Science.gov

Sample records for advanced nurse practitioners

  1. Evaluating the Outcomes of Advanced Neonatal Nurse Practitioner Programmes.

    ERIC Educational Resources Information Center

    Redshaw, Margaret; Hart, Bev; Harvey, Merryl; Harris, Anne

    The outcomes of advanced neonatal nurse practitioner (ANNP) programs in the United Kingdom were examined. The different programs of education currently available for nurses wishing to become ANNPs were compared, and the outcomes of ANNP programs, as demonstrated in the levels of performance of practitioners undertaking different programs, were…

  2. Experiences of the advanced nurse practitioner role in acute care.

    PubMed

    Cowley, Alison; Cooper, Joanne; Goldberg, Sarah

    2016-05-01

    The aim of the service evaluation presented in this article was to explore the multidisciplinary team's (MDT) experiences and perception of the advanced nurse practitioner (ANP) role on an acute health care of the older person ward. A qualitative case study was carried out comprising semi-structured interviews with members of the MDT, exploring their experiences of the ANP role. An overarching theme of 'Is it a nurse? Is it a doctor? No, it's an ANP' emerged from the data, with three subthemes: the missing link; facilitating and leading holistic care; and safe, high quality care. The ANP role is valued by the MDT working with them and provides a unique skill set that has the potential to enhance care of older patients living with frailty. While there are challenges to its introduction, it is a role worth introducing to older people's wards. PMID:27125941

  3. Emergency nurse practitioners' perceptions of their role and scope of practice: is it advanced practice?

    PubMed

    McConnell, Donna; Slevin, Oliver D; McIlfatrick, Sonja J

    2013-04-01

    There are multiple interpretations of the nurse practitioner role which appear to be shaped by discourses within and outside the profession and its regulatory body. This study aimed to explore and clarify the role and scope of practice of emergency nurse practitioners in a region in the United Kingdom and determine if they fulfil the proposed criteria for Advanced Nurse Practitioners. A survey approach using questionnaires (n=42) was adopted. The sample included all emergency nurse practitioners working in Accident and Emergency Departments and Minor Injury Units in the region. Statistical data was analysed using SPSS for Windows and qualitative data was content analysed for themes. Results revealed a variation in education. Investigation of role typology and scope of practice revealed a relatively homogenous group where the clinical aspect of the role dominated. The scope of practice was perceived to be influenced by internal factors such as competence; however protocol use, referral rights and prescribing authority could be considered ways that nursing management and medical staff indirectly control the role. Findings suggested that emergency nurse practitioners were working at a level significantly beyond registration, yet do not fulfil the Nursing and Midwifery Council proposed criteria for Advanced Nurse Practitioner. PMID:23615513

  4. Nursing: What's a Nurse Practitioner?

    MedlinePlus

    ... nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification in their ... Nurse Practitioners (NAPNAP) and through local hospitals or nursing schools. In addition, many doctors share office space ...

  5. Nurse Practitioner Pharmacology Education.

    ERIC Educational Resources Information Center

    Waigandt, Alex; Chang, Jane

    A study compared the pharmacology training of nurse practitioner programs with medical and dental programs. Seventy-three schools in 14 states (40 nurse practitioner programs, 19 schools of medicine, and 14 schools of dentistry) were surveyed by mailed questionnaire about the number of hours devoted to the study of pharmacology. The major findings…

  6. The School Nurse Practitioner

    ERIC Educational Resources Information Center

    Igoe, Judith Bellaire

    1975-01-01

    Denver's four-month intensive course in primary health care for experienced nurses serving in disadvantaged areas, followed by inservice training with regular consultation available from a local physician, has produced school nurse practitioners who extend the traditional role to include comprehensive evaluations, management of minor illnesses,…

  7. Advanced nurse practitioner-led referral for specialist care and rehabilitation.

    PubMed

    Mashlan, Wendy; Hayes, Julie; Thomas, Ceri

    2016-02-01

    In response to the need for appropriate and timely care of frail older patients admitted to hospital, a dedicated advanced nurse practitioner (ANP)-led referral service was developed. The service has continued to evolve over the 13 years since its implementation in accordance with changing service demands. This article describes the role of the ANP in care of the elderly/rehabilitation medicine and focuses on one area of clinical practice developed by the team: an ANP-led referral service. The aim of developing the service was to ensure that patients who required specialist care and rehabilitation could be identified and assessed as soon as possible after admission, with the premise that they could be transferred to a bed in care of the elderly medical wards. This was perceived by the ANPs to be advantageous for patients, who would receive care from a specialist team, and for care of the elderly staff who could use their knowledge and skills appropriately and safely. PMID:26938608

  8. Professionalism in Nursing Behaviors of Nurse Practitioners.

    ERIC Educational Resources Information Center

    Adams, Donna; Miller, Barbara K.

    2001-01-01

    A survey of 502 nurse practitioners found that more than half had written research proposals or participated in research projects recently; nearly 50% wrote their own job descriptions; 93% belonged to the American Academy of Nurse Practitioners; and maintaining certification was the motivation for some professional behaviors. (Contains 29…

  9. Preparation for Advanced Nursing Practice.

    ERIC Educational Resources Information Center

    Frik, Seigina M.; Pollock, Susan E.

    1993-01-01

    Lehman College's graduate nursing program uses theory-based courses to prepare advanced nurse practitioners. Students increase scholarly inquiry skills and clinical decision making; use of nursing conceptual models helped them plan and evaluate their practice. (SK)

  10. The High School Nurse Practitioner

    ERIC Educational Resources Information Center

    Nader, Philip R.; And Others

    1978-01-01

    Expanding the role of the high school nurse through pediatric nurse practitioner training, the addition of a full-time health aide, and the use of clinic management holds promise as one method of improving total health care for adolescents. (MJB)

  11. Top 10 reasons to become a trauma nurse practitioner.

    PubMed

    Galicyznski, Susan F

    2006-01-01

    Nurse practitioners have played a pivotal role in both advances in patient care and healthcare policy over the last 40 years. As the healthcare environment continues to change, so too does the role of the nurse practitioner. Nurse practitioners are becoming the norm instead of the exception in the critical care setting and, more recently, have been welcomed as valuable members to trauma teams around the country. As the role continues to evolve and grow, the growing pains will multiply. This article will discuss one nurse's experience of being the new nurse practitioner in a new role and the challenges, both positive and negative, that have grown out of that experience. PMID:17052090

  12. Resocialization: A Model for Nurse Practitioner Preparation

    ERIC Educational Resources Information Center

    Malkemes, Lois C.

    1973-01-01

    Conventional education programs socialize the nurse for one way of functioning, but, for effective practitioner performance, the nurse must develop a different concept of her nursing identity. Increased knowledge and skills will not alone make the nurse a practitioner; there must be a role change. (Author)

  13. Advanced Nurse Practitioner Educational Needs for Safe and Efficient Radiological Imaging.

    PubMed

    Logsdon, Roberta; Gleason, Robyn

    2015-01-01

    This study evaluated perceived knowledge and educational preparedness of advanced practice nurses (APNs) in the area of radiological imaging, including awareness and utilization of the American College of Radiology Appropriateness Criteria (ACR-AC). Previous studies have found a need for further education in radiological imaging for medical students, residents, and hospitalists; however, little to no research has been done to assess such knowledge and educational preparedness among APNs. An e-mail link to a researcher-developed questionnaire was sent to Florida licensed APNs. Statistical analysis used descriptive, parametric, and nonparametric methods including frequencies, percentages, and Mann-Whitney U statistics. Florida licensed APNs (n = 905) from 175 educational programs and 10 specialty areas responded to the questionnaire; 75.9% (n = 681) had never heard of the ACR-AC. Years of experience and training in acute care specialties increased perceived competency in ordering radiological tests. Results among APNs were similar to those reported from physician studies, and 92.3% of respondents (n = 829) stated that additional APN imaging education would be beneficial. These findings highlight the importance of incorporating more radiological imaging information into APN education, which could lead to a reduction in overall costs and improvement in perceived competence and knowledge of appropriate imaging utilization. PMID:26218489

  14. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... are furnished by a registered professional nurse who meets a State's advanced educational and clinical... registered professional nurse who meets the requirements specified in either paragraphs (b)(1) or (b)(2) of... practitioner must— (i) Be currently licensed to practice in the State as a registered professional nurse;...

  15. Cost-Effective School Nurse Practitioner Services.

    ERIC Educational Resources Information Center

    Sobolewski, Susan D.

    1981-01-01

    A broader utilization of school nurse practitioners by school districts represents a cost-effective approach in meeting educational goals. School nurse practitioners provide extended nursing services to high risk children, assist in coordinating health services between the school and the child's parents, participate in classroom presentations on…

  16. The Psychiatric Family Nurse Practitioner: A Collaborator in Family Practice

    PubMed Central

    Cunningham, Patricia D.

    1999-01-01

    The potential of the psychiatric family nurse practitioner (Psych.F.N.P.) to contribute to family practice through physical care and mental health care exists in the here and now. This role is a synthesis of 2 advanced practice roles, the psychiatric clinical nurse specialist (Psych.C.N.S.) and family nurse practitioner (F.N.P.), both of which continue to have great utility independently. This synthesis is a practical application of concepts that have evolved to meet the changing patterns of health care delivery. At this time, dual certification as a Psych.C.N.S. and F.N.P. best reflects the broad practice expertise of the psychiatric family nurse practitioner. The experienced psychiatric family nurse practitioner provides direct care for both physical and psychological needs of patients in a family practice setting. PMID:15014701

  17. Preterm labor: role of the nurse practitioner.

    PubMed

    Doyle, Jennifer; Silber, Angela

    2015-03-12

    The nurse practitioner may play a pivotal role in diagnosing preterm labor through risk assessment and physical exam. While treatment and management of preterm labor are usually beyond the nurse practitioner's scope of practice, they can play an important role in preventing preterm birth through assessment, action, or advocacy. PMID:25585096

  18. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a... this section. (1) If the State specifies qualifications for pediatric nurse practitioners, the... (ii) Meet the State requirements for qualification of pediatric nurse practitioners in the State...

  19. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a... this section. (1) If the State specifies qualifications for pediatric nurse practitioners, the... (ii) Meet the State requirements for qualification of pediatric nurse practitioners in the State...

  20. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a... this section. (1) If the State specifies qualifications for pediatric nurse practitioners, the... (ii) Meet the State requirements for qualification of pediatric nurse practitioners in the State...

  1. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a... this section. (1) If the State specifies qualifications for pediatric nurse practitioners, the... (ii) Meet the State requirements for qualification of pediatric nurse practitioners in the State...

  2. 42 CFR 441.22 - Nurse practitioner services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Nurse practitioner services. 441.22 Section 441.22... General Provisions § 441.22 Nurse practitioner services. With respect to nurse practitioner services that... State plan must meet the following requirements: (a) Provide that nurse practitioner services...

  3. How emergency department staff perceive acute nurse practitioners.

    PubMed

    Bryson, Clare

    2016-03-01

    Over the past few years, emergency nursing has introduced new roles to allow nurses to practise at advanced levels. The well established emergency nurse practitioner role, which focuses on patients with minor illnesses and injuries, is being expanded and remodelled, partly to fill the gap created by the decline in the number of emergency medicine doctors. One emergency department in Scotland has introduced an extended nursing role called the acute nurse practitioner, which enables nurses to work at an extended level in the majors area of the department. This article discusses findings from a study that examined a range of healthcare clinicians' perceptions of this newly established service. Findings suggest that the service is received positively by colleagues and patients, but also highlight a number of issues that need to be addressed to enhance the service and support implementation in other emergency departments. PMID:26948226

  4. Practice Management Skills for the Nurse Practitioner.

    ERIC Educational Resources Information Center

    Sportsman, Susan; Hawley, Linda J.; Pollock, Susan; Varnell, Gayle

    2001-01-01

    An expert panel identified 20 business concepts important for a family nurse practitioner curriculum. A focus group of practitioners verified the concepts and clarified relevant information to be taught. The business concepts center on management and operations of a clinical practice. (SK)

  5. Nurse Practitioner Residency Programs: An Educational Journey

    ERIC Educational Resources Information Center

    Rys, Gregory P.

