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To advocate for the systematic review as a rigorous, competency-aligned option for the Doctor of Nursing Practice (DNP) project.
A descriptive and conceptual analysis was used, drawing on existing literature, historical context, and a case study of a three-semester curriculum integrating systematic review methodology. Data sources included peer-reviewed research, professional guidelines, and faculty experience in teaching and mentoring DNP students.
Integrating systematic reviews as DNP projects equips students with competencies in evidence synthesis, critical appraisal, knowledge translation, and project management. A three-semester scaffolded approach to conducting a systematic review has the potential to foster strong student engagement, build essential skills, and prepare graduates to lead evidence-based practice change.
Systematic reviews meet DNP project criteria when paired with practice-focused implementation and evaluation components. This approach offers an alternative where site access, time, or feasibility limits primary data collection, while ensuring methodological rigor and professional relevance.
Adopting systematic reviews as DNP projects can reduce clinical site burden, expand project opportunities, and strengthen evidence-based practice capacity in nursing. Broader acceptance and standardization of this model could enhance practice-based doctoral education globally.
No Patient or Public Contribution.
To design and develop a novel co-produced intervention tool aimed at facilitating discussions that lung cancer nurses have with lung cancer patients about clinical trial opportunities; and promote trial recruitment.
A multi-phase qualitative focus group (phase 1) and co-production (phase 2) study.
The rigorous design and content of the intervention tool was informed by qualitative data from seven focus groups with lung cancer healthcare professionals (n = 38) and patients and their carers (n = 22) to establish barriers and facilitators to clinical trial participation. Data collection took place across England and Scotland between October and December 2023. Findings from a previously published systematic review were also incorporated to inform intervention tool design. The tool was developed through an extended co-production workshop comprising lung cancer nurses (n = 7), lung cancer patients (n = 2) and health researchers (n = 4). The COM-B model of behavioural change underpinned both phases of the project to guide tool development.
Phase 1 focus groups identified the need for a tool to provide basic trial information to patients, and to support lung cancer nurses in discussing trials with patients, thus improving nurses' knowledge, confidence, and awareness of trials. The phase 2 coproduction workshop identified that the tool should consist of two elements: a patient-facing information pamphlet and a large poster for nurses to assist them in discussing trial opportunities.
The study results demonstrate how nurses can be supported to discuss clinical trial opportunities with patients, with the potential to increase long-term recruitment to clinical trials.
Lung cancer nurses often lack confidence to support patients to make informed choices about trial enrolment. By addressing this issue, participation in lung cancer clinical trials can be significantly improved to benefit patient outcomes and trial participation rates.
The tool has the potential to be used across a range of different cancer settings and sites to increase recruitment to clinical trials.
The COREQ checklist was utilised to ensure that robust processes were followed and reported on.
Patients and members of the public were involved in all study processes and contributed to the study design, interpretation of the data, and intervention design. Their contributions included reviewing focus group topic guides, reviewing data analysis, the co-production of the intervention tool, and co-authoring this paper, ensuring the research addressed the needs and priorities of lung cancer patients when making an informed choice about clinical trial participation.
To develop and validate the End-of-Life Care Assessment Tool for Dementia (EoLC-ATD).
A methodological study with multiple phases.
Five sub-studies comprising: a review of 90 validated dementia measures to compile an item bank of advanced dementia symptoms; focus groups with registered nurses on advanced dementia symptom identification and relevance of item bank inclusions; Delphi surveys with dementia experts seeking consensus on the EoLC-ATD constructs and items; pilot testing of the EoLC-ATD; and field testing of the EoLC-ATD in persons with dementia.
The item-bank included 180 symptoms, most of which focus group nurses (n = 17) identified as occurring in advanced dementia. Delphi surveys with dementia experts (n = 31) achieved 70% consensus for 25 of 26 EoLC-ATD items. Pilot testing of the EoLC-ATD by two nurses in eight persons with dementia showed good agreement for six constructs (Cohen's Kappa 0.856–0.927) and 26 items (Cronbach's alpha 77.0). An ‘other sympto’ item was included following RN recommendation. The 27-item EoLC-ATD field tested by 17 nurses in persons with dementia (n = 113) accurately identified advanced dementia symptoms (Cronbach's alpha 77.0, p < 0.001). Mortality at 180 days after baseline EoLC-ATD was significant (p < 0.001, area under the ROC curve p = 0.769).
The EoLC-ATD accurately and reliably identified symptoms of advanced dementia.
