Nursing Expert Panel Research Articles

Development and pilot testing of the graduate nurse transitional success scale to measure the transition to practice for the newly licensed registered nurse

Background: The successful transition to independent practice of the Newly Licensed Registered Nurse (NLRN) secures patient safety and contribute to optimal patient outcomes. In a health care environment where patients present more acutely requiring more complex nursing care, the ability to ensure the NLRN’s successful transition to independent practice is crucial. A review of the literature identified a lack of a tested instrument to measure NLRN transitional success.Methods: An instrument was developed to meet this deficit. Content validity was established from the literature and from the review of the newly developed tool by an expert panel of nurses. Reliability of the instrument was tested with a sample of 50 self-identified NLRNs who completed the survey anonymously via Qualtrics®.Results: The final survey instrument consisted of 24 items rated using a 5-point Likert-type scale and five open ended questions. Internal consistency was assessed with Cronbach’s α with Total Score (24 items) α = .932 and the subcategories ranging from α = .770 (4 items) to α = .862 (4 items). Years of Experience was a statistically significant divider in terms of self-reported readiness, with those with 2-3 years' experience significantly different in mean total score from those with < 1 year and 1-2 years.Conclusions: The development of a tool to measure transitional success for the NLRN is possible. Further confirmatory Factor Analysis of the tool with different groups of NLRNs is required. A valid, reliable instrument to evaluate a successful transition to practice allows for individualized transition plans, orientation periods, and ultimately patient safety.

Development and psychometric testing of the perception of nursing profession instrument.

Perceptions of the nursing profession influence career choices in nursing. An unrealistic perception might lead students to drop out of nursing education programmes. Objective measurement of the nursing applicants' perceptions at the student selection stage could enhance their career choices in nursing. To develop and psychometrically evaluate the Perception of Nursing Profession Instrument (PNPI). Mixed method design. Two versions of the PNPI were developed during the years 2016-2022. The first version was based on documents describing the nursing profession and the second version was based on an integrative literature review, a focus groups study and a document analysis of descriptions of the nursing profession. The meta-ethnographic approach was used to synthesize the results and form a theoretical framework for developing the PNPI (60 items). Item content validity was evaluated by an expert panel of nurses (n = 7). The psychometric properties of the instrument were analysed using the item response theory approach. The development process resulted in the 40-item PNPI with the following subscales: the content of nursing work, the career in nursing, the nature of nursing work and the characteristics of a nurse. The psychometric analysis revealed unidimensionality and goodness of fit to the partial credit model; however, the item difficulty was not well matched with the participants' abilities. The PNPI is a novel instrument for objectively measuring perceptions of the nursing profession. For further development, item difficulty must be enhanced to improve the measurement accuracy of the nursing applicants' perceptions of the nursing profession. Perceptions of the nursing profession influence career choices, but there is a lack of objective assessment instruments that can be used in nursing student selection setting to measure the perception. The results of this study offer an instrument to measure perception, while also suggesting ideas for further development.

American Academy of Nursing Expert Panel consensus statement on nursing's roles in ensuring universal palliative care access

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.

The Synergy Tool: Making Important Quality Gains within One Healthcare Organization

Background: Evidence-based clinical care delivery begins with comprehensive assessments of patients’ priority needs. A Canadian health sciences corporation conducted a quality improvement initiative to enhance clinical care delivery, beginning with one acute care site. A real-time staffing tool, the synergy tool, was used by direct care providers and leadership to design and implement patient-centered care delivery. The synergy tool is the patient characteristics component of the Synergy Model™, developed by an expert panel of nurses in the 1990s. Since then, the tool has been effectively used to assess a variety of patient populations on eight important characteristics, informing real-time staffing decisions. Methods: Plan-Do-Study Act cycles were managed by department-based project teams with assistance from business analytics and a quality/safety officer. Results: Initial findings demonstrate reductions in nurse missed breaks, improved workload management, and significant increases in staff engagement. Conclusions: The synergy tool is an easy-to-use tool that can be used to highlight priority care needs for individual patients or specific patient populations. The tool informs real-time staffing decisions, ensuring a better fit between patient needs and nurse staffing assignments. Although this initiative began with nurses, project work is expanding to include inter-professional teams.

Psychometric testing of the Revised Humane Caring Scale for adult patients in Singapore.

In this study, we examined the validity and reliability of the Revised Humane Caring Scale as used by adult patients in a tertiary hospital in Singapore. A three-phase descriptive quantitative study was conducted. In phase I, an expert panel of nurses and inpatients examined the content validity of the scale; phase II comprised a pilot study on 20 patients; and in phase III, a large-scale study on 235 patients was implemented to test the internal consistency of the scale. The results revealed that the content validity index of the scale ranged from 0.856 to 1, and the scale had a high inter-rater agreement kappa value of 0.940. Cronbach's alpha ranged from 0.798 to 0.877 in phase II, and from 0.579 to 0.760 in phase III, respectively. The Revised Humane Caring Scale revealed good content validity and an acceptable level of internal consistency. The scale is an acceptable measurement tool for evaluating adult patients' satisfaction during hospitalization.

