OBJECTIVE: Clinical trials (CTs) play a crucial role in advancing medical knowledge and patient care but are increasingly complex and resource-intensive. This scoping review aims to explore the current approaches for evaluating workload (WL) in oncology CTs and identify tools for measuring clinical research nurses\' WL.
METHODS: The search was conducted through MEDLINE, Scopus, CINAHL, and COCHRANE databases and carried out through the framework developed by Arksey and O\'Malley and revised by the Joanna Briggs Institute. Data extraction and synthesis were performed to analyze instruments used for WL assessment and their dimensions.
RESULTS: Of the 1,005 records identified, 12 meet the inclusion criteria. The complexity and WL associated with CTs can be attributed to five main domains: (1) protocol, (2) single case, (3) data management, (4) regulatory, and (5) worker-related. These instruments varied in their approaches, scoring systems, and domains assessed. Notably, the protocol-related domain was prevalent across most instruments, highlighting its importance in WL evaluation. Furthermore, findings revealed a wide range of WL scores across different studies, emphasizing the complexity and variability in WL management within CTs.
CONCLUSIONS: This scoping review underscores the importance of evaluating WL in CTs and provides insights into existing tools and approaches. Nurses, as integral members of clinical research teams, bear significant responsibilities in trial management, necessitating a balanced approach to WL allocation. Future research should focus on validating and standardizing assessment tools to optimize resource allocation and enhance research efficiency in CT centers.
CONCLUSIONS: Understanding WL dynamics in CTs is essential for nurses involved in research delivery. By utilizing validated WL assessment tools, nurses can advocate for appropriate staffing levels and promote efficient trial management, ultimately improving patient outcomes and research quality in CT settings.

OBJECTIVE: This rapid review provides an overview of the current landscape of, and the criteria used for admission into nurse practitioner programs.
METHODS: A series of application and admission criteria were collected from nurse practitioner programs in Canada, the United States of America (USA) and Australia. Key descriptive statistics and indicators were analyzed.
RESULTS: Most programs in the USA and Canada required a minimum grade point average (GPA) between 3.00 and 3.24, while Australian programs did not identify minimum GPA requirements. Contrastingly, Australian programs required the highest minimum clinical practice hours. Many North American programs required writing samples, while Australian programs did not.
CONCLUSIONS: Despite role similarity, nurse practitioner admission criteria differ substantially between Canada, the USA and Australia, hindering standardization and integration of the role globally.

BACKGROUND: In 2011, the Institute of Medicine published a report on the future of nursing, which recommended nurse practitioner postgraduate training in the form of fellowships or residencies. Since then, the number of postgraduate programs has grown, but data is still scarce regarding their efficacy and benefits.
OBJECTIVE: The goal of this integrative review is to synthesize available literature regarding the outcomes of nurse practitioner postgraduate fellowships and/or residencies on clinical competence and perceived readiness to practice.
METHODS: CINAHL, PubMed, and citation searching were used to search relevant subject headings, MeSH headings, and keywords related to fellowships and residencies for nurse practitioners, resulting in 11 articles being included based on inclusion and exclusion criteria. Synthesis was completed using the Garrard Matrix method to identify common themes among the studies.
RESULTS: Eight quasi-experimental and three cross-sectional studies were included in this review. Programs included multiple areas of focus, including primary care, critical care, and pediatric acute care. Common themes among the studies were an increased level of preparedness, reduced turnover, and greater job satisfaction.
CONCLUSIONS: The major theme found among the studies was an increased confidence and preparedness to practice. Minor themes include increased job satisfaction and decreased intent to quit.

