Papers by Anne-Marie Brady
medRxiv (Cold Spring Harbor Laboratory), Nov 27, 2022
doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by pee... more doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
Journal of clinical nursing, Jan 15, 2015
The aim was to examine current scope of practice among nurses and midwives in Ireland. The object... more The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. A postal survey design was used to examine registered nurses' and midwives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal conseque...
Journal of Advanced Nursing, 2015
Aims. To review, discuss and compare nursing and midwifery regulatory and professional bodies' sc... more Aims. To review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks. Background. Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society. Design. Discussion paper. Data sources. Twelve scope of practice and associated decision-making frameworks (January 2000-March 2014). Implications for nursing. Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice. Conclusion. Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decisionmaking provides a very public statement about the status of nursing in a given jurisdiction.
Aim: To identify and synthesise the evidence underpinning the health policymaking process to info... more Aim: To identify and synthesise the evidence underpinning the health policymaking process to inform the development of a health related policy analysis framework. Design: A mixed methods review using ‘Best Fit’ Framework synthesis. Data sources: PUBMED and CINAHL+ databases for English language papers published between March 2013 and March 2017. Review Methods: Titles were screened, data abstracted and analysed by two authors at each stage. Findings from included studies were coded against six a priori categories which had been constructed through a preliminary literature review, consultation and consensus. Results: 68 papers were included. There exists empirical support for six key domains which require to be addressed in the policymaking and analysis process: 1) Context 2) Process 3) Content 4) Stakeholder Consultation 5) Implementation 6) Evaluation. Failure to contextualise and integrate these six domains in problem identification, policy analysis, strategy and policy developmen...
Journal of advanced nursing, Jan 23, 2018
To examine and describe disciplinary discourses conducted through professional policy and regulat... more To examine and describe disciplinary discourses conducted through professional policy and regulatory documents in nursing and midwifery in Ireland. A key tenet of discourse theory is that group identities are constructed in public discourses and these discursively-constructed identities become social realities. Professional identities can be extracted from both the explicit and latent content of discourse. Studies of nursing's disciplinary discourse have drawn attention to a dominant discourse that confers nursing with particular identities, which privilege the relational and affective aspects of nursing and in the process, marginalise scientific knowledge and the technical and body work of nursing. We used critical discourse analysis to analyse a purposive sample of nursing and midwifery regulatory and policy documents. We applied a four-part, sequential approach to analysing the selected texts. This involved identifying key words, phrases and statements that indicated dominant...
BACKGROUND Multimorbidity is defined as the presence of two or more chronic diseases and associat... more BACKGROUND Multimorbidity is defined as the presence of two or more chronic diseases and associated comorbidities. There is a need to improve best practice around the provision of well-coordinated, person-centred care for persons with multimorbidity (PwMs). Present health systems across the European Union (EU) focus on supporting a single disease framework of care; the primary challenge is to create a patient centric integrated care ecosystem to understand and manage multimorbidity. ProACT is a large-scale Horizon 2020 funded project, that involved the design, development and evaluation of a digital health platform to improve and advance home-based integrated care, and supported self-management, for older adults (aged 65+) living with multimorbidity. OBJECTIVE This paper describes the trial implementation protocol of a proof of concept (PoC) digital health platform (ProACT) in two EU member states (Ireland and Belgium) to support older persons with multimorbidity self-managing at ho...
Issues in Mental Health Nursing, 2020
Irish Travellers are a small indigenous minority group with a distinctive lifestyle and culture w... more Irish Travellers are a small indigenous minority group with a distinctive lifestyle and culture which sets them apart from the general population. Travellers are vulnerable to significant mental distress which is exacerbated by the social disadvantage that they experience. A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in one health care region in Ireland to provide support for Travellers and increase their access to mental health services. The aim of this paper is to present the findings from an evaluation which explored Travellers access to the and reasons for accessing the TMHLN, the interventions provided and their experiences of and perceptions of the role of the TMHLN. A descriptive qualitative approach was used. Ten Travellers who used the service were interviewed. Following data analysis, three themes emerged: factors affecting Traveller mental health; accessing the TMHLN and the Travellers experiences and perceptions of the TMHLN. The participants were extremely positive about the TMHLN and valued the support provided. The findings highlight how the interpersonal skills associated with mental health nursing set against recovery orientated and culturally congruent practices are suitable approaches when working with Travellers.
