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• Supporting family caregivers is a crucial public health issue • The RAISE Family Caregiving Act of 2018 identifies supporting family caregivers as a national priority • Nurses have a vital role in advancing support for family caregivers • National recommendations to support family caregivers can be used to target nursing research, practice, and policy Recognizing family caregivers as vital providers of long-term assistance to loved ones with chronic illness, several national organizations developed recommendations to improve support for family caregivers. This article categorizes these recommendations to advance family-centered nursing practice, develop health policies, and advocate for family caregiver support. Six reports of caregiver recommendations published in the United States from 2016 to 2021 were analyzed using thematic analysis. The 108 recommendations were organized into five categories: policy; caregiver assessment and support; health professional practices; public awareness; advance care planning. Ensuring economic security, establishing a national data collection strategy, addressing caregivers' diverse needs, improving access to health care and support services, and increasing public awareness were highlighted. The recommendations provide a roadmap for nurses at all levels of practice to advocate for a national agenda to develop, fund, and implement inclusive health care policies and interventions to address unmet caregiver needs and maximize support. [ABSTRACT FROM AUTHOR]

Abstract Purpose To develop an instrument to assess the nurse's role and responsibilities in healthcare transition planning (HCTP) for youth and young adults (YYA) with chronic illness and/or disability (CI/D) that will determine to what extent nurses are involved with providing HCTP services; and identify the specific activities that nurses engage in when providing HCTP services. Design and Methods A panel of seven experts in the field were used to determine content validity. Results The final NR-HCTP instrument contains a total of 68 items (17 main items, 5 containing sub items) representing activities that nurses engage in when providing HCTP services, their level and extent of involvement, and their level of knowledge in the areas of HCTP. Practice Implications An exploration of nurse's roles in HCTP for YYA with CI/D allows for discussion of current nursing practices in the transition process. The information obtained may be used to identify gaps in knowledge and practice guidelines, develop nursing core elements and educational materials to support nurses in their role, and inform nursing administrators in the development of appropriate HCTP position descriptions. Highlights • Increasing concern over the successful transition to adult healthcare • Nurses are an essential group of professionals who care for YYA with CI/D. • Development and validation of an instrument to evaluate nurses' roles in HCTP • Only instrument of its kind • Serve as a needs assessment for nurses and for quality improvement projects [ABSTRACT FROM AUTHOR]

Background The updated American Heart Association/American Stroke Association guidelines favor conscious sedation over general anesthesia but allow that choice of anesthesia modality during endovascular therapy for acute ischemic stroke (AIS) to be based on a specific clinical scenario taking patient risk factors into consideration. Little evidence is available on who is most suited to provide anesthesia management to AIS patients undergoing these emergent endovascular interventions. Given the limited data on sedation management and the nursing role during endovascular revascularization therapy, a nationwide survey was conducted. The purpose of this study was to gather data on current practice about anesthesia/sedation management and nursing involvement during endovascular revascularization procedures among AIS patients. Methods A survey was presented in English and electronically distributed to all current and past Association for Radiologic and Imaging Nursing (ARIN) members via the ARIN List Serve with a 1-month timeline to respond to the survey questions. The survey consisted of 17 multiple-choice questions with free-text response available when applicable. Some of the multiple-choice questions allowed choice of all applicable answers. Members were asked to participate if they worked in the interventional radiology/interventional neuroradiology department and were currently involved in the management of AIS patients during endovascular revascularization therapy. Recipients had the option of whether to complete the survey or to skip any question in the survey. To maintain confidentiality, response via SurveyMonkey was considered consent. Results A total of 109 nurses responded to the survey questions. In most cases, the certified registered nurse anesthetist or the anesthesiologist was responsible for the anesthesia management of AIS patients undergoing endovascular revascularization procedures regardless of the anesthesia modality chosen (36.19%). If a registered nurse (RN) was responsible for sedation management, most of the time (33.33%) she or he felt comfortable in this role. Approximately 20% of responding RNs preferred to have the anesthesia team member in this role, 8.57% were somewhat uncomfortable in this role, and 1.90% reported being uncomfortable. Approximately 47.66% of the survey respondents confirmed that the RN providing procedural sedation was qualified to administer vasoactive drips, whereas 8.41% disagreed. Conclusions Randomized clinical trials are necessary to establish if there is truly a difference in clinical outcomes among AIS patients who are managed with general anesthesia versus conscious sedation during endovascular revascularization interventions, as well as comparing clinical outcomes of AIS patients from stroke centers where anesthesia is always provided by the anesthesia team versus stroke centers using a variety of providers. Large longitudinal studies are necessary as most facilities perform less than six procedures per month, and data will need to be correlated with National Institute of Health Stroke Scale scores and imaging findings. [ABSTRACT FROM AUTHOR]