Development and Validation of a Collaborative Behaviors Objective Assessment Tool for End-of-Life Communication

Helping families make end-of-life decisions requires close collaboration between physicians and nurses. However, medical and nursing students have little formal training in how to collaborate in this task, and few instruments are available to measure collaborative behaviors. The objective of this project was to develop and validate observational assessment tools to measure specific interprofessional competencies in medical and nursing students related to end-of-life discussions. A literature search for evidence-based guidelines and competencies and focus groups with an expert panel of nurses and physicians were used to outline best collaborative practice behaviors for nurses and physicians in an end-of-life decision making simulation. The panel used these practice-behavior checklists to rate videotaped student scenarios and then refined the checklists for validity and clarity until the tools had acceptable inter-rater reliability. The setting was a workshop teaching end-of-life communication to third-year nursing and medical students. Inter-rater reliability was measured using percent agreement and kappa; internal consistency was measured using Cronbach's alpha. Collaborative behaviors objective assessment tools (CBOATs) for nursing and medical students were developed. For the medical CBOAT we found 85% agreement between raters, with an overall kappa of 0.744 and Cronbach's alpha of 0.806. For the nursing CBOAT there was 81% agreement, with a kappa of 0.686 and Cronbach's alpha of 0.845. Development of an end-of-life CBOAT clarified the important collaborative behaviors needed by physician and nurse. The resulting instruments provide a helpful guide for teaching interprofessional sessions related to the end of life and measuring student outcomes using an objective strategy.

WIC (The Special Supplemental Nutrition Program for Women, Infants, and Children): Policy versus practice regarding breastfeeding

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides foods, education, and referrals to participants who are considered to be at nutritional risk. The outreach of the program is impressive, and nearly 9.17 million people participated in the program in 2010. WIC participation is associated with many positive outcomes, including improved birthweights and childhood dietary practices. Despite these benefits, WIC mothers experience lower breastfeeding rates when compared with demographically similar women who do not participate in the WIC program. According to WIC, “A breastfeeding mother and her infant shall be placed in the highest priority level.” Despite this statement and others that support breastfeeding, WIC allocates only 0.6% of its budget toward breastfeeding initiatives. Formula expenses accounted for 11.6% ($850 million) of WIC's 2009 expenses. The inconsistency between WIC's policies that encourage breastfeeding vs. practices that favor formula begs further examination. Research shows consistent success with peer counseling programs among WIC participants; however, little money is budgeted for these programs. Rebates included, WIC spends 25 times more on formula than on breastfeeding initiatives. The American Academy of Nursing Expert Panel on Breastfeeding is calling for a re-evaluation of how these taxpayer dollars are spent. Additionally, the American Academy of Nursing recommends a shift from formula bargaining to an investment in structured peer counseling programs. All WIC programs should offer peer counseling support services that encourage breastfeeding and meet the needs of the families they serve.

Tool Kit for Screening Otologic Function of Older Adults1

To propose a hearing health care tool kit, for use in primary care, that includes a new, comprehensive, and easy-to-administer self-report tool, namely, the Screening for Otologic Functional Impairments (SOFI). The target population for the proposed tool kit includes older adults with multimorbidity who are (a) at risk for hearing-related functional deficits and/or (b) likely to benefit from targeted audiologic interventions designed to optimize function, support independence, maximize safety, and cultivate self-sufficiency and social connectedness (American Academy of Nursing's Expert Panel on Acute and Critical Care, 2012). Twenty-nine older adults with varying levels of hearing impairment drawn from 2 ear, nose, and throat clinics and 1 university clinic underwent hearing testing and completed a series of self-report tools designed to assess otologic function and depression. All of the participants completed the SOFI on 2 occasions. The SOFI has high reliability and validity and the potential for identifying older adults requiring audiologic intervention. The proposed tool kit, for use in primary care, includes several components that are integral to help-seeking behavior. The goal is to identify older adults with multimorbidity who are at risk for otologic conditions, that, once identified and treated, may help promote older adults' quality of care and life.