Journal of Nursing Management, 2019
Aim: To develop a tool for the analysis of nursing, midwifery and health-related policy and profe... more Aim: To develop a tool for the analysis of nursing, midwifery and health-related policy and professional guidance documents. Background: Analysis tools can aid both policy evaluation and policy development. However, no framework for analysing the content of professional regulation and guidance documents among healthcare professionals currently exists. Method: This study used an action research, cooperative inquiry design. Data were generated from two integrative literature reviews and discussions held during the cooperative inquiry meetings. Results: A set of key themes to be considered in the development or evaluation of health policy or professional regulation and guidance documents were identified. These themes formed the basis of the six domains considered by the Health-related Policy Analysis Tool (HrPAT): Context, Process, Content, Stakeholder Consultation, Implementation, and Evaluation. Conclusion: Use of the HrPAT can assist in policy development, evaluation and implementation, as well as providing some retrospective analytical insights into existing health policies. Implication for Nursing Management: Professional regulation documents, guidelines and policy reports should be capable of being scrutinised for their content, quality, and developmental process. The HrPAT can assist relevant stakeholders in the development , analysis and evaluation of such documents, including local, servicelevel policies and guidelines.
Journal of Advanced Nursing, 2015
Aim. Analysis of a national database of enquiries to a professional body pertaining to the scope ... more Aim. Analysis of a national database of enquiries to a professional body pertaining to the scope of nursing and midwifery practice. Background. Against a backdrop of healthcare reform is a demand for flexibility in nursing and midwifery roles with unprecedented redefinition of role boundaries and/or expansion. Guidance from professional regulatory bodies is being sought around issues of concern that are arising in practice. Design. Qualitative thematic analysis. Method. The database of telephone enquiries (n = 9818) made by Registered Nurses and midwives to a national regulatory body (2001-2013) was subjected to a cleaning process and examined to detect those concerns that pertained to scope of practice. A total of 978 enquires were subjected to thematic analysis. Findings. Enquiries were concerned with three main areas: medication management, changing and evolving scope of practice and professional role boundaries. The context was service developments, staff shortages and uncertainty about role expansion and professional accountability. Other concerns related to expectations around responsibility and accountability for other support staff. Conclusion. Efforts by employers to maximize the skill mix of their staff and optimally deploy staff to meet service needs and/or address gaps in service represented the primary service context from which many enquiries arose. The greatest concern for nurses arises around medication management but innovation in healthcare delivery and the demands of service are also creating challenges for nurses and midwives. Maintaining and developing competence is a concern among nurses and midwives particularly in an environment of limited resources and where re-deployment is common.
Journal of Nursing Management, 2009
Aim This paper reports a review of the empirical literature on factors that contribute to medicat... more Aim This paper reports a review of the empirical literature on factors that contribute to medication errors. Background Medication errors are a significant cause of morbidity and mortality in hospitalized patients. This creates an imperative to reduce medication errors to deliver safe and ethical care to patients. Method The databases CINAHL, PubMed, Science Direct and Synergy were searched from 1988 to 2007 using the keywords medication errors, medication management, medication reconciliation, medication knowledge and mathematical skills, and reporting medication errors. Results Contributory factors to nursing medication errors are manifold, and include both individual and systems issues. These include medication reconciliation, the types of drug distribution system, the quality of prescriptions, and deviation from procedures including distractions during administration, excessive workloads, and nurseÕs knowledge of medications. Implications for nursing management It is imperative that managers implement strategies to reduce medication errors including the establishment of reporting mechanisms at international and national levels to include the evaluation and audit of practice at a local level. Systematic approaches to medication reconciliation can also reduce medication error significantly. Promoting consistency between health care professionals as to what constitutes medication error will contribute to increased accuracy and compliance in reporting of medication errors, thereby informing health care policies aimed at reducing the occurrence of medication errors. Acquisition and maintenance of mathematical competency for nurses in practice is an important issue in the prevention of medication error. The health care industry can benefit from learning from other high-risk industries such as aviation in the prevention and management of systems errors.
