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Introduction: The World Health Organization (WHO) called for the expansion of all nursing roles, including advanced practice nurses (APNs), nurse practitioners (NPs) and clinical nurse specialists (CNSs). A clearer understanding of the impact of these roles will inform global priorities for advanced practice nursing education, research, and policy. Objective: To identify gaps in advanced practice nursing research globally. Materials and methods: A review of systematic reviews was conducted. We searched CINAHL, Embase, Global Health, Healthstar, PubMed, Medline, Cochrane Library, DARE, Joanna Briggs Institute EBP, and Web of Science from January 2011 onwards, with no restrictions on jurisdiction or language. Grey literature and hand searches of reference lists were undertaken. Review quality was assessed using the Critical Appraisal Skills Program (CASP). Study selection, data extraction and CASP assessments were done independently by two reviewers. We extracted study characteristics, country and outcome data. Data were summarized using narrative synthesis. Results: We screened 5840 articles and retained 117 systematic reviews, representing 38 countries. Most CASP criteria were met. However, study selection by two reviewers was done inconsistently and language and geographical restrictions were applied. We found highly consistent evidence that APN, NP and CNS care was equal or superior to the comparator (e.g., physicians) for 29 indicator categories across a wide range of clinical settings, patient populations and acuity levels. Mixed findings were noted for quality of life, consultations, costs, emergency room visits, and health care service delivery where some studies favoured the control groups. No indicator consistently favoured the control group. There is emerging research related to Artificial Intelligence (AI). Conclusion: There is a large body of advanced practice nursing research globally, but several WHO regions are underrepresented. Identified research gaps include AI, interprofessional team functioning, workload, and patients and families as partners in healthcare. PROSPERO registration number: CRD42021278532. [ABSTRACT FROM AUTHOR]

Introduction: Nurses work in global settings and must be prepared to enter practice and provide culturally appropriate care to diverse populations. As faculty we want to ensure the achievement of programmatic, national, and global competencies for our student's successful future practice. Methods: Aligning current programs with American Association of Colleges of Nursing's (AACN) New Essentials provides an opportunity to consider new approaches and address challenges. By merging the New Essentials with the Consortium of Universities for Global Health (CUGH) competencies, we facilitate the achievement of programmatic outcomes, mission, and values in nursing education. Results: Using an entrustable professional activities framework provides a clear measure of achieving priority competencies. We created an approach other faculty might find helpful. Discussion: Entrustable professional activities, well established in medical education, are emerging as a valuable tool to measure the achievement of competencies in the preparation of nurses. [ABSTRACT FROM AUTHOR]

Purpose: Hypertension is prevalent in Uganda and achieving treatment goals remains a challenge. Our aim was to assess the impact of a bundled nurse‐led intervention on hypertension physiologic measures and lifestyle modification, and to explore perceptions of the interventions to enhance sustainability. Design and setting: We employed a sequential explanatory mixed‐method design. The study was conducted at a large urban private hospital in Uganda from September 2018 to May 2019. Sample: Participants were clinic patients with hypertension currently under care. A total of 54 participants were enrolled in two study groups. Two focus groups with 16 participants and 2 nurse‐educator interviews were conducted. Methods: Blood pressure and weight were measured at baseline, three, six, and nine months. The Self‐Care of Hypertension Inventory was used to assess lifestyle modification. Monthly education and group‐support with text‐message follow‐up were implemented. Two focus‐groups and nurse‐educator interviews were conducted to assess perceptions post‐implementation. The analysis included descriptive statistic, multivariate analysis and qualitative analysis for themes and subthemes. Findings: Overall, participants had a mean weight loss of 7.7 kg (p = 0.001) and a mean reduction in systolic blood pressure (SBP) of 9.5 mm Hg (p = 0.001). Improvement in biometric outcomes was associated with lifestyle modification such as taking medicine as prescribed (p = 0.008), eat lots of fruit and vegetables (p = 0.043), and control your body weight (p = 0.015). Thematic analysis yielded the following themes: Knowledge and understanding, Attitude change, Adherence—a real struggle, and Adapting to what suits us. Participants found group support, shared learning, and knowledge reinforcement enhanced their knowledge and self‐efficacy. Nurse educators were motivated by the patients' favorable responses to the Bundled Education and Support with Text (BEST) intervention. Conclusion: Findings support the use of nurse‐led interventions to enhance the achievement of hypertension treatment goals. To sustain the achieved lifestyle modification and blood pressure outcomes, participants expressed a desire for continued support, information access, and inclusion of patients as champions for knowledge dissemination. Future studies need to explore the provision of enabling structures to support nurse‐led interventions in routine non‐Communicable disease (NCD) care. Clinical relevance: Hypertension knowledge‐gaps exist among patients and may reflect missed opportunities for patient engagement and education for behavior change. Bundled nurse‐led hypertension interventions can significantly improve lifestyle modification and enhance hypertension outcomes. Persons supported and empowered with knowledge can act as conduits to wider communities in championing knowledge dissemination. [ABSTRACT FROM AUTHOR]