    2016-01-01

    Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with…

  6. Where is family in the family nurse practitioner program? Results of a U.S. family nurse practitioner program survey.

    PubMed

    Nyirati, Christina M; Denham, Sharon A; Raffle, Holly; Ware, Lezlee

    2012-08-01

    Though recent progress in family nursing science can serve the family nurse practitioner (FNP) to intervene in the regulation of family health, whether those advances are taught to FNP students has been unclear. All 266 FNP programs in the United States were invited to participate in a survey to assess the content and clinical application of family nursing theories in the curriculum. The majority of FNP programs frame family as the context of care for the individual. Though FNP students receive a foundation in family nursing theory in core courses, they are not usually expected to use family assessment methods in clinical practicum courses or to plan interventions for the family as the unit of care. The authors challenge educators to consider family nursing science as an essential component of the FNP program as the Doctor of Nursing Practice (DNP) evolves and becomes requisite for entry into advanced practice. PMID:22529244

  7. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner, physician assistant, certified nurse...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker... nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical..., certified nurse midwife, clinical psychologist, or clinical social worker service are payable under...

  8. Credentialing for nurse practitioners: an update.

    PubMed

    Magdic, Kathy S; Hravnak, Marilyn; McCartney, Sharon

    2005-01-01

    The public has the right to safe, quality healthcare delivered by professionals with the appropriate education, training, and experience. The Joint Commission on Accreditation of Healthcare Organizations, the Accreditation Association for Ambulatory Healthcare, and managed care organizations take this commitment very seriously. One mechanism required by these agencies to ensure patient safety is the process of credentialing and delineation of clinical privileges for medical staff and allied health professionals, such as Acute Care Nurse Practitioners. This commitment extends to patients receiving healthcare through the technology of telemedicine and to those requiring emergency care resulting from trauma, disasters, and varying forms of terrorism. In addition, safeguards must be in place to prevent identity theft of healthcare providers, including Acute Care Nurse Practitioners. It is essential that Acute Care Nurse Practitioners be familiar with the regulations that impact and guide the process of credentialing and obtaining clinical privileges in a variety of venues. PMID:15714014

  9. Pediatric Nurse Practitioner Program: Theories for Extended Pediatric Nursing Practice.

    ERIC Educational Resources Information Center

    Brady, Margaret A.

    A description is provided of "Theories for Extended Pediatric Nursing Practice," a required course for pediatric and family nurse practitioner students in a California state university program. The course description presents information on the curricular placement of the course, prerequisites, in-class time allotments, and the focus of the course…

  10. Considerations for design of an e-learning program augmenting advanced geriatric nurse practitioner's clinical skills training.

    PubMed

    Rostad, Hanne M; Grov, Ellen Karine; Moen, Anne

    2014-01-01

    E-learning programs offer learners flexibility, more control over their learning experience, possibilities for repetition and allows for learning to be more individualized compared to traditional teaching methods. This paper presents considerations for an interdisciplinary project to design an e-learning program for graduate students enrolled in a master's program in Advanced Geriatric Nursing. The e-learning program offers new opportunities for learners to apply theoretical knowledge and develop their skills in the process of collaborative knowledge creation. A model based on the systematic development of instruction and learning and a pedagogical framework for e-learning has guided the design process. This paper explains how the e-learning program was created and how content was developed and implemented in an e-learning environment. PMID:24943556

  11. Nurse Practitioners: Leadership Behaviors and Organizational Climate.

    ERIC Educational Resources Information Center

    Jones, L. Colette; And Others

    1990-01-01

    A survey of 317 nurse practitioners examined the relationship of individual perceptions of the leadership climate in their organizations and self-reported formal and informal leadership behaviors. All five leadership dimensions were predicted by at least one organizational climate dimension. (JOW)

  12. Nurse Practitioner Research: Some Neglected Issues

    ERIC Educational Resources Information Center

    Williams, Carolyn A.

    1975-01-01

    Two current evaluation projects of the Family Nurse Practitioner Training Program at the University of North Carolina at Chapel Hill compare the utilization or quality of services provided by graduates practicing in different care settings. Clinical trial studies are essential first steps in assessing an innovation in health care delivery. (EA)

  13. Recommendations for nurse practitioner residency programs.

    PubMed

    Brown, Kameka; Poppe, Anne; Kaminetzky, Catherine; Wipf, Joyce; Woods, Nancy Fugate

    2015-01-01

    The purpose of this study was to identify and prioritize critical aspects needed in the design and execution of new nurse practitioner (NP) residency programs. Subjects answered a series of questions on formulating residency programs and on key outcomes and cost measures related to their sustainability. These results serve as potential guideposts for future work in NP residency standardization and sustainability development. PMID:25501654

  14. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for nurse practitioners' and clinical nurse... HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners' and clinical... ending December 31, 1997, allowed amounts for the services of a nurse practitioner or a clinical...

  15. Primary health care nurse practitioners in Canada.

    PubMed

    DiCenso, Alba; Auffrey, Lucille; Bryant-Lukosius, Denise; Donald, Faith; Martin-Misener, Ruth; Matthews, Sue; Opsteen, Joanne

    2007-08-01

    Canada, like many countries, is in the midst of primary health care reform. A key priority is to improve access to primary health care, especially in remote communities and areas with physician shortages. As a result, there is an increased emphasis on the integration of primary health care nurse practitioners. As of March 2006, legislation exists in all provinces and two territories in Canada that allows nurse practitioners (NPs) to implement their expanded nursing role. In this paper, we will briefly review the historical development of the NP role in Canada and situate it in the international context; describe the NP role, supply of NPs in the country, and the settings in which they work; propose an NP practice model framework; summarize facilitators and barriers to NP role implementation in primary health care delivery; and outline strategies to address the barriers. PMID:18041990

  16. Development of the Nurse Practitioner Standards for Practice Australia.

    PubMed

    Cashin, Andrew; Buckley, Thomas; Donoghue, Judith; Heartfield, Marie; Bryce, Julianne; Cox, Darlene; Waters, Donna; Gosby, Helen; Kelly, John; Dunn, Sandra V

    2015-01-01

    This article describes the context and development of the new Nurse Practitioner Standards for Practice in Australia, which went into effect in January 2014. The researchers used a mixed-methods design to engage a broad range of stakeholders who brought both political and practice knowledge to the development of the new standards. Methods included interviews, focus groups, surveys, and work-based observation of nurse practitioner practice. Stakeholders varied in terms of their need for detail in the standards. Nonetheless, they invariably agreed that the standards should be clinically focussed attributes. The pillars common in many advanced practice nursing standards, such as practice, research, education, and leadership, were combined and expressed in a new and unique clinical attribute. PMID:26162455

  17. Development of the Nurse Practitioner Standards for Practice Australia

    PubMed Central

    Buckley, Thomas; Donoghue, Judith; Heartfield, Marie; Bryce, Julianne; Cox, Darlene; Waters, Donna; Gosby, Helen; Kelly, John; Dunn, Sandra V.

    2015-01-01

    This article describes the context and development of the new Nurse Practitioner Standards for Practice in Australia, which went into effect in January 2014. The researchers used a mixed-methods design to engage a broad range of stakeholders who brought both political and practice knowledge to the development of the new standards. Methods included interviews, focus groups, surveys, and work-based observation of nurse practitioner practice. Stakeholders varied in terms of their need for detail in the standards. Nonetheless, they invariably agreed that the standards should be clinically focussed attributes. The pillars common in many advanced practice nursing standards, such as practice, research, education, and leadership, were combined and expressed in a new and unique clinical attribute. PMID:26162455

  18. Practice management skills for the nurse practitioner.

    PubMed

    Sportsman, S; Hawley, L J; Pollock, S; Varnell, G

    2001-01-01

    The faculties of three schools of nursing involved in a collaborative family nurse practitioner (FNP) program designed a study to address issues involved in preparing the nurse practitioner for the challenges of practice management in the clinical environment. The purposes of the study were to (1) identify business concepts necessary to successfully manage a primary care practice; (2) determine which of these concepts should be incorporated into an FNP curriculum; and (3) clarify information to be taught regarding each identified concept. Fifty-four business concepts related to primary care were identified from a literature review. A survey was then developed to assess the extent to which the identified concepts were necessary for an FNP to effectively manage a practice. Seven experts and five FNP faculty responded to the survey. The Content Validity Index (CVI) defined by Lynn (1986) was applied and 20 concepts necessary for an FNP to effectively manage a practice were identified. A focus group that included nurse practitioners (both faculty and nonfaculty) from the three collaborative sites connected by interactive telecommunications determined that all 20 of the identified concepts should be included in an FNP curriculum. Additionally, the focus group clarified relevant information to be taught regarding each identified concept. PMID:11559878

  19. Academics and practitioners: nurses as intellectuals.

    PubMed

    Holmes, Colin A

    2002-06-01

    Academics and practitioners: nurses as intellectuals In the author's experience, nurse educators working in universities generally accept that they are 'academics', but dismiss suggestions that they are 'intellectuals' because they see it as a pretentious description referring to a small number of academics and aesthetes who inhabit a conceptual world beyond the imaginative capacity of most other people. This paper suggests that the concept of the 'intellectual', if not the word itself, be admitted into nursing discourse through the adoption of a non-élitist Gramscian understanding, similar to the more recently formulated conception of the reflective practitioner. According to the Italian Marxist scholar Antonio Gramsci, intellectuals are those people who develop ways in which to construct the conditions of their own existence, a possibility he believed was open to all. It is suggested that, from a Gramscian perspective, all nurses are intellectuals to varying degrees, and nurse educators should not only be nurturing their own intellectualism but also the potential for intellectualism as it exists within each individual. The ways in which this project are related to Habermasian critical theory are also briefly outlined. PMID:12071908

  20. Transitioning from physician to nurse practitioner

    PubMed Central

    Flowers, Monica; Olenick, Maria

    2014-01-01

    Foreign-educated physicians (FEPs), also known as “international medical graduates”, represent a rich source of potential primary-care providers. Despite their high level of medical knowledge and skills as well as ethnic and cultural diversity suited to meet the demands of patients, FEPs face many barriers in their attempt to continue to practice medicine in the USA. The program of study at Florida International University’s Nicole Wertheim College of Nursing and Health Sciences provides FEPs the opportunity to have an impact on health care and continue to practice medicine in the USA by becoming nurse practitioners. PMID:24489472

  1. Theoretical links supporting the use of problem-based learning in the education of the nurse practitioner.

    PubMed

    Chikotas, Noreen Elaine

    2008-01-01

    The need to evaluate current strategies in educating the advanced practice nurse, specifically the nurse practitioner, is becoming more and more imperative due to the ever-changing health care environment. This article addresses the role of problem-based learning (PBL) as an instructional strategy in educating and preparing the nurse practitioner for future practice.Two theoretical frameworks supporting PBL, andragogy and constructivism, are presented as important to the use of PBL in the education of the nurse practitioner. PMID:19244802

  2. Consortium approach for nurse practitioner education.

    PubMed

    van Soeren, M H; Andrusyszyn, M A; Laschinger, H K; Goldenberg, D; DiCenso, A

    2000-10-01

    In 1995, a 10-university consortium approach to deliver a post-baccalaureate primary care nurse practitioner programme funded by the Ontario Ministry of Health was launched throughout Ontario, Canada. A combination of traditional and distance teaching methods, in English and French, were used. A 5-year research project was initiated to evaluate the entire programme, the effect of nurse practitioners on patient and health-care system outcomes and examine practice patterns. Participants included deans and directors (n = 10), regional co-ordinators (n = 5) and course developers, some of whom were also course professors (n = 8). This article is a report of the evaluation of the consortium programme after the first year from the perspective of groups involved in implementation and delivery. Results of qualitative analyses of participant perceptions from researcher-led focus groups and asynchronous electronic interviews provided the framework for the evaluation, and revealed the rationale for the consortium method, strengths, limitations and recommendations. Sharing ideas, resources and delivery and increased student access in remote areas were perceived as positive outcomes. Limitations included the short time period to develop programme content, identify and plan for distance education resources, and too little communication between universities and students. Researchers concluded that the consortium approach was effective for nurse practitioner education. Key factors identified for programme planning were communication, resources, curriculum and workload. Included among the recommendations was to allow sufficient time for role and course development before beginning a similar programme. PMID:11095220

