IAANMP: Showcasing excellence and highlighting IAANMP members’ research and innovation – recent publications

We are delighted to showcase the outstanding work, research, innovation, and leadership undertaken by members of the Irish Association of Advanced Nurse and Midwife Practitioners across Ireland. These contributions reflect the breadth, depth, and diversity of advanced practice, demonstrating excellence in clinical care, research, education, service development, and healthcare innovation.

Collectively, they highlight the significant and evolving role that ANPs and AMPs play in shaping and transforming healthcare delivery nationwide.

The projects and publications presented demonstrate the contribution of advanced practice to patient care, service delivery, and healthcare development. They also illustrate the ongoing commitment of ANPs and AMPs to evidence-informed practice, professional development, and the evaluation and improvement of healthcare services.

This platform offers an opportunity to showcase the real impact of advanced practice on healthcare delivery and to inspire continued innovation, scholarship, and excellence in every area of advanced nursing and midwifery.

Evaluating subcutaneous furosemide in an acute community collaborative, nurse-led heart failure service: A real-world pilot study

Author: Norma Caples, ANP Heart Failure, University Hospital Waterford.

Reference: Caples N. Evaluating subcutaneous furosemide in an acute community collaborative, nurse-led heart failure service: A real-world pilot study. British Journal of Cardiac Nursing. 2026;21(5):1-7. doi.org/10.12968/bjca.2025.0057.

Background: Subcutaneous furosemide offers an alternative to intravenous (IV) therapy for decompensated heart failure, but evidence for the standard formulation in integrated care models is limited.

Aim: Evaluate the feasibility, safety, tolerability, and clinical outcomes of standard subcutaneous furosemide within a nurse-led, acute-community, heart failure service.

Methods: Eleven patients received nurse-prescribed subcutaneous furosemide with daily community monitoring and heart failure nurse oversight. Weight, NT-proBNP, renal function, and hospital admission were analysed.

Results: NT-proBNP decreased by 43.6 per cent (median 2734 to 1542pg/ml; P=0.083). New York Heart Association class improved (median 3 to 2; P=0.003) and weight decreased (81.0 to 77.0 kg; P=0.012). Electrolytes remained stable, renal function improved in eight patients, and no infusion-site reactions occurred. Hospital admission was avoided in 10/11 patients (90.9%).

Conclusions: Standard subcutaneous furosemide was feasible, safe, and well tolerated within a nurse-led integrated pathway, supporting community-based diuresis as an alternative consideration to IV therapy.

The Irish COPD paradox and the promise of virtual care

Authors: Emma Lynn Burke;^1,2 Clare Connolly;² Niki Byrne;² Karolina Glomba;¹ Ian McCabe;³ David Tiernan;³ Sheila Gleeson;³ Hemendra Worlikar;³ Derek O’Keeffe;³ and Sinead Walsh.² 1: Respiratory Department, Galway University Hospital, Galway. 2: Respiratory Integrated Care, Galway City Hub, HSE West Northwest, Galway. 3: HIVE Lab, University of Galway, Galway.

Reference: Burke EL, Connolly C, Byrne N, et al. The Irish COPD paradox and the promise of virtual care. Front Digit Health. 2026;8:1838140. doi:10.3389/fdgth.2026.1838140.

Introduction: Ireland has the highest chronic obstructive pulmonary disease (COPD) hospitalisation rate in the Organisation for Economic Co-operation and Development (OECD) – 315 per 100,000 vs an average of 190 – yet possesses the infrastructure and reform ambition – through Sláintecare – to deliver care differently. Virtual care pathways underpinned by remote patient monitoring offer one route out of this costly, hospital-centric cycle, but the question is not simply whether they work. It is how, for whom, and at what cost to equity.

Methods: We conducted a 20-month prospective mixed-methods feasibility study at Galway University Hospital, enrolling 85 adults with high-risk COPD (GOLD Group B/E) into a nurse-led, protocol-driven, virtual care pathway using tablet-based remote monitoring with 5G connectivity. Clinical outcomes were evaluated against historical baselines; patient experience was explored through focus groups and serial surveys, with findings interpreted through a critical realist lens and the NASSS (non-adoption, abandonment, scale-up, spread, and sustainability) framework.

Results: Of 152 exacerbation episodes managed on the platform, 148 (97.3%) were completed without hospital admission. Mean length of stay was 5.15 days – a 51.5 per cent reduction against the regional baseline of 11.8 days (p < 0.001) – translating to an estimated €949,000 in gross hospital cost avoidance. Borg dyspnoea and CAT (COPD assessment test) scores improved significantly beyond minimal clinically important differences. However, the qualitative data complicates this picture.

Discussion: Patients embraced the platform largely because hospital terrified them, not because the technology delighted them. The ‘digital safety net’ generated its own anxieties around device failure and clinical abandonment, and families – particularly daughters and grandchildren – absorbed a hidden burden of technical troubleshooting that the model depends on but does not account for. Most critically, every participant owned a smartphone.

In a country where 37 per cent of over-65s are digitally excluded, and where COPD prevalence is itself socially patterned, the absence of digitally excluded patients from our sample is not a limitation to footnote; it is the finding. Without deliberate design of hybrid digital-analogue pathways, Ireland risks cementing an inverse digital care law in which the most effective care reaches those who need it least.

