Robert G. Hanks

Development and testing of an instrument to measure protective nursing advocacy

Patient advocacy is an important aspect of nursing care, yet there are few instruments to measure this essential function. This study was conducted to develop, determine the psychometric properties, and support validity of the Protective Nursing Advocacy Scale (PNAS), which measures nursing advocacy beliefs and actions from a protective perspective. The study used a descriptive correlational design with a systematically selected sample of 419 medical-surgical registered nurses. Analysis of the 43-item instrument was conducted using principal components analysis with promax rotation, which resulted in the items loading onto four components. The four subscales have sufficient internal consistency, as did the overall PNAS. Satisfactory evidence of construct, content, and convergent validity were determined. Implications for nursing practice include using the PNAS in conjunction with an educational program to enhance advocacy skills, which may help to improve patient outcomes.

The Medical‐Surgical Nurse Perspective of Advocate Role

UNLABELLED Nursing advocacy for patients is viewed as a vital role for the nursing profession; however, there is little empirical research regarding nursing advocacy. PROBLEM The medical-surgical nursing specialty is the largest specialty in acute care settings, but few advocacy studies have focused exclusively on this specialty population. METHODS The purpose of this study was to explore the nurse advocacy actions and workplace support for advocacy using written narrative responses to a mailed survey using a medical-surgical nursing sample. FINDINGS The responses help to illuminate the importance of the advocate role for this nursing specialty and provide preliminary information on the advocacy actions and workplace support as reported by the nurses. CONCLUSIONS The resulting data provide a basis for examining the workplace environmental support for nursing advocacy, further delineate the actions of the nurse advocate, and clarify how nurse advocates follow patient desires regarding care. In addition, the results can be used in education, improving advocacy skills, and safety initiatives.

Sphere of Nursing Advocacy Model

The Sphere of Nursing Advocacy (SNA) model explains and depicts nursing advocacy on behalf of a client. The SNA model views the client as continually protected from the external environment by a semipermeable sphere of nursing advocacy that allows clients to self advocate if the client is emotionally and physically able or to be advocated for by the nurse if the patient is unable to advocate for him- or herself. The SNA model can be used to guide research or it can provide the basis for instruction on the subject of nursing advocacy.

Hemostasis, Coagulation Abnormalities, and Liver Disease

Coagulopathy-related bleeding events are a major concern in the management of acute and chronic liver disease. The liver attempts to maintain a balance between procoagulant and anticoagulant factors, and providers struggle with poor prognostic indicators to manage bleeding and critical complications. Subtle changes in patient presentation that may require extensive provider-directed interventions, such as blood transfusions, intravenous fluid management, mitigating possible sepsis, and evaluating appropriate pharmacologic treatment, are discussed.

Patient Advocacy at the APRN Level: A Direction for the Future

Patient advocacy is seen as a critical role for the nursing profession. Although there is an existing body of literature surrounding the registered nurse level of patient advocacy, little is known about the advanced practice registered nurse (APRN) and patient advocacy. This article examines the existing patient advocacy research literature and existing APRN competencies to provide direction for further research.

Increasing Psychiatric Mental Health Nursing HESI Grade Allocation Percentage in a Psychiatric Nursing Course

BACKGROUND Scant evidence is found in the literature regarding the unit-level Health Education Systems, Inc. (HESI) examinations. This study aims to (a) compare student Psych HESI examination scores between cohorts after increasing grade allocation from 5% to 15%, and (b) examine student perceptions of the impact of increasing the percentage of course grade allocation. METHOD An ex post facto research design analyzed differences in Psych HESI examination scores. HESI examination mean score differences between groups were analyzed using ANOVA. Narrative responses were analyzed using content analysis. RESULTS Psych HESI examination means increased from 836 in spring 2015 (5% of course grade) to 905 in fall 2015 (15% of course grade). Narrative response themes included (a) Validated Learning; (b) Compelled Participants to Study More; (c) Incongruent With Class Content and Preparation Books; and (d) Stress-Producing. CONCLUSION HESI examination scores improved with increasing course grade percentage allocated to the HESI score. Students indicated positive and negative perceptions of the increased grade allocation. [J Nurs Educ. 2018;57(10):604-608.].

The Texas Gulf Coast Graduate Nurse Education Demonstration: Collaboration in Action

Advance Practice Registered Nurses (APRNs) are increasing in number and their value is becoming more evident as Texas and the region face a severe shortage of primary care physicians. APRNs can assist in meeting the needs of a growing and complex healthcare system. Increasing the pool of APRNs will allow healthcare providers to improve access to care and deliver quality outcomes. Hospitals and other healthcare providers have been limited in the number of APRN students they could accept for clinical training due to cost. The Graduate Nurse Education (GNE) Demonstration project was mandated by Section 5509 of the 2010 Affordable Care Act. The primary goal of this demonstration is to increase the number of APRNs who will provide primary care, preventive care, transitional care, chronic care management, and other services for Medicare beneficiaries. To meet this demand, it is necessary to increase the number of qualified clinical training sites. As part of a collaborative effort, Memorial Hermann-Texas Medical Center was one of five healthcare systems that participated in the

The Lived Experience of Nursing Advocacy

200 million funded Demonstration, which offsets the reasonable cost of clinical training for APRNs. Memorial Hermann partnered with four schools of nursing - Prairie View A&M University, Texas Womens University, University of Texas Medical Branch, and University of Texas Health Science Center at Houston - as well as area hospitals and non-hospital community based centers to provide APRNs clinical training. This article describes the collaborative efforts of the Texas Gulf Coast GNE Demonstration as well as the implementation plan, results, and benefits of all participating partners and schools of nursing.