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A Survey of Nurses' Views of the Current and Future Role of Community Registered General Nurses (CRGN)

ABSTRACT

Aim

To explore the views of community registered general nurses and directors of public health nursing on the current and future role of the community registered general nurse in the Republic of Ireland.

Design

Anonymous cross-sectional descriptive survey.

Methods

Two questionnaires were developed; one targeted at community registered general nurses and one targeted at assistant directors of public health nursing or directors of public health nursing who were working with community registered general nurses. Social media was used to recruit participants. Descriptive statistics were used while data from open-ended questions were analysed using NVivo software.

Results

A total of 97 community registered general nurses and 28 assistant directors of public health nursing or directors of public health nursing completed the surveys in 2023. There was consensus that community registered general nurses provide holistic care, including case management of adults with complex health needs living in the community. However, lack of promotional opportunities coupled with poor remuneration has resulted in job dissatisfaction. Respondents felt that community registered general nurses should focus on older adults, whereas public health nurses should focus on child health.

Conclusion

The role of the community registered general nurse needs to be clarified, and a promotional pathway developed to attract new graduates to this post.

Impact

This paper outlined the current role and vision for the future role of community registered general nurses.

Reporting Method

CROSS guidelines.

Client or Public Contribution

No patient or public contribution.

What Does This Paper Contribute to the Wider Global Clinical Community?

This paper contributes to the challenges community nurses face regarding increased demand for community nursing, lack of career structure for some community nurses, and difficulties with staff retention within the community.

Public-private mix for tuberculosis in urban health systems in least-developed, low-income and lower-middle-income countries and territories: a systematic review

Por: Vidyasagaran · A. L. · Teixeira de Siqueira Filha · N. · Kakchapati · S. · Hall · T. F. · Naznin · B. · Tajree · J. · Quayyum · Z. · Joshi · D. · Sibeudu · F. T. · Ogbozor · P. A. · Arize · I. N. · Shrestha · G. · Golder · S. · Ahsan · M. · Adhikary · S. · Agwu · P. · Elsey · H.
Objective

To evaluate the impact of public–private mix (PPM) models for tuberculosis (TB) on health, process and system outcomes, adopting the WHO’s definition of PPM, which is a strategic partnership between national TB programmes and healthcare providers, both public and private, to deliver high-quality TB diagnosis and treatment.

Design

Systematic review without meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Data sources

EMBASE, MEDLINE, Health Management Information Consortium, Social Sciences Citation Index, Science Citation Index, Emerging Sources Citation Index, CENTRAL, Database of Disability and Inclusion Information Resources, WHO Library Database and 3ie.

Eligibility criteria

We included all primary studies examining PPM models delivering TB services in urban health sectors in least-developed, low-income and lower–middle-income countries and territories.

Data extraction and synthesis

17 reviewers were involved in data extraction in COVIDENCE using a prepiloted template. All extractions were completed by a single reviewer and checked by a second reviewer. Quality appraisal was carried out using the mixed-methods appraisal tool, covering mixed-methods, qualitative and quantitative study designs. Narrative synthesis was carried out by tabulating and summarising studies according to PPM models and reported in line with the synthesis without meta-analysis guidelines.

Results

Of the 57 included studies, covering quantitative (n=41), qualitative (n=6) and mixed-method (n=10) designs, the majority were from Southeast Asia (n=37). PPM models had overall positive results on TB treatment outcomes, access and coverage and value for money. They are linked with improved TB health workers’ skills and service delivery. Most outcomes tended to favour interface models, although with considerable heterogeneity. Inconsistent implementation of national TB guidelines, uncoordinated referrals and lack of trust among partners were identified as areas of improvement. Evidence was lacking on the involvement of informal providers within PPM models.

Conclusions

PPM models can be effective and cost-effective for TB care in urban low- and middle-income countries contexts, particularly when levels of mistrust between public and private sectors are addressed through principles of equal partnership. The evidence indicates that this may be more achievable when an interface organisation manages the partnership.

PROSPERO registration number

CRD42021289509.

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