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How the United Kingdom’s Nursing and Midwifery Council Applies Guidance When Exercising Its Disciplinary Functions 英国护理和助产委员会在行使其纪律职能时如何应用指导
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-10-01 DOI: 10.1016/S2155-8256(22)00080-1
Cathal T. Gallagher PhD, Fatima Saleem MPharm

Background

The Nursing and Midwifery Council (NMC) is responsible for addressing concerns about UK-registered nurses and midwives through its fitness-to-practice process.

Purpose

To assess whether the NMC considers relevant factors at all stages of its deliberations into nurse misconduct, as required by the determinations in the appeal cases of Cohen v. General Medical Council (GMC), Zygmunt v. GMC, and Azzam v. GMC, and to assess whether the circumstances described in its Sanctions Guidance warranting the suspension or removal of a nurse from the practice register lead to that outcome.

Methods

Cases between July and September 2021 that highlighted aggravating circumstances deemed as serious enough to warrant removal were identified and included in this study. Specific factors, including patient safety and dishonesty, included when determining impairment of fitness to practice were compared with their subsequent consideration when determining the severity of sanction. Pearson’s χ2 and Fisher’s exact tests were used to detect any variation from the expected distribution of data.

Results

Fifty-nine cases met the inclusion criteria. Each of the four factors considered was more likely to be heard when determining a sanction after first being factored into the consideration of impairment. Where the aggravating factors of dishonesty or risk of harm to patients or the public were identified as an aspect of a nurse’s misconduct, the sanctions of suspension or removal were no more likely to be imposed than when they were absent.

Conclusion

The NMC does, in general, factor the rulings of High Court appeal cases into their deliberations on the impairment of fitness to practice; however, we were unable to demonstrate that dishonesty or risk of harm were more likely to result in suspension or removal of a nurse from the practice register.

