Thursday, 26 March 2015

Social Media Editor Vacancy

Applications are invited for the position of

Social Media EditorJournal of Advanced Nursing

We are seeking applications for this exciting new position within one of the leading international nursing journals.

The journal has a successful social media presence, but we are now seeking a dedicated Social Media Editor to drive forward our ambitious social media strategy. The successful candidate for the position of Social Media Editor will possess the following skills and attributes:
  • Background in nursing research 
  • Excellent understanding of social media platforms, strategies and trends
  • Good networks and connections in the nursing community
  • Understanding of JAN’s brand and ethos
  • Energetic and pro-active approach
  • Excellent communication skills

The main functions within this role are:
  • Maintaining and increasing current activity on Twitter, the JANinteractive blog and YouTube
  • Engaging in conversations and forming connections with relevant organisations and opinion leaders
  • Creating and inviting social media content
  • Making recommendations regarding new platforms and activities that could increase JAN’s reach, and advising on trends

The post involves working closely with the Publisher, the other Editors, and the Editor-in-Chief. Applicants should note that this position requires a weekly commitment of time, with additional days required for meetings. The successful candidate would ideally start work on the journal in June 2015.

Applications should include a curriculum vitae, a short assessment of the strengths and weaknesses of JAN’s current social media presence, and an accompanying letter outlining the skills you will bring to this position.

Please send your application, in confidence, to:
Rosie Hutchinson, Senior Journals Publishing Manager, Wiley: jan@wiley.com

Applications to arrive no later than 20th April 2015



Editor Vacancy

Applications are invited for the position of
Editor, Journal of Advanced Nursing.

One of the current team of Editors, Lin Perry, will be stepping down in 2015. Therefore we are seeking applications for the position to complete a team of five Editors within one of the leading international nursing journals.

The Journal of Advanced Nursing (JAN) is an international, peer-reviewed scientific journal which contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. Detailed information about the journal can be found here.

The successful candidate for the position of Editor will be recognized internationally for his or her academic and research achievements, will have worked at a strategic level within academia or healthcare, and will have an impressive track record of publications and presentations at conferences.

The ideal candidate will possess the following skills and attributes:
  • Sound scientific judgement
  • Professional standing
  • Broad knowledge of nursing and midwifery on an international level
  • Awareness of trends and standards within knowledge dissemination
  • Excellent written and verbal communication
  • Ability to work to tight deadlines
  • Previous experience in Editor-type role
  • Based in Asia-Pacific
The main functions within this role are: manuscript handling and quality control, strategic development, and journal promotion. The post involves working closely with the Publisher, the other Editors, and the Editor-in-Chief.

Applicants should note that this position requires a weekly commitment of time, with additional days required for meetings. The successful candidate would ideally start work on the journal in June 2015.

Applications should include a curriculum vitae, a short assessment of the strengths and weaknesses of JAN, and an accompanying letter outlining the skills you will bring to this position. A description of the role is available on request.


Please send your application, in confidence, to:
Rosie Hutchinson, Senior Journals Publishing Manager, Wiley: jan@wiley.com

Applications to arrive no later than 20th April 2015



Wednesday, 25 March 2015

What do nurses think about climate change?

Roger Watson, Editor-in-Chief

Do nurses have views on climate and environmental issues? Do nurses even think about environmental issues?

In my keynote address at the East Asian Forum of Nursing Scholars in Taiwan earlier this year I was asked to address 'Global issues facing nursing' and I specifically referred to climate change and environmental issues as being important.  On a visit to Mainland China late last year I saw work by a masters student on how nurses need to prepare for climate change and the effect it will have on vulnerable people - for example the effect of heatwaves on older people - and we have had at least one other article in JAN on this issue recently (Kangasniemi et al. 2014).

It appears that nurses do think about climate and environmental issues according to a study from Sweden by Anäker et al. (2015) titled: 'Nurses’ perceptions of climate and environmental issues: a qualitative study'.  As explained by the authors: 'The aim of this study was to explore nurses’ perceptions of climate and environmental issues and examine how nurses perceive their role in contributing to the process of sustainable development.'  Using a combination of individual interviews and focus groups with 18 nurses they found that: 'While being green is not the primary task in a lifesaving, hectic and economically challenging context, nurses’ perceived their profession as entailing responsibility, opportunities and a sense of individual commitment to influence the environment in a positive direction.'