BACKGROUND: Advanced practice providers (APPs), including physician assistants/associates (PAs), nurse practitioners (NPs) and other non-physician roles, have been developed largely to meet changing healthcare demand and increasing workforce shortages. First introduced in primary care in the US, APPs are prevalent in secondary care across different specialty areas in different countries around the world. In this scoping review, we aimed to summarise the factors influencing the development, recruitment, integration, retention and career development of APP roles in hospital health care teams.
METHODS: We conducted a scoping review and searched Ovid MEDLINE, Ovid Embase, Ovid Global Health, Ovid PsycINFO and EBSCOhost CINAHL to obtain relevant articles published between Jan 2000 and Apr 2023 that focused on workforce management of APP roles in secondary care. Articles were screened by two reviewers independently. Data from included articles were charted and coded iteratively to summarise factors influencing APP development, recruitment, integration, retention and career development across different health system structural levels (macro-, meso- and micro-level).
RESULTS: We identified and analysed 273 articles that originated mostly from high-income countries, e.g. the US (n = 115) and the UK (n = 52), and primarily focused on NP (n = 183) and PA (n = 41). At the macro-level, broader workforce supply, national/regional workforce policies such as work-hour restrictions on physicians, APP scope of practice regulations, and views of external collaborators, stakeholders and public representation of APPs influenced organisations\' decisions on developing and managing APP roles. At the meso-level, organisational and departmental characteristics, organisational planning, strategy and policy, availability of resources, local experiences and evidence as well as views and perceptions of local organisational leaders, champions and other departments influenced all stages of APP role management. Lastly at the micro-level, individual APPs\' backgrounds and characteristics, clinical team members\' perceptions, understanding and relationship with APP roles, and patient perceptions and preferences also influenced how APPs are developed, integrated and retained.
CONCLUSIONS: We summarised a wide range of factors influencing APP role development and management in secondary care teams. We highlighted the importance for organisations to develop context-specific workforce solutions and strategies with long-term investment, significant resource input and transparent processes to tackle evolving healthcare challenges.

UNASSIGNED: This article aims to address the hypothesis that the incorporation of the use of an Advanced Practice Registered Nurse and the Situation-Background-Appearance-Review and Notify form from the Interventions to Reduce Acute Care Transfers program will reduce the number of hospital transfers from nursing home facilities.
UNASSIGNED: This hypothesis was measured using de-identified data on hospital transfers from three facilities, as well as de-identified Situation-Background-Appearance-Review and Notify and Quality Initiative forms completed by the nursing staff at these facilities.
UNASSIGNED: The collective number of hospital transfers seen over the eight-week pre-intervention period was 115 compared with the collective number of transfers seen over the eight-week post-intervention period which was 75. This represents an 34.8% overall reduction in hospital transfers.
UNASSIGNED: Implications of this project include the confirmation that the use of the Situation-Background-Appearance-Review and Notify tool integration of an Advanced Practice Registered Nurse can help reduce hospital transfers. These findings can help to initiate future projects and protocol changes.

OBJECTIVE: This article appraises models and theories related to advanced nursing practice. It argues that while the role of the advanced nurse practitioner builds on and extends beyond traditional nursing, it remains firmly grounded in \'caring\'.
BACKGROUND: The stereotype that nurses \'care\' and doctors \'cure\' is fading. Increasingly, nurses have crossed boundaries and conducted independent assessment, diagnosis, prescribing and consultation, which used to be the doctor\'s role. Confusion and argument have arisen due to the higher-level practice of the advanced nurse practitioner, as many questions where these \'doctor nurses\' stand.
METHODS: A literature review.
METHODS: Databases, including CINAHL, Medline and Google Scholar, were searched.
METHODS: Databases were searched, and relevant studies and review articles from 1970 to 2023 were identified using the following keywords: \'advanced nurse practitioner\', \'nurse practitioner\', \'advanced nursing\', \'advance practice\', \'nurse practitioner\', \'nursing theory\' and \'nursing model\'.
RESULTS: Although advanced nurse practitioners identify themselves as nurses, there is limited use of nursing theory to conceptualize this new level of practice and to define their contribution to the multi-disciplinary team. It is noted that a holistic approach to personalized patient care, based on therapeutic relationships and effective communication, may help us identify the unique contribution of the advanced nurse practitioner.
CONCLUSIONS: The development of advanced nursing theory needs to capture this holistic approach and its caring element to recognize the value and strengthen the identity allegiance of this hybrid role.
UNASSIGNED: Holistic approach and patient-centred care, effective communication and the therapeutic relationship are strong characteristics relating to ANP practice, the latter of which is yet to be clearly defined and captured in nursing theories. Conceptualizing ANP practice and capturing their valuable nursing care will enable better understanding and clarity for the role to realize its full potential.

BACKGROUND: Surgical care practitioners (SCPs) are non-medical workers involved in various aspects of the management of surgical patients. The role includes assisting and performing surgical procedures. More than 60,000 laparoscopic cholecystectomies (LC) are performed annually in the UK. With ever-increasing pressure on waiting lists, it is important to look at fully utilising the skills of our entire workforce. We report what we believe is the first published series of LC performed by an SCP.
METHODS: A retrospective review of a prospectively collected database was performed. The primary outcome was any complication requiring intervention. Secondary outcomes were minor complications, operative time, length of stay, conversion and readmission.
RESULTS: In total, 170 patients were operated on. Indications were biliary colic in 127 (74.7%), cholecystitis in 30 (17.6%) and pancreatitis in 13 (7.6%). Mean operating time was 65min (range 35-152min). Fifty-three operations were assisted by a consultant, 110 by a specialist or associate specialist grade (SAS) doctor and 7 by a core trainee (CT2). Some 139 (81.7%) patients were discharged on the day of surgery and 24 (14.1%) stayed one night in hospital. There were no major complications. Five patients required readmission, three with pain and two with port site infections. There were no conversions or transfusions required.
CONCLUSIONS: There is a paucity of published data on surgical outcomes of procedures performed by SCPs. With a structured, supervised approach, SCPs could be trained to take on more complex procedures and further strengthen the surgical workforce. This study demonstrates that elective LC can be safely performed by an appropriately trained and supervised SCP.

