This study provides a closer look to the possibility of having advanced practice in public health nursing by analyzing the power relations between nursing practice and social structures. Representatives from the public health sector, national authorities, and the private sector were invited in a round table discussion. Transcriptions were coded and later on categorized and analyzed drawing upon the concepts of Foucault. Foucauldian analysis hands an important insight on how social structures and institutions can steer the creation of an advanced practice in public health nursing in the Philippines. Various social institutions view the relevance of a master's prepared nurse according to their societal roles and functions. Requisite competencies of a master's prepared nurse in public health nursing include fulfilling the role of a clinician, leader and manager, supervisor, and a researcher. PRBON, CHED, DOH, and nursing schools need to work together to define the knowledge of an advanced practice in public health nursing, to implement appropriate surveillance mechanisms, and to establish a compliant practice.

The role of the nurse practitioner (NP) has been successfully implemented globally including in some Southeast Asian countries. However, the Philippines has yet to enact this expanded role, not with standing being faced with the common factors influencing the evolution of the NP role indicated in the literature. With the proposed repeal of the current Philippine Nursing Law to include Advanced Practice Nursing, this study aimed to determine the knowledge and attitudes of nurses and physicians in the Philippines on the NP role. Sixty-six participants (41 nurses and 25 physicians) completed the survey on the knowledge and attitude on the NP role, conducted in two tertiary-level hospitals in Manila. Nurses have statistically higher scores on items regarding general understanding of the NP role, and on the difference of the NP from senior nurses. However, the difference of overall survey scores on the knowledge and attitude on the NP role between nurses and physicians was statistically non-significant. These results support the need to raise awareness on the role of the NPs by educating nurses, physicians, and other healthcare professionals in the Philippine setting.
Advanced practice nursing ; nurse practitioner ; knowledge ; attitudes

PURPOSE: This study was conducted to identify the present conditions of clinical practicum through analyzing guidebooks used in education institutions for oncology advanced practice nursing programs and to discuss future directions. METHODS: Ten of a total of 13 education institutions participated in this study and ten guidebooks were reviewed from June 1 to October 31, 2014. The standard curriculum developed by the Korean accreditation board of nursing education was used to analyze the present conditions and an analyzing frame was developed by a research team. Two coders independently recorded the data, agreement was 92% and all disagreements was concurrent after discussion. RESULTS: Courses in the area of 'advanced oncology nursing' were most highly established and, courses in the area of 'introduction of oncology nursing' were least established. Some learning objectives were never dealt with and some learning objectives were over dealt with. The national cancer center was most used for practicum. Diverse homework and evaluation methods were used. CONCLUSION: Through analyzing clinical practicum guidebooks for oncology advanced practice nursing students, we found that balanced practicum courses are needed to improve the quality of oncology advanced practice nurse programs.
Accreditation ; Advanced Practice Nursing* ; Curriculum ; Education ; Education, Nursing ; Humans ; Learning

PURPOSE: The purpose of this study was to describe the level of satisfaction with the role of Korean oncology advanced practice nurses (KOAPNs) among cancer patients, physicians, and nurses. METHODS: This study was conducted with 176 patients who had experienced KOPANs' care more than three times, as well as 82 physicians and 190 nurses who have worked with KOAPNs at four hospitals in Korea. RESULTS: The results indicate that 1) Overall satisfaction in the patient group was high (3.61) and they were most satisfied with the 'attentiveness' domain; 2) Overall satisfaction in the physician group was also high (3.61), however, that in the nurse group was relatively low (3.28); 'coordination & cooperation' showed the highest score for satisfaction in both groups, while 'research' domain showed the lowest score; 3) Cancer type in patients, working department in physicians or nurses, and duration working with KOAPNs in nurses showed significant association with satisfaction; and 4) The ratio of KOAPNs-to-patient, time since introduction of the KOAPNs policy, and incentive system were institutional factors showing significant association with it. CONCLUSION: These findings suggest the necessity for identification and standardization of the roles of KOAPNs, as well as promotion of awareness of KOAPNs' care.
Advanced Practice Nursing ; Humans ; Korea ; Motivation ; Oncology Nursing

PURPOSE: The purpose of this study was to analyze the actual working hours of an oncology advanced practice nurse (APN) at a university hospital according to the duties and tasks outlined in the job description. METHODS: An assessment tool for this study was created based on the job description of APN as defined by the Korean Nurses Association, and was later verified by a specialist party. Twenty-three oncology APNs recorded their nursing activity on the assessment tool. The working hours and distribution were analyzed according to specific duty and task. RESULTS: Average working hours per day for APNs totaled 9.3 hours. Time for duties was allocated as follows in order of priority: 28.0% for therapeutic intervention and 19.8% for clinical decision making. Time allotted for tasks was distributed as follows: 19.5% for special nursing care and 9.8% for planning treatment and nursing interventions. CONCLUSION: This study allowed insight into the actual time spent by oncology APNs on duties and tasks outlined in the job description. These findings should contribute to management of the changing role of oncology APNs. Furthermore, the results may be used as a basic resource for the continued professional development of the work of oncology APNs.
Advanced Practice Nursing ; Decision Making ; Job Description ; Nursing ; Nursing Care ; Oncology Nursing ; Specialization