  3. Praxis and the role development of the acute care nurse practitioner.

    PubMed

    Kilpatrick, Kelley

    2008-06-01

    Acute care nurse practitioner roles have been introduced in many countries. The acute care nurse practitioner provides nursing and medical care to meet the complex needs of patients and their families using a holistic, health-centred approach. There are many pressures to adopt a performance framework and execute activities and tasks. Little time may be left to explore domains of advanced practice nursing and develop other forms of knowledge. The primary objective of praxis is to integrate theory, practice and art, and facilitate the recognition and valuing of different types of knowledge through reflection. With this framework, the acute care nurse practitioner assumes the role of clinician and researcher. Praxis can be used to develop the acute care nurse practitioner role as an advanced practice nursing role. A praxis framework permeates all aspects of the acute care nurse practitioner's practice. Praxis influences how relationships are structured with patients, families and colleagues in the work setting. Decision-makers at different levels need to recognize the contribution of praxis in the full development of the acute care nurse practitioner role. Different strategies can be used by educators to assist students and practitioners to develop a praxis framework. PMID:18476854

  4. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    PubMed

    Vogel, Wendy H

    2016-01-01

    Oncology care is becoming increasingly complex. The interprofessional team concept of care is necessary to meet projected oncology professional shortages, as well as to provide superior oncology care. The oncology advanced practitioner (AP) is a licensed health care professional who has completed advanced training in nursing or pharmacy or has completed training as a physician assistant. Oncology APs increase practice productivity and efficiency. Proven to be cost effective, APs may perform varied roles in an oncology practice. Integrating an AP into an oncology practice requires forethought given to the type of collaborative model desired, role expectations, scheduling, training, and mentoring. PMID:27249776

  5. The marketability of nurse practitioners in New York City.

    PubMed

    Garfield, R

    2000-01-01

    Until recently nurse practitioners (NPs) in independent practices have almost exclusively served Medicaid populations, and, most NP care has been provided by NP employees in physicians' offices or HMOs. The author explores the willingness of affluent or insured private pay patients to choose NPs as their primary care providers by using both focus groups and telephone interviews of adults between 25 and 50 years of age. Findings included the common perception that physicians were best prepared by education at diagnosing illness and valued for their overall expertise and likelihood to treat patients with respect. Nurses were most liked for their "compassion and caring," their willingness to listen to client concerns, and focus on disease management and health promotion. Nurses were least liked for having "bad attitudes" and being overworked. Only 23% of the survey participants were familiar with the term "advanced practice nurse" while 76% had heard of NPs. PMID:11029915

  6. Nurse Practitioner Management of Type 2 Diabetes

    PubMed Central

    Richardson, Gail Carr; Derouin, Anne L; Vorderstrasse, Allison A; Hipkens, James; Thompson, Julie A

    2014-01-01

    Context Multifactorial barriers prevent primary care clinicians from helping their adult patients with type 2 diabetes achieve good control of hemoglobin A1c (HbA1c) levels. Patients’ depression and low self-efficacy can complicate diabetes management by impairing tasks needed for effective disease self-management. Objectives: To evaluate whether nurse practitioners in collaborative practices with primary care clinicians are effective in helping improve control of HbA1c, blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) in adults with uncontrolled hyperglycemia, and to assess whether nurse practitioner-guided care affects depression and self-efficacy in these patients. Design: De-identified preintervention and postintervention data were collected from prospective review of medical charts of patients in a managed care organization’s primary care clinics. Main Outcome Measures: Preintervention and postintervention HbA1c values were evaluated as the primary outcome measure. Preintervention and postintervention values for BP, LDL-C, body weight, and depression and self-efficacy scores were secondary outcome measures. Results: After intervention, 50% of 26 patients achieved HbA1c benchmarks, 95.6% achieved systolic and diastolic BP benchmarks, and 57.8% achieved LDL-C benchmarks. Wilcoxon paired samples tests showed significantly increased self-efficacy (z = −3.42, p < 0.001) from preintervention to postintervention. Depression scores decreased slightly from preintervention (mean = 0.44, standard deviation = 1.34, median < 0.001) to postintervention values (mean = 0.18, standard deviation = 0.73, median < 0.001), but this decrease was not significant. Conclusion: Integrating nurse practitioners into primary care teams to provide innovative methods of support to adults with uncontrolled hyperglycemia improves clinical outcomes and self-efficacy for patients with type 2 diabetes. PMID:24867560

  7. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... doctor of medicine or osteopathy, as set forth in section 1861(r)(1) of the Act. (b) Qualifications. For... established standards for nurse practitioners. (ii) Possess a master's degree in nursing or a Doctor...

  8. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... doctor of medicine or osteopathy, as set forth in section 1861(r)(1) of the Act. (b) Qualifications. For... established standards for nurse practitioners. (ii) Possess a master's degree in nursing or a Doctor...

  9. Challenges to the Identity Formation of the School Nurse Practitioner.

    ERIC Educational Resources Information Center

    O'Donoghue, Patricia Drogos; Hogan, Eleanor Phipps

    1980-01-01

    The problems arising in using nurse practitioners as school nurses are discussed, including the training program involved, the individual's self-concept within the position, and the faculty's attitude. (JMF)

  10. Managed care organizations' arrangements with nurse practitioners: a Connecticut perspective.

    PubMed

    O'Donnell, J P; Cohen, S S; Mason, D J; Baxter, K; Chase, A B

    1998-01-01

    Executives in more than 50% of managed care organizations (MCOs) in New York and Connecticut were interviewed for information on the roles, participation, and listing of NPs as primary care providers. MCO executives are highly satisfied with their primary care provider NPs, particularly in women's health and geriatrics, secondary to spending more time teaching and explaining procedures than physicians. Among both health care professionals and the general public there is an overall lack of current knowledge and/or confusion about NPs and their practice. Eighty-two percent of executives in MCOs thought their organization should encourage the use of NPs as primary care providers. Beginning in the early 1960s, advanced practice nursing has shown steady growth. Research has found that NPs provide cost-effective, quality-driven patient care (Brown & Grimes, 1995; Cohen & Juszczak, 1997; Frampton & Wall, 1994; Hardy & Evans, 1995). Many thought health care reform would lead to an expansion of advanced practice nurses (APNs) and other nonphysician providers as primary care providers (Aiken & Salmon, 1994). Funding for and enrollment in graduate nursing programs rose nationwide (American Association of Colleges of Nursing, 1996). Anecdotal reports indicated that NPs were not included in MCO primary care provider panels. The purpose of this study was to explore MCO arrangements with nurse practitioners and the factors that influence them. PMID:10614235

  11. Team Development Curriculum. Family Nurse Practitioner/Physician Assistant Program.

    ERIC Educational Resources Information Center

    Dostal, Lori

    A curriculum consisting of four modules is presented to help nurse practitioners, physician assistants, and physicians develop team practices and improve and increase the utilization of nurse practitioners and physician assistants in primary care settings. The curriculum was prepared in 1981-1982 by the California Area Health Education Center…

  12. Making "cents" of the business side of nurse practitioner practice.

    PubMed

    Luster-Tucker, AtNena

    2016-03-15

    Nurse practitioners produce excellent patient outcomes and should be allowed to practice to the full extent of their education and training. In addition to clinical skills, nurse practitioners need to understand the business side of practice in order to ensure fair and equitable compensation. PMID:26886267

  13. Practice environment for nurse practitioners in California. Identifying barriers.

    PubMed Central

    Anderson, A L; Gilliss, C L; Yoder, L

    1996-01-01

    Barriers exist that prevent nurse practitioners from using their primary health care knowledge and skills. We present the incidence of and specific barriers experienced by nurse practitioner respondents in California, the state with the largest number of nurse practitioners in the nation. A January 1995 survey was sent to all nurse practitioners certified in California to elicit their experiences regarding legal or social barriers in their practice, with space for an open-ended response. Of an estimated 3,895 nurse practitioners in California, 2,741 (70%) returned surveys. Most nurse practitioner (65%) respondents in California are providing primary care. Perceived barriers to practice are lack of prescriptive authority, lack of support from physicians, reimbursement difficulties, and lack of public awareness. Current barriers to nurse practitioner practice in California are similar to national barriers discovered in 1992 data. The development of interprofessional dialogue and the recognition of the contributions of all primary care professionals are some of the steps that can be taken to reduce these barriers and increase the use and effectiveness of nurse practitioners in primary care. PMID:8987426

  14. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Nurse practitioners' services. 410.75 Section 410.75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.75 Nurse practitioners' services. (a)...

  15. A Career Model for Nurse Practitioners. Allied Health Professions Project.

    ERIC Educational Resources Information Center

    Wood, Lucile A.

    Described in this document is a five-stage curriculum model for the training of nurse practitioners which was developed through the Allied Health Professions Project (AHPP). Based on a national survey of nursing occupations, stage I of the curriculum model includes the 60 percent of activities common to all practitioners, and stage II includes the…

  16. NPACE nurse practitioner practice characteristics, salary, and benefits survey: 1999. Nurse Practitioner Associates for Continuing Education.

    PubMed

    Pulcini, J; Vampola, D

    2000-11-01

    The purpose of this article is to present the results of a practice characteristics, salary, and benefits survey of 1,557 nurse practitioners from the United States who attended national nurse practitioner conferences in Las Vegas, Nevada, Orlando, Florida, Chicago, Illinois, and Boston, Massachusetts, in 1999. Specific data are presented on the demographics of the population, practice characteristics and responsibilities, benefits for full- and part-time employees, and salary by region, years of practice, type of certification, and location of the practice. The salary data were compared with the 1995-1996 and 1996-1997 NPACE practice characteristics, salary, and benefits surveys (Pulcini & Fitzgerald, 1997; Pulcini, Vampola, & Fitzgerald, 1998). PMID:11858321

  17. Nurse practitioners: leadership behaviors and organizational climate.

    PubMed

    Jones, L C; Guberski, T D; Soeken, K L

    1990-01-01

    The purpose of this article is to examine the relationships of individual nurse practitioners' perceptions of the leadership climate in their organizations and self-reported formal and informal leadership behaviors. The nine climate dimensions (Structure, Responsibility, Reward, Perceived Support of Risk Taking, Warmth, Support, Standard Setting, Conflict, and Identity) identified by Litwin and Stringer in 1968 were used to predict five leadership dimensions (Meeting Organizational Needs, Managing Resources, Leadership Competence, Task Accomplishment, and Communications). Demographic variables of age, educational level, and percent of time spent performing administrative functions were forced as a first step in each multiple regression analysis and used to explain a significant amount of variance in all but one analysis. All leadership dimensions were predicted by at least one organizational climate dimension: (1) Meeting Organizational Needs by Risk and Reward; (2) Managing Resources by Risk and Structure; (3) Leadership Competence by Risk and Standards; (4) Task Accomplishment by Structure, Risk, and Standards; and (5) Communication by Rewards. PMID:2254526

  18. A regional approach to the education of nurse practitioner candidates to meet the health needs of rural Australians.

    PubMed

    Francis, Karen; Boyd, Michal; Latham, Heather; Anderson, Judith; Bradley, Angela; Manners, Jan

