The ongoing pandemic in Singapore is part of a global pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To control the spread of COVID-19 and prevent the healthcare system from being overwhelmed, 'circuit breaker' measures were introduced between 7 April and 1 June 2020 in Singapore. There is thus a crucial need for innovative approaches to the provision and delivery of healthcare in the context of safe-distancing by harnessing telemedicine, especially for patients with chronic diseases who have traditionally been managed in tertiary institutions. We present a summary of how the Virtual Monitoring Clinic has benefited the practice of our outpatient rheumatology service during the COVID-19 pandemic. The virtual consultations address the need for safe-distancing by limiting face-to-face appointments and unnecessary exposure of patients to the hospital where feasible. This approach ensures that the patients are monitored appropriately for drug toxicities and side-effects, maintained on good disease control, and provided with patient education.
Ambulatory Care/methods* ; Antirheumatic Agents/therapeutic use* ; COVID-19 ; Delivery of Health Care ; Humans ; Nurse Practitioners ; Pharmacists ; Rheumatic Diseases/drug therapy* ; Rheumatology/methods* ; SARS-CoV-2 ; Singapore ; Telemedicine/organization & administration* ; Tertiary Care Centers

PURPOSE: The purpose of this study was to construct a clear definition of the concept of clinical supervision among psychiatric mental health nurse practitioners (PMHNPs) in South Korea. METHODS: The hybrid model was used to perform concept analysis on supervision. Results from both the theoretical review of 17 studies and a field study interviewing 12 PMHNPs were included in the final process. RESULTS: The concept of supervision was found to have complex features and to consist of multi-dimensional meaning units, with 4 levels (including 11 attributes and 36 indicators). The dimensions and their 11 attributes are suggested as follows: 1) Learning dimension (intensive practice, clinical knowledge and skills, reflective practice), 2) professional support dimension (supervision function, evaluation and feedback, supervisory relationship, autonomy), 3) institutional dimension (supervision framework, policy of clinical supervision), and 4) consequential dimension (ensure the qualities of nursing care, professional development). CONCLUSION: Based on the results, supervision is defined as: “The provision of guidance and feedback on matters of personal, professional, and educational development in the context of a supervisee's experience of providing safe and appropriate nursing care.” The findings in this study provide helpful insights for understanding supervision and practice development.
Humans ; Korea ; Learning ; Mental Health ; Nurse Practitioners ; Nursing ; Nursing Care ; Organization and Administration ; Psychiatric Nursing

The health care system is changing from ‘pay for volume’ to ‘pay for value.’ These changes are turning health care delivery into a more cost-effective and coordinated care setup that drives hospitals to lower costs and greater quality gains. The present perioperative care service in Korea has proven to be costly, fragmented, and neither evidence-based nor patient-centered. Recently, a new concept of a perioperative care model termed perioperative surgical home (PSH) has been proposed. The PSH is a patient-centered, team-based, and coordinated perioperative care setup, composed of the head anesthesiologist-perioperativist in tandem with dedicated nurse practitioners and other PSH team doctors. All pre-, intra-, and postoperative patient care functions are performed by a single PSH team, not several different departments. The PSH care extends from the decision to operate till 30 days post-discharge. Several evidence-driven perioperative strategies for reducing postoperative complications and shortening hospital stay can be adapted to each specific hospital situation, rather than strictly applying any given strategies. With the PSH, patients are more satisfied and experience better outcomes. It is also a good hospital business model. The expanded role of anesthesiologists in the PSH has the potential to invigorate the specialty.
Anesthesiology* ; Commerce ; Delivery of Health Care ; Head ; Health Care Costs ; Humans ; Korea ; Length of Stay ; Medical Errors ; Nurse Practitioners ; Patient Care ; Perioperative Care ; Postoperative Complications ; Value-Based Purchasing

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.
Hospitals, General ; Humans ; Job Satisfaction ; Nurse Clinicians ; Nurse Practitioners ; Nursing ; Patient Selection ; Physician Assistants ; Prescriptions

PURPOSE: The main purpose of this study was to identify the essential meaning of clinical supervision for psychiatric mental health nurse practitioners. METHODS: Data were collected in 2015 through individual in-depth interviews using open-ended questions from 9 women psychiatric mental health nurse practitioners. Each interview lasted about 90 minutes. Verbatim transcripts were analyzed using the Giorgi's phenomenological analysis method. RESULTS: The results of the analysis showed the following four categories: ‘Barren mental health site alone’, ‘Enduring with reflective supervision’, ‘Professional competence enhanced by continuous supervision’, ‘Maintaining a healthy life balance as a psychiatric mental health nurse practitioner’. CONCLUSION: The findings in this study provide helpful insights for understanding the need for clinical supervision in the psychiatric mental health nurse practitioner course. The results also provide support for the psychiatric mental health nurse practitioner course and practice development for psychiatric mental health nurses at the work site.
Female ; Humans ; Mental Competency ; Mental Health* ; Methods ; Nurse Practitioners* ; Organization and Administration* ; Qualitative Research ; Workplace

