressing system-wide safety gaps to improve patient safety.

Design of a nursing psychoeducation program to reduce preoperative anxiety in adults.

IntroductionPreoperative anxiety, with its multifactorial origins, affects a wide range of surgical patients, leading to adverse physiological and psychological effects in the perioperative period. Customized, autonomous nursing interventions are needed to address individual person needs. The shift toward outpatient surgery emphasizes the need for restructured nursing approaches. Existing literature suggests that preoperative nursing consultations offer opportunities for assessing needs, providing information, and prescribing anxiety-reduction strategies. Psychoeducation, a specialized skill within mental health and psychiatric nursing, has proven effective in alleviating preoperative anxiety and reducing postoperative complications. The aim is to obtain and analyze the information reflecting nurses’ understanding of the design, structure, and operationalization of a psychoeducation program to reduce preoperative anxiety in adults.MethodsA qualitative, exploratory, descriptive study was conducted. Data were collected through a 90-min focus group session held online via Zoom Meetings videoconferencing platform. Inclusion criteria for the participant’s selection were established. The focus group was guided to deliberate on potential strategies for crafting effective psychoeducational interventions. Data collection ceased upon reaching theoretical saturation and gathered information was submitted for content analysis. Ethical procedures were ensured.ResultsOf the participants, 10 were specialist nurses (7 working in mental health and psychiatric nursing and the remaining in medical-surgical nursing), with an average age of 41 and an average of 15 years working in surgical services. The nurses selected the target population, the structure and content of the psychoeducation sessions, and the resources and addressed the perceived importance, effectiveness, and feasibility of the designed psychoeducation program.DiscussionThe study revealed the nurses’ understanding of the design of a psychoeducation program potentially effective in reducing preoperative anxiety in adults, in an outpatient surgery context. This result will allow the transfer of the produced knowledge to nurses’ professional practice reflecting lower levels of anxiety and promoting a better surgical recovery. This is an unprecedented study conducted in Portugal, adding substantial knowledge to the nursing discipline. However, further research into implementing psychoeducation in a surgical context is suggested aiming to consolidate the results of research already carried out internationally.

Exploring Factors Affecting the Rollout of a Policy on Registered Advanced Nurse Practitioners in Ireland

Aim. To identify the barriers and enablers to the implementation of a national policy to increase and develop the advanced nurse practitioner (ANP) workforce in Ireland. Background. The Department of Health (Ireland) introduced a policy to increase the number of ANPs to 2% of the nursing workforce. Evaluation provides information to inform successful policy implementation and development of ANP roles in healthcare services. Methods. Qualitative descriptive design. Twenty candidate ANPs participated in four focus groups. Nine key stakeholders were also interviewed. Results. Analysis identified four barriers: lack of infrastructural resources; delay in releasing and arranging replacements for candidate ANPs; role resistance from administration, allied healthcare professionals and other nurses; and lack of organisational readiness. The five enablers were: supportive physicians; Nursing and Midwifery Practice Development Units; supportive directors of nursing; role awareness and clarity; and educational preparation. Conclusions. This evaluation identifies barriers and enablers to the implementation of a national policy to increase the critical mass of advanced practitioners within the healthcare services. Evaluation at the implementation phase informed the roll-out of future advanced practice initiatives. Implications for Nursing Management. To support advanced practice development, leadership, infrastructure, and resource planning are needed to harness known enablers and address identified barriers to the implementation and sustainability of these posts.

'We are pulled to the four corners': Qualitative role descriptions of advanced practice children's nurses in Malawi.