护理和助产委员会(NMC)负责通过其健康实践过程解决对英国注册护士和助产士的担忧。目的评估NMC是否按照Cohen诉通用医学委员会(GMC)、Zygmunt诉GMC和Azzam诉GMC上诉案件的裁决要求,在其审议护士不当行为的各个阶段考虑了相关因素,并评估其制裁指南中描述的暂停或将护士从执业登记册中除名的情况是否导致了这一结果。方法确定2021年7月至9月期间的加重情节被认为严重到需要转移的病例,并将其纳入本研究。具体的因素,包括病人的安全和不诚实,在确定是否适合行医的损害时,将其与确定制裁的严重性时的后续考虑进行比较。使用Pearson χ2和Fisher精确检验来检测数据预期分布的任何变化。结果59例符合纳入标准。在首先考虑损害因素后,在确定制裁时,所考虑的四个因素中的每一个都更有可能被听到。当不诚实的加重因素或对病人或公众造成伤害的风险被确定为护士不当行为的一个方面时,停职或撤职的制裁并不比他们缺席时更有可能施加。结论NMC在审议妨碍执业能力时,一般会参考高等法院上诉案件的裁决;然而,我们无法证明不诚实或伤害风险更有可能导致暂停或从执业登记册中删除护士。
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引用次数: 0
Thematic Analysis of Health Professions Sunset Reports: Foci, Gaps, Impacts, and Best Practices 卫生专业夕阳报告的专题分析:焦点、差距、影响和最佳做法
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-10-01 DOI: 10.1016/S2155-8256(22)00094-1
David C. Benton PhD, RN, FRCN, FAAN, Alyson S. Brenton RN, MSN, CNL, Peggy Seller Benson MSN, RN, MSHA, NE-BC, Katherine Stansfield MN, RN, Phyllis Johnson DNP, MSN, RN, FNP-BC
<div><h3>Background</h3><p>Sunset reviews, along with performance audits<span> and judicial reviews, orientate regulatory boards to act in the public interest and to address any weaknesses in the boards’ efficiency. Although sunset reviews gained popularity after their introduction in the 1970s and 1980s, their limited success in terminating agencies, along with the resources needed to conduct the reviews, have led to sunset legislation being repealed in several jurisdictions in favor of broader program evaluation or general audit processes. Increased interest in trying to limit the growth of the number of professions requiring a license to practice has seen a revival of interest in both sunrise and sunset reviews over the past decade.</span></p></div><div><h3>Purpose</h3><p>To review existing sunset reports related to nursing and other health professions licensing boards and identify the foci, best practices, and criteria used by states in their evaluations.</p></div><div><h3>Methods</h3><p>A review and systematic examination of existing literature was performed with a mixed-methods approach and a range of analytical techniques. Manual and computer-based qualitative analyses were used to identify themes. Documents were analyzed for thematic content, the centrality of various themes, and how they may inform the development of more standardized approaches to assess the performance of regulatory bodies.</p></div><div><h3>Results</h3><p>A total of 329 reports were identified from 24 US states. The 329 reports were analyzed and varied in length from 3 to 727 pages with an average report length of 68 pages. Collectively, 22,420 pages were analyzed. The review identified that many evaluations were based on opinion or survey responses rather than quantifiable or empirical evaluations. As a result, objective analysis of the approaches is difficult to assess, both within and across jurisdictions. The study identified 26 themes with considerable overlaps and connections between them. By coding various themes to the content of the reports, researchers identified groups of the most strongly related themes. The most connected group, <em>main areas of performance scrutiny,</em> relates to the major responsibilities and functions of licensing boards. The next most connected group encompasses the administrative and <em>operational concerns</em> involved in the conduct of the review. The least connected group is those elements that delineate the <em>authority and focus</em> of the review and encompass the basis of the legislative authority used to enable the review. Best and promising practices were also identified, including the following: (a) information provision (e.g., guidance notes that explain the process and provide public input); (b) comparative data sets (e.g., conducting reviews on a range of boards simultaneously); (c) accountability and publication of responses (e.g., improvement recommendations or commendation for best practices are made available).
背景日落审查,连同绩效审计和司法审查,引导监管委员会为公众利益行事,并解决董事会效率方面的任何弱点。虽然日落审查在20世纪70年代和80年代引入后受到欢迎,但在终止机构方面取得的有限成功,以及进行审查所需的资源,导致日落立法在一些司法管辖区被废除,转而支持更广泛的项目评估或一般审计过程。在过去的十年里,越来越多的人试图限制需要执照的职业数量的增长,这使得人们对日出和日落审查的兴趣重新燃起。目的审查与护理和其他卫生专业许可委员会有关的现有日落报告,并确定各州在其评估中使用的重点、最佳做法和标准。方法采用混合方法和一系列分析技术对现有文献进行综述和系统检查。使用手工和计算机定性分析来确定主题。分析了文件的主题内容、各种主题的中心地位,以及它们如何为制定更标准化的方法来评估监管机构的绩效提供信息。结果从美国24个州共鉴定出329份报告。对329份报告进行了分析,报告长度从3页到727页不等,平均报告长度为68页。总共分析了22,420页。审查发现,许多评价是基于意见或调查答复,而不是可量化或经验性评价。因此,很难对这些方法进行客观分析,无论是在司法管辖区内还是跨司法管辖区内。该研究确定了26个主题,它们之间有相当大的重叠和联系。通过将各种主题编码到报告的内容中,研究人员确定了相关性最强的主题组。联系最紧密的一组,即审查工作表现的主要领域,与发牌委员会的主要责任和职能有关。下一个联系最密切的小组包括进行审查所涉及的行政和业务问题。联系最少的一组是那些描述审查的权威和重点并包含用于使审查成为可能的立法权威基础的要素。还确定了最佳和有希望的做法,包括以下内容:(a)提供信息(例如,解释流程并提供公众意见的指导说明);(b)比较数据集(例如,同时对一系列委员会进行审查);(c)问责制和公布回应(例如,提供改进建议或对最佳做法的表彰)。对已发表的日落评审报告主题内容的分析确定了一系列潜在指标,如果将其标准化,可以提供更大的跨学科委员会和跨司法管辖区学习。用于进行日落审查的标准和报告中包含的重点为董事会成员和工作人员教育内容创作者提供了见解。还确定了进一步研究的相关机会。
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引用次数: 0
Building the Future of Regulation on the Steps From Our Past 45 Years 在过去45年的基础上构建监管的未来
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-10-01 DOI: 10.1016/S2155-8256(22)00078-3
Maryann Alexander PhD, RN, FAAN (Editor-in-Chief)
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引用次数: 0
Legislative Highlight: Indiana House Bill 1003 立法亮点:印第安纳州众议院法案1003
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-10-01 DOI: 10.1016/S2155-8256(22)00083-7
Nicole Livanos JD, MMP
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引用次数: 0
Editorial Advisory Board 编辑顾问委员会
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-10-01 DOI: 10.1016/S2155-8256(22)00093-X
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引用次数: 0
Corrections to Lavin et al. (2022) 对Lavin et al.(2022)的修正
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-07-01 DOI: 10.1016/S2155-8256(22)00064-3
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引用次数: 0
No Shortage of Bills to Reverse Workforce Trends 扭转劳动力趋势的法案比比皆是
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-07-01 DOI: 10.1016/S2155-8256(22)00065-5
Nicole Livanos JD, MPP
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引用次数: 0
A Retrospective Review of NCLEX Candidates’ Testing Behavior: Examining the Relationship Between Repeat Testing, Time-to-Test, and Discipline NCLEX考生考试行为的回顾:重复测试、测试时间和纪律之间的关系
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-07-01 DOI: 10.1016/S2155-8256(22)00062-X
Nicole Kaminski-Ozturk PhD, Richard Smiley MS, Elizabeth Zhong PhD, Brendan Martin PhD