Aim: Globally, the rapid increase of hypertension is particularly prevalent in low‐ and middle‐income countries. Hypertension is the most significant modifiable risk factor for stroke and ischaemic heart disease, the leading cause of mortality in Vietnam. The aim of this study was to gain insight into the provision of hypertension care in Vietnam by exploring provider perceptions. Methods: A sequential exploratory mixed‐method design was selected to allow for the initial qualitative interview findings to be incorporated into the development of the hypertension education workshop. Data were collected through semistructured interviews of 15 Vietnamese clinicians involved in the care of patients with hypertension. Results: Anxiety related to diagnosis of hypertension and specifically fear of having a stroke was mentioned by half of the participants. Several themes also emerged regarding barriers to implementing lifestyle modification to improve patient hypertension outcomes. There were contradictory opinions on the nurse's role in providing patient education across clinical settings. A lack of systematic structure and evidence‐based teaching resources was also noted. Conclusions: Gaining the provider's perspective increases understanding of the regional culture and context of hypertension care. The increased understanding can be used to improve provider education and enhance hypertension population outcomes. SUMMARY STATEMENT: What is already known about this topic? There is an increasing global prevalence of hypertension, the leading modifiable risk factor for cardiovascular morbidity and mortality.Lifestyle modifications are first‐line treatment to attaining hypertension goals and improving patient outcomes.Strengthening nursing intellectual capital by building nurse skills and knowledge can maximize their contribution and enhance population health. The implications of this paper: Awareness of patient culture strengthens patient education and enhances uptake of lifestyle modifications.Nurses, when appropriately equipped and supported, are ideally situated to significantly improve hypertension outcomes.Appropriately educating nurses and clarifying role expectations would develop nursing intellectual capital and add value to the health‐care system in Vietnam. [ABSTRACT FROM AUTHOR]

Hypertension is the most significant contributor to premature death globally. As embedded providers, nurses have valuable insight on how to improve hypertension outcomes. A sequential mixed-method study was conducted in Zambia to explore provider perceptions of hypertension care and develop contextually relevant education for nurses. The Zambian and US nurse researchers interviewed 15 nurses and provided a hypertension education workshop. Thematic evaluation identified categories of infrastructure and belief & behaviors with a shared subcategory of medication. A statistically significant result was found in the health care providers knowledge and attitude toward hypertension, one of two pre and post-tests analysis (z = –2.17, p < 0.05, r = –.33) and (z = -.41, p =.67). Developing efficient and effective solutions to increase hypertension care must be made at the policy level and incorporate locally relevant information. Nurses, who have cultural and contextual expertise, are ideally situated to reach population health goals. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the perceptions of nurse leaders in Ethiopia, Kenya, Tanzania, and Uganda who have taken on expanded roles through task shifting. Understanding how nurses perceive task shifting directs education and training to more effectively meet population health needs in their communities. Participants were nurse leaders in countries with complex health care systems and few resources. Participants identified conflicting roles and expectations that were not consistent with their role preparation or scope of practice.