Converting threats from COVID-19 in long term care into opportunities for improvement

The effects of the COVID-19 pandemic on long term care (LTC) have been published in the literature and experienced by residents, their support persons and nursing staff. The morbidity and mortality, as well as the threats of isolation and psychosocial distress continue. Both LTC residents and staff experience physiological and psychological impacts. Nurses can use the current threats produced by the pandemic to advocate for alternate models of care and reduced isolation for residents. The pandemic is an opportunity for nursing advocacy in LTC for shared governance and empowerment, involvement in policy development, and oversight in policy implementation. Nurses are presented with the opportunities for advocacy related to resources and reshaping the paradigm of residential care for older adults.

Ethical Challenges of Nonreading Older Adult Women’s Autonomy in Receiving Percutaneous Coronary Intervention Under Familial Paternalism in Taiwan

In the context of familial paternalism in Taiwan, nonreading older adult women (NOAWs) may passively disengage from treatment and submit to the decisions of their families. The purposes of this case study were to examine the ethical conflicts regarding the autonomy of hospitalized NOAWs receiving percutaneous coronary intervention in a cultural environment of familial paternalism and to propose a theoretical framework based on a literature review to resolve the ethical challenges specific to this cultural context. The proposed framework “Nursing advocacy model for engaging NOAWs with their medical treatment” was established on the basis of relational ethics, nursing advocacy, and shared decision making. Our argument does not question traditional Chinese cultural values. Instead, we advocate for NOAWs to engage with their treatment, express their preferences, and communicate with their families in a decision-making process that incorporates mutual respect and understanding within the context of Chinese culture.

Nursing, advocacy and public policy

This article draws attention to the nature and importance of public policy. It argues that if nurses are to influence the quality of healthcare effectively, they must be engaged with policymakers to get nursing care issues on the policy agenda. There is an ethical imperative to do so, driven by the advocacy role of the nurse and rooted in the values base of nursing. In addition, it is argued that if one takes the role of patient advocacy seriously, as core to the nursing role, two things are required of nurses: We must (a) broaden the conceptualisation of patient advocacy beyond the individual patient to the system of healthcare resourcing and provision and (b) see systemic change as important as change at the bedside.

Factors influencing clinical nurses’ advocacy for people with disability

Purpose: Clinical nurses are the ideal health care providers to advocate for vulnerable and underserved populations such as people with disability. This study aimed to understand factors influencing nursing advocacy for people with disability among clinical nurses.Methods: The subjects of this study were 186 clinical nurses who were working in three hospitals in B and D cities. Self-report questionnaires were used to collect the data. Data were analyzed using IBM SPSS Statistics 25 with descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression analysis.Results: Clinical experience and esthetical nursing competency have positive correlations with nursing advocacy, and optimism-human rights has a negative correlation with nursing advocacy. Factors influencing nursing advocacy for people with disability were identified as patient directivity (<i>β</i>=0.36, <i>p</i>=.001), optimism-human rights (<i>β</i>=-0.18, <i>p</i>=.008) and clinical experience (≥10) (<i>β</i>=0.14, <i>p</i>=.036). The final model consisting of these factors explained 19% of the variance of nursing advocacy (F=14.99, <i>p</i>=.001).Conclusion: The findings of this study indicate the importance of developing and implementing nursing interventions that can improve patient directivity and optimism-human rights toward people with disability among clinical nurses. These nursing advocacy interventions can be provided as part of continuing education as well as the nursing curriculum.

Focus and trends in nurse advocacy in the Pan American Health Region: a bibliometric analysis

Objective: this study examined scholarly output relating to nursing advocacy contributions toward influencing policy by authors in countries of the Pan American Health Organization. Method: the study utilizes a bibliographic analysis of papers indexed in Scopus authored by PAHO member state scholars. VOSviewer conducted coauthor and cooccurrence analysis to generate visualizations of the relationships between authors, countries of origin and keywords. Results: 7,773 papers with 21,523 authors met the inclusion criteria. An increase of publications on policy starting in 1962 was found. Co-authorship identified a fragile relationships structure with few authors bridging networks of collaboration. By country of origin, 22 of 35 member states contributed to policy literature; 17 in a connected network and 5 contributing but neither connected to peers nor other member states. Keyword analysis identified 20 specific data clusters. Conclusion: our findings are aligned with the Nursing Now Campaign. This bibliographic analysis provides an important benchmark into current policy advocacy activity in PAHO against which future progress in the region can be assessed. There is scope for greater collaboration amongst authors and this could be targeted toward engagement of nurses in member states not-yet or only partially active in this space.

A Right to Vote: A Case Study in Nursing Advocacy for Public Policy Reform

In February 2014, the Government of Canada under Stephen Harper introduced the ‘Fair Elections Act’. This reform to the elections act removed provisions for access to voting for individuals lacking certain forms of identification. Noting that this would have a disproportionate impact on people experiencing homelessness, nursing advocates joined with other activists to try to prevent then subsequently overturn this legislation. The purpose of this paper is to explore the 93rd competency of the College of Nurses of Ontario, “Advocates and promotes healthy public policy and social justice,” by unpacking a case example of advocacy for voting rights. This paper addresses the challenges faced by nurses in doing public policy advocacy and concludes with lessons learned. Fulfilling our college mandated requirement to be politically active means ensuring that public policies are just, equitable, and reflective of the progressive values of Nursing.

Nursing Advocacy and Long Acting Injectables to Reduce High Readmission Rates: Quality Initiative

INTRODUCTION: Nonadherence to medications for schizophrenia relates to frequent readmissions. Long-acting injectable (LAI) medications are shown to increase adherence and reduce admissions. AIMS: (1) Identify frequent readmissions to psychiatry. (2) Improve nursing advocacy for patients appropriate for LAIs through in-service. METHODS: Chart audits were employed for data collection. Academic detailing and dashboards were used for voluntary nursing education. The chart audit spanned 90 days pre and post in-service. All admissions to psychiatry were screened; patients with readmissions under 30 days (with the same admitting diagnosis), a schizophrenia spectrum diagnosis, and nonadherent with oral antipsychotics were included. Results: Forty-four patients met criteria and amassed 49 frequent readmissions. For inclusion criteria, the admission rate decreased by 53% and LAI prescriptions increased by 9%. Three patients from the first audit group and one from the second were initiated on LAIs. CONCLUSIONS: Attitudes toward LAIs may be improving based on RN advocacy and collaboration.