Background

Concerns about the competence of repeat NCLEX test takers have persisted, resulting in a patchwork of regulatory policies that limit the number of test attempts or the conditions under which a candidate can retest in certain U.S. jurisdictions.

Purpose

To examine possible corrolaries between repeat test-taker status and future practice discipline and to investigate the relationship between time-to-test and repeat testing.

Methods

Data were collected on nearly a quarter of a million registered nurse (RN) and practical nurse (PN) NCLEX candidates who passed the examination between 2013 and 2017. Multivariable generalized estimating equation models were used to assess the likelihood of discipline (0, 1) and the need for repeat testing (0, 1). Propensity score matching was employed to address initial group imbalance on all available covariates for models assessing discipline.

Results

The rate of discipline among the RN (1.0%, n = 2,029) and PN (1.8%, n = 749) samples was low. After applying propensity score matching, repeat test-taker status was found to be weakly aligned with practice discipline for RNs (p = .047) but was not correlated for PNs (p = .13). In contrast, adjusting for sex, race, ethnicity, and age, RN candidates who delayed taking the test for 60 days were 5% more likely to need to retake the NCLEX (p < .001). For PN candidates, a delay of 90 days was associated with a 9% increase in the likelihood of needing to retake the NCLEX (p < .001).

Conclusion

Empirical evidence supports the comparable safety profile of single– and multi–test-taker groups, underscoring the need to revaluate restrictions that limit the conditions under which candidates can retest. Furthermore, ongoing outreach to nursing programs to emphasize the importance of prompt NCLEX testing and the possible deleterious effects of delays, by even a few months, is important.

