Conectar
Traditional wellness programming focuses on bringing together individual clinicians during personal time for resources and skill building, without a focus on skill building in the contexts and teams they are embedded in daily. We developed a dialectical behaviour therapy (DBT)-informed consultation group, ‘Complex Care Rounds’ (CCR), implemented within the usual workflow of a primary care clinic. The goal of CCR was to facilitate interprofessional team communication and enhance clinician motivation and efficacy, while simultaneously addressing medical and social needs of patients. During the twice-weekly group, team members provided validation and shared feedback while acknowledging the needs of the clinician and patient. The aim of this study was to explore clinician perspectives on participation in CCR and to create a conceptual model to understand CCR’s influence on individual team members as well as team dynamics.
The research was completed at the Comprehensive Care Programme, a primary care programme for patients with Medicare insurance at high risk of hospitalisation at an academic institution in Chicago, Illinois, USA.
This was a qualitative research study examining reflective essays written by participants on how participating in CCR has impacted them. Template analysis, a form of thematic analysis, was applied to code and organise themes.
Participants included 12 clinical team members (physicians, nurses, social service team members) and 7 trainees (AmeriCorps members, medical students) from the Comprehensive Care Programme.
We found that CCR’s shared team frameworks (theme 1) grounded in DBT promoted a practice of self-compassion (theme 2) as well as a validating team environment (theme 3) within our interprofessional team. Improvements to patient care (theme 4) extended from increased personal capacity, support from team members and a structured approach to team interactions.
DBT-informed consultation groups embedded within a clinical practice have the potential to promote a practice and culture of interprofessional team members tending to self and others, while also building one’s own skills and capacity to care for complex patients.
Clinical trial: NCT04489693; Pre-results"
This review explores the roles, competencies, and scope of practice of APNs in critical care based on international literature. It also derives implications for the development of advanced nursing roles in Austria.
Integrative review.
The research team conducted a systematic search of PubMed, CINAHL, and Web of Science to identify relevant peer-reviewed publications from 2007 to 2023.
A systematic search of electronic databases was undertaken, following Whittemore and Knafl's five-step methodology. The included publications met the defined inclusion criteria and were appraised for quality using the Joanna Briggs Institute critical appraisal checklists. Relevant data were extracted and thematically analysed.
The analysis of 14 international studies revealed recurring themes related to APN core competencies and scope of practice in critical care. These were structured according to Hamric's model. However, Austria faces several challenges, including limited legal frameworks, missing educational structures, and a lack of role clarity. These factors hinder the implementation of APN roles.
Internationally, APNs demonstrate advanced clinical skills, provide leadership in team-based care, and integrate evidence-based practice. These attributes enhance patient outcomes and system efficiency. In Austria, restrictive regulations, limited education, and unclear roles hinder these competencies. Reform is needed to align with international standards, and further research should explore their implementation in Austria.
A gap exists between internationally demonstrated APN competencies and the current state of advanced nursing practice in Austria. This highlights the need for clearer role definitions, regulatory frameworks, and educational strategies. Addressing this gap would strengthen APN roles and improve healthcare quality. This study highlights the need to bridge this disparity.
This review follows the PRISMA 2020 guidelines for systematic reviews Page et al. (2021).
No patient or public contribution.
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