Purpose Nurses' role and image as portrayed in young children's literature were described and analyzed. Design and Methods A total of 30 children's books (pre-kindergarten through grade two audience) written in English were chosen using progressive theoretical sampling. Included were books, both fiction and non-fiction and with varying years of publication, that mentioned nurses and/or were about general healthcare topics. The books were analyzed using the method of qualitative media analysis which is derived from the theoretical framework of symbolic interactionism. Results Nurses were generally portrayed positively but simply and inaccurately in this sample of children's literature. The seven themes discovered were labeled as nurse characters using traits evident in the sample: nurse unlikely, nurse minimal, nurse caring, nurse subordination, nurse skillful, nurse diversity, and nurse obvious. Conclusion The image of nursing is socially and culturally constructed, and accurate portrayals of nurses and their roles are necessary in all media. Thus, better representation of nurses in children's books is needed as young children's literature is an important first exposure to the art and science of nursing. Practice Implications Future children's books authored by nurses may more closely reflect accurate contemporary nursing practice and contribute to an improved image of the nursing profession. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the study was to identify the role of the Parkinson's disease specialist nurse in providing support both for people with Parkinson's disease (PD) and their spouses. Background: PD is a neurodegenerative disease with symptoms that affect many aspects of daily life. In Sweden, specialised nurses called Parkinson's disease specialist nurses (PD specialist nurses) have been working for over a decade to support PD patients and their families. Method: A qualitative approach was taken using dyad interviews with each PD patient and spouse. The analysis was conducted using conventional qualitative content analysis. Findings: The analysis resulted in the identification of one overarching category; competent, professional practice, tailored for the individual. Four categories: professional competence, nursing practice, continuity of contact and emotional support, are distinct but related to each other and show different nuances of the same phenomenon. Conclusion: The work of PD specialist nurses in providing support to PD patients and their relatives should be tailored to individual patients and their families as well as including skilled nursing care to relieve the impact of the disease on daily life. [ABSTRACT FROM AUTHOR]

To address some of the main nurse's role in facilitating patients' participation and engagement to prepare for the stress of surgery. These include published peer reviewed literature, web-based resources, and professional organizations' resources. Psychological and physical optimization of surgical patients during the preoperative phase is a novel approach known as the prehabilitation program. A multidisciplinary team of health professionals work in synergy to prepare patients for the upcoming surgery. Different roles and responsibilities may be allotted to the nurse, whereas one of which may focus on patient education. Being cognizant of low health literacy rates while using various teaching strategies known to promote patient understanding may increase patient participation to prepare for surgery. This article may guide nurses who are new to the concept of health literacy and patient activation. We wish to sensitize nurses to a few strategies to support patient understanding and involvement. This overview can help others who are establishing a prehabilitation unit in their institution to highlight the important role a nurse can play toward patient education. [ABSTRACT FROM AUTHOR]

Summary: Aim: People diagnosed with serious mental illness have higher rates of physical morbidity and decreased longevity, yet these people are not adequately served by health care systems. Nurses may provide improved physical health support to consumers with serious mental illness but this is partly dependent on nurses having necessary skills and interest in training opportunities for this component of their work. This survey investigated Australian nurses' interest in training across areas of physical health care including lifestyle factors, cardiovascular disease, and identifying health risks. Methods: A nation-wide online survey of nurse members of the Australian College of Mental Health Nurses. The survey included an adapted version of a sub-section of the Physical Health Attitudes Scale. Participants were asked to indicate their interest in various aspects of physical health care training. Results: Most (91.6%) participants viewed educating nurses in physical health care as of moderate or significant value in improving the physical health of people with serious mental illness. Interest in training in all areas of physical health care was over 60% across the health care settings investigated (e.g. public, private, primary care). Forty-two percent sought training in all nine areas of physical health care, from supporting people with diabetes, to assisting consumers with sexually-related and lifestyle issues. Conclusions: The findings suggest that nurses in mental health services in Australia acknowledge the importance of training to improve physical health care of consumers with serious mental illness. Training programs and learning opportunities for nurses are necessary to reduce inequalities in health of people with serious mental illness. [Copyright &y& Elsevier]