Clinical scope and workforce contribution of ANPs in general practice: A cross-sectional study

Authors: Keye C, McCann P, Loftus Moran O, Hammond M, Deehan J, Nolan Ryan L, Lynch K, Kelly C. On behalf of the General Practice Advanced Nurse Practitioners Ireland Group.

Reference: Keye C, McCann P, Loftus Moran O, et al. Clinical scope and workforce contribution of advanced nurse practitioners in general practice: a cross-sectional study. Journal of Research in Nursing. 2026;0(0). doi:10.1177/17449871261452880.

Aim: To examine the clinical activity and workforce contribution of Advanced Nurse Practitioners (ANPs) working in general practice.

Background: Primary care systems internationally are experiencing increasing demand due to ageing populations, rising multimorbidity, and workforce shortages. Advanced nursing practice has expanded globally as a strategy to strengthen service capacity, improve access, and maintain quality outcomes. Although there is substantial evidence regarding patient outcomes associated with advanced practice roles, there is comparatively limited empirical data describing the day-to-day clinical activity of ANPs in primary care settings.

Methods: This national cross-sectional descriptive study, conducted in Ireland and reported in accordance with the STROBE Statement, involved a one-week activity capture of general practice ANPs (GP ANPs) and candidate ANPs (cANPs) working across general practice settings. Data collected included consultation type, prescribing activity, complexity of care, and clinical outcomes. Data were analysed using descriptive statistics.

Results: Twenty GP ANPs/cANPs recorded 1,659 consultations, including 757 full episodes of care (45.6%). Practice spanned acute illness (adults and children), chronic disease management, women’s health, and preventive services. Medication optimisation activity included 503 medication reviews, 251 prescriptions issued, and 59 medications deprescribed. About 15 per cent of consultations were classified as complex and 14.8 per cent involved multiple presenting complaints. Most consultations were independently managed.

Conclusion: GP ANPs demonstrate broad clinical capability and contribute substantially to general practice capacity. The findings highlight the value of a holistic nursing approach, which is well suited to chronic disease management, health promotion, patient education, and the management of multimorbidity, supporting access to care and strengthening primary care workforce capacity.

Making nursing visible in general practice: Responsible action research as an approach to developing nurse-sensitive metrics

Authors: Orla Loftus Moran, Mary Casey, School of Nursing, Midwifery and Health Systems, University College Dublin.

Reference: Loftus Moran O, Casey M. Making nursing visible in general practice: Responsible action research as an approach to developing nurse-sensitive metrics. Nurs Inq. 2026;33(3):e70130. doi:10.1111/nin.70130.

Abstract: This critical discussion paper argues that the development of nurse-sensitive metrics in general practice is not simply a technical task of selecting indicators, but an ethical and methodological process through which nursing contribution becomes known, named, and represented. Although health systems increasingly prioritise measurement, accountability and performance data, important dimensions of nursing practice remain poorly captured, particularly in community and primary care contexts. In general practice, nursing care is characterised by generalist, relational, preventive, and cumulative forms of care, making the direct transfer of metrics developed outside this context problematic.

General practice nurses represent a substantial workforce, yet their contribution remains only partially visible within existing healthcare data systems. This paper advances a Responsible Action Research approach to developing nurse-sensitive metrics grounded in everyday practice. Drawing on Action Research, implemented through Appreciative Inquiry and informed by the Quality Action Research Checklist, the paper considers how collaborative inquiry can support general practice nurses to articulate dimensions of nursing quality that may otherwise remain tacit.

Inclusion of perspectives from general practitioners, patients, and practice administrators further situates this inquiry within the broader ecology of care. The paper argues that responsible metric development requires attention not only to what is eventually measured, but to the transparency, reflexivity, and accountability of the process through which potential indicators are generated. By reframing metric development as a practice-engaged process of knowledge generation, it offers a methodological contribution to debates on how nursing work can be made visible without reducing its complexity.

Mapping menopause education for healthcare professionals: A scoping review

Authors: Catriona Keye, Margaret Murphy, Mohamad Saab, Michelle O’Driscoll.

Reference: Keye C, Murphy M, Saab MM, O’Driscoll M. Mapping menopause education for healthcare professionals: A scoping review. Climacteric. 1-9. doi:10.1080/13697137.2026.2676683. Published online: 22 Jun 2026.

Abstract: Menopause is a natural life stage with substantial impacts on women’s quality of life and long-term health. Education on menopause for healthcare professionals (HCPs) remains limited and inconsistently embedded across health disciplines. This scoping review mapped current evidence on menopause education, including available programmes, delivery approaches, and extent of curricular integration.

Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a search of six databases and grey literature (last searched May 2025) identified original research evaluating menopause-specific education for undergraduate and postgraduate HCPs. Data were synthesised using deductive and inductive analyses. Of 5034 records identified, 14 studies met the inclusion criteria: Nine evaluated educational interventions and five examined curricular provision. Most studies originated from the USA and focused on medical residents. Education formats varied widely, including structured curricula, case-based learning, online modules, telemedicine encounters, and peer-supported platforms.

Core content commonly addressed menopause physiology, symptom management, and hormone therapy, while long-term health implications and equity-focused content were infrequently included. Interventions consistently improved knowledge, confidence, and preparedness for menopause care. Despite widespread recognition of its importance, menopause education remains inadequately integrated across healthcare training. Standardised, multidisciplinary and equity-focused menopause education frameworks are urgently required to strengthen clinical competence and improve care for midlife women.