对复读NCLEX考试考生能力的担忧一直存在,导致监管政策的拼凑,限制考试次数或考生可以在某些美国司法管辖区重新考试的条件。目的探讨复试者状态与未来执业纪律之间可能存在的相关性,并调查复试时间与复试之间的关系。方法收集2013年至2017年通过NCLEX考试的近25万注册护士(RN)和执业护士(PN)考生的数据。使用多变量广义估计方程模型来评估学科的可能性(0,1)和重复检验的必要性(0,1)。倾向得分匹配用于解决评估学科模型中所有可用协变量的初始组不平衡。结果RN (1.0%, n = 2029)和PN (1.8%, n = 749)样本的纪律性较低。应用倾向得分匹配后,发现重复考生状态与RNs的练习纪律弱相关(p = 0.047),但与PNs无关(p = 0.13)。相比之下,调整性别、种族、民族和年龄后,延迟60天参加考试的注册护士考生需要重新参加NCLEX考试的可能性增加了5% (p <措施)。对于PN考生来说,延迟90天需要重新参加NCLEX考试的可能性增加9% (p <措施)。结论:经验证据支持单考生组和多考生组的可比性安全性,强调有必要重新评估限制考生复试条件的限制。此外,不断扩大护理项目,强调及时进行NCLEX检测的重要性,以及即使延迟几个月也可能产生的有害影响,这是很重要的。
{"title":"A Retrospective Review of NCLEX Candidates’ Testing Behavior: Examining the Relationship Between Repeat Testing, Time-to-Test, and Discipline","authors":"Nicole Kaminski-Ozturk PhD,&nbsp;Richard Smiley MS,&nbsp;Elizabeth Zhong PhD,&nbsp;Brendan Martin PhD","doi":"10.1016/S2155-8256(22)00062-X","DOIUrl":"10.1016/S2155-8256(22)00062-X","url":null,"abstract":"<div><h3>Background</h3><p>Concerns about the competence of repeat NCLEX test takers have persisted, resulting in a patchwork of regulatory policies that limit the number of test attempts or the conditions under which a candidate can retest in certain U.S. jurisdictions.</p></div><div><h3>Purpose</h3><p>To examine possible corrolaries between repeat test-taker status and future practice discipline and to investigate the relationship between time-to-test and repeat testing.</p></div><div><h3>Methods</h3><p>Data were collected on nearly a quarter of a million registered nurse (RN) and practical nurse (PN) NCLEX candidates who passed the examination between 2013 and 2017. Multivariable generalized estimating equation models were used to assess the likelihood of discipline (0, 1) and the need for repeat testing (0, 1). Propensity score matching was employed to address initial group imbalance on all available covariates for models assessing discipline.</p></div><div><h3>Results</h3><p>The rate of discipline among the RN (1.0%, <em>n</em> = 2,029) and PN (1.8%, <em>n</em> = 749) samples was low. After applying propensity score matching, repeat test-taker status was found to be weakly aligned with practice discipline for RNs (<em>p</em> = .047) but was not correlated for PNs (<em>p</em> = .13). In contrast, adjusting for sex, race, ethnicity, and age, RN candidates who delayed taking the test for 60 days were 5% more likely to need to retake the NCLEX (<em>p</em> &lt; .001). For PN candidates, a delay of 90 days was associated with a 9% increase in the likelihood of needing to retake the NCLEX (<em>p</em> &lt; .001).</p></div><div><h3>Conclusion</h3><p>Empirical evidence supports the comparable safety profile of single– and multi–test-taker groups, underscoring the need to revaluate restrictions that limit the conditions under which candidates can retest. Furthermore, ongoing outreach to nursing programs to emphasize the importance of prompt NCLEX testing and the possible deleterious effects of delays, by even a few months, is important.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 2","pages":"Pages 4-9"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41425240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Amalgamation of Professional Regulators: Conflicting Perceptions and Beliefs Among Canadian Regulatory Leaders 专业监管机构的合并:加拿大监管领导人之间相互冲突的看法和信念
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-07-01 DOI: 10.1016/S2155-8256(22)00059-X
Tracey L. Adams PhD

Background

In Canada and the United Kingdom, there is discussion about amalgamating nursing and other professional regulatory bodies to improve efficiency; however, there is a dearth of research on the advantages and disadvantages of amalgamation.

Purpose

To begin to address this gap, this article explores Canadian regulatory leaders’ views about professional regulator amalgamation.

Methods

In-depth interviews were conducted with 83 Canadian regulatory leaders (in regulatory bodies, government, and other related roles). Qualitative description analyses were conducted on interview transcripts.

Results

Participants identified several advantages of amalgamation, believing it was valuable for small, under-resourced regulators, as well as for regulators in the same field, such as nursing and oral healthcare. Some participants anticipated improvements in regulatory effectiveness that would benefit regulators, governments, and society. However, participants also raised concerns about amalgamation: prioritizing efficiency over effectiveness, lack of evidence of success, and concerns about inequality. Participants also provided advice to facilitate amalgamation.

Conclusion

Limited evidence and conflicting views on this regulatory change encourage caution among those pursuing amalgamation of professional regulators. It is clear that collaboration is key to successful amalgamation; thus, it should not be forced or mandated.

