Search

Background: Advanced Nurse Practitioners (ANPs) are highly skilled health care professionals with the potential to play a major role in improving the quality and accessibility of health care services. However, there is emerging evidence of disquiet among nurse practitioners who often work in suboptimal work environments. Therefore, it is important to understand the elements that contribute to ANPs' job satisfaction and retention in healthcare services. Aim: To examine the effects of commitment to the workplace, work engagement, and influence at work on job satisfaction and intention to leave of ANPs. Methods: A total of 153 ANP's on the advanced practice section of the Nursing and Midwifery Board of Ireland register completed a web survey between July and August 2020. Independent variables (commitment to the workplace, work engagement, and influence at work) were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ). Multivariable logistic regression models were used to investigate the association between dependent and independent variables. Results: Participants who reported higher levels of influence at work and higher levels of commitment to the workplace were also satisfied in their job (OR 1.05, 95% CI 1.01-1.09, p = 0.025), (OR 1.10, 95% CI 1.06–1.14, p < 0.001) respectively. Additionally, ANPs with higher levels of commitment to work were significantly less likely to leave their role (OR 0.94, 95% CI.92–.96, p < 0.001). Conclusion: Healthcare organisations can improve job satisfaction and decrease intention to leave by creating environments in which ANPs are supported by their colleagues and supervisors, and facilitate their practice to the full extent of their capabilities. [ABSTRACT FROM AUTHOR]

Given the impact of austerity on higher education systems, an intellectual concern with the impact of austerity on faculty seems appropriate. In this article, austerity is explored through the everyday lived experience of faculty and its impact on both their personal and professional contexts. This aspect has been under-researched in the higher education literature and addresses the complexities and contradictions that the austerity can create for faculty. The study located in the Republic of Ireland provides an interesting context as the global financial crisis in 2008 resulted in 9 years of austerity measures that impacted on all aspects of the economy and particularly on the higher education sector. A social realist approach using Archer's morphogenetic framework was employed. The framework facilitated an in-depth understanding of the relationship between structure, culture and agency and how austerity was experienced by faculty within their institutions.

Aim: The aim of this study was to investigate the relationship between advanced nurse practitioners' self-leadership and commitment to the workplace, work engagement and influence at work. Background: The concept of self-leadership is particularly suited to ANPs, who are required to take responsibility for their work roles. An optimum balance between the ANPs' psychosocial work environment and self-leadership may positively impact work ability in this group and can be compromised by interactions between and among these variables. Design: A cross-sectional correlational study was conducted from July 2020 to August 2020 on 153 ANPs across a national health service. Methods: The survey was distributed to respondents online. The revised selfleadership questionnaire was used to measure self-leadership, and three scales from the Copenhagen Psychosocial Questionnaire were used to measure commitment to the workplace, work engagement and influence at work. Multiple linear regression was used to examine the association between self-leadership and the psychosocial variables. Results: ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. No relationship was found between selfleadership and influence at work. Conclusion: Improving self-leadership among ANPs by involving them in strategic leadership activities at an organizational level could be an effective strategy for optimizing the role and facilitating ANPs to contribute at an organizational level beyond the clinical interface. However, organizational support is required to ensure that ANPs practise to the full potential of their training and capability. Patient or Public Contribution: No patient or public contribution. Impact: This study provided new evidence of a relationship between ANPs' selfleadership and psychosocial factors. This study found that ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. Policymakers and organizational leaders can optimize the ANP role and facilitate ANPs to contribute strategically to improve care systems. This study identifies a relationship between ANPs' self- leadership and specific psychosocial variables. [ABSTRACT FROM AUTHOR]

Aim: SSI is one of the most prevalent healthcare‐associated infections and is associated with extended hospital stays, increased need for reoperation and higher hospital readmission rates. Implementing systematic SSI surveillance can reduce these adverse outcomes. Implementing a surveillance system into a hospital is a complex intervention requiring that staff involved in a patient's perioperative journey have the knowledge of SSI prevention, the data required for surveillance, an understanding of how data informs quality improvement initiatives and their role in surveillance. The aim of this study was to evaluate the impact of a complex intervention on the knowledge and attitudes of healthcare professionals towards surgical site infection (SSI), SSI prevention and surveillance in a university hospital setting. Design: The study used a quasi‐experimental pre‐test–post‐test design. Method: The impact of a complex intervention was evaluated by measuring healthcare professionals' (n = 74) knowledge of and attitudes towards SSI and surveillance. Normalisation process theory (NPT) guided the study and the development of the intervention. Results: There was a statistically significant increase in scores on the knowledge of SSI and prevention from pre‐intervention to post‐test. The knowledge of risk factors scores at post‐test was significantly higher than that at pre‐intervention. Overall attitudes to SSI prevention and surveillance were good both pre‐intervention and post‐test but there was a significant change in the attitude of participants. The findings reveal an overall positive impact of the complex intervention on the knowledge and attitude of healthcare professionals relating to SSI, SSI prevention and surveillance; however, the extent of the change varied across items measured. [ABSTRACT FROM AUTHOR]

