Paediatric Nurse Education

Current Awareness Newsletter

December 2015

Outreach Your Outreach Librarian can help facilitate evidence-based

practise for all members of staff, as well as assisting with academic study and research. We can help with literature searching, obtaining journal articles and books, and

setting up individual current awareness alerts.

Literature Searching We provide a literature searching service for any library member. For those embarking on their own research it is advisable to book some time with one of the librarians for a 1 to 1 session where we

can guide you through the process of creating a well-focused literature research and introduce you to the health databases

access via NHS Evidence.

Critical Appraisal Training We also offer one-to-one or small group training in

literature searching, accessing electronic journals, and critical appraisal/Statistics. These are essential courses that teach how to

interpret clinical papers.

For more information, email: katie.barnard@uhbristol.nhs.uk

Books Books can be searched for using SWIMS our online catalogue at

www.swims.nhs.uk. Books and journals that are not available on site or electronically may be requested from other locations.

Please email requests to: library@uhbristol.nhs.uk

mailto:katie.barnard@uhbristol.nhs.ukhttp://www.swims.nhs.uk/mailto:library@uhbristol.nhs.uk

Contents

1: Tables of Contents from

December’s Paediatric Nurse

Education journals

2: New NICE Guidance

3: Latest relevant Systematic

Reviews from the Cochrane

Library.

4: NHS Behind the Headlines

5: Quick exercise

6: Current Awareness database

articles

Tables of Contents from Nurse Education journals

The links below will take you to the full Tables of Contents.

If you require full articles please email: library@uhbristol.nhs.uk

Nurse Educator January/February 2016, Volume 41, Issue 1

Nurse Education in Practice November 2015, Volume 15, Issue 6

Upcoming Lunchtime Drop-in Sessions

December (12pm)

Tues 1st Understanding articles

Weds 9th Statistics

Thurs 17th Literature Searching

January (1pm)

Monday 4th Literature searching

Tuesday 12th Critical Appraisal

Wednesday 20th Statistics

Thursday 28th Library Resources

The Library and Information Service provides free specialist information skills training for

all UHBristol staff and students.

To book a place, email: library@uhbristol.nhs.uk

If you’re unable to attend we also provide one-to-one or small group sessions. Contact

library@uhbristol.nhs.uk or katie.barnard@uhbristol.nhs.uk to arrange a session.

mailto:library@uhbristol.nhs.ukhttp://journals.lww.com/nurseeducatoronline/pages/currenttoc.aspxhttp://journals.lww.com/nurseeducatoronline/pages/currenttoc.aspxhttp://www.nurseeducationinpractice.com/currenthttp://www.nurseeducationinpractice.com/current

New NICE Guidance

NG26 Children’s attachment: attachment in children and young people who are adopted from care, in care or at high risk of going into care

NG24 Blood transfusion

Latest relevant Systematic Reviews

from the Cochrane Library

Anti-TNF agents for paediatric psoriasis Antihistamines for the common cold Decision aids for people considering taking part in clinical trials Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children Immunotherapy (oral and sublingual) for food allergy to fruits Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD)

NHS Behind the Headlines

Last line in antibiotic resistance under threat

Thursday Nov 19 2015

"The last line of antibiotic defence against some serious infections is under threat," The

Guardian reports, after researchers found that E.coli bacteria from food products in China has

developed resistance to colistin, a polymixin antibiotic…

http://www.nice.org.uk/guidance/ng26http://www.nice.org.uk/guidance/ng26http://www.nice.org.uk/guidance/ng24http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD010017.pub2http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD009345.pub2http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD009736.pub2http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD009385.pub2http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD009385.pub2http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD010522.pub2http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD009885.pub2http://www.nhs.uk/news/2015/11November/Pages/Last-line-in-antibiotic-resistance-under-threat.aspx

Quick exercise

Systematic Reviews There are 7 key steps that need to be taken when carrying out a Systematic Review. Can you put them in order?