PURPOSE: This study was conducted to provide basic data for quality improvement among oncology advanced practice nurses (oncology APNs) through increasing job satisfaction by determining their job satisfaction level and analyzing the influencing factors. METHODS: The subjects were 114 certified oncology APNs working at general hospitals in metropolitan areas. Data were collected using a structured questionnaire from August 4 to October 29, 2018. The instruments were the Role Conflict Scale, Self-Efficacy Scale, Professional Self-Concept Scale, and the Level of Job Satisfaction. The data were analyzed using descriptive statistics, t-tests, chi-square tests, ANOVA, Pearson’s correlation coefficients and multiple regression in SPSS version 23.0, IBM. RESULTS: Factors that significantly affected job satisfaction were number of years since being certified as an oncology APN (β=-.20, p=.031), oncology advanced practice (β=.38, p<.001), and professional self-concept (β=.44, p<.001). The explanatory power was 39.4%. CONCLUSION: These results showed that factors significantly affecting job satisfaction were number of years since being certified as an oncology APN, advanced practice in oncology, and professional self-concept. Job satisfaction was found to be higher when the number of years since being certified as an oncology APN was shorter and professional self-concept was higher.
Advanced Practice Nursing ; Hospitals, General ; Job Satisfaction ; Oncology Nursing ; Quality Improvement

PURPOSE: This study was conducted to provide fundamental information for a system establishment of advanced practice nursing for gynecological cancer patients (APN-GCP). METHOD: Data was collected by focus group and individual interviews and analyzed in the framework of the Grounded theory method mapped by Strauss and Corbin (1990). There were 13 subjects in this study (nurses, doctors, patient and her family). RESULT: We identified 87 concepts, 22 sub-categories, and 10 categories. Categories for role expectation were arrangement of diagnosis and treatment process, giving information of treatment course, support of treatment process, patients' right toward making a decision of treatment, counseling and teaching after discharge from hospital, medical insurance and financial problems, counseling about sexual problems and use of family and community resources. All subjects perceived the necessity of an APN-GCP. An APN-GCP requires over 2~7 years clinical experience and a master's degree. Services would be performed from initial registration to termination of treatment or death, and accomplished on an outpatient clinic basis. CONCLUSION: The nursing delivery system and curriculum should be developed for a women's health nurse practitioner including APN-GCP. As a further step, cost-effectiveness and projected estimation of manpower of APN-GCP should be studied in the future.
Advanced Practice Nursing* ; Ambulatory Care Facilities ; Counseling ; Curriculum ; Diagnosis ; Focus Groups ; Humans ; Insurance ; Nurse Practitioners ; Nursing ; Patient Rights ; Women's Health

PURPOSE: The purposes of this study were to develop a problem based learning (PBL) module for cancer symptom management and oncology emergencies, and to evaluate the module after applying it for students in an advanced practice nurse program for oncology. METHODS: This study was a methodological research project. We invited a total of 13 graduates from an advanced practice nurse program to evaluate topics for the PBL module development. Five experts developed a PBL module for a selected topic. Eight students from an advanced practice nurse program participated in the PBL learning experience and evaluated their learning experiences. RESULTS: Tumor lysis syndrome, pain, disseminated intravascular coagulation and hypercalcemia were evaluated to be the most relevant and needed topics for the module. Oncology emergency PBL module-tumor lysis syndrome was developed through expert validation. Evaluation of PBL learning was 3.76 (out of 4 points) in a pilot test. CONCLUSION: The new PBL module provided a positive learning experience to students. The new PBL module can be used as the standardized clinical practice education in the oncology advanced practice nurse program and developing further PBL modules for different topics is recommended.
Advanced Practice Nursing ; Disseminated Intravascular Coagulation ; Education ; Emergencies ; Humans ; Hypercalcemia ; Learning ; Oncology Nursing ; Problem-Based Learning* ; Tumor Lysis Syndrome

PURPOSE: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. METHODS: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. RESULTS: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). CONCLUSION: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.
Advanced Practice Nursing ; Chronic Disease ; Community Health Nursing ; Counseling ; Focus Groups ; Health Promotion* ; Humans ; Hypertension* ; Nurse Practitioners ; Nursing ; Primary Health Care* ; Vulnerable Populations

PURPOSE: The purposes of this study were to develop a taxonomy for detection of errors related to hypertension management and to apply the taxonomy to retrospectively analyze the documentation of nurses in Advanced Practice Nurse (APN) training. Method: We developed the Hypertension Diagnosis and Management Error Taxonomy and applied it in a sample of adult patient encounters (N = 15,862) that were documented in a personal digital assistantbased clinical log by registered nurses in APN training. We used Standard Query Language queries to retrieve hypertension-related data from the central database. The data were summarized using descriptive statistics. Result: Blood pressure was documented in 77.5% (n = 12,297) of encounters; 21% had high blood pressure values. Missed diagnosis, incomplete diagnosis and misdiagnosis rates were 63.7%, 6.8% and 7.5% respectively. In terms of treatment, the omission rates were 17.9% for essential medications and 69.9% for essential patient teaching. Contraindicated anti-hypertensive medications were documented in 12% of encounters with co-occurring diagnoses of hypertension and asthma. CONCLUSION: The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.
Adult ; Advanced Practice Nursing ; Asthma ; Blood Pressure ; Computers, Handheld ; Diagnostic Errors ; Education, Nursing ; Humans ; Hypertension ; Informatics ; Medical Errors ; Patient Safety ; Retrospective Studies