Development Of Nursing Practice Research Articles

Characteristics of advanced practice nurses’ clinical competence in primary healthcare settings: a scoping review protocol

Objective: This scoping review aims to identify the clinical competency characteristics, in terms of knowledge, skills, and attitudes, of advanced practice nurses in primary care settings. Introduction: Although much has been written about the competencies of advanced practice nurses, more detail about the skills, knowledge, and attitudes that inform their clinical competency in primary health care needs to be ascertained. This will promote the development, implementation, and evaluation of advanced nursing practice in contexts where it is unavailable. Inclusion criteria: Studies that address the clinical competency characteristics of advanced practice nurses in primary health care settings will be considered for inclusion. Methods: This review will be conducted according to JBI methodology for scoping reviews. A comprehensive search will be conducted in PubMed, CINAHL (EBSCOhost), Web of Science, Scopus, Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO), Embase (Elsevier), Science Direct (Elsevier), Cochrane Library, and Google Scholar for primary and secondary qualitative, quantitative, and mixed methods studies on the topic of relevance. Gray literature will be searched in DART-E, TESES CAPES, CAUL (Australian Digital Theses), and Theses Canada Editorials. Letters, editorials, commentaries, conference abstracts, and documents published by advanced practice nurses’ associations will also be considered for inclusion. Two independent reviewers will screen the studies at title and abstract and full text. The same reviewers will extract relevant data using an instrument developed by the reviewers. These data will be presented in a narrative synthesis to facilitate the analysis of the evidence found. Review registration: Open Science Framework https://osf.io/tnrjz/

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.

Promoting speaking-up behaviours among nurses working in the care for older people: A scoping review.

To explore interventions employed to foster speaking-up behaviours of registered nurses (RNs) working in the care of older people. Scoping review. The updated Joann Briggs Institute scoping review methodological guidelines were followed. CINAHL, PubMed, PsycINFO, and Scopus were searched. A total of 1691 titles and abstracts were screened, resulting in 11 articles that met the inclusion criteria. Analysis focused upon intervention types, methodologies, speaking up strategies, barriers and effectiveness. Education was the most used intervention. There is a lack of published research on successful interventions to promote speaking-up behaviours in the care of older people, particularly relating to poor care practices. Evidence of speaking-up interventions in the residential aged care setting is absent. This highlights the need to develop strategies to support the RN to lead and enable others to raise care concerns. Developing strategies that enable staff, care recipients and their families to speak up about care concerns is a vital future area for nursing practice development. Nursing leadership of such strategies is central to improving the quality of care for older people, particularly those living in residential aged care. Older people receiving care should feel respected and be treated humanely. Evidence suggests this is often not the case. This review found a paucity of interventions to promote speaking-up about poor care practices among RNs working in the care of older people. Future research needs to address this, to empower RNs and improve the care afforded to older people. The PRISMA-ScR (Tricco etal., Annals of Internal Medicine, 169, 467-473, 2018) were adhered to throughout this scoping review. No patient or public contribution in this review.

Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients.

Hemorrhagic stroke is a serious condition that leads to high morbidity and mortality rates, particularly within the first 30 days following the stroke. One serious complication is increased intracranial pressure (IICP), which worsens neurological symptoms and can result in death or disability. To develop and implement a clinical nursing practice guideline (CNPG) for prevention and management of IICP in hemorrhagic stroke patients. This study had two phases: (1) Evidence trigger and support, identifying clinical problems and gathering empirical evidence, and (2) Evidence-observed, where a CNPG was developed and implemented. The CNPG was based on the Nursing Role Effectiveness Model and Soukup's Nursing Practice Development Model, covering preoperative and postoperative care and key nursing activities such as assessment, prevention, and management. The study assessed the CNPG's impact on nurses' knowledge, practices, and implementation feasibility. Nineteen registered nurses from the Surgical Intensive Care Unit were included and analyzed using descriptive statistics, interquartile range, and the Wilcoxon signed-rank test. The findings showed a significant improvement in nurses' mean knowledge scores after implementing the nursing guideline for preventing IICP in hemorrhagic stroke patients (p < 0.000). The overall mean knowledge score was high (X̄ = 23.11, SD = 2.54, Mdn = 23, IQR = 5). Additionally, the total mean nursing practice score (X̄ = 122.53, SD = 17.80) and overall mean perceived implementation feasibility score were both high (X̄ = 4.68, SD = .35). The findings suggest that integrating nursing practice guidelines and providing training to enhance nurses' knowledge significantly contribute to positive outcomes in both structure and process. Regarding structure, nurses demonstrated increased knowledge and proficiency in nursing practices. Regarding process outcomes, evidence-based guidelines were effectively utilized, paving the way for practical application in future nursing practice.

