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1.
Br J Community Nurs ; 27(Sup4): S16-S18, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1776680

ABSTRACT

Louise Rooney has worked in the NHS for 34 years in various roles, but her passion is the treatment of lymphoedema and how best to support patients with this underestimated and debilitating chronic condition. She has been working as a lymphoedema clinical nurse specialist since 2009; in 2019, she became the lymphoedema clinical lead at the Walsall Palliative Care Centre, Walsall Healthcare NHS Trust. In this article, Rooney elaborates on the implications of the COVID-19 pandemic on the lymphoedema service, her own practice and that of her colleagues.


Subject(s)
COVID-19 , Lymphedema , Nurse Clinicians , Female , Humans , Palliative Care , Pandemics
2.
Aquichan ; 22(1): e2214, ene. 26, 2022.
Article in English, Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1662774

ABSTRACT

Objetivo: analizar los factores facilitadores y las barreras para el cumplimiento del rol profesional de las enfermeras y enfermeros en tiempos de pandemia y desastres. Material y método: revisión integrativa según método analítico SALSA, realizada en ocho bases de datos: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus y Pubmed. Los descriptores utilizados fueron: 'rol de la enfermera' AND 'pandemia' AND 'paciente' AND 'infección por coronavirus', en idiomas inglés, español y portugués. A los 11.031 artículos encontrados se aplicaron filtros y criterios de inclusión y exclusión; después de ello un total de 32 artículos conformaron la muestra final. Resultados: considerando los objetivos planteados y los resultados obtenidos, se advierte que todas las acciones se enfocaban en tres instancias principales: a) formación y actualización para el desempeño del rol; b) factores predictores, facilitadores y barreras para ejercer el rol frente a una pandemia; y c) evidencia el rol frente a pandemias. Conclusión: este estudio hizo posible conocer, tanto las barreras, como los aspectos facilitadores que permiten el cumplimiento del rol profesional de enfermería frente a pandemias o catástrofes. Además, dejo claro que las enfermedades infecciosas emergentes deben abordarse en forma inmediata, colaborativa y multidisciplinaria. La experiencia, el liderazgo y la formación profesional de enfermeras y enfermeros son atributos claves que estos profesionales poseen, para permitir que su rol sea más proactivo durante una situación de emergencia.


Objective: to analyze the enablers and barriers to nurses' professional role fulfillment during pandemics and disasters. Materials and methods: this was an integrative review based on the SALSA analytical method, carried out in eight databases, namely: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus, and Pubmed. The descriptors used were the following: 'nurse's role' AND 'pandemic' AND 'patient' AND 'coronavirus infection', in English, Spanish and Portuguese. Filters along with inclusion and exclusion criteria were applied to the 11,031 articles found, after which the final sample consisted of a total of 32 articles. Results: considering the objectives set and the results obtained, it is noted that all actions focused on three main instances, namely: a) training and updating for role performance; b) predictors, enablers, and barriers for exercising the role in the face of a pandemic; and c) evidence of the role in the face of pandemics. Conclusion: this study allowed understanding both the barriers and the enablers that allow the fulfillment of nurses' professional role in the face of pandemics or catastrophes. It also clarified that emerging infectious diseases must be addressed in an immediate, collaborative, and multidisciplinary way. Nurses' experience, leadership, and professional training are key attributes that these professionals possess to enable their role to be more proactive during an emergency situation.


Objetivo: analisar os fatores facilitadores e as barreiras para o cumprimento do papel profissional de enfermeiros e enfermeiras em tempos de pandemia e desastres. Materiais e método: revisão integrativa segundo método analítico SALSA, realizada em oito bases de dados: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus e PubMed. Os descritores utilizados foram: "papel da enfermeira" AND "pandemia" AND "paciente" AND "infecção por coronavírus", em inglês, espanhol e português. Aos 11 031 artigos encontrados, foram aplicados filtros e critérios de inclusão e exclusão. Depois disso, 32 artigos conformaram a amostra final. Resultados: considerando os objetivos propostos e os resultados, constata-se que todas as ações se enfocavam em três instâncias principais: a) formação e atualização para o desempenho do papel; b) fatores preditores, facilitadores e barreiras para exercer o papel ante uma pandemia e c) evidência do papel profissional ante pandemias. Conclusões: este estudo torna possível conhecer tanto as barreiras quanto os aspectos facilitadores que permitem o cumprimento do papel do profissional de enfermagem ante pandemias e catástrofes. Além disso, deixa claro que as doenças infecciosas emergentes devem ser abordadas de forma imediata, colaborativa e multidisciplinar. A experiência, a liderança e a formação profissional de enfermeiras e enfermeiros são atributos-chave desses profissionais para permitir que seu papel seja mais proativo durante uma emergência.