Journal of Nursing Management, 2006
The Community Client Need Classification System-a dependency system for community nurses Aim The ... more The Community Client Need Classification System-a dependency system for community nurses Aim The aim of this paper was to discuss the predictive validity and reliability of the Community Client Need Classification System (CCNCS), the results of using this tool and public health nursesÕ satisfaction with the system. Background Public health nurses provide the majority of community nursing services in Ireland. The traditional method of measuring workload in the community is based on recording the number of visits. The revised Easley-Storfjell instrument for Caseload/Workload Analysis was modified for the Irish context and permission from the authors was sought to use it in this study and was thus named the CCNCS. Methods A convenience sample of 29 public health nurses used the CCNCS to classify 1352 clients for 2 weeks. Results The elderly and child health groups accounted for the majority of the nursesÕ direct and indirect time. Predictive validity analysis demonstrated a positive relationship between needs level and nursing time. Nurses reported that the CCNCS was useful in predicting the needs of new and existing clients. Conclusions This classification system, albeit in the first draft of its revised form, was perceived by the chosen sample of public health nurses as useful in measuring their workload. Further research is required to ascertain the reliability of the modified classification system with a larger sample size.
Journal of Clinical Nursing, 2008
Aim. To refine, test and evaluate the Community Client Need Classification System (CCNCS).Backgr... more Aim. To refine, test and evaluate the Community Client Need Classification System (CCNCS).Background. Workload assessment in community nursing is complicated by the range of services that may be delivered in one patient interaction. The CCNCS is a workload measurement system designed to capture the direct and indirect elements of community nursing work and is suitable for use with all care groups in the community.Design. Survey.Method. Forty‐four community nurses implemented the CCNCS with all clients in their caseload for four weeks. Community nursing in the Irish Republic is known as public health nursing. The Public Health Nurses (PHNs) recorded the total time in minutes that was spent on each client each week. The satisfaction with and experiences of PHNs using the CCNCS during the study period was also recorded.Results. Participants endorsed the utility of the CCNCS for use in community nursing. Inter‐rater and intra‐rater reliability results were positive with high level ...
6.3.2 Evolving roles of nurses and midwives and negotiating role boundaries 6.3.3 Impacts on care... more 6.3.2 Evolving roles of nurses and midwives and negotiating role boundaries 6.3.3 Impacts on care delivery 6.4 Theme 2: Scope of practice, understanding and use 6.4.1 Understanding my scope of practice 6.4.2 Use of scope of practice Framework 6.4.3 Aspects of scope 6.5 Theme 3: Expanding scope of practice 6.5.1 Expanded scope 6.5.2 Barriers to expanded scope 6.5.3 Enablers of expanded scope 6.6 Theme 4: Professional competence 6.6.1 What is competence? 6.6.2 Gaining and maintaining competence 6.6.3 Competence and the practitioner 6.7 Theme 5: Practice setting and context 6.7.1 Legislation, policies, guidelines and regulation 6.7.2 Practice concerns 6.8 Theme 6: Reflections on the current Framework 6.8.1 General thoughts on the current Framework 6.8.2 Comments on individual sections of the Framework 6.9 Summary of findings 6.10 Case examples of expanded practice 6.10.1 Case example of midwifery practice 6.10.2 Case example of advanced practice: Reflective tool 7 DISCUSSION 7.1 Introduction 7.2 Self-reported scope of practice 7.3 Expanding practice: Enablers and barriers 7.4 Scope of practice and role boundaries 7.5 Perspectives on the Framework 7.6 Strengths and limitations of the study design 8 CONCLUSIONS AND RECOMMENDATIONS
International Journal of Integrated Care, 2017
Quality of Life Research, 2021
Purpose This study aims to explore the prevalence of CRC survivorship issues and their impact on ... more Purpose This study aims to explore the prevalence of CRC survivorship issues and their impact on survivors’ quality of life (QoL). Methods This study utilised a mixed methods sequential explanatory design. Adult CRC survivors between 6- and 60-months post-diagnosis (n = 304) were purposively recruited from three hospitals and twenty-one cancer support centres in Ireland. QoL was evaluated using the EuroQol and FACT-C questionnaires and results compared to population norms. 22 survey participants took part in semi-structured interviews exploring the impact of survivorship issues on their daily lives. Results While CRC survivors reported QoL outcomes comparable to or better than normative populations, 54% were dissatisfied with their QoL. The most common survivorship issues reported included negative body image (74%), fatigue (68%), sexual dysfunction (66%) and sleep disturbance (59%). Thematic analysis of the qualitative data illustrated survivors’ attempts to live with the impact of...
International Journal of Integrated Care, 2017
Uploads
Papers by Anne-Marie Brady