The EoLC-ATD provides registered nurses with a single measure of advanced dementia symptoms that will help in identifying symptom-responsive palliative care requirements.
The EoLC-ATD will address the current lack of a validated dementia symptom measure for use by aged care home registered nurses to identify unique palliative and end-of-life care needs according to presenting symptoms in persons living with advanced dementia.
STROBE Statement for cohort and mixed methods studies.
An eight-member Expert Advisory Group, which provided guidance and advice throughout the study, was composed of three carers of persons living with dementia, two dementia care clinicians, a dementia care clinical educator, and two dementia clinician researchers.
To explore multidisciplinary clinical, academic, policy and governance stakeholders' perceptions of enablers and barriers to implementing designated registered nurse prescribing in Australia, using a systems-thinking approach.
A two-phase explorative study using a systems-thinking lens to investigate complex health-system interdependencies.
Fifty-three participants were recruited from all Australian states and territories, including registered nurses, nurse practitioners, pharmacists, medical practitioners and health-service planners. Phase 1 involved interviews and focus groups conducted between February 2024 and April 2024 (n = 45), analysed using deductive content analysis, guided by the Sustainability of Innovation Framework. Phase 2 was a face-to-face workshop conducted in August 2024 (n = 28), with data from participant discussions and observer field notes analysed inductively and refined through reflexive dialogue. Reflexive analysis of the findings allowed the construction of recommendations for implementation in various healthcare contexts.
In Phase 1, participants representing all Australian jurisdictions and healthcare contexts identified that successful adoption of designated registered nurse prescribing is contingent upon several interrelated system components. These interconnected factors influence each other within the broader healthcare system and serve as the focus for Phase 2.
In Phase 2, participants reported context-specific service models, stakeholder engagement, financial support, clear messaging and workforce/organisational readiness for new models of care and service delivery were recognised as dynamic interrelated elements. Three overarching themes for successful implementation were generated: The Standard—just one piece of the puzzle. Harnessing collective capability. Shared wisdom for success.
National implementation of registered nurse prescribing requires consistent but context-responsive reforms. A systems-thinking approach underscores the need for whole-of-system strategies, acknowledging interdependencies and avoiding rapid, unplanned implementation. This study highlights that sustainable adoption of registered nurse prescribing in Australia depends on recognising system interdependencies and their dynamic nature.
Designated registered nurse prescribing has the potential to improve timely access to medicines and enhance patient-centred care when implemented with whole-of-system support.
This study provides key systems-level recommendations to guide policymakers and healthcare services to successfully implement designated registered nurse prescribing across various settings.
This study highlights key stakeholders' perspectives, providing valuable insights on the essential elements required for the successful adoption of this expanded practice.
Broad systems-level recommendations are offered to guide policymakers and healthcare services to successfully implement designated prescribing across various settings, taking into account the complexity of the healthcare system.
Consolidated criteria for reporting qualitative research guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Not registered.
This study aimed to evaluate the impact of the Community Care Program, which was the amalgamation of three outreach services—post-acute care, Residential In-Reach, and the Hospital Admission Risk Program—into a single integrated care model. Specifically, we assessed its effects on unplanned hospital readmissions and emergency department re-presentations at 30-, 60- and 90-days post-enrolment.
A pragmatic, real-world, population-based observational study was conducted using an interrupted time series analysis. The study included 4708 adult patients across two periods: pre-amalgamation (November 2014–October 2016), and post-amalgamation (May 2017–October 2018). Data were sourced from the National Centre for Healthy Ageing Data Platform, with statistical analyses conducted using Generalised Least Squares models to account for autocorrelation.
The study observed a significant increase in quarterly program enrolments post-amalgamation, from 578 to 1011 per quarter. The 30-day readmission rate decreased from 11.8% to 8.52% post-amalgamation. However, interrupted time series analysis revealed no statistically significant changes in the slopes of readmission and emergency department re-presentation rates after the program's amalgamation. The program did not result in significant changes in 60- or 90-day outcomes.
The amalgamation of post-acute care, Residential In-Reach, and the Hospital Admission Risk Program into the Community Care Program led to increased service utilisation without a significant impact on reducing unplanned hospital readmissions or emergency department re-presentations. Although the program amalgamation demonstrated improved accessibility, its longer-term impact remains inconclusive, highlighting the need for continuous refinement and further evaluation to optimise system efficiency. No patient or public contribution occurred in this study.
This study adhered to the STROBE guidelines for observational research.
FreshRSS 