Journal of Nursing Regulation最新文献_第4页

The rise of virtual care in nursing practice: A global bibliometric review 虚拟护理在护理实践中的兴起：一项全球文献计量回顾

IF 6.3 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-10-01 DOI: 10.1016/j.jnr.2025.08.013

Alex S. Borromeo MN, RN , Allan M. Manaloto PhD, RN, LPT , Rhealeen V. Vicedo MAN, RN , Ronilo Antonio PhD, LPT , Jonathan D. Cura PhD, RN , Walton Wider PhD

Background

Virtual care technologies such as telehealth, eHealth, remote monitoring, and telenursing are now integral to healthcare. Nurses are key to their delivery, yet research regarding these modalities remains fragmented, with limited theoretical grounding and attention to structural factors. Focused synthesis is needed to highlight the role of nursing and guide education, policy, and practice.

Purpose

This study aimed to map the global landscape of virtual care in nursing by identifying trends, intellectual foundations, and emerging directions through comprehensive bibliometric analysis. It addresses the lack of an integrative synthesis that critically evaluates how virtual care is conceptualized, studied, and applied within the nursing profession.

Methods

A bibliometric research design was adopted that integrated co-citation and co-word analysis techniques. In total, 7,669 peer-reviewed articles were retrieved from the Scopus database. The VOSviewer software was used to conduct co-citation analysis to identify influential publications and intellectual clusters, and co-word analysis was used to explore thematic structures and emerging discourses.

Results

Co-citation analysis revealed four dominant domains: (1) theoretical and methodological foundations; (2) telehealth applications and eHealth readiness; (3) clinical outcomes and patient-centered interventions; and (4) policy and workforce development. The co-word analysis included themes in health service delivery, digital literacy, interprofessional collaboration, and psychosocial dimensions of elder care. The findings point to underexplored areas such as equity, nurse workload, and sociotechnical integration.

Conclusions

This dual-lens analysis offers a novel synthesis of virtual nursing care. This study advances the systems-level understanding of virtual care by revealing areas of robust insights as well as neglected areas of study. The findings support evidence-based strategies for nursing education, workforce development, and the equitable implementation of digital health.

虚拟医疗技术，如远程医疗、电子医疗、远程监控和远程护理，现在是医疗保健不可或缺的一部分。护士是分娩的关键，然而关于这些模式的研究仍然是碎片化的，缺乏理论基础和对结构因素的关注。需要有针对性的综合，以突出护理的作用，并指导教育，政策和实践。目的本研究旨在通过综合文献计量分析，识别趋势、知识基础和新兴方向，绘制护理领域虚拟护理的全球图景。它解决了缺乏一个综合的综合，批判性地评估虚拟护理是如何概念化，研究，并在护理专业应用。方法采用文献计量学研究设计，结合共被引和共词分析技术。总共从Scopus数据库中检索了7669篇同行评议的文章。使用VOSviewer软件进行共被引分析，以识别有影响力的出版物和智力集群，并使用共词分析来探索主题结构和新兴话语。结果：(1)理论和方法基础；(2)远程医疗应用和电子医疗准备；(3)临床结果和以患者为中心的干预措施；(4)政策和劳动力发展。共词分析的主题包括卫生服务提供、数字扫盲、专业间合作和老年人护理的社会心理层面。研究结果指出了未被充分开发的领域，如公平、护士工作量和社会技术整合。结论双镜头分析为虚拟护理提供了一种新的综合方法。本研究通过揭示强大的见解领域以及被忽视的研究领域，推进了对虚拟护理的系统级理解。研究结果支持护理教育、劳动力发展和公平实施数字卫生的循证战略。

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引用次数: 0

Closing the surveillance gap: Development of a technology-integrated model for nurse anesthesia student controlled substance oversight 缩小监督差距：开发一个技术集成模型的护士麻醉学生控制物质的监督

IF 6.3 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-10-01 DOI: 10.1016/j.jnr.2025.08.016

Jennifer R. Majumdar PhD, CRNA , Jennifer G. Carroll DNP, CRNA, CENP, CPHQ, FACHE , Keith B. Denison DNP, CRNA , Hallie J.D. Evans DNP, CRNA, APRN, CNE, FAANA