This study investigated emerging roles among specialist child health nurses (CHNs) in Malawi. Advanced nursing role development is globally advocated. Nursing role descriptions provide an evidential basis for workforce planning. Rigorously developed role descriptions are scarce worldwide, especially for Africa. Advanced nursing roles were introduced in Malawi's child health system a decade ago. We followed guidance on generating nursing role descriptions to collect and analyse qualitative data from interviews and focus groups, using qualitative content analysis. We used COREQ reporting standards. More than half (41/80) of Malawi's child health nursing workforce participated. Richly descriptive accounts of roles elicited three themes: leading and developing new services and improving existing ones; holding rare knowledge which uplifts care quality; and responsibility for developing the role. These responsibilities are experienced as a privilege and a burden, often meaning CHNs are 'pulled to the four corners'. We found evidence of remarkable achievements by Malawi's CHNs but also suggestions that they are under heavy strain. Because multi-stakeholder agreement about role content is crucial to successfully implementing advanced nursing roles, we hope the approach taken by this study, and the information generated, could be useful as part of human resources for health strategy development in other lower-resourced countries globally.

The Physical Health Nurse Consultant: Perceptions and Experiences of Those Who Care for People with Mental Illness

Mental health carers are crucial in improving the physical health outcomes of people diagnosed with a mental illness (hereafter referred to as consumers). The long-term and multifaceted mental and physical health support carers provide to consumers can contribute to caregiver burden. Consequently, carers advocate for coordinated and integrated physical healthcare to improve the physical health outcomes of consumers and alleviate caregiver burden. The aim of this qualitative exploratory study is to explore carers’ perceptions and experiences with the Physical Health Nurse Consultant role. Semi-structured interviews with nine carers nominated by consumers were conducted. Interviews were transcribed and reflexively thematically analysed. Three main themes were identified: (i) Therapeutic relationship s were a catalyst for health behaviour change; (ii) Overt and covert positive changes were observed by carer and (iii) Cares’ involvement in integrated mental health and physical health care. Nine carers who were nominated by consumers to be involved in their physical healthcare planning, preferred to adopt a supporting role as this prevented or reduced caregiver burden. The findings support the adoption and continuation of the Physical Health Nurse Consultant role to facilitate positive physical health outcomes for consumers and a reduction in caregiving burden. The benefits of the Physical Health Nurse Consultant provide a compelling argument to embed the role in routine practice. Mental healthcare services should advocate for continued funding and career development for such positions to provide long term benefits for consumers and carers. Future research is required to explore carer and consumer involvement in co-producing future and localised iterations of the Physical Health Nurse Consultant role. This research should also measure the outputs and outcomes of co-production to clarify how the process worked in practice.

Advancing Palliative Care through Advanced Nursing Practice: A Rapid Review

Advancing Palliative Care through Advanced Nursing Practice: A Rapid Review

THE OUTPATIENT CLINIC FOR PATIENTS WITH HEART FAILURE: A PROPOSAL FOR ADVANCED NURSING

Abstract In Italy, Heart Failure represents the leading cause of hospitalization in people over the age of sixty–five and is considered a public health problem of enormous importance, as it entails disabling consequences for the person, such as a significant reduction in the quality of life and the degree of self–sufficiency. Therefore, the person with heart failure requires adequate nursing care in each phase of transition from one care setting to another, as well as in the phase that goes from hospital discharge to the patient‘s return to the home. In the European Guidelines dedicated to Heart Failure it is not specified whether there is a nursing management assistance program dedicated to patients, and if present as it is declined in the various healthcare contexts. The aim of the thesis was to explore in the literature and in the national territory if there are advanced nursing care programs aimed at patients with heart failure and to develop the idea of ​​a nursing–managed clinic, where advanced nursing, which can be introduced into the integrated hospital–community care network for heart failure. For this purpose, a qualitative exploratory survey was developed, divided into two phases: a telephone exploratory survey which considered the cardiological clinics of all the Health Authorities of the Veneto Region and two other Italian Regions; a semi–structured interview addressed to a group of nurses who in the past managed a nursing clinic dedicated to patients with heart failure in a healthcare company in the Veneto Region. The results, especially from the literature review, showed a significant reduction in the risk of hospital readmission and in the mortality rate, an increase in the quality of life. However, differences emerged in the local context regarding the objectives, organization and activity of a Nursing Clinic dedicated to patients with heart failure. The challenge still remains open.