Objective: To describe the clinical, education, and research roles of professional nurses caring for family caregivers. Data Scores: Review of literature and Websites on the professional nursing role and family caregivers. Conclusion: The growing number of family caregivers of cancer patients will need education and support. The professional oncology nurse is best suited to assess, teach, and support these family caregivers, as well as contribute to the evidence base of these areas of practice. Implications for Nursing Practice: Professional nurses caring for oncology patients need to expand their role to include additional support and education of family caregivers. [Copyright &y& Elsevier]

Extravasation of intravenous contrast administered for computed tomography remains of concern in pediatric patients. It is of great interest to any pediatric radiology department to decrease extravasation events in an effort to reduce even small adverse outcomes and improve the overall patient experience in the radiology department. Here, a total of 17 extravasation events, as reported and documented in departmental quality assurance at our institution over 4 years, were retrospectively reviewed for factors contributing to the number of adverse extravasation events. We found that pediatric nursing plays a central role in both achieving and maintaining a low extravasation rate at our institution. [Copyright &y& Elsevier]

Abstract: Background: The process of withdrawal of treatment in critical care environments has created ethical and moral dilemmas in relation to end of life care in the UK and elsewhere. Common within this discourse is the differing demands made on health professionals as they strive to provide care for the dying patient and family members. Despite reports that withdrawal of treatment is a source of tension between those nurses and doctors involved in the process, the role of the nurse in facilitating withdrawal of treatment has received relatively little attention. Objectives: To illustrate how differing dying trajectories impact on decision-making underpinning withdrawal of treatment processes, and what nurses do to shape withdrawal of treatment. Design: Qualitative methods of enquiry using clinical vignettes and applying Charmaz''s grounded theory method. Methods and settings: Single audio-recorded qualitative interviews with thirteen critical care nurses from four intensive care specialities: cardiac; general; neurological and renal were carried out. Interviews were facilitated by an end-of-life vignette developed with clinical collaborators. Findings: Across critical care areas four key dying trajectories were identified. These trajectories were shaped by contested boundaries associated with delayed or stalled decision-making around how withdrawal of treatment should proceed. Nurses provided end of life care (including collaborative and action-oriented skills) to shape the dying trajectory of patients so as to satisfy the wishes of the patient and family, and their own professional aims. Conclusions: Differing views as to when withdrawal of treatment should commence and how it should be operationalised appeared to be underpinned by the requirements of the role that health professionals fulfil, with doctors focusing on making withdrawal of treatment decisions, and nurse''s being tasked with operationalising the processes that constitute it. Multidisciplinary teams need a ‘shared’ understanding of each other''s roles, responsibilities, aims, and motivations when planning and implementing the dying trajectory of withdrawal of treatment. [Copyright &y& Elsevier]

Abstract: Decisional support is a multifaceted process of facilitating patients'' decision making regarding treatment choices. Effective decisional support practices of nurses in relation to the use of anticancer therapies in patients with advanced disease are central to quality cancer care. A recent qualitative descriptive study (n =21) exploring the decision making practices of doctors and nurses in one tertiary cancer centre in New Zealand identified many complexities associated with nurses and their participation in decisional support. The study revealed that cancer nurses had varied opinions about the meaning and importance of their roles in treatment related decision making. This variation was significant and led the researchers to undertake a detailed secondary exploration of factors that impacted on the nurses'' involvement in the provision of decisional support. Four key groups of factors were identified. These were factors relating to degree of knowledge, level of experience, beliefs and understandings about nursing roles and cancer therapies, and structural interfaces in the work setting. Understanding these factors is important because it allows modification of the conditions which impact on the ability to provide effective decisional care. It also provides some understanding of clinical drivers associated with nurses'' decisional support work with patients who have advanced cancer. [Copyright &y& Elsevier]

