====== Physician–nurse task shifting ======

A [[coaching]] program is an effective method of improving nurse-physician relationships, leading to enhanced workplace performance
((Yusuf FR, Kumar A, Goodson-Celerin W, Lund T, Davis J, Kutash M, Paidas CN. Impact of Coaching on the Nurse-Physician Dynamic. AACN Adv Crit Care. 2018 Fall;29(3):259-267. doi: 10.4037/aacnacc2018624. PMID: 30185492.)).
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Physicians, nurses and hospital administrators should highlight the physician-nurse collaboration in feeding critically ill patients and reinforce the cooperation based on potential influencing factors. Further research is required to establish feasible cooperative protocol and evaluate the effectiveness of the approach
((Mei B, Wang W, Shen M, Cui F, Wen Z, Ding J. The physician-nurse collaboration in feeding critically ill patients: A multicenter survey. Appl Nurs Res. 2017 Aug;36:63-67. doi: 10.1016/j.apnr.2017.05.007. Epub 2017 May 28. PMID: 28720241.)).
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[[Management]] of [[Critical care]] patients is changing due to a rise in population [[age]], [[comorbidity]] and complexity. To accommodate these changes, the demand is increasing for advanced practice [[nurse]]s. More knowledge is needed regarding the role of advanced practice critical care nurses in [[Europe]] countries. The aim of the study was a  literature review describing skills and competencies required for advanced practice critical care nursing in Europe and to investigate related [[policy]].

Egerod et al. performed a scoping [[review]] including [[paper]]s published in 1992-2019 targeting policy and the intersection of advanced practice nursing (level of practice), critical care nursing (specialty area), and Europe (geographical origin).

Design and data sources: Main sources of evidence were [[PubMed]], [[EMBASE]], [[PsycINFO]], [[CINAHL]], [[Cochrane]] Library, SweMed+, [[Scopus]], ERIC and Social Sciences Citation Index. They also searched [[grey literature]], webpages, reference lists and performed hand-search.

Results: The search identified 11,478 papers/references of which 42 were included. Four levels of practice were identified with unclear boundaries: professional nurse, specialized nurse, advanced practice nurse and advanced critical care practitioner (nurse or other). Most skills and competencies described in the literature were generic to advanced practice and only a few were area-specific to critical care. Advanced practice critical care nurses were often unable to fulfill their role because education, supportive policy, and legislation were lacking.

This scoping review informs the policymakers and the INACTIC study of existing advanced practice in critical care nursing in [[Europe]]. The advanced role in critical care nursing is characterized by [[inconsistency]] regarding policy, [[education]], [[title]]s, [[role]]s, scope of practice, [[skill]]s and competencies. Levels of practice and areas of [[specialization]] need to be clarified. Most skills and competencies identified were generic for advanced practice nursing and many were generic for any profession. [[Physician–nurse task shifting]] needs to be more clearly defined and patient outcomes described. Given the scarcity of [[paper]]s in this target area, they believe it might be too early to conduct a systematic review at this time
((Egerod I, Kaldan G, Nordentoft S, Larsen A, Herling SF, Thomsen T, Endacott R; INACTIC-group. Skills, competencies, and policies for advanced practice critical care nursing in Europe: A scoping review. Nurse Educ Pract. 2021 Jul 5;54:103142. doi: 10.1016/j.nepr.2021.103142. Epub ahead of print. PMID: 34265667.)).