    2014-11-28

    Abstract Background: Local health services expressed interest in supporting a nurse practitioner program specifically designed for rural practice environments. Aim: To develop and deliver a generalist nurse practitioner program that prepares candidates for practice in rural contexts. Methods: The Master of Clinical Nursing (Nurse Practitioner) program was designed with an understanding of the burden of disease impacting on rural Australians, application of the national health priorities, the Australian Government's refocus on preventative health care and rural health workforce shortages. Results: This program offers nurses who work in rural and remote settings an opportunity to advance their careers. Increasing the numbers of rural nurse practitioners will improve rural populations access to healthcare and potentially improve health outcomes. Conclusion: This program will equip those seeking endorsement as a nurse practitioner to effectively work in rural contexts. PMID:25429988

  19. Cooperative m-learning with nurse practitioner students.

    PubMed

    Wyatt, Tami H; Krauskopf, Patricia B; Gaylord, Nan M; Ward, Andrew; Huffstutler-Hawkins, Shelley; Goodwin, Linda

    2010-01-01

    New technologies give nurse academicians the opportunity to incorporate innovative teaching-learning strategies into the nursing curricula. Mobile technology for learning, or m-learning, has considerable potential for the nursing classroom but lacks sufficient empirical evidence to support its use. Based on Mayer's multimedia learning theory, the effect of using cooperative and interactive m-learning techniques in enhancing classroom and clinical learning was explored. The relationship between m-learning and students' learning styles was determined through a multimethod educational research study involving nurse practitioner students at two mid-Atlantic universities. During the 16-month period, nurse practitioner students and their faculty used personal digital assistants (PDAs) to participate in various m-learning activities. Findings from focus group and survey responses concluded that PDAs, specifically the Pocket PC, are useful reference tools in the clinical setting and that all students, regardless of learning style, benefited from using PDAs. It was also demonstrated that connecting students with classmates and other nurse practitioner students at distant universities created a cooperative learning community providing additional support and knowledge acquisition. The authors concluded that in order to successfully prepare nurse practitioner graduates with the skills necessary to function in the present and future health care system, nurse practitioner faculty must be creative and innovative, incorporating various revolutionary technologies into their nurse practitioner curricula. PMID:20455369

  20. Alliances of cooperation: negotiating New Hampshire nurse practitioners' prescribing practice.

    PubMed

    Sampson, Deborah A

    2009-01-01

    Nurse practitioner legislation varies among states, particularly in relation to practice without physician oversight, altering the legal environment within which nurse practitioners can use knowledge and skills to meet patient needs. Using New Hampshire as a case study, this historical analysis of nurse practitioners' negotiations over time for independent practice, defined in state practice acts, illuminates the complex social and economic factors affecting nurses' struggle to gain legal rights over their own professional practice without supervision and intervention from another profession. In New Hampshire, not only did organized medicine oppose nurses rights to practice, but pharmacists demanded the right to control all aspects of medication management, including who could prescribe and under what circumstances prescribing could occur. Shifting social and political terrain as well as changes in legislative and state professional board leadership affected the environment and negotiations of a small group of nurses who were ultimately successful in obtaining the right to define their own professional practice. PMID:20067085

  1. Palliative Care Education in Nurse Practitioner Programs: A Survey of Academic Deans.

    PubMed

    Jensen-Seaman, Kari; Hebert, Randy S

    2016-01-01

    The need for clinicians trained in palliative care will increase as more Americans live with life-limiting illness. Although multiple studies have described the nature of palliative care education in prelicensure programs, there have been no similar studies of nurse practitioner programs. We surveyed 101 nurse practitioner programs. Most programs provide little instruction in palliative care; education is often limited to a few hours of lecture. One-third of programs offer no instruction. Although palliative care is an important component of advanced practice nursing practice, programs may not be providing adequate education. PMID:26862687

  2. Hiring appropriate providers for different populations: acute care nurse practitioners.

    PubMed

    Haut, Cathy; Madden, Maureen

    2015-06-01

    Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. PMID:26033108

  3. Patients' Evaluations of Gynecologic Services Provided by Nurse Practitioners.

    ERIC Educational Resources Information Center

    Wagener, J. Mark; Carter, Glenna

    1978-01-01

    The development, operating principles, and users' evaluations of a broad based gynecologic program emphasizing effective birth control on a university campus are discussed. A major feature explored is the use of nurse practitioners as the primary service providers. (JMF)

  4. The Business Management Preceptorship within the Nurse Practitioner Program.

    ERIC Educational Resources Information Center

    Wing, Donna Marie

    1998-01-01

    A nurse practitioner business preceptorship provides students with knowledge of basic business, accounting, finance, economics, marketing, and reimbursement. A lack of qualified faculty can be offset with adjunct business faculty. Selection of placement sites should provide challenging management experiences. (SK)

  5. Institutional collaboration not competition: preparing family nurse practitioners to serve rural areas.

    PubMed

    Varnell, Gayle; Pollock, Susan; Klotz, Linda; Green, Alexia; Sportsman, Susan

    2002-01-01

    In response to the need for an increased number of family nurse practitioners in rural Texas, The University of Texas at Tyler, Texas Tech University Health Sciences Center, and Midwestern State University entered into a collaborative arrangement to provide advanced education to nurses in outlying areas of the state. The catchment area for the project encompassed 72 counties, representing half the land mass in Texas. This article presents the development of the collaborative model, strategies used for implementation, and evaluation of this collaborative effort. The collaborative family nurse practitioner program is based on collegiality rather than competition to better meet the needs of students and communities in a cost-effective manner. Communication between the institutions and faculty has been a key factor in the success of the program. The addition of nurse practitioners from this project has the potential to greatly increase access to health care in large, underserved populations. PMID:12096365

  6. "Noses and eyes": nurse practitioners in New Zealand.

    PubMed

    Diers, Donna; Goodrich, Annie W

    2008-03-01

    Principles for understanding and evolving nurse practitioner practice, politics and policy are distilled from 40 years of experience in the United States and Australia. The issues in all countries are remarkably similar. Some historical and conceptual grounding may assist the continuing development of this expanded role for nursing in New Zealand. PMID:18557366

  7. Reiki therapy: the benefits to a nurse/Reiki practitioner.

    PubMed

    Whelan, Kathleen M; Wishnia, Gracie S

    2003-01-01

    This study evaluates how nurses who gave Reiki therapy perceived the benefit of this therapy on their clients and on themselves concurrently as providers of the therapy. As an adjunct, the study's purpose was to enhance the understanding and credibility of nurse/Reiki practitioners. PMID:12889549

  8. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.75... practitioner in accordance with State law, and must meet one of the following: (1) Obtained Medicare billing... Nursing Practice (DNP) doctoral degree. (2) Obtained Medicare billing privileges as a nurse...

  9. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.75... practitioner in accordance with State law, and must meet one of the following: (1) Obtained Medicare billing... Nursing Practice (DNP) doctoral degree. (2) Obtained Medicare billing privileges as a nurse...

  10. Can nurse practitioners and physicians beat parochialism into plowshares?

    PubMed

    Phillips, Robert L; Harper, Doreen C; Wakefield, Mary; Green, Larry A; Fryer, George E

    2002-01-01

    Nurse practitioners have evolved into a large and flexible workforce. Far too often, nurse practitioner and physician professional organizations do not work together but rather expend considerable effort jousting in policy arenas. Turf battles interfere with joint advocacy for needed health system change and delay development of interdisciplinary teams that could help patients. A combined, consistent effort is urgently needed for studying, training, and deploying a collaborative, integrated workforce aimed at improving the health care system of tomorrow. The country can ill afford doctors and nurses who ignore one another's capabilities and fail to maximize each other's contributions cost-effectively. PMID:12224875

  11. The Practitioner-Researcher in Nursing.

    ERIC Educational Resources Information Center

    Jarvis, Peter

    2000-01-01

    Practitioner-researchers are emerging in many fields in response to rapid change and a view of research as systematic and rigorously controlled learning. The gap between theory and practice widens because of variations in practice settings, making practitioner knowledge important. Commentaries by Paul Yerrell, David R. Thompson, Philip Burnard,…

  12. Optimizing safety of COPD treatments: role of the nurse practitioner

    PubMed Central

    Spencer, Pamela; Hanania, Nicola A

    2013-01-01

    As the prevalence of chronic obstructive pulmonary disease (COPD) continues to grow, management of the disease still faces considerable challenges. Despite the existence of effective pharmacological treatments, patient adherence is often poor. Side effects of medications and patients’ concerns about potential side effects may contribute to poor adherence. Situated as they are at the frontline of patient care in the clinic, nurse practitioners play an important role in the management of COPD. This review discusses the current literature on medications available for management of COPD, focusing primarily on their safety and tolerability. This information can be particularly important for nurse practitioners, who can be invaluable in identifying side effects, and providing education to patients with COPD on the available treatments and the associated side effects. By helping patients to understand the balance of benefits and risks of treatment, nurse practitioners may be able to help improve adherence and thereby improve patient outcomes. PMID:23459224

  13. The nurse practitioner in family planning services: law and practice.

    PubMed

    Roemer, R

    1977-06-01

    Before 1971, when Idaho became the 1st state to authorize expanded scope of functions for registered nurses, nearly all states made it illegal for any nurse to perform diagnosis or prescribe treatment, creating an ambiguity as more and more nurses were equipped by education and technology to perform new tasks. Today 30 states have liberalized the scope of nursing functions, making it possible for nurses and nurse-midwives to assume, among other tasks, family planning functions. A table gives the status of legislation and regulations governing nurse practitioners and nurse-midwives in each state. The area of greatest controversy is the prescription of oral contraceptives. In some states it is allowed under doctor's supervision or in rural areas or in areas where clear need exists for a nurse to dispense such medication. Usually this dispensing is limited to a single course of treatment. Nurse-midwives are rapidly being accepted as extensions of scarce medical facilities. Generally nurse-midwives are authorized to provide prenatal and postpartum care, to handle normal deliveries, and do family planning work including fitting diaphragms and inserting and removing IUDs. An innovation is the family planning nurse practitioner. Several courses for such practitioners have been set up across the U.S. Graduates may, with medical direction, perform bimanual pelvic examinations and breast examinations, take blood pressure, prescribe contraception, fit diaphragms, insert IUDs, examine vaginal secretions microscopically, and refer patients with problems to physicians. In a California program both registered and nonregistered nurses are being trained as women's health specialists who may make routine examinations in both pregnant and nonpregnant women and give family planning advice. Non-RN family planning specialists being trained include licensed vocational nurses, baccalaureate degree holders in nonnursing fields, and qualified persons with less formal education. The 24-week

  14. The Employment of Nurse Practitioners and Physician Assistants in U.S. Nursing Homes

    ERIC Educational Resources Information Center

    Intrator, Orna; Feng, Zhanlian; Mor, Vince; Gifford, David; Bourbonniere, Meg; Zinn, Jacqueline

    2005-01-01

    Purpose: Nursing facilities with nurse practitioners or physician assistants (NPs or PAs) have been reported to provide better care to residents. Assuming that freestanding nursing homes in urban areas that employ these professionals are making an investment in medical infrastructure, we test the hypotheses that facilities in states with higher…

  15. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists' services and services furnished incident to their professional..., and clinical nurse specialists' services and services furnished incident to their...