PURPOSE: This exploratory study aims to identify various factors influencing the rehabilitation nursing competencies (RNC) of nurses in various types of health institutes. METHODS: The researcher developed a questionnaire consisting of 45 items based on the ARN rehabilitation nursing competency model. Subjects were 434 nurses working at general hospitals, long-term care facilities, or community health centers. RESULTS: Nurses' RNC were significantly higher among those who have higher levels of education, receive continuing education in rehabilitation nursing, and practice more frequently in rehabilitation nursing. Age and duration of nursing career were significant only for interprofessional care domain. General hospital nurses scored highest in every domain while nurses working at long-term care facilities scored lowest in every domain. Multiple regression analysis showed that practicing daily or more than twice per week in rehabilitation nursing, achieving master's degree or higher, and working at long-term care facilities were statistically significant factors with RNC. These factors explained 31.1% of the total variability in RNC in this sample. CONCLUSION: Currently, there is no official certification program for rehabilitation nurse practitioners in South Korea. The results of this study would be useful in developing RNC training programs for Korean nurses, and provide strong evidence for necessity of certified rehabilitation nurse specialists.
Academies and Institutes ; Certification ; Community Health Centers ; Education ; Education, Continuing ; Hospitals, General ; Humans ; Korea ; Long-Term Care ; Nurse Practitioners ; Nursing ; Rehabilitation Nursing* ; Rehabilitation* ; Specialization

PURPOSE: Child Health nurse practitioners (CHNPs) in Korea have important roles in disease management and health promotion for children and adolescents. Yet, practices of CHNPs licensed and employed in hospitals have not been adequately identified. Thus, in this study the scope of practice by CHNPs and job satisfaction and stress were investigated and compared according to the CHNPs' position in the working place. METHODS: A descriptive cross-sectional survey design was used. All 53 licensed CHNPs participated in the mail survey which included a 71-item questionnaire on job performance and job satisfaction and a job contents questionnaire. Descriptive statistics, chi2 test, independent t-test and Mann-Whitney U test were used to compare CHNPs employed as nurse practitioner (NP) and CHNPs employed as staff nurses. RESULTS: Compared to CHNPs employed as staff nurses, CHNPs employed as NPs more frequently provided education, environment management, coordination and research in their practice areas. No significant difference was found in job satisfaction between the two groups except for the administration and income subdomains. Only the physical exertion subdomain in job stress was stressful to CHNP employed as staff nurse. Conclusions: Job performance of CHNPs in Korea needs to be revised to include more practical practice in education, coordination, and research related areas. CONCLUSIONS: Job performance of CHNPs in Korea needs to be revised to include more practical practice in education, coordination, and research related areas.
Adolescent ; Child ; Child Welfare* ; Child* ; Cross-Sectional Studies ; Disease Management ; Education ; Health Promotion ; Humans ; Job Satisfaction* ; Korea ; Nurse Practitioners* ; Pediatric Nurse Practitioners ; Physical Exertion ; Postal Service ; Statistics, Nonparametric ; Task Performance and Analysis ; Workplace*

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

This is a qualitative phenomenological study that explored the challenges found by fifteen purposively selected Filipino nurses in the pursuit of their profession. These nurses started to practice their profession within the years 2004 to the present. Data gathering was done through electronic mail using a semi-structured questionnaire as the main instrument and Colaizzi's method was employed in data analysis. Four (4) central themes, together with their corresponding sub themes, emerged from this study: (1) Challenges faced are nurse volunteerism, poor pay, and extreme workload; (2) Responses to these challenges are underemployment, working abroad, rest and recreation, and spiritual beliefs/ practices; (3) Future plans are teaching fellow nurses or peers, advanced studies and clinical specialization, and return to nursing practice (for those who left the profession at the time of this study's pursuit); and (4) Appreciation of the nursing profession due to their heightened awareness of its nobility and importance, learned resilience as individuals, developed desire to continuously learn, and attained competencies as nurses. Professional nursing organizations, in collaboration with concerned government agencies, private healthcare companies, and nursing schools nationwide, should strive to provide greater employment opportunities and more conducive work environments to address the perceived challenges and to, ultimately, improve the plight of the country's nurse practitioners for optimal delivery of quality nursing care.

Human ; Male ; Female ; Workload ; Electronic Mail ; Schools, Nursing ; Workplace ; Employment ; Nurse Practitioners ; Surveys And Questionnaires ; Government Agencies ; Volunteers ; Recreation

PURPOSE: This study was conducted to examine understanding of the meaning of well-dying and types of such views held by medical practitioners and nursing students. METHODS: The Q-methodology was used to analyze the subjectivity of each item. The P-sample was made up of 22 medical practitioners or nursing students. The P-sample was instructed to rate 33 statements using a 7-point scale to obtain forced normal distribution. They were asked to make extra comments on the statements that were placed on both ends of the distribution curve. The PC-QUANL Program was used for the factor analysis of the collected data. RESULTS: The participants had three types of meaning of well-dying. Total variance explained by these types was 57.97%" where type 1 was "reality-oriented", type 2 "relationship-oriented" and type 3 "obeying-the-nature". CONCLUSION: The participants' subjective views on well-dying influences their medical practice on patients who are facing death. Therefore, medical practitioners should have profound insights concerning life and death. To that end, a training program is needed to help medical practitioners develop a proper view on well-dying by subjectivity type.
Education ; Humans ; Nurse Practitioners ; Students, Nursing* ; Terminal Care