OBJECTIVE: Advanced practice nursing roles in cancer care are diverse and exist across the cancer care continuum. However, the titles used and the scope of practice differ across countries. This diversity is likely to be misleading to patients and influence nurses\' contribution to health care. An understanding of the current state of advanced practice nursing roles in cancer care internationally is needed to inform opportunities for future role development and enhance cancer nursing career pathways.
METHODS: This scoping review included a systematic search of four databases: MEDLINE, CINAHL, PsycINFO, and Academic Search Complete. Independent screening for papers meeting the review\'s inclusion criteria was undertaken using online screening software. Data extraction, coding, and mapping were undertaken in NVivo 12.
RESULTS: Of the 13,409 records identified, 108 met the review\'s inclusion criteria. A variety of roles in cancer care settings were described. The United States and the United Kingdom had the most titles for advanced practice nursing roles. Tumor-specific roles were described and integrated into different phases of the cancer care continuum. Trends in continuing professional development for advanced practice nurses in cancer care included the rise in Fellowship programs in the United States and practice-based education in the United Kingdom.
CONCLUSIONS: The differences in advanced practice nursing roles in cancer care allow regional and institutional variation to meet the needs of patient populations and health care system demands. However, a lack of clarity surrounding titles and roles results in confusion and underutilization of these nurses\' highly specialized skill sets.
CONCLUSIONS: Incongruence in titles and scope of practice internationally will ultimately result in a merging of roles. There is a need for international agreement on education requirements for advanced practice nursing roles to promote career pathways.

BACKGROUND: Prolonged periods of immunosuppression during hematopoietic stem cell transplant (HSCT) can result in serious infectious complications and contribute to transplant-related morbidity and mortality. Adherence to standardized pre and postinfection screening guidelines, prescribed medications, and early identification of infectious symptoms through comprehensive patient and family education are crucial to minimizing infectious complications. Advanced practice nurses (APNs) are key members of the multidisciplinary care team in the HSCT specialty, maintaining a specialized skillset and scope of practice which includes a holistic based, preventative medicine and risk mitigation approach.
METHODS: This review sought to describe the role of the APN in HSCT care and to further examine existing APN led models of care which focus on infection prevention and education throughout the HSCT treatment journey.
RESULTS: No studies specifically examined the APN role in infectious diseases risk assessment, screening, and management throughout the HSCT journey were identified throughout our review, however, there was considerable evidence to demonstrate the benefits of APN led care in the oncology and solid organ transplantation specialty which led to improvements in continuity of care, overall patient outcomes, and multidisciplinary team collaboration. The key themes identified in our review, were the role of the APN in the delivery of comprehensive patient and family education, the role of the APN in supporting, mentoring, and educating junior medical and nursing teams, the collaboration between the APN and the multidisciplinary care team, and the role of the APN in prompt recognition, triage, and management of treatment related complications, such as infection.

Electronic health records are integral to the advanced practice registered nurse role, yet access and training during academic preparation are profoundly limited. Lack of exposure to electronic health records prevents students from becoming fully prepared for the responsibilities of clinical practice and potentially impacts quality of care, patient safety, and communication among patients and providers. This scoping review of 20 articles on electronic health record use in advanced practice registered nursing student education shows significant gaps in current research. Nine articles were classified as research. The remaining 11 were non-research reports of teaching innovations describing the use of simulated electronic health records in graduate nursing education or the use of an electronic health record in interprofessional education activities. Most of the limited research did not use valid and reliable instruments or robust designs, employed disparate approaches and tools to study the phenomenon, and measured low-level outcomes such as student navigation and confidence in using electronic health records. The non-research literature draws attention to the deficits in educational resources, including unaffordable electronic health records for academic use. Although rigorous evidence is lacking, a common theme throughout the reviewed literature was the benefit of simulation to develop electronic health record skills.