Evidence map›Paper›PMID 41422521›Full record

ArticleNursing open2025

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

Fania Pagnamenta, Tim Rapley, Monique Lhussier

Abstract read
In one paragraph

Article in Nursing open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Fania PagnamentaThe Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0002-5831-5799
Tim RapleyNorthumbria University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0003-4836-4279
Monique LhussierNorthumbria University, Newcastle upon Tyne, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo understand Lead Tissue Viability Nurses' agency, autonomy and authority to perform their role.

backgroundLead Tissue Viability Nurses need both clinical autonomy and organisational authority to improve wound care, patient safety, and cost-effectiveness. Their role goes beyond bedside care to include strategic decisions shaping policy, resources, and quality initiatives. Despite this, the role is often misunderstood and under-recognised. This study, based on the four pillars of advanced nursing practice-clinical practice, education, research, and leadership-examines the challenges they face.

designA qualitative study.

methodsInterviews with six Lead Tissue Viability Nurses working in large tertiary care organisations. A thematic analysis was undertaken.

resultsThe results aligned with the four pillars of advanced nursing practice. Six sub-themes emerged, reflecting the skills, knowledge, and influences involved, and critically, the challenges faced in meeting role expectations: Clinical Practice-working with clinical specialties (a); Education-supporting generalist nurses (b); Leadership-collaborating with dressing companies (c) and national bodies (d); Research-partnering with clinicians (e) to implement national guidance (f).

conclusionOur study highlights the restricted agency that constrains their capacity to meet the complex demands of the role. Their specialised knowledge frequently remains unacknowledged and underutilised, while their contributions are often marginalised within organisational discourse. To attain the level of recognition commensurate with this senior nursing position, their distinct professional and organisational identity should be clearly articulated. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Lead Tissue Viability Nurses should be acknowledged for their advanced practice role, reflecting the specialist expertise and leadership they bring to patient care. Additionally, they must be granted the agency, autonomy and authority necessary to implement best practice. IMPACT: Ensuring that Lead Tissue Viability Nurses can execute their duties effectively and achieve high-quality outcomes will directly influence patient care. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution at this stage, as this study was about exploring the nurses' organisational role from their perspective.

Indexed as

NursesNurse's RoleProfessional AutonomyTissue SurvivalAdultFemaleHumansInterviews as TopicLeadershipMaleMiddle AgedQualitative ResearchauthorityautonomyLead Tissue Viability Nursesnursepowerprofessional identity

Identifiers

PMID41422521
PMCPMC12718612

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.