Climates and associated factors for evidence-based practice implementation among nurses: a cross-sectional study

BackgroundThe organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses.AimsTo clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices.MethodsThis study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate.ResultsThe nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate.ConclusionThe climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices.Relevance to clinical practiceUnderstanding nurses’ perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation.Patient or public contributionClinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate.

A55‘Who’s in charge? Me!’ Using simulation for band 5 nurses who are learning to lead

The ‘Standards Framework for Nursing and Midwifery Education’ set out by the Nursing and Midwifery Council states that nurses are expected to develop ‘supervision and leadership skills’ [1]. However, band 5 nurses at a NHS Trust indicated their reticence about taking on ‘nurse in charge’ roles and wanted to build their confidence in engaging in challenging conversations with an assertive approach. As an education provider, we worked alongside the Trust nursing practice development team to develop and deliver a simulation-based workshop to help improve band 5 nurses leadership skills through simulated scenarios. The workshop was integrated into a leadership development day. To encourage all nursing staff to ‘embrace their inner leader’, The Royal College of Nursing described five ways to do so – be a role model, show emotional intelligence, motivate others, create shared goals and display courage [2]. Scenarios, with actors, were developed to allow practice of these strategies whilst having difficult conversations from within a leadership role and included: listening to a colleague with personal difficulties, dealing with angry relatives, supporting a patient after unwelcome news and discussing with a clinician concerns about professionalism and kindness. Participants were provided a communication framework (STEPS: start, time, empathy, provision of support, sense check)) to assist their preparation, pacing, framing and summarizing. Of the 12 sessions completed ( Everyone was so brilliant! I was so nervous about the simulation but (the facilitator) has been wonderful. Actors were amazing. Facilitators have been so kind and knowledgeable. Attending this study day has given me better confidence in my own ability to be in charge and deal with challenging situations. STEPS has given me a very good guide in dealing with professional communication as a nurse in charge. Live actors are very beneficial for us as it gives us real life actions to follow and deal with daily situations in the ward. Immersive and interactive. This simulation-based workshop developed with RCN leadership values in mind, has supported 180 band 5 nurses with their leadership roles. It has been immensely well received and has assisted these nurses in their workplaces. Based on the success of the first 12 sessions, 12 additional sessions are planned with pre and post feedback data from attendees being collated for analysis. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Pediatric Specialty Nursing Associations and their Role in Leadership Development.

Professional organizations have a long and rich history of promoting leadership development since the late 1800s. Professional nursing organizations and associations advocate for the profession of nursing and nurses, develop health care policies and standards that ensure the highest level of patient care quality, assure the highest level of education, provide professional development and continuing education, and offer research, networking, and career advancement opportunities for their members. Currently there are 10 nationally based pediatric nursing specialty organizations and associations, most of which also have regional or local chapters. To use a scoping review to identify and summarize contributions of pediatric nursing organizations and associations in the United States to leadership development in pediatric nursing practice. Although there are leadership programs sponsored by professional nursing organizations and mentions of leadership in their mission and "about us" statements, there is very little empirical evidence of the contributions that pediatric nursing specialty bodies make to the development of leaders. Membership in a professional nursing organization provides nurses with professional development; continuing education including journal subscription and conference attendance; networking; opportunities for specialty certification, career advancement, and leadership development; and research-based clinical standards and guidelines that promote best practice. The relationship between membership in pediatric professional organizations and leadership is clear in mission statements and strategic plans. Nurse leaders play a key role in advancing the organization's mission and goals. Nursing faculty, practice executives, and professional organizations and associations have an obligation to demonstrate value of membership in advancing the profession and developing future leaders. Future research is needed to describe the contributions of pediatric nursing professional organizations to leadership development of nurses.