A. Quality assessment

B. Study selection

C. Synthesis

D. Data extraction

E. Define the question

F. Literature search

G. Writing up

For assistance with carrying out a systematic review search or a literature search, please email library@uhbristol.nhs.uk.

mailto:library@uhbristol.nhs.uk

Current Awareness Database Articles

If you require full articles please email: library@uhbristol.nhs.uk

Title: The juggling act: Do student nurses who care for dependants need an adapted course? An applied policy research study. Citation: Nurse education today, Nov 2015, vol. 35, no. 11, p. 1085-1090 (November 2015) Author(s): Kiernan, Matthew D, Proud, Carole, Jackson, Sue Abstract: In line with many countries worldwide, the Department of Health mandate to Health Education England seeks to promote the diversity of applicants by widening participation in nurse education. A number of studies have explored the experience of non-traditional students undertaking nursing courses. This study aimed to explore and understand the experiences of student nurses undertaking their nurse education whilst caring for dependant family. The study used an applied qualitative research approached based on methods developed for applied social policy research. The study was undertaken in an institution of higher education in the North East of England. The study population consisted of a convenience sample of 14 respondents, 13 female and 1 male. Ten respondents lived with partners and 3 had disabled dependants within the family. The age range of dependent children ranged from 3months to 19years. Data was collected through focus groups and telephone interviews using a semi-structured interview schedule. Framework analysis was used to analyse the data. Three superordinate themes were identified, Altruism and Commitment, Maturity and Family and Social Mobility, that best encapsulate the characteristics that enable this group to function well and complete their nurse education. Analysis identified a highly motivated group of students who's individual accounts showed that their lives, whilst in nurse education, were a constant series of compromises and 'juggling' between the demands of the course and the demands of their families. This group of students do not need an adapted course, but instead wish for a realistic nursing course where expectations are managed in an honest way. Basic common sense and good management of nursing courses will help ensure that this motivated group of people achieve their goals with minimum hardship or difficulties. Copyright © 2015 Elsevier Ltd. All rights reserved.

Title: Effects of a Clown-Nurse Educational Intervention on the Reduction of Postoperative Anxiety and Pain Among Preschool Children and Their Accompanying Parents in South Korea. Citation: Journal of pediatric nursing, Nov 2015, vol. 30, no. 6, p. e89. (2015 Nov-Dec) Author(s): Yun, O Bok, Kim, Shin-Jeong, Jung, Dukyoo Abstract: This study examined the effects of a clown-nurse educational intervention on children undergoing day surgery for strabismus. This was a quasi-experimental study, using a nonequivalent control group, non-synchronized design. Fifty preschool children and their parents were invited to participate. The children in the intervention group (n=23) received clown therapy and subsequently reported significantly lower states of physiological anxiety, which was evidenced by systolic blood pressure, standardized behavioral anxiety tests, and post-surgery pain, than the control group (n=27). In addition, the parents in the experimental group showed a low state of physiological anxiety, evidenced by systolic blood pressure, pulse rates, standardized behavioral anxiety tests, and

mailto:library@uhbristol.nhs.uk

state-trait anxiety. The use of preoperative clown intervention may alleviate postoperative problems, not only for children, but also for their parents. Copyright © 2015 Elsevier Inc. All rights reserved.

Title: Reduction of Secondhand Smoke Exposure in the Cars of Children With Cancer. Citation: Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses, Nov 2015, vol. 32, no. 6, p. 401-409 (November 2015) Author(s): Peck, Kelly R, Tyc, Vida L, Huang, Qinlei, Zhang, Hui Abstract: This study examined whether an intervention designed to reduce secondhand smoke exposure (SHSe) among children being treated for cancer had effects in the specific setting of a motor vehicle. The parents or guardians (n = 71) of children being treated for cancer were randomized to either a behavioral secondhand smoke (SHS) reduction program or a standard care control group. Parental reports of SHSe were collected over the course of 12 months. Younger children were exposed at baseline more than their older counterparts. The greatest initial declines in car exposure were observed among children ≤5 years old in the intervention group compared with same-aged peers in the control group. After the 3-month time point, the control group showed greater reductions in car exposure in comparison with the intervention group. Interventions that teach parents strategies to manage their smoking while driving in their personal vehicles may produce even greater reductions in child exposure and should be developed. Based on the age-specific results reported here, future studies should account for effects of child age and use setting-specific measures of SHS. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

