This discursive paper synthesises empirical evidence and expert professional opinion on the factors that enable or hinder the development and sustainability of specialist and advanced practice roles. Providing a critical appraisal of current knowledge, it provides a reference source for disciplinary debate and policy development regarding the nursing and midwifery resource and informs clinicians of the myriad issues that can impact on their capacity to expand their scope of practice.

o’leary d.f. & ni mhaolrúnaigh s. (2012)  Information‐seeking behaviour of nurses: where is information sought and what processes are followed? Journal of Advanced Nursing 68(2), 379–390. Abstract Aim.  This paper is a report of a study on how nurses inform their decision‐making in the workplace. Background.  Despite the growing availability of research evidence, nurses have been slow to adopt it into their daily decision‐making. Method.  The study was undertaken in Ireland between 2006 and 2007 using a sequential mixed methods approach. In phase 1, the views of a quota sample of 29 nurses were explored using semi‐structured interviews incorporating vignettes. Phase 2 involved the design and dissemination of a survey to a disproportionate stratified random sample of 1356 nurses. The response rate was 29%. Findings.  In decision‐making, nurses accessed other people, especially nursing colleagues, the most frequently. Sources that provided prepackaged information such as guidelines were favoured over sources that provided access to original research. The process of information‐seeking for routine and non‐routine decisions was different. Nurses making routine decisions relied mostly on their experience and an assessment of the patient. In non‐routine decision‐making, participants experienced more uncertainty about their decisions. Accordingly, sources of information used were more varied and the information‐seeking process more extensive. The study highlighted the complexities of establishing whether information used in decision‐making is research based or not. Conclusion.  Routine practices should be reviewed and updated regularly through organizational mandates, as nurses do not generally question them. Research information to inform non‐routine decision‐making must be easily available to nurses in their workplace, as information searches generally prioritize finding enough, rather than the best, information to make a decision.

There is international recognition of the need for workforce planning to meet the diverse population health needs and the move to person-centred as opposed to service-centred models of health care against the background of a largely physician-led health service model. Bryant-Lukosius, DiCenso, Brown, and Pinelli (2004) suggest that the difference between phrases such as "advanced practice nursing" and "advanced nursing practice" relates to whether one is referring to what nurses do, i.e. "advanced nursing practice", or referring to the level at which the roles are constructed, i.e. "advanced practice nursing". Evidence of nurses' and midwives' experiences in role expansion indicates that many embrace role expansion and that they function effectively in expanded roles; however, nurses and midwives may experience scope of practice as either enabling or restricting . As advanced practice is a level of practice rather than a specific role (Ryley & Middleton, 2016), one strategy to develop a more efficient Abstract Aim: To describe the enablers and challenges to the development and implementation of advanced nursing and midwifery practice roles in Ireland. Background:Leadership strategies need to be put in place to enhance the development and implementation of advanced nursing and midwifery practice roles. Method:A descriptive qualitative approach using semi-structured interviews with key stakeholders (n = 15) was undertaken with nurses and midwives working in specialist and advanced practice roles and participants from other areas such as legislative, regulatory, policy, pharmacy, medicine and education. Results: Participant's perspectives on the enablers and challenges to enacting specialist and advanced practice roles resulted in the generation of three themes: organisational factors; collegial, interprofessional and interpersonal support; and role clarity, economic and regulatory contexts. Conclusion: Addressing organisational factors, encouraging collegial and interprofessional support and establishing role clarity contribute to the effective development and implementation of the role of advanced practitioners.Implications for nursing and midwifery management: Managers of nursing services need to provide leadership in developing strategies to enhance the enablers and overcome the challenges to advanced practice role development in their own organisation. K E Y W O R D Sadvanced practice, barriers and challenges, midwifery, nursing

There is no single best way to conduct a rapid review but researchers can ensure they are adhering to best practice by being systematic, having subject and methodological expertise on the review team, reporting the details of the approach they took, highlighting the limitations of the approach, engaging in good evidence synthesis and communicating regularly with end users, other team members and experts.

It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making and knowledge sharing. This paper outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer and a client at two residential care facilities for older people in Ireland. The theoretical concept of Team Psychological Safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without fear of censure. Study results suggest that TPS was an important catalyst in enhancing understanding and power sharing across professional boundaries and thus in the development of interprofessional teamwork. There were differences between the teams. In one facility, the team developed many characteristics of interprofessional teamwork while at the other there was only a limited shift. Stability in team membership and organisational norms relating to shared decision making emerged as particularly important in accounting for differences in the development of TPS and interprofessional teamwork.2