Advanced Practice Pediatric Oncology Nursing as Imagined or In Place in Four Lower- and Upper-Middle-Income Countries

The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middle-income countries (LMICs) presents opportunities and challenges. The authors explore the implications of pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential benefits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered. Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized. Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture. The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to significantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation. The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations.

Croatian consultancy practices: a nurse’s experience report

INTRODUCTION: The article analyses the professional path of a nurse consultant. Nursing consulting is an expanding and stimulating profession with advanced practice roles and responsibilities. It emphasizes the nurse consultancy practice created through persistent effort, challenges, successes, and personal growth. Engaging in partnerships with healthcare organizations to enhance patient care, optimize workflows, and address challenges within the healthcare system. OBJECTIVE: To report on a nurse’s work experience as a nursing consultancy practice in Croatia's healthcare system. METHODOLOGY: The methodology utilizes descriptive, qualitative, and narrative approaches, with a specific focus on personal experiences and reflections. This methodology aims to share the nurse's journey and the transformative impact of their work in the nursing field. The study emphasizes the significance of authenticity, tenacity, and ongoing learning in nursing management and the execution of nurse consultancy practice in Croatia. RESULTS: The author underscores the significance of embracing a fresh outlook on Croatia's nursing and healthcare systems, particularly workflow integration and a comprehensive perspective of organizational and management business concepts. It provides insights into the process of establishing new hospitals, encompassing expertise in general management as well as specialized abilities in leadership and healthcare management. It also explores the evolution of patient rights and advocates for increased empowerment of nurses in influencing healthcare policies and decision-making, utilizing business Intelligence data to guide the advancement of the field. CONCLUSION: In summary, the nurse is dedicated to transforming the nursing profession by implementing innovative ideas and procedures, focusing on changing patient care attitudes and practices. The narrative journey embarked upon in this has provided a profound understanding of the nurse's career, offering insights into their thoughts, struggles, attitudes, and triumphs, the process of growth, adaptation, and unwavering commitment to bringing about a positive impact in the field of the nursing profession.

DEVELOPMENT AND IMPLEMENTATION OF THE INFORM GUIDELINES FOR THE TREATMENT AND MANAGEMENT OF PROSTHETIC HIP INFECTION

Hip prosthetic joint infection (PJI) is a debilitating complication following joint replacement surgery, with significant impact on patients and healthcare systems. The INFection ORthopaedic Management: Evidence into Practice (INFORM:EP) study, builds upon the 6-year INFORM programme by developing evidence-based guidelines for the identification and management of hip PJI.A panel of 21 expert stakeholders collaborated to develop best practice guidelines based on evidence from INFORM \[1\]. An expert consensus process was used to refine guidelines using RAND/UCLA criteria. The guidelines were then implemented over a 12-month period through a Learning Collaborative of 24 healthcare professionals from 12 orthopaedic centres in England. Qualitative interviews were conducted with 17 members of the collaborative and findings used to inform the development of an implementation support toolkit. Patient and public involvement contextualised the implementation of the guidelines. The study is registered with the ISCRTN (34710385).The INFORM guidelines, structured around the stages of PJI management, were largely supported by surgeons, although barriers included limited awareness among non-surgical team members, lack of job planning for multidisciplinary teams, and challenges in ensuring timely referrals from primary care. Psychological support for patients was identified as a critical gap. Advanced Nurse Practitioners and multidisciplinary team (MDT) coordinators were seen as potential bridges to address these knowledge gaps. The guidelines were also viewed as a useful tool for service development.This study presents the first evidence-based guidelines for hip PJI management, offering a comprehensive approach to prevention, treatment, and postoperative care. Effective implementation is crucial, involving wider dissemination amongst primary and community care, as well as non-specialist treatment centres. Further resources are needed to ensure job planning for MDTs and psychological support for patients. Overall, this study lays the foundation for improved PJI management, benefiting patients and healthcare systems.