This is a pioneering study with nurses and the authors conclude that: 'This study also highlights the importance of introducing the topic of sustainability in nursing education. The topic should be incorporated throughout nursing education programmes. It is important that nursing students be prepared to cope with situations arising as a result of climate change.'

You can listen to this as a podcast.

References

Anäker A, Nilsson M, Holmner A, Elf M (2015) Nurses’ perceptions of climate and environmental issues: a qualitative study Journal of Advanced Nursing doi: 10.1111/jan.12655


Kangasniemi M. Kallio H, Pietilä A-M (2014Towards environmentally responsible nursing: a critical interpretive synthesis Journal of Advanced Nursing 70(7), 14651478. doi:10.1111/jan.12347

Friday, 13 March 2015

Overweight and obesity to perinatal women and their children

Jennifer Ohlendorf

I am an assistant professor in the Marquette University College of Nursing in Milwaukee, WI. Along with Dr Marianne Weiss and Dr Debra Oswald, I examined factors that are predictive of women participating in weight self-management behaviours after the birth of a baby (Olhedorf et al. 2015) in an article titled: ‘Predictors of engagement in postpartum weight self-management behaviours in the first 12 weeks after birth’ and published in JAN.

Risks of overweight and obesity to perinatal women and their children are well established. What is not well established is how providers can have an impact on that risk. Weight self-management is a process driven by a woman’s daily eating and physical activity behaviours. Providers cannot make daily choices for women, and thus must determine ways to exert influence over those behaviours during routine healthcare encounters.

In this study, we explored factors that might predict which women were more likely to engage in postpartum weight self-management (PPWSM) behaviours. Transitions Theory and the Integrated Theory of Health Behaviour Change guided selection of concepts for the study, including transition conditions and level of patient activation. Patient activation is a concept that measures one’s likelihood to actively manage a health condition – but has not been tested in a perinatal population to predict weight self-management behaviours.

Patients experiencing a difficult postpartum transition have lower activation levels; those with lower activation levels are less likely to engage in PPWSM behaviours. Providers should assess factors in women’s lives complicating their transition to motherhood, making them less able to actively engage in PPWSM behaviours. Next steps include testing whether activation-based interventions can be effective in promoting healthy PPWSM behaviours.

There are health risks for both mothers and babies that are associated with weight issues during pregnancy and during the postpartum period – In particular, there is good evidence that women who do not lose their pregnancy weight before the first postpartum year is up are more likely to be overweight or obese later in life. Our current models of prenatal care do not prioritize weight management among other health issues for all women; indeed, previous research I've done revealed that women were interested in weight management, but that their providers did not address it during their prenatal or postnatal care.

The U.S. Institute of Medicine has stated that all providers should be counselling all pregnant and postnatal women regarding healthy weight gain in pregnancy, and also about ways to prevent retention of weight gained after the birth of the baby. This research recognizes the fact that weight management is a self-management process—providers cannot directly manage this process because women make their own eating and physical activity choices each day. There are many programmatic studies looking at ways to help women lose their pregnancy weight, but there is a gap in the literature around processes women use to self-manage weight. Of particular interest to us is the possibility of developing effective ways that providers could influence the behaviours of women self-managing their weight to promote healthy eating and physical activity to ultimately have an effect on weight status.

In this study, we selected concepts from both Transitions Theory and the Integrated Theory of Health Behaviour Change in order to determine factors that would predict women’s engagement in healthy eating and physical activity behaviours after their baby was born. Included in the predictors was a concept – patient activation – which refers to an individual’s tendency to be an active participant in managing their health condition. Previously, patient activation had been used among adults with an illness to study. This was the first study examining patient activation in a healthy population to determine its relationship to health promotion behaviours.

We predicted that transition difficulty and patient activation would predict engagement in weight self-management behaviours, and that social support and social influence would moderate that relationship. Women (n=124) were enrolled during their post-birth hospitalization, and completed surveys that day and by phone 6 and 12 weeks.

