Exploring Agency, Autonomy and Authority Among Lead Tissue Viability Nurses: A Qualitative Study

Area of Science:

• Nursing Practice
• Healthcare Management
• Advanced Practice Roles

Background:

• Lead Tissue Viability Nurses (LTVNs) are crucial for advancing wound care, patient safety, and cost-effectiveness.
• Their role extends beyond clinical practice to strategic decision-making in policy and quality initiatives.
• The LTVN role is often misunderstood and under-recognized, despite its impact.

Purpose of the Study:

• To investigate the agency, autonomy, and authority of Lead Tissue Viability Nurses.
• To understand the challenges faced by LTVNs in fulfilling their advanced practice roles.
• To examine the LTVN role through the lens of the four pillars of advanced nursing practice.

Main Methods:

• A qualitative study design was employed.
• Semi-structured interviews were conducted with six Lead Tissue Viability Nurses.
• Thematic analysis was used to interpret the interview data.

Main Results:

• Findings aligned with the four pillars of advanced nursing practice: clinical practice, education, research, and leadership.
• Six sub-themes emerged, detailing skills, knowledge, influences, and challenges.
• Key challenges included collaboration with specialties, supporting generalists, engaging with industry, and implementing national guidance.

Conclusions:

• Lead Tissue Viability Nurses experience restricted agency, limiting their ability to meet role demands.
• Their specialized knowledge is frequently unacknowledged and underutilized.
• Clear articulation of their professional and organizational identity is necessary for appropriate recognition and to enable effective practice.