Patient-Reported Outcome and Experience Measures in Advanced Nursing Practice: What Are Key Considerations for Implementation and Optimized Use?

ObjectiveTo discuss the opportunities and challenges of implementing patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) within advanced practice nursing services in cancer care. MethodsThis discussion paper has been informed by an environmental scan of evidence from systematic reviews and primary studies evaluating the use and implementation of PROMs and PREMs. Literature from the contexts of cancer and chronic disease, including nursing and multidisciplinary supportive care literature, has been included. ResultsAdvanced practice nurses are well-positioned to evaluate and respond to PROMs and PREMs data; several studies have highlighted improved patient outcomes concerning quality of life, symptom distress, and functional status within nurse-led services. Nevertheless, the implementation of PROMs and PREMs in cancer care and nurse-led services is variable. Previous studies have highlighted implementation challenges, which can hinder comparability and generalizability of PROMs and PREMs instruments. Advanced practice nurses should consider these challenges, including ways to use standardized PROM instruments. Electronic PROMs, while efficient, may exclude individuals at risk of inequity. Complex, lengthy, and frequent administration of PROMs may also overburden people living with or after cancer, with people affected by cancer expressing preference for flexible use in some studies. Therefore, the involvement of people affected by cancer in planning for PROMs/PREMs implementation may overcome this challenge. Finally, organizational considerations in implementation should address financial investments, including initial costs for technology and training and consideration of the operationalization of PROMs within existing infrastructure for the seamless utilization of PROMs data. ConclusionDespite the potential of advanced practice nursing services to enhance patient-reported outcomes and experiences, variability in the implementation of PROMs and PREMs poses challenges. Use of validated measures, electronic or paper-based instruments, and the preferences of people affected by cancer for the use of PROMs and PREMs must be carefully considered in consultation with end users for successful implementation. Implications for PracticeIn planning for the implementation of PROMs and PREMs within nurse-led services, implementation risks may be mitigated through establishing clear guidelines for their use, investment in the development of the required infrastructure, user education, and rigorous implementation processes, including patient involvement in PROMs/PREMs selection.

Intensive care nurses’ and nurse anaesthetists’ motivation to enrol in an academic master’s program: A qualitative study

Background: Nurses worldwide are increasingly working in environments characterized by healthcare reforms, complex patient care and technological advancements that require the integration of evidence-based practice. There is also a growing need for continuous education, systematic competence research and competence assessment instruments to meet the rapid changes in critical and anaesthesia care settings. Aim: The aim of this study was to explore and describe anaesthetists’ (NAs) and intensive care nurses’ (ICNs) motivation for enrolling in an academic master’s program. Method: A qualitative study was carried out, using focus groups. Data were analysed by means of qualitative content analyses. The participants were 11 students from an academic master’s program at a Norwegian university. Findings: The participants’ motivation was linked to the theme “improving patient care through continuous learning” and supported by three categories: understanding research; learning to argue within an intraprofessional team; improving and further developing the NAs and ICNs professions. Conclusion: Continuous learning to improve patient care for the critically ill was the main motivating factor for NAs and ICNs to enrol in an academic master’s program. NAs and ICNs enrolled in the academic master’s program with little or no support from the hospitals, and they reported that, in a busy ward, the time available for learning is scarce. The finding that NAs and ICNs desire continuous learning is relevant for hospital leaders who struggle to achieve patient safety goals and retain/recruit highly competent advanced nurses.

Bridging the gap: How investing in advanced practice nurses could transform emergency care in Africa.