We found that transition difficulty was negatively associated with patient activation – that is, that women with higher levels of difficulty were less activated for postpartum weight self-management; further, patient activation was positively associated with engagement in the behaviours – so, women with higher patient activation had healthier eating behaviours and reported more minutes of physical activity. Neither social support nor social influence moderated that relationship. Analysis of social influence in this sample revealed that women reported that their providers and hospital nurses were as influential over their health behaviours as their mothers and significant others.

Clinically, we now know that providers must consider a woman’s context if they intend to influence her weight self-management behaviours. It appears that nurses and providers must use their influence to address things that are making the postpartum transition difficult so that women will be able to spend energy on weight self-management behaviours.

Our next steps will be to test the interventions tailored to activation level to determine whether they can be effective in this population to promote engagement in weight self-management behaviours.


Jennifer M. Ohlendorf, PhD RN
Marquette University, Milwaukee, Wisconsin, USA

Reference

Ohlendorf JM, Weiss ME, Oswald D (2015) Predictors of engagement in postpartum weight self-management behaviours in the first 12 weeks after birth Journal of Advanced Nursing doi: 10.1111/jan.12640



Tuesday, 10 March 2015

Response to Commentary: Relevance of competence and competencies to nursing

Jane O’Connell, RN PhD NP FFACNP
Glenn Gardner, RN PhD FACN
Fiona Coyer, RN PhD



Response to Commentary on O’Connell J. Gardner, G. & Coyer F. (2014) Beyond competencies: using a capability framework in developing standards for advanced practice nursing. Journal of Advanced Nursing 70(12), 2728-2735

Lima et al. write in defence of the capacity for competencies to provide an enduring framework for learning and teaching across all levels of nursing. Their Commentary raises some interesting and important points and will inform much needed discussion on the nature of ongoing development of skills and knowledge across learning domains in nursing. We concur with Lima et al’s assertion that development of nursing practice from foundation to advanced is a continuum; indeed this assumption is core to the thesis of our paper. Where we dissent is their conceptualization of capability as a disjuncture in this continuum.

Lima et al draw upon the work of Heywood et al (1992) to support their position for a proposed third approach (as distinct from a competence to capability model) to framing the development of an advanced nurse. The work of Heyward’s team, whilst relevant at the time, is limited in application to the contemporary health service context. It was developed 20 years ago to inform the now defunct Australian Standards Framework, and there has been no empirical work since to further test these concepts and processes. Conversely, the propositions developed in the O’Connell et al paper are informed by contemporary empirical research on advanced practice in nursing (for example O’Connell et al 2014b ; Gardner et al 2006), medicine and other health disciplines (for example Dijksterhuis et al, 2013; Durning et al, 2011).

Our paper proposes moving beyond competencies to capability as a framework for developing clinicians who will utilize advanced skills and knowledge in conditions of complexity. Lima et al suggest that the anecdotal evidence of undergraduate nursing curricula developers, teachers and students will attest to the fact that new nursing graduates also work to this level. They support this claim with reference to the Australian Qualifications Framework (AQF) (2013). This Framework explicates the level of knowledge and skill and their application for graduates across ten levels of vocational and higher education courses. It is a complex and graduated taxonomy of levels and qualifications that define the ‘relative complexity and depth of achievement and the autonomy required of graduates to demonstrate that achievement’ (AQF 2013). However Lima et al have been very selective in the example they use, selecting just one line out of context in the specifications for Bachelor Degree.

Further reading and comparison of the knowledge, skills and application criteria of AQF Level 7 (Bachelor Degree for the graduate nurse) and AQF Level 9 (Masters Degree for advanced practice nurse) will show a very different profile of practice; one that supports a capability framework for advanced practice in nursing.