Global health diplomacy: An integrative review of the literature and implications for nursing

The increasing interconnectedness of the world and the factors that affect health lay the foundation for the evolving practice of global health diplomacy. There has been limited discussion in the nursing literature about the concept of global health diplomacy or the role of nurses in such initiatives. A discussion of this concept is presented here by the members of a Task Force on Global Health Diplomacy of the American Academy of Nursing Expert Panel on Global Nursing and Health (AAN EPGNH). The purpose of this article is to present an integrative review of literature on the concept of global health diplomacy and to identify implications of this emerging field for nursing education, practice, and research. The steps proposed by Whittemore and Knafl (2005) were adapted and applied to the integrative review of theoretical and descriptive articles about the concept of global health diplomacy. This review included an analysis of the historical background, definition, and challenges of global health diplomacy and suggestions about the preparation of global health diplomats. The article concludes with a discussion of implications for nursing practice, education, and research. The Task Force endorses the definition of global health diplomacy proposed by Adams, Novotny, and Leslie (2008) but recommends that further dialogue and research is necessary to identify opportunities and educational requirements for nurses to contribute to the emerging field of global health diplomacy.

Standards of Practice for Culturally Competent Nursing Care: A Request for Comments

Authors’ Note: This document was developed through collaboration of members of The american academy of Nursing expert Panel on global Nursing and Health and The Transcultural Nursing Society, with participation by members of The american academy of Nursing expert Panel on Cultural Competence. Sharon M. Weinstein, MS, CRNI, RN, FaaN, Larry Purnell, PhD, RN, FaaN, Cheryl Leuning, PhD, RN, and Ruth Davidhizar, DNS, RN, aRNP, BC, FaaN, also participated in the discussion and critique during the development of this document. Standards of Practice for Culturally Competent Nursing Care: A Request for Comments

Research on the care environment: Celebrating signs of success, posing questions to advance future investigations

Research on the care environment: Celebrating signs of success, posing questions to advance future investigations

Commentary on “American Academy of Nursing Expert Panel on Global Nursing and Health: White Paper on Global Nursing and Health”

Commentary on “American Academy of Nursing Expert Panel on Global Nursing and Health: White Paper on Global Nursing and Health”

American Academy of Nursing Expert Panel on Global Nursing and Health: White Paper on Global Nursing and Health

The American Academy of Nursing's (AAN) Expert Panel on Global Health's white paper examines critical issues in the international nursing arena, including the global shortage of nurses, legal and ethical issues in recruiting international students for nursing positions in developed countries, the nurse faculty shortage, faculty and student exchanges, effects of the U.S. Citizenship and Immigration Services law, and laws governing new practice within the public domain. Realistic models directed toward viable solutions to these issues are critically needed. It offers 13 recommendations to address issues from a global perspective, including hosting a conference on global nursing, health research, and faculty exchanges; annual meetings; and an international conference of world nurse leaders, the AAN, and Global Panel representatives to discuss this white paper and plan follow-up actions. The final white paper approved by the AAN in 2005 and is published here to stimulate discussion regarding current and future initiatives.

Nursing practice evaluation using an expert panel process

Purpose – There is increasing evidence in the literature that patient outcome is strongly linked to the quality of nursing care. In practice, the process of measuring the quality of nursing care is complex and multifaceted as it is dependent not only on the skills and practices of the individual nurse, but also on the professional and organisational structure that is practised within. The expert panel concept was developed to address clinical standards and practice at The Royal Melbourne Hospital. The Nursing Expert Panel's purpose was to evaluate nursing practice, identify practice deficits, highlight areas of clinical innovation and excellence, and make recommendations where appropriate to improve patient outcome. The aim of this paper is to investigate this.Design/methodology/approach – A pilot programme to evaluate eight clinical areas was developed and implemented. The key areas of evaluation included clinical care as well as the managerial and professional practices that support patient care. The Ex...

American Academy of Nursing Expert Panel Report

The members of the Expert Panel on Cultural Competence of the American Academy of Nursing (AAN) envisioned this article to serve as a catalyst to action by the Academy to take the lead in ensuring that measurable outcomes be achieved that reduce or eliminate health disparities commonly found among racial, ethnic, uninsured, underserved, and underrepresented populations residing throughout the United States. The purposes of this article are to (a) assess current issues related to closing the gap in health disparities and achieving cultural competence, (b) discuss a beginning plan of action from the Expert Panel on Cultural Competence for future endeavors and continued work in these areas beyond the 2002 annual conference on Closing the Gap in Health Disparities, and (c) provide clearly delineated recommendations to assist the Academy to plan strategies and to step forward in taking the lead in reshaping health care policies to eliminate health care and health disparities.