  16. An Evaluation of Nurse Practitioner Student Experiences with Online Education

    ERIC Educational Resources Information Center

    Heale, Roberta; Gorham, Robyn; Fournier, Jennifer

    2010-01-01

    Many nurse practitioner (NP) education programs have embraced distance education opportunities. A comparison of the experiences of NP students in one course delivered across nine sites was undertaken. Some sites offer traditional face-to-face sessions and others provide tutorials online. A survey of all the students evaluated barriers with respect…

  17. The Transition to First Position as Nurse Practitioner.

    ERIC Educational Resources Information Center

    Kelly, Norma R.; Mathews, Maureen

    2001-01-01

    Focus groups of 21 recent nurse practitioner graduates revealed that, as they begin practice, they experience loss of time and privacy, changed relationships, isolation, and role ambiguity. Although they felt adequately prepared, they felt anxiety, inadequacy, and uncertainty. Mentoring and other ways to assist transition were recommended. (SK)

  18. Pediatricians' Attitudes Toward Pediatric Nurse Practitioners in South Carolina

    ERIC Educational Resources Information Center

    Holzemer, William L.; And Others

    1978-01-01

    Results of a survey support the statement that pediatricians have a negative attitude toward the pediatric nurse practitioner (PNP) in South Carolina, generally due to the physicians' feelings that the PNP is not competent at child illness management. Implications for pediatric residencies are discussed. (LBH)

  19. Curriculum Trends in Nurse Practitioner Programs: Current and Ideal.

    ERIC Educational Resources Information Center

    Bellack, Janis P.; Graber, David R.; O'Neil, Edward H.; Musham, Catherine; Lancaster, Carol

    1999-01-01

    Responses from 84 of 140 nurse-practitioner program directors indicated greatest dissatisfaction with curricular areas of information systems and business management; most important curriculum topics were primary care, prevention, and patient relationships; and barriers to curriculum change included an already-crowded curriculum and limited…

  20. Complementary and Alternative Medicine: Core Competencies for Family Nurse Practitioners.

    ERIC Educational Resources Information Center

    Burman, Mary E.

    2003-01-01

    Directors of family nurse practitioner education programs (n=141) reported inclusion of some complementary/alternative medicine content (CAM), most commonly interviewing patients about CAM, critical thinking, evidence-based medicine, laws, ethics, and spiritual/cultural beliefs. Definition of CAM was medically, not holistically based. More faculty…

  1. Universe of Goals. Pediatric Nurse Practitioner/Associate Programs.

    ERIC Educational Resources Information Center

    Taunton, Roma Lee; Soptick, John M.

    Goals for the Pediatric Nurse Practitioner Associate Programs (PNP/A) are provided for the following areas: health care delivery systems; role responsibility; legal base for PNP/A role; growth and development; family-cultural factors; common childhood problems/illnesses/accidents; communication; assessment; recording; evaluation/interpretation;…

  2. Perceived Barriers to Nurse Practitioner Practice in Rural Settings

    ERIC Educational Resources Information Center

    Lindeke, Linda E.; Jukkala, Angela; Tanner, Mary

    2005-01-01

    Rural residents experience the same incidence of acute illness as urban populations and have higher levels of chronic illness. Overall, access to adequate rural health care is limited. Nurse practitioners (NPs) have been identified as safe, cost-effective providers in meeting these challenges in rural settings. This replication study was conducted…

  3. Advanced practice registered nurse certification.

    PubMed

    Alleman, Kim; Houle, Katherine

    2013-01-01

    Advanced practice registered nurses (APRNs) in nephrology began to be certified through the Nephrology Nursing Certification Commission (NNCC) in 2006. Since that time, the APRN Consensus Model has been developed, which addresses licensure, accreditation, certification, and education and which strongly recommends specialty certification for advanced practice nurses. This article discusses NNCC certification for advanced practice in nephrology nursing and describes the major components of the APRN Consensus Model. PMID:23923801

  4. 42 CFR 418.304 - Payment for physician and nurse practitioner services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for physician and nurse practitioner... Payment for physician and nurse practitioner services. (a) The following services performed by hospice physicians and nurse practitioners are included in the rates described in § 418.302: (1) General...

  5. Nurse Practitioner Primary Care Competencies in Specialty Areas: Adult, Family, Gerontological, Pediatric, and Women's Health.

    ERIC Educational Resources Information Center

    Crabtree, M. Katherine; Stanley, Joan; Werner, Kathryn E.; Schmid, Emily

    This document presents the nurse practitioner primary care competencies that a national panel of representatives of nine national organizations of the five primary care nurse practitioner specialties--adult, family, gerontological, pediatric, and women's health--identified as necessary for entry-level primary care nurse practitioners. Section 1…

  6. Redesigning a School Health Workforce for a New Health Care Environment: Training School Nurses as Nurse Practitioners.

    ERIC Educational Resources Information Center

    Brindis, Claire D.; Sanghvi, Rupal; Melinkovich, Paul; Kaplan, David W.; Ahlstrand, Karin R.; Phibbs, Stephanie L.

    1998-01-01

    School nurses trained as nurse practitioners can help resolve the problems of ready access to and appropriate use of primary care, early detection of medical problems, and efficient use of school staff. This paper describes a project in which Denver's school nurses received training as nurse practitioners, suggesting ways to solve problems in role…

  7. Non-nurse college graduates: a new resource for future nurse practitioners.

    PubMed

    Smith, P L; Shoffner, D H

    1991-01-01

    Non-nurse college graduates are admitted to the master's of science in nursing (MSN) degree program at the University of Tennessee, Knoxville (UTK). Over the years, a majority of these non-traditional students have chosen the family nurse practitioner clinical concentration. The purpose of this study was to compare non-traditional and traditional family nurse practitioner (FNP) graduates in terms of academic and career-development characteristics. The study population consisted of all 91 (48 non-traditional and 43 traditional) UTK FNP graduates from 1981 to 1986. Little difference was found between the two groups' academic success in the program, self-perceptions of clinical preparedness for practice, current participation in the workforce, and self-perceptions of acceptance from administrators, other nurses and physicians in current work settings. Several notable differences between the two groups were found. The non-traditional FNP graduates had higher Graduate Record Examination (GRE) mean scores. More non-traditional than traditional FNP graduates were employed initially as nurse practitioners. Similarly, more non-traditional FNP graduates were currently employed as nurse practitioners in primary health care settings. Fewer non-traditional FNP graduates expressed satisfaction with their initial or current nursing positions. In regard to career goals, however, more of the non-traditional FNP graduates stated their intent was to be functioning as nurse practitioners in the future. Non-nurse college graduates with an interest in health care are a rich resource from which to recruit practicing nurse practitioners for the future. PMID:1996179

  8. Investigating the nursing practitioners perspectives about undergraduate nursing internship and apprenticeship courses: is renewing required?

    PubMed

    Jamalmohammadi, Ali; Asghari, Mohammad; Shajari, Jila; Modares, Maryam

    2013-09-01

    Nurses' professional capacity plays an important role in the health system to achieve their mission. This study aimed to investigate the perspectives of nursing practitioners about undergraduate nursing internship and apprenticeship courses and possible ways of renewing the courses. This cross sectional survey was performed over 258 bachelors and practitioners of nursing graduates of Alborz University of medical sciences in the second half of 2012. Based on a multi-stage sampling schedule, questionnaires were used to collect data about the perspectives of nursing practitioners about undergraduate nursing internship and apprenticeship courses. There were 81.4% of females and 80.6%, 17.1% and 2.3% of organizational post of participants were nurse, head nurse and supervisor respectively. The occupied posts for 60.1%, 25.6% and 14.1% of subjects, respectively were nurse, head nurse and the supervisor. The application of the internship and apprenticeship courses in bachelor of nursing were in moderate to high levels. The highest percentages of responses for internship and apprenticeship training courses were in internal surgery nursing and special nursing and the minimum percentage of responses were for community hygiene nursing and mental health nursing. Due to observing moderate to high levels of fulfillment and lack of compliance of training courses, renewing to improve the quality and effectiveness of training programs are highly recommended. This can be effective in the future of nursing career and provide a practical training environment to achieve the goals of theoretical training and can lead nurses to become specialized in their field. PMID:23985116

  9. Biosimilars in the United States: Considerations for Oncology Advanced Practitioners

    PubMed Central

    Mayden, Kelley D.; Larson, Paul; Geiger, Danielle; Watson, Holly

    2015-01-01

    Biosimilars will enter the US market soon, potentially lowering costs and increasing patient access to important oncology biologics. Biosimilars are highly similar, but not identical, to their reference product. Subtle variations arise due to their inherent complexity and differences in manufacturing. Biosimilars are not generic drugs. They will be approved through a separate US regulatory pathway—distinct from conventional biologics license applications—based on analytic and clinical studies demonstrating no clinically meaningful differences from the reference product. As policies on US biosimilars evolve, it is important that advanced practitioners receive comprehensive, ongoing education on them, particularly regarding differences from small-molecule drugs; their approval pathways vs. conventional regulatory pathways; evaluation of quality, safety, and efficacy; safety monitoring; and product identification to facilitate accurate safety reporting. Advanced practitioners will play a key role in educating nurses and patients on biosimilars. Nurse education should highlight any differences from the reference product (e.g., approved indications and delivery devices) and should emphasize assessment of substitutions, monitoring for adverse events (e.g., immune reactions), and the need for precise documentation for safety reports. Patient education should address differences between the biosimilar and reference product in administration, handling and storage, and self-monitoring for adverse events. PMID:26649244

  10. Oral Health Education for Pediatric Nurse Practitioner Students

    PubMed Central

    Golinveaux, Jay; Gerbert, Barbara; Cheng, Jing; Duderstadt, Karen; Alkon, Abbey; Mullen, Shirin; Lin, Brent; Miller, Arthur; Zhan, Ling

    2014-01-01

    The aim of this study was to evaluate whether an interdisciplinary, multifaceted oral health education program delivered to pediatric nurse practitioner students at the University of California, San Francisco, would improve their knowledge, confidence, attitudes, and behaviors regarding the provision of oral health assessments, consultations, referrals, and services to young children during well-child visits. Thirty pediatric nurse practitioner students were included in the study. Participants completed a written survey before and after receiving an interdisciplinary educational intervention that included didactic education, simulation exercises, and clinical observation by a pediatric dental resident. Between pre-intervention and post-intervention, a significant improvement was seen in the pediatric nurse practitioners’ knowledge of oral health topics (p<0.001), confidence when providing oral health counseling (p<0.001), and attitudes about including oral health counseling in their examinations (p=0.006). In the post-intervention survey, 83 percent of the subjects reported having incorporated oral examinations into their well-child visits. Our study suggests that providing an interdisciplinary oral health educational program for pediatric nurse practitioner students can improve their knowledge, confidence, attitudes, and behaviors regarding the incorporation of oral health care services during routine well-child visits. PMID:23658403

  11. Advanced or advancing nursing practice: what is the future direction for nursing?

    PubMed

    Gray, Alastair

    Advanced nursing practice roles have emerged over the last 25 years in response to two major challenges: first, the significant reduction in available doctors; and, second, the rise in numbers of patients with complex health needs. It is suggested that, with a major drive to respond to the first problem, with its emphasis on the development of medical skills, the development of advanced nursing practice (which has the potential to have a significant impact on the second challenge of the rise in long-term conditions) has very much taken second place. Moreover, advanced nursing practice roles have become so medically focused that not only is advanced nursing practice not evident, but neither are the recognised sub-roles that are fundamental to advancing practice. These include innovation, education, research and clinical leadership. This article argues that in the current climate it is essential that advanced nurse practitioners not only demonstrate advanced practice, but also actively embrace the concept of 'advancing' nursing practice as the dominant feature of new roles. PMID:26768039

  12. Exploring the Factors that Influence Nurse Practitioner Role Transition

    PubMed Central

    Barnes, Hilary

    2014-01-01

    The transition from registered nurse (RN) to nurse practitioner (NP) is often a stressful career change. Data are lacking on the factors affecting NP role transition. This study examined the relationships between NP role transition, prior RN experience, and a formal orientation. From a sample of 352 NPs, only a formal orientation contributed significantly to the regression model indicating a positive relationship with NP role transition (b = 6.24, p < .001). Knowledge of the factors that explain NP role transition is important to inform the discipline how best to support NPs during entry into practice. PMID:25685113

  13. The NNP/DNP shortage: transforming neonatal nurse practitioners into DNPs.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2009-01-01