Jane O’Connell, RN PhD NP FFACNP
Glenn Gardner, RN PhD FACN
Fiona Coyer, RN PhD
Queensland University of Technology
email: J1.oconnell@qut.edu.au



References

Australian Qualifications Framework Council. (2013). Australian Qualifications Framework. 2nd edition. Available at http://www.aqf.edu.au/wp-content/uploads/2013/05/AQF-2nd-Edition-January-2013.pdf accessed 5/3/2015

Dijksterhuis M., Schurwith L., Braat D., Teunissen P. & Scheele F. (2013). A qualitative study on trainees’ and supervisors’ perceptions of assessment for learning in postgraduate medical education. Medical Teacher, 35, 1396-1402.

Durning S., Artino A., Pangaro L., van der Vleuten C. & Schurwith L. (2011). Context and clinical reasoning: understanding the perspective of the expert’s voice. Medical Education, 45, 927-938.

Gardner G., Dunn S., Carryer J. & Gardner A. (2006). Competency and capability: imperative for nurse practitioner educationAustralian Journal of Advanced Nursing. 24(1): 8-14

Heywood, L., Gonczi, A. & Hager, P. (1992). A guide to development of competency standards for professions. Canberra: Australian Government Publishing Service.

O’Connell J., Gardner G. & Coyer F. (2014b) Profiling emergency nurse practitioner service: an interpretive study. Advanced Emergency Nursing Journal 36(3).



Staffing models and nursing outcomes

Roger Watson, Editor-in-Chief

Does the ratio of different types of nurses make any difference to patient outcomes? It seems that in some cases it does and not always how you would expect. A study in ICU from Taiwan by Yang et al. (2015) titled 'The impact of three nursing staffing models on nursing outcomes' and published in JAN addresses this by looking at three different models with different percentages of Registered Nurses (RN) to nurse aides and with different ratios of graduate and ICU trained nurses.

Unexpectedly, the model with 100% RNs was the one where most medication errors were made. It appears that where RNs are responsible for checking medications and also administering them that more mistakes are made than when they simply check the medication and a nurses aide administers. Otherwise, a higher percentage of RNs had a positive impact on urinary tract infections, rate of bloodstream infections and ventilator weaning. The lower percentage RN groups incurred higher nursing costs.

The authors conclude: 'These findings suggest that use of different skill mix models that substitute nurse aides for RNs impact nursing care activities and quality of care' and 'we suggest that hospitals employ and train their own nurse aides and develop a training system and education materials for RNs and nurse aides to maintain patient safety and improve quality of care.


You can also listen to this post as a podcast.


Reference

Yang P-H, Hung C-H, Chen Y-C (2015) The impact of three nursing staffing models on nursing outcomes Journal of Advanced Nursing doi: 10 1111/jan.12643



Doctor and nurse teamwork in general practice

Roger Watson, Editor-in-Chief

'Internationally, a shortage of doctors entering and remaining in general practice and an increasing burden of chronic disease has diversified the nurse’s role in this setting. Despite a well-established general practice nursing workforce, little attention has been paid to the ways doctors and nurses collaborate in this setting.' This is the basis of a study from Australia by McInnes et al. (2105) titled 'An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice' and published in JAN.

The study took the shape of an integrative literature review spanning 14 years up to 2014. A final review of 11 articles out of over 200 retrieved showed 'the facilitators of and barriers to collaboration and teamwork between GPs in general practice: (1) roles and responsibilities; (2) respect, trust and communication; and (3) hierarchy, education and liability.'

The authors conclude: 'As the number of doctors entering and remaining in general practice declines, it is crucial that nurses are supported and encouraged to participate in decision-making processes and goal setting of the practice. Without the concerted support of GPs and clarity around the nurse’s scope of practice, it is likely that nurses working in general practice will not receive recognition as a highly competent and respected interdisciplinary member of the general practice team. Further research exploring collaboration and teamwork between GPs and nurses working in general practice may provide insight into the issues which influence nursing leadership and staff retention in this hierarchical healthcare setting.


You can listen to this post as a podcast.


