Advanced geriatric nurses should collaborate with their managers to create a role that takes advantage of their knowledge and skills, as well as collaborate with colleagues to enhance understanding of utilisation of their role.

Background: Older adults constitute an important population group receiving primary care services. Registered nurses (RNs) need comprehensive knowledge and skills to adequately address the complex needs of frail older adults. Despite the need for RNs with advanced qualifications, integrating the new advanced roles for RNs into interdisciplinary teams has proved to be challenging. Previous research on the integration of new advanced roles for RNs indicates that the degree to which they are integrated into their workplaces affects how they use their knowledge and skills. Integration is therefore seen as important in this study, which focuses on the introduction of advanced geriatric nurses (AGNs) into the Norwegian healthcare system. Aims:The overall aim of this study was to investigate the role of AGNs, what AGNs and their collaborators see as an appropriate scope of practice for these nurses and how AGNs are being integrated into the Norwegian healthcare system. The aim was investigated through three sub-studies that: I) describe AGNs' experiences in their new role, II) investigate the level of agreement among AGNs, their colleagues and their leaders regarding which activities related to different functions are seen as appropriate for AGNs and III) investigate the degree to which AGNs are integrated into their workplaces. Methods:The study employed an exploratory sequential mixed methods design. In 2016, each AGN in the total sample of AGNs in Norway (N = 21) was interviewed about her/his role. In 2017, 23 AGNs and 195 of their colleagues (including leaders) answered a questionnaire focusing on the integration of AGNs and their scope of practice. The interview data were analysed by content analysis (Sub-study I). A series of cross-tabulations were conducted to identify the respondents' reporting of the appropriateness of different activities (Sub-study II). The survey data pertaining to the integration of the AGNs were analysed through cross-tabulations, Pearson's chi-squared test, Fisher's exact test and the Kruskal-Wallis test (Sub-study III). Results:The AGNs explained that they had developed a complex and extensive role and that they had developed a new 'gaze' based on a combination of their new knowledge and skills with their experience and interests. This new gaze provided them with the ability to see a wider range of medical, social and environmental problems in the older adults' situations compared to before they started the educational programme. The AGNs related that How to cite this article:

The World Health Organisation estimates that the proportion of people over the age of 60 in the world will almost double from the current 12%-22% by 2050. 1,2 Due to costs and patient preferences, over the past decade many countries have seen a shift away from hospitals and institutionalised care (e.g., nursing homes) for older adults to in-home comprehensive health and care services for older adults (e.g., home health care services [HHCS]). This has resulted in increased workloads for HHCS, 1-3 as care-dependent older adults

Objective Globally, the number of digital health solutions is increasing, but they are not always designed with access and utilisation for people with impairments in mind. Development efforts have often not included the voice and requirements of people with impairments, who make up 15% of the world’s population, despite the fact that this can help ensure broad access and utilisation. Little attention to and limited inclusion of people with impairments in the development of digital health solutions results in continued and reinforced inequalities in health services provision for people with impairments. This review investigates the needs and barriers of people with impairments related to use of digital health solutions and strategies to foster user participation, access and utilisation of digital health solutions. Methods This scoping review, based on the Joanna Briggs Institute Manual, had five phases: 1) identification of aim and research questions, 2) literature search in five databases (April/May 2020), 3) literature screening based on predetermined inclusion and exclusion criteria, 4) data extraction, and (5) reporting results. Results The literature search resulted in 5968 sources, of which 25 met our inclusion criteria. People with impairments appreciate digital health solutions that are designed to meet their specific impairment-related challenges. The reported needs and barriers related to technological design varied depending on the individuals’ challenges. The literature reported different types of participatory co-design strategies to foster access and utilisation of digital health solutions. Conclusion This scoping review support needs for increased awareness among developers to design solutions that meet people’s needs, contexts and states of health. By applying universal design as a strategy and including people with different types of impairments, starting in the idea creation phase of digital health solutions and throughout the development, developers can design solutions with better accessibility. Digital health solutions that are accessible and usable have a tremendous opportunity to foster health equity and achieve health promotion, prevention and self-care. This in turn can contribute to closing the gap between different population groups, reduce disparities and get the most from available healthcare services.

Background Globally, new nurse practitioner roles have been introduced into interdisciplinary teams. Research indicates that agreement among the different healthcare providers regarding one another’s role and scope of practice is important for establishing interdisciplinary teamwork. Lack of agreement regarding a new nurse practitioner’s scope of practice may hinder collaboration. Aim To investigate the level of agreement among advanced geriatric nurses (AGNs), their colleagues and their leaders regarding which activities related to direct and indirect care, teaching/supervision, coordination and research and development work are perceived as appropriate for AGNs. Design A cross‐sectional descriptive survey. Methods The total population of AGNs in Norway (n = 26) and a sample of their colleagues, including leaders (n = 465), were invited to answer an online questionnaire. Twenty‐three (88.5%) AGNs and 195 (42%) colleagues answered the questionnaires. A series of cross‐tabulations were conducted to identify the respondents reporting on the appropriateness of different activities. Results The respondents identified all of the activities related to coordination, teaching/supervision and research and development work as appropriate for AGNs. Although the respondents considered several of the direct and indirect care activities as appropriate, there were conflicting views on the activities that traditionally fall within the medical field vs. those that traditionally fall within the nursing field. The AGNs saw most of the nursing and medical activities as appropriate, but their colleagues and leaders saw only some of the nursing activities as appropriate. The results also showed that there was high disagreement among the leaders regarding appropriate activities. Conclusion The results indicate that healthcare providers agree on which activities related to teaching/supervision, coordination, and research and development work are appropriate to include in AGNs’ scope of practice, but that there are conflicting views regarding activities related to direct and indirect care.

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Bakgrunn: Innleggelse av perifert venekateter (PVK) er den vanligste kliniske invasive prosedyren sykepleiere rutinemessig utfører i sykehus. Åtti prosent av alle pasienter på sykehus har behov for et PVK. Likevel mislykkes sykepleiere med prosedyren i et av tre tilfeller, saerlig når pasienter har vanskelig venevei. Dermed utsettes pasienten for komplikasjoner som smertefulle stikk, hematom og arterie-og nerveskade samt forsinkelse i medisinsk behandling. Sykepleieres kunnskap om PVK-prosedyren er ikke godt nok undersøkt.Hensikt: Å beskrive sykepleieres erfaringer og utfordringer ved PVKinnleggelse. Denne studien vil bidra til å bedre sykepleieres kompetanse, styrke pasientsikkerheten og pasientenes opplevelse i forbindelse med PVKprosedyren.