    Neonatal nurse practitioners (NNPs) represent a high-demand specialty practice that is especially targeted for US secondary and tertiary care neonatal intensive care units (NICUs). NNPs make primary decisions about the caregiving of high-risk newborns at the time of admission, throughout hospitalization, at transfer, and at discharge that require an advanced knowledge base in neonatology as well as NICU clinical experience. NNPs prepared at the master's level are currently in very short supply, with some estimates suggesting that for each NNP who graduates, there are 80 positions open across the country. Even with the present shortage, due to the high cost of NNP education, NNP programs are diminishing and those that are remaining are not graduating a sufficient number of new NNPs each year to keep up with the demand. To add to the basic shortage problem, in 2004 the American Association of Colleges of Nursing decided that by 2015, the terminal degree for all nurse practitioners should move from the master's degree to the doctor of nursing practice (DNP) degree. That decision added a minimum of 12 months of full-time education to the advanced education requirements for nurse practitioners. What impact will the decision to require a DNP degree have on NNP specialty practice? Will even more NNP programs close because of faculty shortages of NNPs prepared at the DNP level? If a worse shortage occurs in the number of NNPs prepared to practice in NICUs, will physician assistants or other nonphysician clinicians who meet the need for advanced neonatal care providers replace NNPs? What steps, if any, can nursing take to ensure that NNP specialty practice is still needed and survives after supplementing the DNP requirement to NNP education? PMID:19704297

  14. Nurse practitioners, canaries in the mine of primary care reform.

    PubMed

    Contandriopoulos, Damien; Brousselle, Astrid; Breton, Mylaine; Sangster-Gormley, Esther; Kilpatrick, Kelley; Dubois, Carl-Ardy; Brault, Isabelle; Perroux, Mélanie

    2016-06-01

    A strong and effective primary care capacity has been demonstrated to be crucial for controlling costs, improving outcomes, and ultimately enhancing the performance and sustainability of healthcare systems. However, current challenges are such that the future of primary care is unlikely to be an extension of the current dominant model. Profound environmental challenges are accumulating and are likely to drive significant transformation in the field. In this article we build upon the concept of "disruptive innovations" to analyze data from two separate research projects conducted in Quebec (Canada). Results from both projects suggest that introducing nurse practitioners into primary care teams has the potential to disrupt the status quo. We propose three scenarios for the future of primary care and for nurse practitioners' potential contribution to reforming primary care delivery models. In conclusion, we suggest that, like the canary in the coal mine, nurse practitioners' place in primary care will be an indicator of the extent to which healthcare system reforms have actually occurred. PMID:27085958

  15. Nurse practitioners, certified nurse midwives, and nurse anesthetists: changing care in acute care hospitals in New York City.

    PubMed

    Mezey, M; Dougherty, M; Wade, P; Mersmann, C

    1994-12-01

    To respond to the shrinking pool of primary care physicians and to demands from managed care programs for cost containment, hospitals in New York City have increased their use of nurse practitioners, certified nurse midwives, and nurse anesthetists, creating an increased demand for these personnel. We report here on a survey of hospitals and schools of nursing in New York City and present findings on (a) current use of, and projected demand for nurse practitioners (NPs), certified nurse midwives (midwives) and nurse anesthetists (anesthetists) in hospitals in New York City; (b) the practice patterns of NPs, midwives, and anesthetists currently employed in hospitals; and (c) current and projected enrollment and curriculum in NP, midwifery, and anesthetist education programs in the New York metropolitan area. PMID:7853064

  16. On the night shift: advanced nurse practice in emergency medicine.

    PubMed

    Jenkins, Jennifer

    2016-05-01

    Advanced nurse practitioners in the author's emergency department (ED) work autonomously and as part of a team to assess, diagnose and treat patients with unexplained and undiagnosed illnesses and injuries over a 24-hour cycle of care. The complexity of the role in EDs is often not fully understood, and expectations can vary between trusts and between different clinical areas within trusts. This article describes one night shift in the author's ED to explain the complexity of advanced nurse practitioners' roles in this environment. The article focuses on autonomous decision-making skills and the use of advanced clinical skills in the context of evidence-based practice. PMID:27165394

  17. Mental health nurse practitioners in Australia: improving access to quality mental health care.

    PubMed

    Fisher, Jacklin E

    2005-12-01

    Under The Nurses Amendment (Nurse Practitioners) Act 1998, New South Wales became the first state in Australia to legislate for nurse practitioners. Mental health was identified as a priority 'area of practice' for nurse practitioners. Issues surrounding the implementation of the nurse practitioner role in Australia and the potential for the role to address the current crisis in mental health nursing and the mental health sector will be discussed. The potential for partnerships with other health-care providers, in particular medical practitioners, will demonstrate how successful implementation of the role can fulfil consumer demand for primary prevention counselling, improve access to mental health services and early intervention, and provide mental health services that better reflect national priorities. This examination of the Australian context will be contrasted with a review of the overseas literature on mental health nurse practitioners. PMID:16296989

  18. Nurse practitioner succession planning: forward thinking or just an after-thought?

    PubMed

    Raftery, Chris

    2013-11-01

    This paper examines the concept of backfill and succession planning for an elite speciality nursing group, nurse practitioners. Nurse practitioners work in many public, private, inpatient and outpatient settings across the country. This discussion is relevant to all practicing nurse practitioners, but especially those with their own specific patient group. A nurse practitioner is an elite nursing specialist with specific speciality skills. While present, nurse practitioners can be most effective at holistically managing their patient group. However, if an endorsed nurse practitioner is no longer present, for a short or long interval, their specific skills and abilities cannot be easily substituted or replaced in the short term. This potential compromise in patient care can be detrimental to the developing reputation of the role of the nurse practitioner. In order to address the shortage of specifically skilled nurse practitioners across the country in all specialties, there is a need to forward plan and consider contingencies for succession in the event of short- or long-term absences from the clinical environment. Succession planning is the key to patient safety and the successful implementation of the role of the nurse practitioner. PMID:23838033

  19. Japan and its healthcare challenges and potential contribution of neonatal nurse practitioners.

    PubMed

    Eklund, Wakako

    2010-01-01

    Challenge has the potential to create opportunities for innovation. This applies to new developments aimed at enhancing existing systems of healthcare delivery. The development of the neonatal nurse practitioner's role in the United States is undoubtedly 1 such example of an innovation that was made in response to the challenge in neonatal healthcare delivery. This challenge and concomitant change was generated by a significant increase in neonatal patient needs, survival of smaller and sicker neonates, a rising acuity level, and the accompanying need to elevate the standard of healthcare for neonates. Nursing has faced such challenges more than once and been called upon to change the scope of practice not only in the United States but also globally. Japanese nursing is at a new historic moment since the end of World War II. There is an increased interest in expanding the role of nursing in collaboration with physicians to meet the complex needs of a growing neonatal intensive care population. However, for a nation where traditionally physician-led medicine was believed to maintain patient safety, nursing role advancement is met with significant opposition. This article will first describe the differences between neonatal intensive care unit workforce in Japan and in the United States and then introduce recent neonatal healthcare issues and the nation's response including an exploration of the neonatal nurse practitioner's (NNP's) role. Various barriers against nurse practitioner's role development are explained to better describe the context of NNP. This article focuses on the current status and direction of the NNP movement and efforts that are being made in Japan. PMID:20442612

  20. Assessment of breastfeeding knowledge of nurse practitioners and nurse-midwives.

    PubMed

    Hellings, P; Howe, C

    2000-01-01

    The purpose of this study was to replicate a national study of physician knowledge, experience, and attitudes about breastfeeding. All family, pediatric, and women's health care nurse practitioners and nurse-midwives in a northwestern state were surveyed using a mail questionnaire; the response rate was 60.4%. Respondents were nearly unanimous in believing that "breast is best" and in recommending breastfeeding to expectant mothers as a part of their role. In general, 70% of respondents considered themselves effective or very effective in meeting the needs of breastfeeding patients. Although respondents were very supportive of breastfeeding, they were less knowledgeable about specific management strategies. There were differences in attitudes among nursing specialties and with years of experience. Overall, this statewide sample of nurse practitioners and nurse-midwives had a better understanding of the benefits of breastfeeding and an increased sense of effectiveness in managing breastfeeding problems than the physician participants in the national study. A national sample of nurse practitioners and nurse-midwives is needed to verify and expand on the results from this single jurisdiction, where 40% of the respondents were graduates of the home institution of the co-investigators. PMID:10907336

  1. Nurse Practitioners: Knowledge, Skills, and Leadership for the End-of-Life Conversation in Intensive Care.

    PubMed

    McRee, Laura; Reed, Pamela G

    2016-01-01

    An impending policy change in Medicare will provide reimbursement for the end-of-life conversation. The rise in numbers of older adults who face serious illness coupled with advances in healthcare technology are increasing the need for providers to address end of life issues in the acute care setting. Doctoral-level nurse practitioners who specialize in acute care of older adults are poised to be leaders and facilitators of this conversation in a particularly challenging context-the intensive care unit. The focus of this article is the new end-of-life policy in relation to the particular contributions that adult gerontology acute care nurse practitioners offer in the acute care setting. PMID:26660780

  2. Expanding the role of the nurse practitioner in the deployed setting.

    PubMed

    Dargis, Julie; Horne, Theresa; Tillman-Ortiz, Sophie; Scherr, Diane; Yackel, Edward E

    2006-08-01

    Today's military is experiencing rapid advances in technology and in manpower utilization. The Army Medical Department is redesigning the structure and function of deployable hospital systems as part of this effort. The transformation of deployable hospital systems requires that a critical analysis of manpower utilization be undertaken to optimize the employment of soldier-medics. The objective of this article was to describe the use of nurse practitioners as primary care providers during deployment. The lived experiences of five nurse practitioners deployed to Operation Iraqi Freedom are presented. Data gathered during the deployment and an analysis of the literature clearly support expanded and legitimized roles for these health care professionals in future conflicts and peacekeeping operations. PMID:16933820

  3. The Role of Army Nurse Practitioners Supporting Wars in Iraq and Afghanistan.

    PubMed

    Lewis, Paul C; Yackel, Edward; Prior, Richard M

    2016-01-01

    Family nurse practitioners are an essential member of the military medical team. They were incorporated into the Army medical system almost as soon as there was an academic program to develop the role in primary care settings. The role for nurse practitioners during deployment has not been as clear. Even though they have been around for 50 years, the specific role nurse practitioners provide is still evolving. This article explores the incorporation of nurse practitioners into Army medicine with a focus on deployed medicine. Nurse practitioners have been shown to be very versatile providers with the requisite skill sets to meet the demands of the combat environment and are able to substitute for other medical assets that are critically short due to sustained conflict. Clarifying the value a nurse practitioner brings to medical care in the combat environment is essential to insure all assets are being employed to provide the best medical care to the US fighting force. PMID:27215868

  4. An explanatory model of nurse practitioner job satisfaction.

    PubMed

    Koelbel, P W; Fuller, S G; Misener, T R

    1991-01-01

    Job satisfaction influences employee retention, worker productivity, and performance quality. To retain qualified nurse practitioners (NPs), health administrators must identify sources of job satisfaction and dissatisfaction. Herzberg's dual-factor theory of job satisfaction addresses extrinsic and intrinsic work-related factors. Expansion of the model to include global job satisfaction and individual differences provided a broad framework for the assessment of nurse practitioner job satisfaction. The expanded model was used to analyze the job satisfaction of 132 NPs registered with the South Carolina State Board of Nursing in 1988 (final response rate = 90%). Participants completed the Index of Job Satisfaction (IJS), the Minnesota Satisfaction Questionnaire-Short Form (MSQ-SF), and the Personal and Work Background Questionnaire (PWBQ). Although the NPs were moderately satisfied with their overall jobs, extrinsic factors were found to be major sources of dissatisfaction. The optimal combination of variables predicted by regression analysis to influence global job satisfaction were age, number of children, urban locations, achievement, company policies and practices, creativity, independence, and compensation. Implications for health administrators to improve the work environments of NPs are discussed. PMID:2007057

  5. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions.