Abstract: Background: St. John''s, Newfoundland and Labrador is one of the smallest Canadian provincial capitals. Like other Canadian coastal communities, St. John''s has been affected by dramatic economic and institutional restructuring that negatively impacted community health. Marginalized populations including people who inject drugs are more negatively affected by the gap between health needs and available services. Methods: A mixed methods needs assessment began with a survey and key informant and focus group interviews to determine attitudes, knowledge, and practices of people with current or previous experience injecting drugs. An environmental scan of programmes and services was conducted followed by a community consultation with key stakeholders, community agencies, study participants, the media, and members of the public to share and validate findings, solicit feedback, and gather data about future knowledge transfer activities. Results: This paper examines two of the five barriers to health and health services for people injecting drugs: First, there was a discrepancy amongst people injecting drugs between awareness and use of safer practices, and second, there was a limited formalized network of health and social programmes and services. Conclusion: Accurate and timely information about safer practices, whilst an essential component of a harm reduction approach, is insufficient to reduce the risk of negative health outcomes for people injecting drugs. Funding new programmes and services, although desirable, is not always feasible in small urban centres with limited human and material resources. Recommendations for promoting health, reducing harm, and building local capacity must consider these limitations. Registered nurses are well positioned to provide leadership through collaborative community-based research, education and advocacy. [Copyright &y& Elsevier]

HIV/AIDS affects the lives of everyone who lives in sub-Saharan Africa. In the past 3.5 years, access to free antiretroviral therapy has increased dramatically as a result of the support of the President''s Emergency Plan for AIDS Relief. Health care must now include caring for those who will live with HIV/AIDS as well as those for whom HIV/AIDS is a terminal illness. This article discusses the contribution of nurse practitioners to the redesign of nurses'' work with HIV1 patients in sub-Africa, especially Uganda. Strategies currently being implemented and those planned for the future to increase access to care and improve the quality of nursing care that patients receive are discussed. [Copyright &y& Elsevier]

Identifying and acquiring the nursing role is key to the development of nurses' professional identity. Understanding nursing students' perceptions in this regard will enable nursing educators to choose teaching strategies that lead to positive development of their students' professional identity. To describe how nursing students perceive the different components of the nursing role at the beginning of the nursing degree. Cross-sectional, descriptive, observational study. 106 first-year nursing students at the University of Huelva, Spain. Data on social and academic variables and variables relating to the instrumental and expressive roles were collected via an adapted, pilot-tested questionnaire assessed by experts. For participants, caregiving is the core of the nursing role in the clinical setting, including both technical execution and patient care aspects. They highlighted the disease prevention, health promotion, restoration, and education profiles of nurses rather than their teaching, professional, and technical profiles. They were acquainted with the concept of postgraduate professional development, but were unaware of the academic pathways leading to it. They considered nurses to be decision-makers, who are nevertheless subordinate to doctors. Students did not consider nursing to be an autonomous profession, although they highlighted its decision-making capacity. They placed greater emphasis on the traditional profile of primary care nurses than on their technical profile, and were able to identify the members of the multidisciplinary healthcare team. • Caregiving is the core of the nursing role. • The nursing profession is not perceived as autonomous. • Disease prevention, health promotion and restoration were the most popular profiles. • Raising awareness of postgraduate education and research appears to be crucial. • Nurse educators have a great responsibility in creating professional roles. [ABSTRACT FROM AUTHOR]

To examine existing published literature regarding nurses and antimicrobial stewardship, and their potential role and contribution, to identify what is known, to evaluate methodologies used in published research, and to review and integrate findings to inform practice and future priorities for research. Integrative review. The approach to this review was informed by Whittemore and Knafl's integrative review methodology. Electronic databases were searched for papers published since the start of the database to November 2019, with abstracts available, related to humans and published in English. Papers were included regardless of practice setting (acute, aged, and primary care) and if they were research based, included nurses as participants and reported specifically on results from nurses or that had implications for nursing practice. Excluded were conference abstracts, and papers focussed solely on nurse prescriber, nurse practitioner, or nurse manager roles. Fifty-two papers were included in the review. Identified themes were: i) nursing knowledge, learning needs and education; ii) nurse perceptions of the nursing role and motivations for involvement; iii) nursing brokerage and influence on information flow to and from patients; iv) nursing workflow, workload and workarounds; and v) nurse leadership. Methodological quality of the included papers varied, limiting transferability and applicability of findings for some of the included studies. Formal inclusion of nurses in antimicrobial stewardship activities has been associated with improved nurse knowledge, nurse confidence, and in some cases improved clinical outcomes for patients. The review reinforces nursing values as a motivator of nursing actions, and reveals the complex yet significant influence of nurses on antimicrobial prescribing. Potential opportunities to enhance nurses' participation and contribution to antimicrobial stewardship include; formal acknowledgement of the nurse role, educating nurses so that they are aware of how they can contribute, collaborating with nurses in planning and implementing local stewardship activities, and ensuring nurse leaders are involved. However, evidence on this topic remains limited. Research is needed to facilitate greater understanding about the nature, scope and influence of the nurse role in antimicrobial stewardship, how nurses enact and carry out their role, and nurses' support needs. Tweetable abstract: Integrative review explores #nurse role in #antimicrobialstewardship. Nurse contribution, influence significant, but not well understood. [ABSTRACT FROM AUTHOR]