This paper aims to highlight the vital importance of investing in advanced practice nursing (APN) for enhancing emergency care throughout Africa. APN's role is increasingly recognized as pivotal in optimizing healthcare, particularly in emergency settings in Africa. It offers improved patient care quality and strengthens the healthcare workforce. Evidence is drawn from successful implementations of APN in various healthcare environments. This includes the development of APN-specific curricula and training, mentorship initiatives, clinical supervision, and defining advanced nursing roles within healthcare organizations. Investing in APNs in emergency care in Africa can lead to improved quality and access to care, cost-effectiveness, enhanced patient outcomes and satisfaction, and opportunities for professional development and career advancement in the healthcare workforce. Despite facing barriers in implementation, APN in emergency care presents innovative solutions. Investing in APN can help healthcare entities and policymakers surmount these challenges, providing specialized patient care and improving health outcomes. The discussion emphasizes the benefits such as enhanced access to care, reduced healthcare costs, and improved patient outcomes, alongside bolstering the healthcare workforce. The necessity and benefits of investing in APN for emergency care in Africa are clear. It is crucial for improving healthcare delivery and outcomes. APN investment leads to a more competent and efficient nursing workforce, capable of addressing complex emergencies and improving patient care. The paper advocates for policies that support APN development and integration into the healthcare system, emphasizing the need for research to assess APN's long-term impact and establish best practices for its implementation in emergency care across Africa.

Knowledge Graph Analysis for Chronic Diseases Nursing based on Visualization Technology and Literature Big Data

The use of knowledge graph analysis for chronic disease nursing based on visualization technology and literature big data is an unexplored area of research in this field of study. To uncover research hotspots and developmental trends in the field of chronic disease nursing, and to provide a scholarly reference, we employed mathematical and statistical methods along with CiteSpace literature visualization analysis software for quantitative analysis of extensive literature data from the Web of Science Core Collection. We examined aspects such as publication trends, journals, author collaborations, research institutions, national and regional distributions, keyword co-occurrence, clustering, time zones, emergence, literature co-citations, and more. These analyses identified the current hotspots and future directions for research. Notably, scholars' interest in chronic disease nursing exhibited a consistent upward trajectory. In particular, the field of artificial intelligence technology application in nursing yielded $3,610$ published papers in $141$ journals with more than or equal to $10$ published papers on the topic, accounting for $58.41 \%$ of the total number of published papers in this field of study. Furthermore, the top three publishers were the “Journal of Clinical Nursing,” “Journal of Advanced Nursing,” and “BMC Health Services Research.” Among authors, Hu, Frank B., Willett, Walter C., and Rimm, Eric B., ranked as the top three, and 12 authors had more than 10 publications. The most active research institutions included Harvard University, Harvard Medical School, Brigham & Women’s Hospital, University of California System, University of London, US Department of Veterans Affairs, Veterans Health Administration (VHA), Harvard T. H. Chan School of Public Health, University of Sydney, and the University of Toronto. The United States, Australia, England, China, Canada, Netherlands, Spain, Italy, Sweden, and Germany emerged as the leading countries in terms of research output, while emerging hotspots encompassed topics such as incidence, rheumatoid arthritis, qualitative research, burnout, kidney transplantation, critical illness, COVID-19, Sars-COV-2, public health, and the well-being of medical staff. These findings present valuable insights for prospective research endeavors.

The role of advanced practice nurses in improving healthcare outcomes for patients with chronic kidney disease: A scoping review protocol.