Controlled substance (CS) diversion poses serious risks to patient safety, provider well-being, and institutional compliance, particularly in anesthesia practice where potent medications are routinely handled. Nurse anesthesia students are often entrusted with CS preparation and administration under indirect supervision but are frequently excluded from automated dispensing systems. When preceptors retrieve medications on students' behalf, transactions are recorded under the preceptor's credentials, eliminating individual accountability and rendering students invisible to surveillance systems. To address this oversight gap, a newly established nurse anesthesia program partnered with a large academic health system to design a standardized, technology-enabled oversight framework. The model will provide each student with role-based, time-limited system credentials synchronized to clinical rotation schedules, ensuring that all CS transactions—dispensing, administration, and waste—are traceable to the individual performing the task. The framework's five pillars—interprofessional collaboration, standardized policy, annual diversion prevention education, analytics-based surveillance, and clear reporting pathways—align with best-practice recommendations from the American Society of Health-System Pharmacists and standards from the Drug Enforcement Administration and The Joint Commission. Although full implementation is pending, this proactive approach exemplifies a scalable, systems-based solution that strengthens diversion prevention while serving as a pedagogical imperative. Furthermore, embedding students in the same surveillance infrastructure as licensed providers prepares them for the regulatory realities of modern healthcare and sets a new standard for safety, accountability, and professional integrity in anesthesia education. This report describes the pre-implementation phase of this quality improvement initiative, highlighting the rationale, development, and expected benefits and challenges of the framework.

受控物质（CS）转移对患者安全、提供者福利和机构依从性构成严重风险，特别是在常规处理强效药物的麻醉实践中。麻醉护士学生经常被委托在间接监督下进行CS的制备和管理，但经常被排除在自动配药系统之外。当指导员代表学生取回药物时，交易记录在指导员的证书下，消除了个人责任，使学生对监控系统不可见。为了解决这一监督缺口，一个新建立的护士麻醉项目与一个大型学术卫生系统合作，设计了一个标准化的、技术支持的监督框架。该模型将为每个学生提供基于角色的、有时间限制的系统证书，与临床轮换时间表同步，确保所有CS事务（分配、管理和浪费）都可追溯到执行任务的个人。该框架的五大支柱——跨专业合作、标准化政策、年度预防转移教育、基于分析的监测和明确的报告途径——与美国卫生系统药剂师协会的最佳实践建议以及美国缉毒局和联合委员会的标准保持一致。虽然尚未全面实施，但这种主动的方法是一种可扩展的、基于系统的解决方案，可以加强分流预防，同时也可以作为教学的必要条件。此外，将学生纳入与有执照的提供者相同的监督基础设施中，为他们适应现代医疗保健的监管现实做好准备，并为麻醉教育的安全性、问责制和专业诚信设定了新的标准。该报告描述了该质量改进计划的实施前阶段，强调了框架的基本原理、开发以及预期的好处和挑战。

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引用次数: 0

How many hours do nurses who re-enter the workforce need to “practise” to maintain safe “practice”? 重新进入工作岗位的护士需要“练习”多少小时才能保持安全的“练习”？

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/j.jnr.2025.06.007

Emma Eaton , Amanda Henderson

Background

The regulation of nursing is needed to assure the public that registered nurses are competent and capable. When nurses do not practice for extended periods, their capacity to provide safe contemporary care gradually lessens. There is little evidence about how best to ensure that nurses who re-enter the workforce will provide safe and competent care.

Purpose

To ascertain the number of hours nurses in a supervised practice arrangement within a clinical environment take to demonstrate competence in maintaining requisite standards of practice following an extended period away from the profession.

Methods

A quantitative evaluation design determined nurses’ workplace performance during a supervised return-to-practice program. Twenty nurses with supervised practice requirements placed in acute clinical areas over a 5-year period (2019–2024) were monitored. The number of supervised hours of practice were recorded until the nurse met the requisite standards for practice. Competence was determined by a user-friendly validated measure of workplace performance based on Nursing and Midwifery Board of Australia standards for practice.

Results

The number of hours that nurses needed to undergo supervised practice to demonstrate the requisite standard of workplace performance after a break contrasted markedly depending on whether nurses had substantial experience in a specialty prior to their break. Nurses (n = 10) with more than 5 years’ experience in a specialty demonstrated requisite standards for practice after 120–216 h of supervised practice, whereas nurses (n = 10) who had different trajectories (i.e., without substantial experience) prior to their return to work needed 450 h of supervised practice before they were deemed suitable for unconditional registration.

Conclusion

Supervised practice needs may vary based on a nurse's previous experience. Understanding different needs of cohorts returning to the profession can assist healthcare leaders in planning for safe supervised practice for nurses returning after prolonged periods.