The experience of staff utilizing data to evaluate and improve person-centred practice: An action research study.

AimExplore how nurses and midwives use patient experience data collected from a mobile health app to influence the development of person‐centred practice.DesignParticipatory action research, underpinned by the Person‐Centred Nursing Framework and Practice Development principles.MethodsSix clinical units in a large health district engaged in three action cycles from 2018 to 2020 using a mobile health app. Nursing/midwifery staff on the units (N = 177) utilized data collected via the app to evaluate and improve person‐centred practice. A pre–post survey using the PCPI‐S was conducted to evaluate staff perceptions of person‐centredness. Data from the surveys (n = 101 in 2018 and n = 102 in 2020) and 17 semi‐structured interviews were used to understand the influence working with these data had on person‐centred practice. The Guidelines for Best Practices in the Reporting of Participatory Action Research have been used to report this study.ResultsImprovements in person‐centred practice were noted across both data sets. There was a statistically significant increase in two domains of the PCPI‐S in the independent t‐test and across all three domains in the paired t‐test results. Thematic analysis resulted in the identification of six themes: Getting everyone on board, once we understood, keeping on track, there's a person in the bed, knowing you're doing a good job and improving over time.ConclusionEngaging with the data collected from the app in a facilitated and collaborative way results in increases in person‐centredness.ImpactThis study provides insight into how nurses and midwives used data from a mHealth app to evaluate and improve person‐centred practice. Utilizing the data generated by the app resulted in increased person‐centredness amongst staff and changes to practice and culture. Nursing and midwifery teams who are supported to engage with patient experience data in an action‐oriented way will see person‐centred practice improvements, affecting patients and staff.

The past, present and future of advanced nursing practice

Kelly Swaby, Julie Reynolds and Gerri Mortimore explore the historical, professional and national developments that have influenced advanced nursing practice in England This article considers the past, present and future development of advanced nursing practice. It traces the historical, professional and national developments that have impacted on advanced nursing practice in England. Current influence and future opportunities and challenges are explored, providing a comprehensive overview of advanced nursing practice in England.

Role of the advanced practice nurse in the management of patients with coronary artery disease

Cardiovascular disease is the leading cause of death in the world and the second leading cause of death in France. Patients with coronary artery disease have a high risk of recurrence. Nevertheless, by acting on health determinants and secondary prevention, it is possible to reduce the risks. With the development of advanced nursing practice, a new professional with specific skills can take charge of and accompany people with this pathology. This player works in an interdisciplinary manner to provide holistic and optimal patient care.

Theory Guided Practices: An Approach to Better Nursing Care through Roy Adaptation Model

Introduction: The nursing discipline is considered an integral part of the health care delivery system. Effective nursing practice needs the application of knowledge, skills, critical thinking, and art of care in an efficient, effective, and considerate method. This can be achieved through an amalgamation of understanding, practice, and nursing theories. The theory provides a logical way to organize for and give direction to nursing care. Theory-guided nursing practices act as a fundamental framework for the development of proactive and organized nursing care that assist to improve quality nursing care. Aim: The paper aims to elaborate on the theory-guided nursing practice by utilization of the Roy Adaptation Model in the clinical setup for delivering effective nursing care. Methodology: This paper will illustrate the case study of a breast cancer patient and the application of Sister Calista Roy’s Adaptation Model into nursing practice and the nursing process. Discussion: Theory-guided assessment, nursing care, and interventions provide the foundation for the development of suitable and meaningful nursing practices. Theories and models provide a basis for quality nursing practices and are considered a vital component of patient, family, and community care. Conclusion: The theory-guided practices are more efficient and possess better control over the outcome of nursing care through a purposeful and systematic approach.

