ブックタイトルThe Journal of Humanitarian Studies

概要

The Journal of Humanitarian Studies

Journal of Humanitarian Studies Vol. 4, 2015Advanced practices for future challengesIn order to meet the healthcare challenges of the 21st century there is a great need for more nursingprofessionals, including so-called“advanced practice nurses”who have developed superior skills indifferent fields. These skilled nurses usually fall into one of two categories:? Specialist clinical nurses are trained to advise care teams facing complex situations and to ensurethe process of transferring research knowledge into clinical practice is effective. They put togetherpractical guidelines and are agents of change within the constant process of improving the qualityof care. In certain instances, they may be required to be part of teams caring for specific types ofpatients and to take on roles in the systematic- monitoring of patients with chronic or debilitatingailments in such specialised fields as diabetes, cardiovascular disease or neurodegenerativedisorders.? Nurse practitioners are trained in the both the nursing and medical fields so that they can provide awide range of services when attending to previously diagnosed patients. They can carry out certainmedical procedures and prescribe drugs and diagnostic tests. In some cases, they can becomefront-line actors. They can carry out advisory consultations and manage any situations that theyfeel competent dealing with alone; if not, they may refer the patient to a physician. They do this bymarrying their nursing skills to those additional skills learnt during their medical training.Advanced practice seems to have captured interest in numerous countries and may well prove to be a solutionto the shortage of physicians. At La Source, we see this particular solution?replacing one professionalgroup with another?as too simplistic. Nurse practitioners are precious and can offer a broadly systemicrange of care. Through the participation in groups or networks of different professionals, they can ensurehigh safety and quality, and they can refer their patients to a physician or another professional dependingon the problems encountered. It is out of the question to think that all front-line medicine could simplybe carried out by nurses, thus alleviating the shortage of physicians. This is simply not reasonable, and itis not what nurses want. However, the quality of work performed by teams including one or more nursestrained in advanced practice has proven to be excellent. It allows physicians more time to concentrate onthe unstable, difficult clinical situations for which they can provide the best monitoringAt La Source, we believe that the medical practices of the future could well evolve towards being interprofessionalhealth centres. Patients could see a physician when necessary (for a diagnosis, instabilityor complications), but would be referred to other competent professionals (e.g. nurses, dieticians orpsychologists) as their ailment or needs change. Furthermore, a patient’s care path might be coordinated bya nursing case manager whose role would be to liaise both inside the health centre and outside it (e.g. witha hospital, specialist physician or home care). Thus, health centres like this would be capable of ensuringa broader range of care to a broader range of patients, more than today’s classic medical practice model.Nursing research and Evidence-Based NursingOne of the major benefits of moving to a system ofuniversity nursing education is the opportunity it createsfor both nursing and interdisciplinary research. At LaSource, nursing research is, above all, clinical research;it aims to provide concrete solutions to questions andproblems encountered by carers carrying out their dayto-dayjobs. However, translating the knowledge derivedfrom research into real practice is a complex process. TheJohanna Briggs Institute, which is associated with LaSource, has described the several phases of this procedure.These go from research or a systematic literature review, La Source’s Library cLa Source人道研究ジャーナルVol. 4, 201539