Reference

McInnes S, Peters K, Bonney A, Halcomb E (2015) An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice Journal of Advanced Nursing doi: 10.1111/jan.12647


Postpartum weight

With reference to their recent JAN article: Predictors of engagement in postpartum weight self-management behaviors in the first 12 weeks after birth which may be summarized as follows:

In this study, we explored factors that might predict which women were more likely to engage in postpartum weight self-management (PPWSM) behaviours. Transitions Theory and the Integrated Theory of Health Behaviour Change guided selection of concepts for the study, including transition conditions and level of patient activation. Patient activation is a concept that measures one’s likelihood to actively manage a health condition – but has not been tested in a perinatal population to predict weight self-management behaviours.

Patients experiencing a difficult postpartum transition have lower activation levels; those with lower activation levels are less likely to engage in PPWSM behaviours. Providers should assess factors in women’s lives complicating their transition to motherhood, making them less able to actively engage in PPWSM behaviours. Next steps include testing whether activation-based interventions can be effective in promoting healthy PPWSM behaviours.

Risks of overweight and obesity to perinatal women and their children are well established. What is not well established is how providers can impact that risk. Weight self-management is a process driven by a woman’s daily eating and physical activity behaviours. Providers cannot make daily choices for women, and thus must determine ways to exert influence over those behaviours during routine healthcare encounters.

Dr Jennifer Ohlendorf writes:

Hello, I am Dr Jennifer Ohlendorf, and I am an assistant professor in the Marquette University College of Nursing in Milwaukee, WI. Along with Dr Marianne Weiss and Dr Debra Oswald, I examined factors that are predictive of women participating in weight self-management behaviours after the birth of a baby.

There are health risks for both mothers and babies that are associated with weight issues during pregnancy and during the postpartum period – in particular, there is good evidence that women who do not lose their pregnancy weight before the first postpartum year is up are more likely to be overweight or obese later in life. Our current models of prenatal care do not prioritize weight management among other health issues for all women – indeed previous research I've done revealed that women were interested in weight management, but that their providers did not address it during their prenatal or postnatal care.

The U.S. Institute of Medicine has stated that all providers should be counselling all pregnant and postnatal women regarding healthy weight gain in pregnancy, and also about ways to prevent retention of weight gained after the birth of the baby. This research recognizes the fact that weight management is a self-management process – providers cannot directly manage this process because women make their own eating and physical activity choices each day. There are many programmatic studies looking at ways to help women lose their pregnancy weight, but there is a gap in the literature around processes women use to self-manage weight. Of particular interest to us is the possibility of developing effective ways that providers could influence the behaviours of women self-managing their weight to promote healthy eating and physical activity to ultimately have an effect on weight status.

In this study, we selected concepts from both Transitions Theory and the Integrated Theory of Health Behaviour Change in order to determine factors that would predict women’s engagement in healthy eating and physical activity behaviours after their baby was born. Included in the predictors was a concept--patient activation – which refers to an individual’s tendency to be an active participant in managing their health condition. Previously, patient activation had been used among adults with an illness to study. This was the first study examining patient activation in a healthy population to determine its relationship to health promotion behaviours.

We predicted that transition difficulty and patient activation would predict engagement in weight self-management behaviours, and that social support and social influence would moderate that relationship.

124 women were enrolled during their post-birth hospitalization, and completed surveys that day and by phone 6 and 12 weeks. What we found was that transition difficulty was negatively associated with patient activation – that is, that women with higher levels of difficulty were less activated for postpartum weight self-management; further, patient activation was positively associated with engagement in the behaviors – so, women with higher patient activation had healthier eating behaviours and reported more minutes of physical activity. Neither social support nor social influence moderated that relationship.

Analysis of social influence in this sample revealed that women reported that their providers and hospital nurses were as influential over their health behaviours as their mothers and significant others. Clinically, we now know that providers must consider a woman’s context if they intend to influence her weight self-management behaviours. It appears that nurses and providers must use their influence to address things that are making the postpartum transition difficult so that women will be able to spend energy on weight self-management behaviours. Our next steps will be to test the interventions tailored to activation level to determine whether they can be effective in this population to promote engagement in weight self-management behaviours.

Reference

Ohlendorf JM, Weiss ME, Oswald D (2015) Predictors of engagement in postpartum weight self-management behaviors in the first 12 weeks after birth Journal of Advanced Nursing doi: 10.1111/jan.12640