Exploring the experience of nursing undergraduates in using gamification teaching mode based on the flow theory in nursing research: A qualitative study

BackgroundWith the development of evidence-based nursing practice, nursing research courses are important in undergraduate programs. However, nursing research courses are highly theoretical, which is difficult for students to understand. Improving the teaching quality of nursing research courses is a challenge for educators. ObjectivesTo understand the learning experience and the effect of gamification teaching on nursing undergraduates, and to provide new ideas for nurse educators. DesignA qualitative research design using individual semi-structured interviews. SettingsGamification teaching was applied in an undergraduate nursing research course over one semester at a university in Central China. ParticipantsPurposive sampling was adopted to select nine undergraduate nursing students who had recently completed gamification teaching in a nursing research course. MethodsData were collected through semi-structured interviews and analyzed using Colaizzi's phenomenological method. ResultsThree major themes and seven subthemes emerged from the interviewees' experience: (1) positive attitude (e.g., acceptance with pleasure and flow experience); (2) self-perceived competence improvement (e.g., creative thinking, collaboration, and knowledge internalization and application); and (3) challenges of gamification teaching (e.g., learning pressure and rationality of game design). ConclusionsThe gamification teaching mode based on the flow theory had a positive effect on the students' learning experience in the nursing research course. It is recommended to improve the game design model and to enhance its effectiveness for classrooms in the future.

Symptoms of dementia or post-traumatic stress disorder? Under-recognised behaviours in veterans with dementia

Background: The veteran community are at increased risk of poor mental health and developing dementia as a result of their miliary service, with the potential to lead to delayed onset post-traumatic stress disorder (DOPTSD). The manifestation of DOPTSD may be misinterpreted as behavioural and psychological symptoms of dementia (BPSD), which create difficulties in caring for the person experiencing these distressing symptoms. Aims: This paper details the development of a screening tool for people with dementia, which aims to reframe and contextualise some of the behaviours under the lens of historic traumatic events. Methods: The utility of the screening tool is demonstrated through the presentation and an analysis of an anonymised case study to support nurse practice development. Conclusions: A trauma history tool offers a more comprehensive and interpretive view of the possible historic, trauma-related causes of current behaviours and can aid informal carers' understanding of the stress and distress reactions of their family members.

Symptoms of dementia or post-traumatic stress disorder? Under-recognised behaviours in veterans with dementia

Background: The veteran community are at increased risk of poor mental health and developing dementia as a result of their miliary service, with the potential to lead to delayed onset post-traumatic stress disorder (DOPTSD). The manifestation of DOPTSD may be misinterpreted as behavioural and psychological symptoms of dementia (BPSD), which create difficulties in caring for the person experiencing these distressing symptoms. Aims: This paper details the development of a screening tool for people with dementia, which aims to reframe and contextualise some of the behaviours under the lens of historic traumatic events. Methods: The utility of the screening tool is demonstrated through the presentation and an analysis of an anonymised case study to support nurse practice development. Conclusions: A trauma history tool offers a more comprehensive and interpretive view of the possible historic, trauma-related causes of current behaviours and can aid informal carers' understanding of the stress and distress reactions of their family members.

Einbindung von Pflegefachpersonen mit Hochschulabschlüssen an deutschen Universitätskliniken: ein Follow-up-Survey