Title: Interacting effects of maternal responsiveness, infant regulatory problems and dopamine D4 receptor gene in the development of dysregulation during childhood: A longitudinal analysis. Citation: Journal of psychiatric research, Nov 2015, vol. 70, p. 83-90 (November 2015) Author(s): Poustka, Luise, Zohsel, Katrin, Blomeyer, Dorothea, Jennen-Steinmetz, Christine, Schmid, Brigitte, Trautmann-Villalba, Patricia, Hohmann, Sarah, Becker, Katja, Esser, Günter, Schmidt, Martin H, Brandeis, Daniel, Banaschewski, Tobias, Laucht, Manfred Abstract: Recent longitudinal studies have indicated that affective and behavioral dysregulation in childhood is associated with an increased risk for various negative outcomes in later life. However, few studies to date have examined early mechanisms preceding dysregulation during early childhood. Aim of this study was to elucidate early mechanisms relating to dysregulation in later life using data from an epidemiological cohort study on the long-term outcome of early risk factors from birth to adulthood. At age 3 months, mothers and infants were videotaped during a nursing and playing situation. Maternal responsiveness was evaluated by trained raters. Infant regulatory problems were assessed on the basis of a parent interview and direct observation by trained raters. At age 8 and 11 years, 290 children (139 males) were rated on the Child Behavior Checklist (CBCL). Additionally, participants were genotyped for the dopamine D4 receptor (DRD4) exon 3 VNTR polymorphism. A significant three-way interaction between maternal responsiveness, DRD4 genotype and infant regulatory problems was detected predicting the CBCL-dysregulation profile (CBCL-DP). Carriers of the DRD4 7r allele with regulatory problems at age 3 months showed significantly more behavior problems associated with the CBCL-DP during childhood when exposed to less maternal responsiveness. In contrast, no effect of maternal responsiveness was observed in

DRD4 7r carriers without infant regulatory problems and in non-carriers of the DRD4 7r allele. This prospective longitudinal study extends earlier findings regarding the association of the CBCL-DP with early parenting and later psychopathology, introducing both DRD4 genotype and infant regulatory problems as important moderators. Copyright © 2015 Elsevier Ltd. All rights reserved.

Title: Leveraging Resources to Improve Clinical Outcomes and Teach Transitional Care Through Development of Academic-Clinical Partnerships. Citation: Nurse educator, Nov 2015, vol. 40, no. 6, p. 303-307 (2015 Nov-Dec) Author(s): Smith, K Melissa, Lutenbacher, Melanie, McClure, Natasha Abstract: Nurse educators need to provide students with clinical experiences that prepare them for our rapidly changing health care environments. This article describes how nurse educators used academic and clinical resources to develop a partnership between a school of nursing and clinical entity to facilitate successful transitions from hospital to home for adult heart failure and pediatric asthma patients.

Title: Adapted Finnegan scoring list for observation of anti-depressant exposed infants. Citation: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, Nov 2015, vol. 28, no. 17, p. 2010-2014 (November 2015) Author(s): Kieviet, Noera, van Ravenhorst, Mariëtte, Dolman, Koert M, van de Ven, Peter M, Heres, Marion, Wennink, Hanneke, Honig, Adriaan Abstract: The Finnegan scoring list (FSL) is widely used to screen for poor neonatal adaptation in infants exposed to anti-depressants in utero. However, the large number of FSL-items and differential weighing of each item is time consuming. The aim of this study was to shorten and simplify the FSL yet preserving its clinimetric properties. This observational study examined infants exposed to an anti-depressant during pregnancy admitted for at least 72 h on a maternity ward. Trained nurses completed the FSL three times daily. Items for the adapted FSL were selected through forward analysis whereby the number of selected items was based on the area under the curve (AUC). Internal validity was assessed by cross-validation. 183 infants met the inclusion criteria. By forward analysis eight equally-weighed items resulted in an AUC of 0.91. In cross-validation, the mean AUC was 0.89 for 8 items. This adapted FSL had a sensitivity of 97.7% and specificity of 37.0% and a sensitivity of 41.9% and specificity of 86.2% regarding a cut-off of, respectively, 1 and 2. An adapted FSL with eight equally-weighed items has acceptable clinimetric properties and can serve as an easy to apply screening tool in infants exposed to anti-depressants during pregnancy.