Subject(s)
Coronavirus Infections , Community Health Nursing , Nurse's Role , Pandemics , Nurse Clinicians
3.
BMJ Open ; 11(12): e050016, 2021 12 16.
Article in English | MEDLINE | ID: covidwho-1598606

ABSTRACT

OBJECTIVES: Ten per cent of patients diagnosed with pancreatic cancer undergo pancreaticoduodenectomy. There is limited previous research focusing on psychological well-being; unmet support needs impact negatively on quality of life. This paper reports the psychological impact of a pancreatic cancer diagnosis and subsequent pancreaticoduodenectomy, exploring how patients' lives alter following surgery and how they seek support. DESIGN: Inductive qualitative study involving in-depth semistructured interviews with 20 participants who had undergone pancreaticoduodenectomy for pancreatic or distal biliary duct cancer. Interviews were audiorecorded, transcribed and anonymised, and thematic analysis used principles of constant comparison. SETTING: Single National Health Service Trust in Northwest England. PARTICIPANTS: Patients were eligible for inclusion if they had had pancreaticoduodenectomy for head of pancreas cancer, periampullary cancer or distal cholangiocarcinoma between 6 months and 6 years previously, and had completed adjuvant chemotherapy. RESULTS: Analysis identified the following main themes: diagnosis and decision making around surgery; recovery from surgery and chemotherapy; burden of monitoring and ongoing symptoms; adjusting to 'a new normal'; understanding around prognosis; support-seeking. Participants seized the chance to have surgery, often without seeming to absorb the risks or their prognosis. They perceived that they were unable to control their life trajectory and, although they valued close monitoring, experienced anxiety around their appointments. Participants expressed uncertainty about whether they would be able to return to their former activities. There were tensions in their comments about support-seeking, but most felt that emotional support should be offered proactively. CONCLUSIONS: Patients should be made aware of potential psychological sequelae, and that treatment completion may trigger the need for more support. Clinical nurse specialists (CNSs) were identified as key members of the team in proactively offering support; further training for CNSs should be encouraged. Understanding patients' experience of living with cancer and the impact of treatment is crucial in enabling the development of improved support interventions.


Subject(s)
Pancreatic Neoplasms , Pancreaticoduodenectomy , Adaptation, Psychological , Humans , Nurse Clinicians , Pancreatic Neoplasms/psychology , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy/adverse effects , Pancreaticoduodenectomy/psychology , Patient Care Team , Prognosis , Qualitative Research , Quality of Life/psychology , State Medicine
6.
Clin J Oncol Nurs ; 25(6): 729-734, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1533300

ABSTRACT

Oncology nurse navigators (ONNs) rely on assessment tools to identify patient priorities so that care may be expedited along the cancer continuum. Few nonproprietary assessment tools exist for ONNs who work in rural and other resource-poor settings to reliably identify and track patient needs and barriers for seamless and timely oncology care.


Subject(s)
Neoplasms , Nurse Clinicians , Patient Navigation , Humans , Neoplasms/diagnosis , Nurse's Role , Oncology Nursing
7.
Br J Nurs ; 30(20): 1210-1211, 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1524633

ABSTRACT

Mark Green, Heart Failure Nurse Specialist, Portsmouth Hospitals University NHS Trust (Mark.Green@porthosp.nhs.uk) was runner up in the Cardiovascular Nurse of the Year category of the BJN Awards 2021.


Subject(s)
Awards and Prizes , Heart Failure , Nurse Clinicians , Heart Failure/epidemiology , Hospitals, University , Humans , Pandemics
8.
Br J Nurs ; 30(20): 1178-1183, 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1524632

ABSTRACT

BACKGROUND: Clinical nurse specialists (CNSs) are experienced senior nurses with advanced clinical knowledge, communication and leadership skills and commonly take on extended roles to optimise care delivery within health and social care. AIM: To critically explore the experience of one clinical nurse specialist who undertook an enhanced qualification to become a surgical first assistant. METHODS: A case-study approach based on Gibbs' reflective model is used to reflect on the experience, its benefits to patient care and the challenges and facilitators related to taking on advanced surgical roles. FINDINGS: Long-term benefits can be achieved by investing in CNSs educated to hold the enhanced surgical first assistant qualification. Advanced roles enhance evidence-based service delivery, while also benefitting the clinical nurse specialist, the patient and the trust.