Significant workforce shortages and economic pressures have led to the expanded scope and reintroduction of new roles for second-level nurses in many Organization for Economic Co-operation and Development countries. Given this, there is a need to understand the emic and etic perspectives of second-level nurses, to ensure collaborative teamwork and safe patient care. This review aimed to systematically identify, appraise, and synthesize qualitative research evidence on healthcare professionals' perspectives on second-level nursing roles in the healthcare workforce. These findings inform recommendations that would influence the development and implementation of these roles in healthcare organisations. A systematic review and thematic synthesis of qualitative research was conducted. Six databases were systematically searched and forward and backwards searching completed. Included studies focused on healthcare professionals' perspectives (including views of second-level nurses themselves) on second-level nursing roles. All included articles were from Organization for Economic Co-operation and Development countries. The Critical Appraisal Skills Programme checklist for qualitative research was used to assess the evidence quality. The results section of each included article was coded and descriptive themes were developed. An interpretative and iterative process led to the final analytic themes. Twenty-six qualitative studies were identified from five countries over 26 years. Four analytic themes were identified: undifferentiated role; efficient but limited; subordinated task-doers; and broadening scope and strengthened identity. The synthesis demonstrated dichotomies wherein some second-level nursing roles were devalued, and others had increasing scope and responsibility. Role and boundary confusion was evident and had not decreased over time. Hierarchies in nursing practice underlined the split between critical thinking and hands-on approaches to care which, in some cases, debased the second-level nursing role because of its association with practical hands-on care. The analytic themes in this synthesis suggest that second-level nurses have faced the same issues over decades with little change. Perceptions of second-level nursing roles are primarily influenced by meso (organisational level) factors and micro (individual, behavioural) factors. The synthesis concludes that a cultural shift in valuing the hands-on care provided by second-level nursing is necessary, along with systems-level shift that clarifies the role of second-level nursing within healthcare teams to enhance collaborative practice. Further research should attend to macro-level influences on perceptions of second-level nurses, the work they do, and how this is valued or institutionally embedded. Tweetable abstract: Healthcare professionals' perspectives on second-level nursing roles: a systematic review and thematic synthesis [ABSTRACT FROM AUTHOR]

Neonatal Intensive Care Unit (NICU) nurses in Korea often experience challenges in providing care for dying infants and their families. However, there is limited understanding about what contributes to the challenges related to end-of-life care. To describe NICU nurses' perceived roles and challenges faced while providing end-of-life care in South Korea. A qualitative descriptive study was conducted with 20 NICU nurses in South Korea using semi-structured interviews. Participants were recruited from two NICUs in Seoul, where infant mortality is the highest in South Korea. Transcribed interviews were coded by two research personnel, and subsequently, a developed coding book was translated by three research personnel. The codes developed were categorized and peer-reviewed to develop themes using conventional content analysis. Nurses' roles during end-of-life care were grouped into four categories: providing information and support, enhancing attachment between the parents and infants, providing direct care to the infant, and completing documentation. Nurses' perceived challenges during end-of-life care included providing end-of-life care without adequate experience and knowledge, environmental constraints on end-of-life care, and conflicted situations during end-of-life care. Although the nurses provided the best care they could, their end-of-life care practice was hindered for various reasons. To enhance NICU nurses' ability to provide and make them more capable of providing high quality EOL care, hospitals need to support nurse education and improve staffing level, and create in NICUs an environment that is favorable for providing EOL care. • Nurses' perceived roles during EOL care were described using four categories. • The reasons why nurses perceived providing EOL care challenging were categorized into three groups. • Nurses stated difficulties in making ethical care decisions and providing emotional support at the time of the death. [ABSTRACT FROM AUTHOR]