    PubMed

    Smith, Tony; Harris, Jillian; Woznitza, Nick; Maresse, Sharon; Sale, Charlotte

    2015-09-01

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as 'a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care'. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities. PMID:26451243

  6. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions

    SciTech Connect

    Smith, Tony; Harris, Jillian; Woznitza, Nick; Maresse, Sharon; Sale, Charlotte

    2015-09-15

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as ‘a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care’. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities.

  7. A focus group study of the use of video-recorded simulated objective structured clinical examinations in nurse practitioner education.

    PubMed

    Barratt, Julian

    2010-05-01

    The objective structured clinical examination (OSCE) is a common method of clinical skills assessment used for advanced nurse practitioner students across the United Kingdom. The purpose of an advanced nursing OSCE is to assess a nurse practitioner student's competence and safety in the performance of commonly used advanced clinical practice skills. Students often feel nervous when preparing for and participating in an OSCE. Consideration of these identified anxieties led to the development of an alternative method of meeting students' OSCE learning and preparation needs; namely video-recorded simulated OSCEs. Video-recording was appealing for the following reasons: it provides a flexible usage of staff resources and time; OSCE performance mistakes can be rectified; it is possible to use the same video-recordings with multiple cohorts of students, and the recordings can be made conveniently available for students with video streaming on internet-based video-sharing sites or virtual learning environments. The aim of the study was to explore the value of using such recordings amongst nurse practitioner students, via online and face-to-face focus groups, to see if they are a suitable OSCE educational preparation technique. The study findings indicate that simulated OSCE video-recordings are an effective method for supporting nurse practitioner educational development. PMID:20202909

  8. Alcohol Abuse Curriculum Guide for Nurse Practitioner Faculty. Health Professions Education Curriculum Resources Series. Nursing 3.

    ERIC Educational Resources Information Center

    Hasselblad, Judith

    The format for this curriculum guide, written for nurse practitioner faculty, consists of learning objectives, content outline, teaching methodology suggestions, references and recommended readings. Part 1 of the guide, Recognition of Early and Chronic Alcoholism, deals with features of alcoholism such as epidemiological data and theories,…

  9. Adversity and advancing nursing knowledge.

    PubMed

    Reed, Pamela G

    2008-04-01

    This column reports the theme of adversity addressed in reference to theoretical and metatheoretical considerations for advancing nursing knowledge. The development and content of three classic nursing theories are presented by Neuman representatives, and by theorists King and Roy. Topics for continued dialogue are identified as derived from the interface between philosophy of science issues and these theories. PMID:18378823

  10. Advanced practice politics and the Oregon nurses' trail.

    PubMed

    Bifano, L C

    1996-01-01

    As health care reform continues to evolve, it is important to consider the context of politics, practice, and power through an examination of nursing's recent history and participation in legislative events. Through a retrospective chronicle that includes interviews, recorded events, and article reviews, the political and legislative history of Oregon nurses in establishing advanced practice for nurse practitioners within the Oregon Nurse Practice Act is described. Prescriptive authority, hospital admitting privileges, and important elements contained in the Oregon Health Plan and Medicare reform are discussed. Questions are posed for the future of health care reform, such as the role of government in determining the quality of care in managed health care. PMID:8710224

  11. Advanced clinical practitioner role in the emergency department.

    PubMed

    Fawdon, Helen; Adams, John

    2013-12-18

    The advanced clinical practitioner role in emergency departments in the UK has developed in an ad hoc manner, without a national framework of registration requirements. This article describes the structure adopted by one NHS trust in England to certify the clinical competence of advanced clinical practitioners in emergency departments through the completion of two portfolios, with a third portfolio to record professional development. The portfolios cover history taking, clinical examination, and interpretation of information and basic investigations to enable the practitioner to undertake medical clerking of a patient attending the emergency department. The portfolios contain evidence of learning and observation of practitioners by middle-grade doctors and consultants. PMID:24345153

  12. Curriculum vitae: An important tool for the nurse practitioner.

    PubMed

    Hicks, Rodney W; Roberts, Mary Ellen E

    2016-07-01

    Advanced practice nurses (APNs) should maintain a curriculum vitae (CV) that comprehensively reflects the individual's work and professional accomplishments. This article guides APNs through best practices for development of a CV. Tips are offered to help guide the content, format, and maintenance of the CV. PMID:27135762

  13. Australian Nurse Practitioner Practice: Value Adding through Clinical Reflexivity

    PubMed Central

    Woods, Michelle; Murfet, Giuliana

    2015-01-01

    The role of the Australian Nurse Practitioner (NP) is in its infancy and at a crossroads where extensive research demonstrates effective quality care and yet the role remains underrecognised and underutilised. The translation of practice into “value” is critical for the sustainability of NP roles and requires the practitioner to adopt a systematic method of inquiry. Kim's (1999) “Critical Reflective Inquiry” (CRI) method was adapted by two Australian NPs who specialise in diabetes and chronic disease management. Kim highlights the intent of CRI as understanding the meaning of practice, delivering improvements to practice through self-reflection, and the critique of practice that can lead to practice changes and development of new models of care translated to “products” of value. Based on the thematically analysis of 3 years of CRI application, the authors formed 5 headings that represented the NP's practice as Specialised Care Access, Complications and Diagnostics Interventions, Pharmaceutical Treatment, Vulnerable Populations, and Leadership. The utility of CRI demonstrates how NP practice is integral to a continuous cycle of addressing health care services gaps, and the conversion of “products” into “value” and positions the NP to assimilate the role of the practitioner-researcher. PMID:25705517

  14. Toward collecting a standardized nursing data set across the continuum: case of adult care nurse practitioner setting.

    PubMed

    Keenan, Gail; Stocker, Julia; Barkauskas, Violet; Treder, Marcy; Heath, Crystal

    2003-01-01

    Viable strategies are needed to move toward collection of a standardized nursing data set across settings for eventual use in examining nursing effectiveness. One strategy is to introduce potential nurse adopters to subsets of valid setting-specific standardized terms and measures to support adoption and initial implementation. The present study was designed to identify the "most clinically useful" NANDA (North American Nursing Diagnoses Association) diagnoses, NOC (Nursing Outcomes Classifications) outcomes, and NIC (Nursing Intervention Classifications) interventions pertinent to the adult care nurse practitioner setting. Ultimately, clinicians must recognize, however, that they will need to use additional terms and measures outside the subsets to more fully describe the nursing care provided. PMID:12881972

  15. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nurse practitioner and physician assistant services... Clinic and Federally Qualified Health Center Services § 405.2414 Nurse practitioner and physician assistant services. (a) Professional services are reimbursable under this subpart if: (1) Furnished by...

  16. Hospital-based nurse practitioner roles and interprofessional practice: a scoping review.

    PubMed

    Hurlock-Chorostecki, Christina; Forchuk, Cheryl; Orchard, Carole; van Soeren, Mary; Reeves, Scott

    2014-09-01

    This scoping review provides current global understanding of the rapidly evolving nurse practitioner role within hospital settings, and considers the level of understanding of its enactment within interprofessional teamwork. Arksey and O'Malley's framework was used to explore recent primary research, reviews, and gray literature in two ways. First, hospital-based nurse practitioner literature was mapped to country of origin, and thematically summarized. Second, clearly developed and consistently defined key interprofessional concepts were identified in the interprofessional literature then conceptually mapped to the nurse practitioner studies by their operationalization. The nurse practitioner review located 103 abstracts. Twenty-nine, originating from four countries, met the inclusion criteria. The interprofessional concept review identified a total of 137 relevant abstracts, however, only ten met the inclusion criteria. Understanding the nurse practitioner role within hospital teams remains limited due to a small number of countries producing evidence, the lack of nurse practitioner role title standardization hindering consistent knowledgebase development, and limited application and inconsistent operationalization of concepts within nurse practitioner research. Research focused on role enactment is needed to understand the uniqueness of the hospital-based nurse practitioner role. PMID:24330003

  17. 78 FR 54255 - HRSA's Bureau of Health Professions Advanced Education Nursing Traineeship Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-03

    ... Education Nursing Traineeship Program AGENCY: Health Resources and Services Administration (HRSA), HHS... Education Nursing Traineeship (AENT) program. Effective fiscal year (FY) 2014, AENT support for part-time... practitioners and nurse midwives. FOR FURTHER INFORMATION CONTACT: Joan Wasserman, DrPH, RN, Advanced...

  18. Expanding acute care nurse practitioner and clinical nurse specialist education: invasive procedure training and human simulation in critical care.

    PubMed

    Hravnak, Marilyn; Tuite, Patricia; Baldisseri, Marie

    2005-01-01

    Programs educating advanced practice nurses (APNs), including acute care nurse practitioners (ACNPs) and clinical nurse specialists (CNSs) may struggle with the degree to which technical and cognitive skills necessary and unique to the care of critically ill patients should be incorporated within training programs, and the best ways these skills can be synthesized and retained for clinical practice. This article describes the critical care technical skills training mechanisms and use of a High-Fidelity Human Simulation (HFHS) Laboratory in the ACNP and CNS programs at the University of Pittsburgh School of Nursing. The mechanisms for teaching invasive procedures are reviewed including an abbreviated course syllabus and documentation tools. The use of HFHS is discussed as a measure to provide students with technical and cognitive preparation to manage critical incidents. The HFHS Laboratory, scenario development and implementation, and the debriefing process are discussed. Critical care technical skills training and the use of simulation in the curriculum have had a favorable response from students and preceptors at the University of Pittsburgh School of Nursing, and have enhanced faculty's ability to prepare APNs. PMID:15714021

  19. Factors enabling advanced practice nursing role integration in Canada.

    PubMed

    DiCenso, Alba; Bryant-Lukosius, Denise; Martin-Misener, Ruth; Donald, Faith; Abelson, Julia; Bourgeault, Ivy; Kilpatrick, Kelley; Carter, Nancy; Kaasalainen, Sharon; Harbman, Patricia

    2010-12-01

    Although advanced practice nurses (APNs) have existed in Canada for over 40 years and there is abundant evidence of their safety and effectiveness, their full integration into our healthcare system has not been fully realized. For this paper, we drew on pertinent sections of a scoping review of the Canadian literature from 1990 onward and interviews or focus groups with 81 key informants conducted for a decision support synthesis on advanced practice nursing to identify the factors that enable role development and implementation across the three types of APNs: clinical nurse specialists, primary healthcare nurse practitioners and acute care nurse practitioners. For development of advanced practice nursing roles, many of the enabling factors occur at the federal/provincial/territorial (F/P/T) level. They include utilization of a pan-Canadian approach, provision of high-quality education, and development of appropriate legislative and regulatory mechanisms. Systematic planning to guide role development is needed at both the F/P/T and organizational levels. For implementation of advanced practice nursing roles, some of the enabling factors require action at the F/P/T level. They include recruitment and retention, role funding, intra-professional relations between clinical nurse specialists and nurse practitioners, public awareness, national leadership support and role evaluation. Factors requiring action at the level of the organization include role clarity, healthcare setting support, implementation of all role components and continuing education. Finally, inter-professional relations require action at both the F/P/T and organizational levels. A multidisciplinary roundtable formulated policy and practice recommendations based on the synthesis findings, and these are summarized in this paper. PMID:21478695

  20. Working in a 'third space': a closer look at the hybridity, identity and agency of nurse practitioners.

    PubMed

    Chulach, Teresa; Gagnon, Marilou

    2016-03-01

    Nurse practitioners (NPs), as advanced practice nurses, have evolved over the years to become recognized as an important and growing trend in Canada and worldwide. In spite of sound evidence as to the effectiveness of NPs in primary care and other care settings, role implementation and integration continue to pose significant challenges. This article utilizes postcolonial theory, as articulated by Homi Bhabha, to examine and challenge traditional ideologies and structures that have shaped the development, implementation and integration of the NP role to this day. Specifically, we utilize Bhabha's concepts of third space, hybridity, identity and agency in order to further conceptualize the nurse practitioner role, to examine how the role challenges some of the inherent assumptions within the healthcare system and to explore how development of each to these concepts may prove useful in integration of nurse practitioners within the healthcare system. Our analysis casts light on the importance of a broader, power structure analysis and illustrates how colonial assumptions operating within our current healthcare system entrench, expand and re-invent, as well as mask the structures and practices that serve to impede nurse practitioner full integration and contributions. Suggestions are made for future analysis and research. PMID:26033156