Title: Integration of public health and primary care: A systematic review of the current literature in primary care physician mediated childhood obesity interventions. Citation: Obesity research & clinical practice, Nov 2015, vol. 9, no. 6, p. 539-552, 1871-403X (2015 Nov-Dec)

Author(s): Bhuyan, Soumitra S, Chandak, Aastha, Smith, Patti, Carlton, Erik L, Duncan, Kenric, Gentry, Daniel Abstract: Childhood obesity, with its growing prevalence, detrimental effects on population health and economic burden, is an important public health issue in the United States and worldwide. There is need for expansion of the role of primary care physicians in obesity interventions. The primary aim of this review is to explore primary care physician (PCP) mediated interventions targeting childhood obesity and assess the roles played by physicians in the interventions. A systematic review of the literature published between January 2007 and October 2014 was conducted using a combination of keywords like "childhood obesity", "paediatric obesity", "childhood overweight", "paediatric overweight", "primary care physician", "primary care settings", "healthcare teams", and "community resources" from MEDLINE and CINAHL during November 2014. Author name(s), publication year, sample size, patient's age, study and follow-up duration, intervention components, role of PCP, members of the healthcare team, and outcomes were extracted for this review. Nine studies were included in the review. PCP-mediated interventions were composed of behavioural, education and technological interventions or a combination of these. Most interventions led to positive changes in Body Mass Index (BMI), healthier lifestyles and increased satisfaction among parents. PCPs participated in screening and diagnosing, making referrals for intervention, providing nutrition counselling, and promoting physical activity. PCPs, Dietitians and nurses were often part of the healthcare team. PCP-mediated interventions have the potential to effectively curb childhood obesity. However, there is a further need for training of PCPs, and explain new types of interventions such as the use of technology. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Title: Establishing the research priorities of paediatric emergency medicine clinicians in the UK and Ireland. Citation: Emergency medicine journal : EMJ, Nov 2015, vol. 32, no. 11, p. 864-868 (November 2015) Author(s): Hartshorn, Stuart, O'Sullivan, Ronan, Maconochie, Ian K, Bevan, Catherine, Cleugh, Francesca, Lyttle, Mark D, PERUKI Abstract: Paediatric Emergency Research in the UK and Ireland (PERUKI) is a collaborative clinical studies group established in August 2012. It consists of a network of 43 centres from England, Ireland, Northern Ireland, Scotland and Wales, and aims to improve the emergency care of children through the performance of robust collaborative multicentre research within emergency departments. A study was conducted regarding the research priorities of PERUKI, to establish the research agenda for paediatric emergency medicine in the UK and Ireland. A two-stage modified Delphi survey was conducted of PERUKI members via an online survey platform. Stage 1 allowed each member to submit up to 12 individual questions that they identified as priorities for future research. In stage 2, the shortlisted questions were each rated on a seven-point Likert scale of relative importance. Members of PERUKI, including clinical specialists, academics, trainees and research nurses. Stage 1 surveys were submitted by 46/91 PERUKI members (51%). A total of 249 research questions were generated and, following the removal of duplicate questions and shortlisting, 60 questions were carried forward for stage 2 ranking. Stage 2 survey responses were submitted by 58/95 members (61%). For the 60 research questions that were rated, the mean score of 'relative degree of importance' was 4.70 (range 3.36-5.62, SD 0.55). After ranking, the top 10 research priorities included questions on biomarkers for serious bacterial illness, major trauma, intravenous bronchodilators for asthma and decision rules for fever with petechiae, head injury and atraumatic limp. Research priorities of PERUKI members have been identified. By sharing these

results with clinicians, academics and funding bodies, future research efforts can be focused to the areas of greatest need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Title: Team Huddle Implementation in a General Pediatric Clinic. Citation: Journal for nurses in professional development, Nov 2015, vol. 31, no. 6, p. 324-327 (2015 Nov-Dec) Author(s): Kellish, Ashley Amorello, Smith-Miller, Cherie, Ashton, Kathleen, Rodgers, Cheryl Abstract: Teamwork and communication are critical to ensure safe and quality patient care. However, the ability to affect these constructs within well-established healthcare settings is challenging. Using a quality improvement approach, staff development educators collaborated with clinical nursing staff to implement a daily team huddle. When incorporated into the workflow, a team huddle can promote communication and positively influence how teams function within a clinical area.(See CE Video, Supplemental Digital Content 1, http://links.lww.com/JNPD/A9).