背景：为了向公众保证注册护士是称职和有能力的，需要对护理进行监管。当护士长时间不练习时，他们提供安全的当代护理的能力逐渐减弱。关于如何最好地确保重新进入劳动力市场的护士提供安全和合格的护理，几乎没有证据。目的确定护士在临床环境中接受监督的执业安排，以证明在长时间离开专业后保持必要的执业标准的能力。方法采用定量评估设计确定护士在监督下重返执业计划中的工作表现。在5年（2019-2024年）期间，对20名具有监督实践要求的护士在急性临床领域进行监测。被监督的实习小时数被记录下来，直到护士达到必要的实习标准。能力是由基于澳大利亚护理和助产委员会实践标准的工作场所绩效的用户友好验证措施确定的。结果护士在休息后需要接受监督实践以证明工作场所绩效的必要标准的小时数与护士在休息前是否具有丰富的专业经验有明显的对比。具有5年以上专业经验的护士（n = 10）在120-216小时的监督实践后证明了必要的实践标准，而在返回工作岗位之前具有不同轨迹（即没有丰富经验）的护士（n = 10）需要450小时的监督实践才能被认为适合无条件注册。结论护士在督导下的实践需求可能因以往经验而异。了解返回职业的群体的不同需求可以帮助医疗保健领导者为长时间返回的护士规划安全监督的实践。

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引用次数: 0

“Protect the public—that's first. The second [goal] is getting the nurse to recovery”: Interviews with alternative-to-discipline program administrators “保护公众——这是第一位的。第二个[目标]是让护士康复”：采访另类纪律项目的管理者

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/j.jnr.2025.06.002

Emily Naiser , Ashley Myers , Christina Orzabal , Georges Naufal , Cindy Weston , Nancy Fahrenwald , Jane N. Bolin

Background

Substance use disorder (SUD) among nurses presents significant challenges for both healthcare professionals and patient safety. Rough estimates suggest that 10 % of nurses, or more than half a million nursing professionals, experience SUD in the United States. Alternative-to-discipline (ATD) programs offer a nonpunitive approach to rehabilitation for nurses while ensuring public safety.

Purpose

This study examines the effectiveness and functioning of ATD programs through the perspectives of state-level program administrators.

Methods

Semi-structured qualitative interviews were conducted with ATD program administrators in the United States. Using a thematic analysis approach, common successes and challenges related to ATD programs were identified.

Results

Administrators from eight ATD programs participated in the interviews, and one submitted written responses to the interview questions. Findings revealed that functionally, ATD programs vary in the supports and restrictions given to nurses and that these decisions are primarily based on public safety. The ATD program administrators utilized the resources available to them but wished they could serve more nurses, minimize the costs to nurses, and provide additional support. While ATD programs facilitate recovery and professional reintegration, barriers such as stigma and resource limitations persist.

Conclusions

This study highlights the need for standardized program guidelines and enhanced support structures to optimize outcomes. These insights contribute to a broader understanding of SUD intervention strategies in nursing, inform policy improvements, and identify future research directions.

护士中的物质使用障碍（SUD）对医疗保健专业人员和患者安全都提出了重大挑战。粗略估计，美国有10%的护士，或超过50万的护理专业人员经历过SUD。纪律替代（ATD）项目为护士提供了一种非惩罚性的康复方法，同时确保了公共安全。目的：本研究从州一级项目管理者的角度考察ATD项目的有效性和功能。方法对美国的ATD项目管理人员进行半结构化定性访谈。采用主题分析方法，确定了与ATD项目相关的共同成功和挑战。结果来自8个ATD项目的管理人员参与了访谈，其中1人对访谈问题进行了书面回答。调查结果显示，ATD项目在功能上对护士的支持和限制各不相同，这些决定主要基于公共安全。ATD项目的管理者利用了现有的资源，但希望他们能服务更多的护士，尽量减少护士的成本，并提供额外的支持。虽然ATD项目促进了康复和重返职业社会，但诸如耻辱和资源限制等障碍仍然存在。本研究强调需要标准化的项目指南和增强的支持结构来优化结果。这些见解有助于更广泛地了解护理中的SUD干预策略，为政策改进提供信息，并确定未来的研究方向。

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引用次数: 0

Postlicensure nurse competence in the United States: A concept clarification 美国持证护士能力：概念澄清

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/j.jnr.2025.06.008

J. Lea Brown, Yang Yu, Ying Xue

Background

Postlicensure nurse competence is a critical factor in healthcare quality and safety, yet a research gap exists in the U.S.-specific context.