在加拿大和英国,有关于合并护理和其他专业监管机构以提高效率的讨论;然而,关于合并的利弊研究却很少。为了开始解决这一差距,本文探讨了加拿大监管领导人对专业监管机构合并的看法。方法对83位加拿大监管机构领导人(监管机构、政府和其他相关角色)进行深度访谈。对访谈笔录进行定性描述分析。结果参与者确定了合并的几个优点,认为这对小型,资源不足的监管机构以及同一领域的监管机构(如护理和口腔保健)是有价值的。一些与会者预期监管效率的提高将有利于监管机构、政府和社会。然而,与会者也提出了对合并的担忧:优先考虑效率而不是效果,缺乏成功的证据,以及对不平等的担忧。嘉宾亦就合并提供意见。关于这一监管变化的有限证据和相互矛盾的观点促使那些寻求合并专业监管机构的人保持谨慎。显然,合作是成功合并的关键;因此,它不应该被强迫或授权。
{"title":"Amalgamation of Professional Regulators: Conflicting Perceptions and Beliefs Among Canadian Regulatory Leaders","authors":"Tracey L. Adams PhD","doi":"10.1016/S2155-8256(22)00059-X","DOIUrl":"10.1016/S2155-8256(22)00059-X","url":null,"abstract":"<div><h3>Background</h3><p>In Canada and the United Kingdom, there is discussion about amalgamating nursing and other professional regulatory bodies to improve efficiency; however, there is a dearth of research on the advantages and disadvantages of amalgamation.</p></div><div><h3>Purpose</h3><p>To begin to address this gap, this article explores Canadian regulatory leaders’ views about professional regulator amalgamation.</p></div><div><h3>Methods</h3><p>In-depth interviews were conducted with 83 Canadian regulatory leaders (in regulatory bodies, government, and other related roles). Qualitative description analyses were conducted on interview transcripts.</p></div><div><h3>Results</h3><p>Participants identified several advantages of amalgamation, believing it was valuable for small, under-resourced regulators, as well as for regulators in the same field, such as nursing and oral healthcare. Some participants anticipated improvements in regulatory effectiveness that would benefit regulators, governments, and society. However, participants also raised concerns about amalgamation: prioritizing efficiency over effectiveness, lack of evidence of success, and concerns about inequality. Participants also provided advice to facilitate amalgamation.</p></div><div><h3>Conclusion</h3><p>Limited evidence and conflicting views on this regulatory change encourage caution among those pursuing amalgamation of professional regulators. It is clear that collaboration is key to successful amalgamation; thus, it should not be forced or mandated.</p></div>","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 2","pages":"Pages 25-33"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47742448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nursing Workforce Challenges in the Postpandemic World 大流行后世界的护理人力挑战
IF 2.4 4区 医学 Q1 NURSING Pub Date : 2022-07-01 DOI: 10.1016/S2155-8256(22)00061-8
Ellen T. Kurtzman PhD, MPH, RN, FAAN, Lauren V. Ghazal PhD, FNP-BC, Shirley Girouard PhD, RN, FAAN, Chenjuan Ma PhD, MSN, Barbara Martin PhD, ACNP-MPH, Blake T. McGee PhD, MPH, RN, Colleen A. Pogue PhD, RN, Kathryn A. Riman PhD, RN, Maggie C. Root MSN, RN, CPNP-AC, CHPPN, Amelia E. Schlak PhD, RN, Jamie M. Smith PhD, RN, Deonni P. Stolldorf PhD, RN, Jacqueline Nikpour Townley PhD, RN, Eleanor Turi MPhil, BSN, RN, CCRN, Hay-ley Germack PhD, MHS, RN
{"title":"Nursing Workforce Challenges in the Postpandemic World","authors":"Ellen T. Kurtzman PhD, MPH, RN, FAAN,&nbsp;Lauren V. Ghazal PhD, FNP-BC,&nbsp;Shirley Girouard PhD, RN, FAAN,&nbsp;Chenjuan Ma PhD, MSN,&nbsp;Barbara Martin PhD, ACNP-MPH,&nbsp;Blake T. McGee PhD, MPH, RN,&nbsp;Colleen A. Pogue PhD, RN,&nbsp;Kathryn A. Riman PhD, RN,&nbsp;Maggie C. Root MSN, RN, CPNP-AC, CHPPN,&nbsp;Amelia E. Schlak PhD, RN,&nbsp;Jamie M. Smith PhD, RN,&nbsp;Deonni P. Stolldorf PhD, RN,&nbsp;Jacqueline Nikpour Townley PhD, RN,&nbsp;Eleanor Turi MPhil, BSN, RN, CCRN,&nbsp;Hay-ley Germack PhD, MHS, RN","doi":"10.1016/S2155-8256(22)00061-8","DOIUrl":"10.1016/S2155-8256(22)00061-8","url":null,"abstract":"","PeriodicalId":46153,"journal":{"name":"Journal of Nursing Regulation","volume":"13 2","pages":"Pages 49-60"},"PeriodicalIF":2.4,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9299514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9318754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
期刊
Journal of Nursing Regulation
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