IntroductionThe effective integration of professional nursing staff with university training into care processes is associated internationally with better patient outcomes. In Germany, there is a current lack of reliable figures on graduates and their areas of responsibility. Therefore, the aim of this follow-up survey, designed as a repetition of a previous one, was to ascertain the number of nurses with a Bachelor's or Master's degree involved in direct patient care at university medical centers. MethodIn a cross-sectional study, chief nursing officers in university medical centers were asked to quote the number of professional nurses with a university degree (Bachelor, Master, Doctorate). Additional questions focused on their tasks and responsibilities and the measures undertaken to facilitate their integration into the organization. The data were analyzed using descriptive statistics. ResultsIn total, n=29 valid questionnaires from 35 university medical centers were included in the analysis, resulting in a response rate of 82.85%. For a total of 18 centers, the number of university-qualified nurses had increased by n=786 between 2015 (n=593) and 2018 (n=1,379).The overall percentage of nurses with a university degree working at a university medical center in the study was 3.16% (SD=1.66; min – max=1.09 – 6.69; Q1 – Q3=1.49 – 4.04; 95% CI 2.30 to 3.95). In direct patient care, the quota was 2.11% (SD=1.40; min – max=0.47 – 5.42; Q1 – Q3=0.87 – 3.16; 95% CI 1.36 to 2.76). The main focus of their duties was on standard care and patient education (graduates with a Bachelor's degree), evidence-based nursing practice development (Master's degree) and research activities (doctoral degree). DiscussionCompared to 2015, the proportion of professional nursing staff with university training has increased but remains at a very low level. These nurses perform relevant clinical tasks and are involved in the development of good practice. However, there is a need for better competence-based differentiation.

Developing a specialist children\u2019s nursing workforce in sub-Saharan Africa: a descriptive programme evaluation

BackgroundAchieving Universal Health Coverage in low and lower-middle income countries requires an estimated additional five and a quarter million nurses. Despite an increasing focus on specialist nursing workforce development, the specialist children’s workforce in most African countries falls well below recommended densities. The Child Nursing Practice Development Initiative was established with the aim of building the children’s nursing workforce in Southern and Eastern Africa, and Ghana. The purpose of this evaluation was to enable scrutiny of programme activities conducted between 2008 and 2018 to inform programme review and where possible to identify wider lessons of potential interest in relation to specialist nursing workforce strengthening initiatives.MethodsThe study took the form of a descriptive programme evaluation. Data analysed included quantitative programme data and contextual information from documentary sources. Anonymised programme data covering student enrolments between January 2008 and December 2018 were analysed. Findings were member-checked for accuracy.ResultsThe programme recorded 348 enrolments in 11 years, with 75% of students coming from South Africa and 25% from other sub-Saharan African countries. With a course completion rate of 94, 99% of known alumni were still working in Africa at the end of 2018. Most graduates were located at top-tier (specialist) public hospital facilities. Nine percent of known alumni were found to be working in education, with 54% of graduates at centres that offer or plan to offer children’s nursing education.ConclusionThe programme has made a quantifiable, positive and sustained contribution to the capacity of the specialist clinical and educational children’s nursing workforce in nine African countries. Data suggest there may be promising approaches within programme design and delivery in relation to very high course completion rates and the retention of graduates in service which merit further consideration. Outputs from this single programme are however modest when compared to the scale of need. Greater clarity around the vision and role of specialist children’s nurses and costed plans for workforce development are needed for investment in specialist children’s nursing education to realise its potential in relation to achievement of Universal Health Coverage.

Zwischen Traum und Trauma - Aufbau und Betrieb einer Kohortenstation für Patient_innen mit COVID-19 in einem Akutspital - Eine Fallstudie.

Description of the setting up of a cohort ward for patients with COVID-19 on a surgical ward including the development of the nursing team. The intrinsic retrospective case study describes the situation, identifies special phenomena in a reflective manner and links them to existing knowledge. Data were anecdotal, routine data were collected in the context of nursing practice development. Setting up the cohort ward in a Swiss hospital consisted of structural and technical planning, infection control measures, the establishment of interprofessional structures, and internal communication. During the four-week operation, 71 patients were treated. The use of practice development methodology initiated a cultural change. The reflection describes a field of tension between "dream and distress": As a dream, the lived experience of optimal care, with well-functioning processes, sufficient material, sufficient personnel and a very good interprofessional cooperation was evaluated. Distress in the form of high infection rates as well as psychological and physical stress did not occur. After the cohort ward was closed, there was a risk working back in normal operations based on existing economical and organizational conditions, with the knowledge that a different cooperation and organization is possible. Positive experiences from the "crisis mode" should be used to further develop essential operations during normal times.