Purpose

This study aimed to clarify the concept of postlicensure nurse competence in clinical settings in the United States, establish an operational definition, and develop a conceptual model.

Methods

The Norris method of concept clarification was used. Data were compiled from literature and health/nursing professional organization websites. Inclusion criteria were full-text articles written in English that were conducted exclusively in the United States, were focused on postlicensure registered nurses, and contained either a theoretical or operational definition of nurse competence.

Results

Data were collected from 44 published articles and information from eight professional organization websites. The analysis revealed that postlicensure nurse competence consisted of five domains: knowledge, technical skills, judgment and decision-making, communication, and professionalism. The conceptual model illustrated that the operational definition of nurse competence is shaped by and relative to three tiers of constantly evolving practice standards at the employer, state board of nursing, and professional organization levels; is acquired and sustained through initial and ongoing education and experience; and impacts various health and healthcare outcomes.

Conclusion

The operational definition provides an improved understanding of what constitutes nurse competence for postlicensure nurses in the United States. The conceptual model further highlights the context, antecedents, and consequences of nurse competence and their relationships. This study provides a framework for the operationalization and assessment of postlicensure nurse competence and helps advance consistency in regulation of postlicensure nurse competence in the United States.

背景持证护士能力是医疗保健质量和安全的关键因素，但在美国具体情况下存在研究差距。目的本研究旨在厘清美国临床执业护士胜任力的概念，建立可操作的定义，并发展概念模型。方法采用诺里斯概念澄清法。数据汇编自文献和卫生/护理专业组织网站。纳入标准是仅在美国进行的英文全文文章，重点关注执照后注册护士，并包含护士能力的理论或操作定义。结果数据来源于44篇已发表的文章和8个专业组织网站的信息。分析发现，持证后护士胜任力包括知识、技能、判断与决策、沟通和专业精神五个方面。概念模型表明，护士能力的操作定义是由雇主、州护理委员会和专业组织层面不断发展的实践标准的三个层次形成的，并与之相关；是通过最初的和持续的教育和经验获得和维持的；并影响各种健康和医疗保健结果。结论操作性定义提高了对美国持证后护士能力构成的理解。概念模型进一步强调了护士能力及其关系的背景、前因和后果。本研究为执照后护士能力的运作和评估提供了一个框架，并有助于促进美国执照后护士能力监管的一致性。

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引用次数: 0

Editorial Bd. Page 社论版

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/S2155-8256(25)00081-X

引用次数: 0

POLICY PERSPECTIVE: The artificial intelligence will see you now 政策视角：人工智能现在就会看到你

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/j.jnr.2025.06.001

Nicole Livanos

引用次数: 0

Characteristics of entry-level nurses: Does the NCLEX definition still apply? 初级护士的特点：NCLEX的定义仍然适用吗？

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/j.jnr.2025.06.005

Nicole Williams , Steven G. Viger , Hong Qian

Background

During the initial licensure period, entry-level nurses face several challenges, such as providing complex care in an ever-evolving healthcare landscape, prioritizing care, role actualization, and more. As the demands in healthcare continue to evolve, it is crucial to understand prevalent entry-level nursing characteristics and practice behaviors and their duration.

Purpose

This study aimed to explore the length of time that entry-level nurse characteristics endure, thus describing the entry-level period.

Methods

Using a mixed-method design with a sample of 193 nurses, a 15-min presentation and discussion regarding the characteristics and practice behaviors of entry-level nurses was facilitated and followed by the administration of a one-question survey that asked, “Does the current NCLEX definition of an entry-level nurse, one with no more than 12 months of experience, still apply?”

Results

Of the 193 participants, 74 % responded “Yes” to the question, and 26 % responded “No.” Themes such as a perception of increased proportion of entry-level nurses working part-time/per diem, increased clinical demands, and the need for entry-level clinical judgment were noted during the sessions. While the participants represented a diverse group of nurses across the United States and Canada, the small sample size prohibits generalizability.

Conclusion

The study results indicate that the definition of an entry-level nurse as one with no more than 12 months of experience remains relevant. Nurse regulators must understand the importance of establishing a framework to define the nursing entry-level period, as this vital time frame creates a basis for licensure assessment and support during the new licensure period.