Title: Suspect, detect and protect: lessons from a lipohypertrophy workshop for children's nurses. Citation: Nursing children and young people, Nov 2015, vol. 27, no. 9, p. 21-25, 2046-2336 (November 12, 2015) Author(s): Venn-Wycherley, Alison Abstract: This article describes a recent training workshop to educate children's nurses on injection technique best practice for diabetes, in particular, lipohypertrophy. The workshop was organised by the Forum for Injection Technique UK, the University of York, Leeds Children's Diabetes Team and Becton Dickinson Signature Solutions, and attended by delegates from Leeds Children's Hospital and the Children and Young Peoples Diabetes Network for Yorkshire and the Humber. The article discusses the causes of lipohypertrophy and the effect it can have on patient's glycaemic levels. There is an emphasis on the importance of regularly inspecting children and young people with diabetes for lipohypertrophy - a common complication of diabetes injection - and promotes the motto 'suspect, detect and protect'. The article also provides practical information for children's nurses on how to examine for lipohypertrophic lesions and guidance on how they can be prevented by adhering to correct injection technique.

Title: Increasing Parental Participation During Rounds in a Pediatric Cardiac Intensive Care Unit. Citation: American journal of critical care : an official publication, American Association of Critical-Care Nurses, Nov 2015, vol. 24, no. 6, p. 532-538 (November 2015) Author(s): Blankenship, Angela, Harrison, Sheilah, Brandt, Sarah, Joy, Brian, Simsic, Janet M Abstract: Inviting parents of sick children to participate during the rounding process may reduce parents' anxiety and improve communication between the parents and the health care team. To increase the percentage of available parents invited to participate in morning rounds in a pediatric

cardiothoracic intensive care unit (CTICU). Invitations to parents to participate in morning CTICU rounds were randomly audited from June 2012 to April 2014 (mean, 15 audits per month). From June 2012 to February 2013 (before intervention), 73% of parents available during morning rounds received an invitation to participate. From April 2013 to May 2013, the following interventions (family participation bundle) were implemented: (1) staff education, (2)"Invitation to Rounds" handout added to the parent welcome packet with verbal explanation, (3) bedside tool provided for parents to communicate desire to participate in rounds with the team, (4) reminder to invite parents added to nursing rounding sheet. Following interventions, family feedback was obtained by 1-on-1 (physician-parent) open-ended conversation. From April 2013 to April 2014, 94% of parents available during morning rounds received an invitation to participate. Reasons for not participating: chose not to participate (63%), sleeping-staff reluctant to wake (25%), not English speaking (7%), breastfeeding (5%). Implementation of a family participation bundle was successful in increasing invitations to parents to participate during morning rounds in the CTICU. Engagement of staff and addressing specific staff concerns was instrumental in the project's success. ©2015 American Association of Critical-Care Nurses.

Title: Nurses in Action: A Response to Cultural Care Challenges in a Pediatric Acute Care Setting. Citation: Journal of pediatric nursing, Nov 2015, vol. 30, no. 6, p. 896-907 (2015 Nov-Dec) Author(s): Mixer, Sandra J, Carson, Emily, McArthur, Polly M, Abraham, Cynthia, Silva, Krystle, Davidson, Rebecca, Sharp, Debra, Chadwick, Jessica Abstract: Culturally congruent care is satisfying, meaningful, fits with people's daily lives, and promotes their health and wellbeing. A group of staff nurses identified specific clinical challenges they faced in providing such care for Hispanic and underserved Caucasian children and families in the pediatric medical-surgical unit of an urban regional children's hospital in the southeastern U.S. To address these challenges, an academic-practice partnership was formed between a group of nurse managers and staff nurses at the children's hospital and nursing faculty and graduate students at a local, research-intensive public university. Using the culture care theory, the partners collaborated on a research study to discover knowledge that would help the nursing staff resolve the identified clinical challenges. Twelve families and 12 healthcare providers participated. Data analysis revealed five care factors that participants identified as most valuable: family, faith, communication, care integration, and meeting basic needs. These themes were used to formulate nursing actions that, when applied in daily practice, could facilitate the provision of culturally congruent care for these children and their families. The knowledge generated by this study also has implications for healthcare organizations, nursing educators, and academic-practice partnerships that seek to ensure the delivery of equitable care for all patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Title: Online Continuing Education for Expanding Clinicians' Roles in Breastfeeding Support. Citation: Journal of human lactation : official journal of International Lactation Consultant Association, Nov 2015, vol. 31, no. 4, p. 582-586 (November 2015) Author(s): Edwards, Roger A, Colchamiro, Rachel, Tolan, Ellen, Browne, Susan, Foley, Mary, Jenkins, Lucia, Mainello, Kristen, Vallu, Rohith, Hanley, Lauren E, Boisvert, Mary Ellen, Forgit, Julie, Ghiringhelli, Kara, Nordstrom, Christina