Copyright of L'Infermiere is the property of IPASVI - Italian Nursing Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and Objectives: The aim of this study was to measure the impact of a complex quality improvement intervention on the incidence of SSI in patients undergoing elective colorectal surgery. Background: Surgical site infections are a major postoperative complication for patients undergoing colorectal surgery. Prevention of SSIs necessitates a complex intervention requiring many elements to be in place to ensure the successful implementation of prevention measures. Design: This study was a non‐equivalent pre‐test post‐test design where consecutive patients undergoing colorectal surgery were surveyed for surgical site infections for 30 days postoperatively and is reported using the SQUIRE 2.0. Methods: A baseline cohort of patients was retrospectively reviewed in a single centre to ascertain the surgical site infection incidence rate in the first 6 months of 2018 (T0) and prospectively at two 6‐month time periods in 2019 (T1, T2) following the introduction of a complex intervention. There were 311 patients included across three time periods. Results: There was a notable decrease in surgical site infection incidence rates from baseline over the course of the study. Univariate analysis identified Body Mass Index, a wound contamination classification of dirty or contaminated, duration of surgery >75th percentile and a National Healthcare Safety Network risk index score of 3 as factors that significantly increase the probability of developing a surgical site infection. Multivariate analysis identified duration of surgery and body mass index increased the probability of an SSI. The results of the logistical regression model found that there was a significant reduction in the probability of an SSI between T0 and T2. Conclusions: The implementation of a complex intervention led to a reduction in the incidence of surgical site infections and improved implementation of evidence‐based practices as part of a care bundle in relation to the prevention of surgical site infections in patients undergoing elective colorectal surgery. Relevance to Clinical Practice: A multicomponent multidisciplinary complex intervention as part of a quality improvement project can successfully reduce the incidence rates of surgical site infections in patients who require elective colorectal surgery. Normalisation Process Theory provides guidance and support in implementing complex interventions for the prevention of surgical site infection. Patient or Public Contribution: Patients provided post‐discharge information on their wound healing as part of the surveillance component of the intervention. Five patients reviewed and provided feedback on a patient information booklet which was developed from this quality improvement intervention. A multidisciplinary steering group guided all stages of the project. [ABSTRACT FROM AUTHOR]

Although the coursework master's degree is becoming the principal conduit for the delivery of continuing education to the professions, it is one of the least understood or researched academic levels in higher education. Furthermore, little is known of coursework master's graduates' experience of research or research supervision following the completion of a thesis as the final assessment of their degree. This article measures graduates' experience of research and research supervision following the completion of a master's degree. The article also examines the relationship between coursework master's graduates' experience of research supervision, completing a research thesis and their development of research capabilities. The findings are considered in the context of the appropriateness of a thesis as the most suitable form of assessment for coursework master's degrees. (Contains 4 tables.)

There has been a proliferation of taught masters' degrees for nurses in recent years, and like masters' programmes in other disciplines, the aspirations of such educational endeavours are far from unanimous. This article reports on part of a wider study, and focuses on a qualitative analysis of the perspectives of two key sets of stakeholders, namely academic education providers, and senior clinical nursing personnel, on masters' education for nurses. Fifteen participants were interviewed in depth, and data were subjected to a qualitative content analysis. Findings indicated that while both sets of participants invoked the discourse of the "knowledgeable doer", that is, the notion of amalgamating a high level of theoretical knowledge with practical know how, there were also differences in how each group deployed this discourse. Academics tended to emphasise the "knowing that" or theoretical aspect of the discourse, whereas those in senior clinical roles adduced the practical component more strongly. We argue that the discourse of the "knowledgeable doer" is far from stable, unified and universally agreed, but rather comprises competing elements with some emphasised over others according to the subject position of the particular individual. We locate the diverse perspectives of the two sets of stakeholders within debates about the status of masters' programmes in relation to vocational and liberal education.

Traditionally the measures used to evaluate the impact of an educational programme on student outcomes and the extent to which students change is a comparison of the student's pre-test scores with his/her post-test scores. However, this method of evaluating change may be problematic due to the confounding factor of response shift bias when student self-reports of change are used. Response shift bias occurs when the student's internal frame of reference of the construct being measured, for example research ability or critical thinking, changes between the pre-test and the post-test due to the influence of the educational programme. To control for response shift bias the retrospective pre-test method was used to evaluate the outcomes achieved from students completing a research module at master's level. The retrospective pre-test method differs from the traditional pre-test-post-test design in that both post-test and pre-test perceptions of respondents are collected at the same time. The findings indicated that response shift bias was evident in that the programme had significantly greater impact on outcomes than identified using the traditional pre-test-post-test design leading to the conclusion that students may overestimate their ability at the commencement of an educational programme. The retrospective pre-test design is not a replacement for the traditional pre-test-post-test measures but may be a useful adjunct in the evaluation of the impact of educational programmes on student outcomes. (Contains 3 tables.)