The number of patients with chronic kidney disease is increasing worldwide; previous studies have suggested that advanced practice nurses, including nurse practitioners and clinical nurse specialists, with expert practice skills can provide high-quality care and solve complex healthcare problems. In general, nurse practitioners are generalist nurses who work as autonomous clinicians with whole personal care. Clinical nurse specialists, in contrast, are nurses with advanced nursing knowledge and skills for individuals or specific populations. Their roles are independent and different; however, similarities exist in their role in potentially improving healthcare outcomes. Although two previous studies described the role of nephrology nurse practitioners, they were systematic reviews, and their outcomes were limited. To clarify the overall aspect of advanced practice nurses' role, it is necessary to extract the studies illustrating advanced practice nurses' practices for patients with chronic kidney disease. This study aims to map the literature describing the role of advanced practice nurses in improving healthcare outcomes for patients with chronic kidney disease. This scoping review will be conducted using the Joanna Briggs Institute methodology for scoping review. Online databases will be searched across MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Web of Science. Only studies published in English will be included, and no date limit will be set. Chronic kidney disease, renal replacement therapy, and advanced practice nurses as keywords and related search terms will be used. Two independent reviewers will screen the title and abstract/full-text; in case of discrepancy, a third reviewer will make the final decision. The results will be extracted and presented following the review question concerning the study characteristics, patients' characteristics, condition of chronic kidney disease, and role of advanced practice nurses.

Nursing skill levels and implementation of Advanced Nursing Practice in Austria: A cross-sectional study

Nursing skill levels and implementation of Advanced Nursing Practice in Austria: A cross-sectional study Abstract: Background: New fields of practice are emerging under the concept of "Advanced Nursing Practice" (ANP) that offer specialised care provided by nurses who hold master's degrees. In Austria, nurses are currently being trained as Advanced Practice Nurses (APN). Aim: The project aimed to investigate which advanced nursing practice tasks according to the Hamric model are undertaken by nurses at different levels of qualification in Austria. Methods: Certified nurses did participate in a cross-sectional survey through an online questionnaire based on the Role Delineation Model and tailored to the Austrian context. The tasks were assigned based on the Hamric model and were tested and evaluated descriptively according to the qualification level through factor analysis. Results: Completed data was available from 105 participants, among them 80% with undergraduate education, 20% with a master's degree. A tendency in the results showed that the level of qualification was related to the activities carried out. The higher the academic degree, the more activities were performed in the field of leadership. The central ANP-competencies, research and education, are rather weak among all respondents. Conclusion: The results show that activities corresponding to the competencies of an ANP are performed by a heterogeneous group of nurses. Conditions and a standardized understanding of ANP need to be established in order to offer a professional practice that matches the competency profile.

Abstract 6302: Home-based supportive care programs for quality-of-life outcomes among patients with advanced cancer: A systematic review

Abstract Objectives This study systematically reviews the literature on the effect of home-based supportive care (HbSC) programs on the quality of life (QoL) of patients with advanced cancer. Methods: The research question ‘Do home-based supportive care programs for patients with advanced cancer improve their QoL?’ was addressed. After registering the plan with PROSPERO (CRD42021235007), literature published from 1 January 1990 to 11 July 2022 was searched on Ovid Medline, Embase, Cochrane library, Web of Science, and Google Scholar and reviewed for inclusion based on predefined criteria. This review only included trial studies published in English. Results: Of 5288 articles identified, 17 studies were judged suitable for inclusion in this review. The components of HbSC programs included home visits, patient and caregiver education, home nursing, psychotherapy, exercise, and telephone consultation. Eight programs included conducting multidisciplinary team meetings. Improvements in QoL were reported in six studies. Specific areas of QoL improved when interventions included home nursing, psychotherapy, patient and caregiver education, and exercise. Conclusion: HbSC programs appear to enable the improvement of the QoL of patients with advanced cancer. The area of QoL that shows improvement could vary depending on the HbSC components. More studies that address HbSC programs are needed to select patients at the proper time and provide suitable programs for patients to benefit most. Citation Format: Inyoung Hwang, Go-Un Wo, Sun-Young Lee, Shin Hye Yoo, Kyae Hyung Kim, Min-Sun Kim, Jeongmi Shin, Hyejin Jeong, Min Seol Jang, Sun Kyung Baek, Eun Hee Jung, Dong-Wook Lee, Belong Cho, Jin Ho Park, Hyuktae Kwon. Home-based supportive care programs for quality-of-life outcomes among patients with advanced cancer: A systematic review [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6302.