Abstract: Lack of health professional support is an important variable affecting mothers' achievement of breastfeeding goals. Online continuing education is a recognized pathway for disseminating content for improving clinicians' knowledge and supporting efforts to change practices. At the time we developed our project, free, accredited continuing education for physicians related to breastfeeding management that could be easily accessed using portable devices (via tablets/smartphones) was not available. Such resources were in demand, especially for facilities pursuing designation through the Baby-Friendly Hospital Initiative. We assembled a government, academic, health care provider, and professional society partnership to create such a tutorial that would address the diverse content needed for supporting breastfeeding mothers postdischarge in the United States. Our 1.5-hour-long continuing medical and nursing education was completed by 1606 clinicians (1172 nurses [73%] and 434 physicians [27%]) within 1 year. More than 90% of nurses and over 98% of physicians said the tutorial achieved its 7 learning objectives related to breastfeeding physiology, broader factors in infant feeding decisions and practices, the American Academy of Pediatrics' policy statement, and breastfeeding management/troubleshooting. Feedback received from the tutorial led to the creation of a second tutorial consisting of another 1.5 hours of continuing medical and nursing education related to breast examination and assessment prior to delivery, provision of anticipatory guidance to pregnant women interested in breastfeeding, maternity care practices that influence breastfeeding outcomes, breastfeeding preterm infants, breastfeeding's role in helping address disparities, and dispelling common myths. The tutorials contribute to achievement of 8 Healthy People 2020 Maternal, Infant and Child Health objectives. © The Author(s) 2015.

Title: Implementing an Evidence-Based Practice Project in the Prevention of Peripheral Intravenous Site Infiltrations in Children. Citation: Journal of infusion nursing : the official publication of the Infusion Nurses Society, Nov 2015, vol. 38, no. 6, p. 430-435 (2015 Nov-Dec) Author(s): Taylor, John T Abstract: More than 90% of hospitalized patients require peripheral intravenous (IV) access for the delivery of fluids, nutrition, or medication. Peripheral IV site complications, such as infiltration and phlebitis, account for the greatest risk to most patients receiving infusion therapy. These complications may result in substantial acute or chronic injury, which may be further exacerbated if the affected individual is a child. Evidence suggests that the implementation of bedside-nurse training and more frequent assessment will reduce the risk for peripheral IV site complications. This project evaluates the implementation of these interventions on a pediatric acute care unit.

Title: Advanced level nursing in England: organisational challenges and opportunities. Citation: Journal of nursing management, Nov 2015, vol. 23, no. 8, p. 1011-1019 (November 2015) Author(s): East, Linda, Knowles, Kate, Pettman, Maria, Fisher, Leslie Abstract: To explore the background, activities and future development needs of advanced practice nurses within a large NHS Trust in England, allowing for a wider review of the current situation within the UK. There are currently no national requirements for advanced practice nursing within the UK, which has led to considerable variability in these roles. Recently, focus has been placed on local governance rather than regulation of advanced practice nursing. However, governance and

coordinated workforce planning within the UK is in its infancy. An electronic survey was sent to all nurses within one Trust identified as practising at an advanced level; a total of 136 responses were received. The survey identified considerable variation in titles, educational preparation and current activities even within similar roles. Some participants identified the need for more support in undertaking professional development activities. The findings echo the wider picture within the UK, and point to the need to actively work on developing strategies for governance, education, and succession planning for advanced practice nursing. In the absence of national regulation, UK NHS Trusts should develop their own registers of advanced practice nurses in order to facilitate improved management, governance and workforce planning systems. © 2014 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

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