The Integral Role of Nurse Practitioners in Community Paramedicine

Georgiev, Rachel; Stryckman, Benoit; Velez, Roseann

doi:10.1016/j.nurpra.2019.07.019

Cited by 8 publications

(18 citation statements)

References 13 publications

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“…For example, Pritchard and Velayudhan (2011) reported that only 17% of community nurses and 36% of primary health care nurses were assessing patients for cognitive decline due to a lack of standards and consistency for dementia education in pre‐registration training. The role of nurses in educating patients about early warning signs of deterioration was noted by several authors (Baker, 2022; Ekong et al., 2016; Georgiev et al., 2019).…”

Section: Resultsmentioning

confidence: 95%

“…Consulting with colleagues was mentioned but without significant detail in some studies (Georgiev et al, 2019;Gray et al, 2018;Waterworth et al, 2015).…”

Section: Nurses' Reaction To Deteriorationmentioning

confidence: 99%

“…Approximately 41% of articles were published 2000-2013 and 59% in the last decade. The United States(Battaglia, 2017;Cochran et al, 2017;Ekong et al, 2016;Georgiev et al, 2019;Issel & Bekemeier, 2010;Lindsay et al, 2009;F I G U R E 1 PRISMA chart ofsearch results, record selection, and inclusion process (Adapted from Page et al, 2021). [Colour figure can be viewed at wileyonlinelibrary.com] McGraw, 2019;Phelan et al, 2018;Poghosyan et al, 2017;Smit et al, 2013;Strømme et al, 2020;Taniguchi et al, 2020;Waterworth et al, 2015;Wenger et al, 2011) and were quantitative by design (n = 11).The remaining included papers involved secondary research (n = 6)(Chin et al, 2011;Katterl et al, 2012;McCourt & Griffin, 2000;Pritchard & Velayudhan, 2011;Rusli et al, 2021;Sworn & Booth, 2020) and narrative accounts (n = 9)(Baker, 2022;Barrett, 2012;Battaglia, 2017;Georgiev et al, 2019;Issel & Bekemeier, 2010;Lopez-Dicastillo et al, 2020;Nazarko, 2019;Start et al, 2016;Tucker & Lusher, 2018).While all included studies were located within the non-hospital, community/primary health setting, some were specific to midwifery(Smit et al, 2013), home health care(Ekong et al, 2016;Gray et al, 2018;Irvine et al, 2000;McGraw, 2019;Rusli et al, 2021;Strømme et al, 2020;Taniguchi et al...…”

mentioning

confidence: 99%

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Clinical deterioration as a nurse sensitive indicator in the out‐of‐hospital context: A scoping review

McCullough,

Baker,

Bloxsome

et al. 2023

Journal of Clinical Nursing

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AimsTo explore and summarise the literature on the concept of ‘clinical deterioration’ as a nurse‐sensitive indicator of quality of care in the out‐of‐hospital context.DesignThe scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews.MethodsStudies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out‐of‐hospital context were included regardless of methodology. Text and opinion papers were also considered. Study protocols were excluded.Data SourcesData bases were searched from inception to June 2022 and included CINAHL, PsychINFO, MEDLINE, The Allied and Complementary Medicine Database, EmCare, Maternity and Infant Care Database, Australian Indigenous HealthInfoNet, Informit Health and Society Database, JSTOR, Nursing and Allied Health Database, RURAL, Cochrane Library and Joanna Briggs Institute.ResultsThirty‐four studies were included. Workloads, education and training opportunities, access to technology, home visits, clinical assessments and use of screening tools or guidelines impacted the ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting.ConclusionsLittle is known about the work of nurses or midwives in out‐of‐hospital settings and their recognition, reaction to and relay of information about patient deterioration. The complex and subtle nature of non‐acute deterioration creates challenges in defining and subsequently evaluating the role and impact of nurses in these settings.Implications for the profession and/or patient careFurther research is needed to clarify outcome measures and nurse contribution to the care of the deteriorating patient in the out‐of‐hospital setting to reduce the rate of avoidable hospitalisation and articulate the contribution of nurses and midwives to patient care.ImpactWhat Problem Did the Study Address?Factors that impact a nurse's ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting are not examined to date.What Were the Main Findings?A range of factors were identified that impacted a nurse's ability to recognise, relay information and respond to clinical deterioration in the out‐of‐hospital setting including workloads, education and training opportunities, access to technology, home visits, clinical assessments, use of screening tools or guidelines, and avoidable hospitalisation.Where and on whom will the research have an impact?Nurses and nursing management will benefit from understanding the factors that act as barriers and facilitators for effective recognition of, and responding to, a deteriorating patient in the out‐of‐hospital setting. This in turn will impact patient survival and satisfaction.Reporting MethodThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Review guidelines guided this review. The PRISMA‐Scr Checklist (Tricco et al., 2018) is included as (supplementary file 1).Data sharing is not applicable to this article as no new data were created or analysed in this study.”No Patient or Public ContributionNot required as the Scoping Review used publicly available information.