Implementation of a new model of management to increase the effectiveness of nursing specialists

Abstract Issue/problem Nurses play a key role in the system of public health. The total number of nurses in Kazakhstan is 105,441 people (January 1, 2019), which is over 40% of all health workers in the health system of Kazakhstan. The continuing problem of insufficiently effective nursing service (NS) in the country prompted us to develop policy options to increase the NS effectiveness. Description of the problem Key problems of the NS in Kazakhstan include the ineffective management of NS in health organizations, which is associated with an underestimation of the role of nurses in the therapeutic and diagnostic process. There is also a discrepancy in the functioning of the system of nursing education, research and practice with European directives. There are inadequate regulatory acts governing the activities of nurses (including the lack of national guidelines, nursing standards, etc.). Results As a result of analyzing the current situation in the country and summarizing the data from systematic reviews, we were developed the Policy Brief on the issues of implementation of a new model of the NS management. As the key policy options, we proposed: 1. Improving the NS management in health organizations based on a revision of the role of nursing staff in the treatment and diagnostic process; 2. Improving the sectoral qualifications system of nursing specialists in accordance with European directives; 3. Ensuring the development of evidence-based nursing practices with the implementation of generally accepted international standards and models, the development of national guidelines and standards for NS. Lessons The proposed measures found support from the Ministry of Health and were included in the action plans. Each of these policy options contributes to increasing the effectiveness of NS in the health system of Kazakhstan, but these options provide more substantial achievement of the goal of enhancing the role and status of a nurse with their combined implementation. Key messages Implementation of a new model of the NS management in which nurses and physicions work on an equal footing and independently can significantly improve the efficiency of NS. Implementation of evidence-based approaches to the formation of a policy in the field of the NS development gives possibility to increase the effectiveness of the reforms in this field.

Quad Council Coalition community/public health nursing competencies: Building consensus through collaboration.

The changing professional environment for community/public health nursing practice necessitates competencies grounded in current evidence-based practice. The Quad Council Coalition (QCC) appointed a Task Force to revise the 2011 QCC Competencies for Public Health Nursing. The goal of the competencies is to guide professional nursing practice, curricula, research, and policy development. This paper describes the process used to develop the revised 2018 Competencies. A biphasic Delphi technique was used to conduct a detailed examination and build consensus. Four individuals representing community/public health practice and education collaborated to identify and implement a systematic process for revising the QCC Competencies. The process included multiple iterations of review and feedback using consistent methods and tools to analyze and synthesize themes. The primary result of this project is the 2018 QCC Competencies document that has strong consensus and provides a coherent voice from professionals on the practice of community/public health nursing. Use of current QCC Competencies will strengthen the community/public health nursing capacity to positively impact the health and well-being of populations.

Nursing Practice to Support People Living With HIV With Antiretroviral Therapy Adherence: A Qualitative Study.

Antiretroviral therapy (ART) management is a core competency for nursing practice in HIV as documented in best practice guidelines. Nurse-led interventions are effective in fostering ART adherence in people living with HIV (PLWH). However, these evidence-based interventions and professional expectations pertaining to these guidelines do not reflect current practice, nor do they expose the challenges faced by nurses. We conducted a qualitative exploratory study with nurses to explore their professional practices in the context of ART adherence. Sixteen nurses participated in data collection: nine in a focus group and seven in individual interviews. We identified four themes: building a therapeutic relationship with PLWH as a foundation of HIV nursing care; nursing activities to support PLWH with ART adherence; challenges faced by nurses providing ART-related care; and resource mobilization supporting nursing practice development in ART management and HIV care. Aspects of HIV nursing practice need to be strengthened to enhance best practice care, such as managing powerlessness in the context of ART nonadherence.