Subject(s)
Nurse Clinicians , Orthopedics , Hospitals , Humans , Leadership
11.
BMJ Open Qual ; 10(4)2021 10.
Article in English | MEDLINE | ID: covidwho-1462980

ABSTRACT

Cystic fibrosis (CF) is a genetic, life-limiting disease without a cure; treatment is complex and lifelong. Respiratory failure is the most common cause of death; however, gastrointestinal disease, diabetes and liver disease are common comorbidities. Coronavirus disease (COVID-19) rapidly changed healthcare services across the globe, including redeployment of healthcare professionals. This adult CF service was challenged to continue a patient facing service within severe staffing and structural limitations.Not only were many members of the CF multidisciplinary team (MDT) redeployed at the start of the first wave, but also both the CF and ambulatory care wards were closed. Fortunately, the CF clinical nurse specialists (CF-CNSs) remained in their role. Rapid change and adaptation of the CF service was required to ensure that patients did not feel abandoned and access to treatment remained available. The role of the CF-CNS was therefore pivotal in this change.The aim of this project was to use quality improvement methodology to plan an emergency service allowing a reintroduction of ambulatory care services. Success was measured by the number of patients clinically reviewed with or without intervention, and the reasons for patients contacting the CF-CNS via email and phone were recorded.In weeks 1 and 2 of the emergency service, the CF-CNSs triaged patients by phone, then reviewed face-to-face when necessary. This first step allowed the CF-CNSs to start two patients on home intravenous antibiotics. This service continued to be developed over the following 12 weeks, leading to a total of 36 patient attendances. In March 2020, n=1187 patients made contact (mostly COVID-19, unwell and medication related), in April n=904 and May n=870 (blood test results, unwell and medication related).The motivation of the CF-CNSs was pivotal to the success of this initiative with the CF MDT available to provide some support and advice. It concluded at week 12, which then saw the opening of the formal ambulatory care ward and returning redeployed ward staff.


Subject(s)
COVID-19 , Cystic Fibrosis , Nurse Clinicians , Adult , Ambulatory Care , Cystic Fibrosis/epidemiology , Cystic Fibrosis/therapy , Humans , SARS-CoV-2
12.
Clin Nurse Spec ; 35(6): 291-299, 2021.
Article in English | MEDLINE | ID: covidwho-1450480

ABSTRACT

PURPOSE: Emergence of the COVID-19 crisis into the healthcare system challenged existing roles and shifted organizational priorities and staff responsibilities. Operating within the spheres of impact, clinical nurse specialists (CNSs) adapted to the needs of the organization and expanded their responsibilities to provide crisis leadership. DESCRIPTION OF PROJECT: The CNSs used advanced practice nursing skills and leadership to implement hospital rounds, identify issues, make decisions, collaborate with stakeholders, disseminate new and emerging information, and evaluate processes in an ongoing pandemic. Using the health crisis management framework, the CNSs demonstrated authentic leadership throughout the prevention, preparedness, response, recovery, and rehabilitation phases. OUTCOME: Data analysis of CNS handoff and meeting communications generated these areas of focus involving the CNSs: (1) clinical practice, (2) supplies, (3) workflows, and (4) people. CONCLUSION: The CNS played a vital role in the planning, training, and evaluation of crisis preparation. New and emerging infectious diseases may continue to confront the healthcare system. Thus, healthcare systems need to remain prepared for public health threats. In the crisis leadership role, the CNS helped the transition to learn and relearn practices. As authentic leaders, CNSs instilled calmness, confidence, trust, and resiliency to the staff during the COVID-19 pandemic.