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Section: Resultsmentioning

confidence: 95%

“…Consulting with colleagues was mentioned but without significant detail in some studies (Georgiev et al, 2019;Gray et al, 2018;Waterworth et al, 2015).…”

Section: Nurses' Reaction To Deteriorationmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical deterioration as a nurse sensitive indicator in the out‐of‐hospital context: A scoping review

McCullough,

Baker,

Bloxsome

et al. 2023

Journal of Clinical Nursing

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“…– Major policy drivers influence the development of new programs or initiatives: multi-professional working in the UK [ 72 114 147 148 ], financial penalties for 30-day readmissions in the USA [ 52 120 149 150 ]…”

Section: Resultsmentioning

confidence: 99%

Designing and Governing Responsive Local Care Systems – Insights from a Scoping Review of Paramedics in Integrated Models of Care

et al. 2022

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Introduction: Programs that fill gaps in fractured health and social services in response to local needs can provide insight on enacting integrated care. Grassroots programs and the changing roles of paramedics within them were analyzed to explore how the health workforce, organizations and governance could support integrated care. Methods: A study was conducted following Arksey and O’Malley’s method for scoping reviews, using Valentijn’s Rainbow Model of Integrated Care as an organizing framework. Qualitative content analysis was done on clinical, professional, organizational, system, functional and normative aspects of integration. Common patterns, challenges and gaps were documented. Results: After literature search and screening, 137 documents with 108 unique programs were analysed. Paramedics bridge reactive and preventative care for a spectrum of population needs through partnerships with hospitals, social services, primary care and public health. Programs encountered challenges with role delineation, segregated organizations, regulation and tensions in professional norms. Discussion: Five concepts were identified for fostering integrated care in local systems: single point-of-entry care pathways; flexible and mobile workforce; geographically-based cross-cutting organizations; permissive regulation; and assessing system-level value. Conclusion: Integrated care may be supported by a generalist health workforce, through cross-cutting organizations that work across silos, and legislation that balances standardization with flexibility.

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“…CHN prevent, diagnose and deal with occupational and environmental diseases and injuries that occur in laboratory department. CHN also provide rehabilitation of laboratory employees who have already been affected by a disease or injury to soften the impact of an ongoing illness or injury that has lasting effects (Georgiev et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Preventive Measures among Hospital Laboratory Employees regarding Occupational Health Hazards

Metwaly¹,

Soliman

Mahmoud

2023

Journal of Nursing Science Benha University

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Background:The practices of safety measures by the clinical laboratory workers in hospitals are necessary for the prevention of occupational hazards. Aim of the study: Was to assess preventive measures among hospital laboratory employees regarding occupational health hazards. Research design: A descriptive research design was used in this study. Setting: The study was conducted in Benha Hospitals at four laboratory departments namely;

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The Integral Role of Nurse Practitioners in Community Paramedicine

Cited by 8 publications

References 13 publications

Clinical deterioration as a nurse sensitive indicator in the out‐of‐hospital context: A scoping review

Clinical deterioration as a nurse sensitive indicator in the out‐of‐hospital context: A scoping review

Designing and Governing Responsive Local Care Systems – Insights from a Scoping Review of Paramedics in Integrated Models of Care

Preventive Measures among Hospital Laboratory Employees regarding Occupational Health Hazards

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