Um modelo de organização e partilha de informação de enfermagem entre hospital e centro de saúde: estudo delphi

INTRODUÇÃO: Uma partilha adequada de informação de enfermagem deve ser encarada como estratégia fundamental para a melhoria da continuidade de cuidados. A informação disponível e o encaminhamento da mesma na Unidade Local de Saúde de Matosinhos - Portugal, não tem dado uma resposta adequada às necessidades de informação sentidas pelos enfermeiros. OBJETIVOS: Este artigo apresenta o desenvolvimento e a definição de um modelo de organização e partilha de informação de enfermagem entre Hospital e Centro de Saúde. MÉTODOS: O estudo foi desenvolvido recorrendo à Técnica Delphi, com três rounds, integrando um painel de enfermeiros em exercício de funções nas diferentes áreas de actuação. RESULTADOS: Os consensos obtidos permitiram chegar a uma hierarquização de aspectos centrais do problema em estudo, nomeadamente dos pressupostos que devem guiar o desenvolvimento do sistema e da informação que deverá efectivamente ser partilhada entre hospital e centro de saúde, com indicação de níveis de prioridade de acesso. CONCLUSÕES: A articulação entre os diferentes contextos de cuidados de saúde deverá ser assegurada por um modelo que garanta a partilha recíproca e confidencial da informação de enfermagem, em tempo real, com recurso às Tecnologias de Informação e Comunicação.

Quality agenda: priorities for action recommendations of the American Academy of Nursing Conference on Health Care Quality

The national focus on improving the quality of health care and a growing body of research on quality methods and outcomes have produced both momentum and urgency for action. In a relatively short time, the science of quality methods and outcomes has made substantial strides. Advances in theory development, increasing use of large datasets, and focused studies of major system problems set the stage for change. What we have learned suggests that improving quality will require a complex blend of short-term and long-term action in many areas: building public awareness, improving the science, changing delivery systems, and altering incentives. This paper highlights conclusions and recommendations from the April 2002 Conference on Measuring and Improving Health Care Quality convened by the American Academy of Nursing Expert Panel on Quality Health Care. Strategic priorities for a unified practice, research, and policy agenda to improve quality of health care are identified. Based on critical analysis of research and dialogue among experts and innovators, priorities for action clustered in five areas: (1) The context for the quality agenda; (2) database issues; (3) advancing research; (4) development of clinical information systems; and (5) public visibility. Attention is needed in each of these areas to stimulate ongoing debate and a meaningful agenda for change.

The Use of NANDA, NIC, and NOC in the Identification and Measurement of Problems, Interventions, and Outcomes in Spinal Cord Injury

PURPOSETo ascertain the possibility of identifying problems experienced by patients with spinal cord injury that are addressed by specific and independent nursing decisions and actions.METHODSA two‐part study was undertaken. Part 1 used the Delphi method with an expert panel of nurses from the 11 spinal cord injury facilities in the U.K. to gain a consensus on presenting patient problems, patient problems with which nurses had major input into resolution, planned patient outcomes for those problems, and interventions undertaken to address the problems in order to achieve the outcomes. NANDA, NIC, and NOC classifications were used to assist the expert panel in defining the problems, interventions, and outcomes identified.Part 2 was an analytic and evaluative, prospective, longitudinal cohort study using participant observation to test empirically the findings of the Delphi study. The care experiences of patient cohorts from two spinal cord injury facilities in the U.K. were examined to see if the patient problems addressed by nurses were identified, whether planned outcomes for those problems were identified, and what interventions were used to address those problems. Linkages were sought among the problems, interventions, and outcomes.FINDINGSThere was general consensus on the patient problems, interventions, and planned outcomes addressed by specific nursing decisions and actions. There was a high level of agreement with the definitions of the problems using NANDA, the definition of the planned outcomes using NOC, and the nursing interventions using NIC. It was possible empirically to attribute patient outcomes for specific problems to the nursing interventions undertaken.DISCUSSIONThe study demonstrated that it is possible — in these times of multi‐, inter‐, and intradisciplinary approaches to care—to identify the contribution a single profession makes to the total care process. It may also be desirable to identify and measure the contribution a particular profession makes to patient outcomes because only thus can the value of the contribution be recognized. Also, the methods used allowed an assessment of outcomes to be undertaken without having to use a randomized control trial.CONCLUSIONSThe study demonstrated both theoretically and empirically that the use of standardized nursing languages can help clarify nursing concepts underlying care processes in patients with spinal cord injuries. If problems, and the actions taken by nurses to address those problems, are identified, those actions can lead to outcomes that can be attributed to nursing activities. The use of standardized nursing languages illuminated aspects of nursing care that are at present hidden.

American Academy of Nursing Expert Panel on Violence Policy Recommendations on Workplace Violence (Adopted 2002)

American Academy of Nursing Expert Panel on Violence Policy Recommendations on Workplace Violence (Adopted 2002)

American Academy of Nursing Expert Panel on Violence Policy Recommendations for Nurses Caring for Victims of Torture (Adopted 2001)

American Academy of Nursing Expert Panel on Violence Policy Recommendations for Nurses Caring for Victims of Torture (Adopted 2001)