Subject(s)
COVID-19/nursing , Nurse Clinicians , Nurse's Role , Nursing Staff, Hospital/organization & administration , Pandemics , COVID-19/epidemiology , Humans , Leadership
14.
Clin Nurse Spec ; 35(4): 157-159, 2021.
Article in English | MEDLINE | ID: covidwho-1393521
15.
Eur J Oncol Nurs ; 54: 102026, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1385500

ABSTRACT

PURPOSE: Oral anti-cancer therapies offer advantages over parenteral therapies in terms of their non-invasive nature and reduced intrusiveness. However, the shift from directly observed administration of these therapies to home administration means that continuous monitoring is needed. The oral anti-cancer therapy market is rapidly growing, with an ever-increasing number of new medicines available for the patients presenting with cancer illnesses. This study aims to (i) evaluate both the cost of providing monitoring consultations of oral anti-cancer therapies, and (ii) to assess the experience of cancer therapy nurses responsible for the monitoring and their opinions of the quality of the service. METHODS: This study provides a mixed methods evaluation of the monitoring of oral anti-cancer therapies. Nurses were asked to record the time taken for them to perform their monitoring duties, and staff related costs were calculated using publicly available salary data. Patient-related costs were calculated using the Human Capital method. Nurses were asked to discuss their experience of monitoring oral anti-cancer therapies in semi-structured interviews. These interviews were subsequently analysed using thematic analysis. RESULTS: 201 recordings and their associated costs were documented. The median consultation time was 33 min, costing €22.10 using Clinical Nurse Specialist salary figures and €26.51 using Advanced Nurse Practitioner salary figures. The associated patient cost was €14.06. Themes of the effect of Covid-19 on the service, expanding and complicated care package requirements, the need for dedicated oral clinics and the future of the service emerged from the interview data. CONCLUSION: The monitoring service provided by nurses may be undervalued. The commitment to fully dedicated oral anti-cancer therapy clinics and an increase in staff to align with the ongoing increase in service demand is seen as vital for the continued safe and effective delivery of this specialist cancer service.


Subject(s)
COVID-19 , Nurse Clinicians , Nurse Practitioners , Humans , Referral and Consultation , SARS-CoV-2
17.
Clin Nurse Spec ; 35(3): 107, 2021.
Article in English | MEDLINE | ID: covidwho-1379485
18.
Br J Nurs ; 30(14): 840-844, 2021 Jul 22.
Article in English | MEDLINE | ID: covidwho-1319860

ABSTRACT

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic relapsing and remitting condition. The COVID-19 pandemic has severely disrupted provision of medical care across the world. IBD clinical nurse specialists (CNSs) played a pivotal role in the care of children with IBD during the pandemic national lockdown and in the recovery phase. This article aims to look at the impact of COVID-19 on the paediatric IBD service in one children's hospital and the effect on the IBD CNSs' workload. METHOD: A retrospective review of clinical notes and the service's IBD database from January 2019 to September 2020. RESULTS: There was a significant increase in the number of email and telephone contacts to the IBD CNS team during lockdown. There was an increase in virtual clinics, and an increase in new IBD patients coming to the service, but a reduction in the number of face-to-face consultant clinics. CONCLUSION: COVID-19 has disrupted medical services to children with IBD and led to a reduction in face-to-face activities but has also led to a significant increase in virtual activities. CNSs have taken up a wider role to cover patient care during a time of both medical and nursing redeployment.


Subject(s)
COVID-19 , Inflammatory Bowel Diseases , Nurse Clinicians , Nurse's Role , Child , Hospitals, Pediatric , Humans , Inflammatory Bowel Diseases/nursing , Retrospective Studies , United Kingdom/epidemiology , Workload/statistics & numerical data
20.
Nurs Leadersh (Tor Ont) ; 34(2): 31-34, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1290137

ABSTRACT

As a clinical nurse specialist, I provide leadership and strategy for our primary care program where I lead clinical initiatives and develop practice tools and guidelines across our clinics. My portfolio encompasses five clinics, one perinatal program, an opioid agonist therapy (OAT) clinic and an intensive case management team, and in the past year I supported several teams that focus on COVID-19 testing and isolation support. Our clinics specialize in serving people who experience significant economic and social marginalization and those who are not well served by traditional health services. Our nurses, in particular, juggle many roles: providing both outreach- and clinic-based care and supporting our injectable OAT program, youth clinic and our transgender specialty care program. Our work has become increasingly complex as our clients navigate survival with competing syndemics - the opioid crisis, COVID-19, a Shigella outbreak and an ongoing housing crisis - among the many significant structural factors that impact our clients' health.


Subject(s)
Leadership , Nurse Clinicians/organization & administration , Nurses/psychology , Primary Care Nursing/standards , COVID-19/epidemiology , Humans , Mental Health , Opioid Epidemic , Pandemics , SARS-CoV-2
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