在最初的许可期间，初级护士面临着一些挑战，例如在不断发展的医疗保健环境中提供复杂的护理，优先考虑护理，角色实现等等。随着医疗保健需求的不断发展，了解流行的入门级护理特征和实践行为及其持续时间至关重要。目的本研究旨在探讨入职护士特征持续的时间长度，从而描述入职期。方法采用混合方法设计，对193名护士进行了15分钟的介绍和讨论，讨论了初级护士的特点和执业行为，随后进行了一项单问题调查，“目前NCLEX对初级护士的定义，即经验不超过12个月的护士，是否仍然适用？”结果在193名参与者中，74%的人回答“是”，26%的人回答“不是”。会议期间注意到诸如对兼职/每日津贴的初级护士比例增加的看法，临床需求增加以及初级临床判断的必要性等主题。虽然参与者代表了美国和加拿大不同的护士群体，但小样本量禁止推广。结论研究结果表明，初级护士的定义为经验不超过12个月的护士仍然具有相关性。护士监管机构必须了解建立一个框架来定义护理入门期的重要性，因为这个重要的时间框架为新许可证期间的许可证评估和支持奠定了基础。

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引用次数: 0

Licensure pathways for internationally educated nurses: An environmental scan of Canadian nursing regulatory bodies 国际教育护士的执照途径：加拿大护理监管机构的环境扫描

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/j.jnr.2025.06.004

Patrick Chiu , Nasrin Alostaz , Apple Hermosisima , Rio Li , Houssem Eddine Ben-Ahmed , Jelena Atanackovic , Damilola Iduye , Natalie Thiessen , Bukola Salami , Kathleen Leslie

Background

Licensure pathways for internationally educated nurses (IENs) in Canada have historically been criticized for being too lengthy, complex, and costly. Reforms to streamline IEN licensure have been inconsistent across Canadian jurisdictions, with limited evidence regarding which licensure pathways best support equitable and ethical regulatory policies for IENs.

Purpose

The present study aimed to map the regulatory landscape to identify key characteristics, similarities, and differences in IEN licensure requirements and explore the options available to meet these requirements across Canadian nursing regulators.

Methods

We conducted an environmental scan of 20 Canadian nursing regulators’ websites. Data were extracted and organized into Excel spreadsheets to facilitate comparisons and were analyzed using directed content analysis.

Results

Findings were organized into two broad categories: licensure requirements and options for meeting these requirements. Licensure requirements were broadly similar across jurisdictions and nursing designations (e.g., licensed practical nurses, registered nurses, registered psychiatric nurses), with certain notable exceptions, including recency or currency of practice requirements and expedited pathways available for IENs from specific countries. The options available to meet licensure requirements varied significantly, creating a potentially confusing patchwork of reforms across nursing regulators that could create inequities in IEN licensure and integration.

Conclusion

The variation in options to meet licensure requirements highlights the need for greater efforts to harmonize and simplify IEN licensure across Canada. Further research is required to evaluate the impact and feasibility of reforms to identify long-term, sustainable, ethical, and equitable solutions.

在加拿大，国际教育护士（IENs）的许可途径一直被批评为太长，复杂和昂贵。简化外籍人员执照的改革在加拿大各司法管辖区并不一致，关于哪种执照途径最能支持外籍人员公平和道德的监管政策的证据有限。目的本研究旨在绘制监管格局，以确定IEN许可要求的关键特征、相似点和差异，并探索满足加拿大护理监管机构这些要求的可用选项。方法对加拿大20个护理监管机构的网站进行环境扫描。数据被提取并组织到Excel电子表格中，以便进行比较，并使用定向内容分析进行分析。调查结果分为两大类：许可要求和满足这些要求的选项。各个司法管辖区和护理指定（例如，持牌执业护士、注册护士、注册精神科护士）的执照要求大致相似，但有一些明显的例外，包括执业的近代性或时代性要求，以及特定国家的IENs可获得的快速途径。满足执照要求的可选方案差别很大，这可能造成护理监管机构改革的混乱，可能造成IEN执照和整合方面的不平等。满足许可证要求的选择的变化突出了需要加大努力来协调和简化加拿大各地的IEN许可证。需要进一步研究评估改革的影响和可行性，以确定长期、可持续、合乎道德和公平的解决方案。

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引用次数: 0

The critical intersection of research and practice in regulation 监管研究与实践的关键交叉点

IF 4.2 4区医学 Q1 NURSING

Journal of Nursing Regulation

Pub Date : 2025-07-01 DOI: 10.1016/j.jnr.2025.06.010

Carol Anne Timmings

引用次数: 0