  1. Effects of a geriatric nurse practitioner on process and outcome of nursing home care.

    PubMed Central

    Kane, R L; Garrard, J; Skay, C L; Radosevich, D M; Buchanan, J L; McDermott, S M; Arnold, S B; Kepferle, L

    1989-01-01

    We compared measures of quality of care and health services utilization in 30 nursing homes employing geriatric nurse practitioners with those in 30 matched control homes. Information for this analysis came from reviews of samples of patient records drawn at comparable periods before and after the geriatric NPs were employed. The measures of geriatric nurse practitioner impact were based on comparisons of changes from pre-NP to post-NP periods. Separate analyses were done for newly admitted and long-stay residents; a subgroup of homes judged to be best case examples was analyzed separately as well as the whole sample. Favorable changes were seen in two out of eight activity of daily living (ADL) measures: five of 18 nursing therapies; two of six drug therapies; six of eight tracers. There was some reduction in hospital admissions and total days in geriatric NP homes. Overall measures of medical attention showed a mixed pattern with some evidence of geriatric NP care substituted for physician care. These findings suggest that the geriatric NP has a useful role in nursing home care. PMID:2504064

  2. Tips for starting your own nurse practitioner practice.

    PubMed

    Calmelat, A

    1993-04-01

    The decision to open a nurse practitioner practice is often difficult to make. Success depends on the possession of specific resources, such as adequate skills, finances, emotional support and the desire to be one's own boss. These skills will be critical as the NP develops a business plan and a budget, and makes important decisions, such as the form the business will take: sole proprietorship, partnership or corporation. Using external resources such as attorneys and accountants is also useful, especially when tackling issues of licenses, taxes and insurance. Start-up costs can be kept to a minimum with creativity and used equipment. In-house laboratories and reference laboratories must conform to strict regulations. A practice without established patients will need to market services aggressively through a successful mix of product, price, place and promotion. Patients' acceptance of the NP office will be enhanced by smooth patient flow, adequate space and cleanliness. PMID:8292127

  3. Nurse practitioners changing health behaviours: one patient at a time.

    PubMed

    Sangster-Gormley, Esther; Griffith, Janessa; Schreiber, Rita; Feddema, April; Boryki, Elizabeth; Thompson, Joanne

    2015-10-01

    In 2005, legislation was enacted allowing nurse practitioners (NPs) to practise in British Columbia, Canada. Although substantial human and financial resources had been dedicated to the implementation of the role, no evaluation has been conducted to date. As part of a larger multiphase, mixed-methods study design, which evaluated the integration of NPs into the British Columbia healthcare system, this article describes findings related to changes that result for patients and the implications for the healthcare system when NPs become part of the care process. Using survey and interview data, themes that emerged were patient satisfaction, access to care, and behavioural changes. Findings suggest that patients are satisfied with the care they receive from NPs and that NPs make positive changes to health behaviour. PMID:26419574

  4. Current Directions in Family Nurse Practitioner Curricula. Proceedings of a National Conference of Representatives from Family Nurse Practitioner Programs (Chapel Hill, North Carolina, January 29-31, 1976)

    ERIC Educational Resources Information Center

    Pickard, C. Glenn, Jr., Ed.; Watkins, Julia D., Ed.

    The conference reported here was held for nurse faculty and physicians from twenty-five family nurse practitioner (FNP) programs based in twenty-one states to provide the participants with an opportunity to consider their common curriculum problems and successes in FNP education. The first half of this booklet contains five paper presentations…

  5. Training Advanced Practice Palliative Care Nurses.

    ERIC Educational Resources Information Center

    Sherman, Deborah Witt

    1999-01-01

    Describes the role and responsibilities of advanced-practice nurses in palliative care and nursing's initiative in promoting high-quality care through the educational preparation of these nurses. (JOW)

  6. A task-based approach to defining the role of the nurse practitioner: the views of UK acute and primary sector nurses.

    PubMed

    Hicks, C; Hennessy, D

    1999-03-01

    There exists within the United Kingdom considerable confusion relating to the definition and occupational boundaries of the nurse practitioner (NP). In consequence, the clinical practice and training of the NP remain unregulated, unstandardized and heavily dependent on local forces. Such a situation is regrettable, particularly in view of the potential value the nurse practitioner has for health care provision and also for influencing national policy decisions. It is conceivable that one reason for the current failure to reach agreement over the role definition of the nurse practitioner relates to the fact that their essential job functions depend upon the context in which the nurse practitioner operates, with primary-based practice differing from acute sector service delivery in sufficient critical ways as to make a generic, inclusive definition impossible. To investigate the veracity of this view, two cohorts of United Kingdom nurses were sampled, one of which worked within the acute sector (n = 49) and the other in the community (n = 420). These groups were surveyed using a unique training needs analysis instrument that had been developed along formal psychometric principles. Both groups perceived advanced clinical activities, including examination and diagnosis, and a range of research activities to be central to the role of the nurse practitioner. The primary sample, however, reported business and management activities as essential tasks, while the acute sector nurses regarded high levels of communication skills, autonomy and risk management to be more important. The implications of the similarities and differences between the two data sets are discussed with reference to different clinical domains. PMID:10210464

  7. The Development of an HIV Training Program for Nurse Practitioners.

    PubMed

    McGee, Kara S; Relf, Michael; Harmon, James L

    2016-01-01

    Responding to a national need for a new workforce of HIV care providers as the first generation of providers decrease their practices or retire, the Duke University School of Nursing, with funding from the Health Resources and Services Administration, developed and implemented a program to train nurse practitioners (NP) to assume the full spectrum of primary care services needed by people living with HIV infection and various co-morbidities. The 12-credit program includes course work in HIV-related epidemiology; pathogenesis; psychosocial, political, ethical, and legal issues; and pharmacology and clinical management. Students complete 392 hours of HIV-specific clinical practice in addition to clinical hours required of all NP students. The program is the only distance-based program of its kind in the United States. Online didactic instruction is complemented by campus-based sessions with interprofessional faculty. We describe the 5 overarching goals that frame the program, and challenges and progress toward achieving those goals. PMID:26733214

  8. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Furnished as an incidental, although integral part of professional services furnished by a nurse... 42 Public Health 2 2010-10-01 2010-10-01 false Services and supplies incident to nurse... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services...

  9. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions

    PubMed Central

    Smith, Tony; Harris, Jillian; Woznitza, Nick; Maresse, Sharon; Sale, Charlotte

    2015-01-01

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as ‘a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care’. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities. PMID:26451243

  10. The changing face of critical care medicine: nurse practitioners in the pediatric intensive care unit.

    PubMed

    Molitor-Kirsch, Shirley; Thompson, Lisa; Milonovich, Lisa

    2005-01-01

    Over the last 50 years, healthcare has undergone countless changes. Some of the important changes in recent years have been budget cuts, decreased resident work hours, and increased patient acuity. The need for additional clinical expertise at the bedside has resulted in nurse practitioners becoming an integral part of the healthcare delivery team. To date, little has been published regarding the role of the nurse practitioners in intensive care units. This article outlines how one pediatric hospital has successfully utilized nurse practitioners in the intensive care unit. PMID:15876885

  11. The consultant nurse - expert practitioner and much more.

    PubMed

    Mitchell, Theresa; Butler-Williams, Carole; Easton, Karen; Ingledew, Ian; Parkin, Donna; Wade, Sharon; Warner, Richard

    The consultant nurse (CN) role is usually described in terms of four domains devised by the Department of Health - clinical practice, education and training, leadership, and research and service development. This study set out to explicate the diversity and complexity of CN roles in an NHS trust; to describe aspects of extraordinary practice and to identify perceived differences between this role and other advanced practice roles. Accounts were written by six CNs and subjected to concept mapping to facilitate identification of extraordinary practice. Four themes emerged: entrepreneurial activity and innovation; clinical autonomy and role dynamism; influential national and international research conduct; consultancy and education across discipline boundaries. These included descriptions of higher order skills that surpass usual requirements of 'expert' or 'advanced' practice. Comparisons with other advanced practice roles are drawn from the literature and data collected in this study. Differences between the roles have implications for sustainability. PMID:20505613

  12. A scoping review of the nurse practitioner workforce in oncology.

    PubMed

    Coombs, Lorinda A; Hunt, Lauren; Cataldo, Janine

    2016-08-01

    The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed(®) , the Cumulative Index to Nursing and Allied Health Sciences (CINAHL(®) ), Web of Science, Journal Storage (JSTOR(®) ), Google Scholar, and SCOPUS(®) . Using the scoping review criteria, the research question was identified "How much care in oncology is provided by nurse practitioners (NPs)?" Key search terms were kept broad and included: "NP" AND "oncology" AND "workforce". The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs. PMID:27264203

  13. Two explanations of nurse practitioner interactions and participatory decision making with physicians.

    PubMed

    Lamb, G S

    1991-10-01

    The purpose of this study was to test a theoretical model that integrated two explanations of nurse practitioner interaction and participatory decision making with physicians. The two explanations were derived from technology theory and social exchange theory. Nurse practitioners (N = 38) responded to a four-scale magnitude estimation instrument measuring each of four concepts in the model: complexity, expected benefit-cost ratio of interaction, interaction, and participatory decision making. Predictions derived from both theories were supported. Nurse practitioner decisions about interaction with physicians were influenced by the dynamics of social exchange with physicians, as well as the technological requirements of primary care. The findings offer nurse practitioners new strategies for managing professional exchanges on behalf of their patients. PMID:1909808

  14. Trends in State Regulation of Nurse Practitioners and Physician Assistants, 2001 to 2010

    PubMed Central

    Gadbois, Emily A.; Miller, Edward Alan; Tyler, Denise; Intrator, Orna

    2016-01-01

    Nurse practitioners and physician assistants can alleviate some of the primary care shortage facing the United States, but their scope-of-practice is limited by state regulation. This study reports both cross-sectional and longitudinal trends in state scope-of-practice regulations for nurse practitioners and physician assistants over a 10-year period. Regulations from 2001 to 2010 were compiled and described with respect to entry-to-practice standards, physician involvement in treatment/diagnosis, prescriptive authority, and controlled substances. Findings indicate that most states loosened regulations, granting greater autonomy to nurse practitioners and physician assistants, particularly with respect to prescriptive authority and physician involvement in treatment and diagnosis. Many states also increased barriers to entry, requiring high levels of education before entering practice. Knowledge of state trends in nurse practitioner and physician assistant regulation should inform current efforts to standardize scope-of-practice nationally. PMID:25542195

  15. Columbia University's Competency and Evidence-based Acute Care Nurse Practitioner Program.

    ERIC Educational Resources Information Center

    Curran, Christine R.; Roberts, W. Dan

    2002-01-01

    Columbia University's acute care nurse practitioner curriculum incorporates evaluation strategies and standards to assess clinical competence and foster evidence-based practice. The curriculum consists of four core courses, supporting sciences, and specialty courses. (Contains 17 references.) (SK)

  16. Methamphetamine use among suburban women: Implications for nurse practitioners

    PubMed Central

    Bairan, Annette; Boeri, Miriam; Morian, Janice

    2012-01-01

    Purpose The purpose of this article is to provide nurse practitioners (NPs) with more effective strategies to diagnose methamphetamine (MA) use and assess healthcare needs of MA-using women. Data Sources The researchers collected data from 65 suburban women who were MA users living in the suburbs of a large southeastern city in the US. We conducted in-depth interviews and focus groups examining their life history, drug history, risk behaviors, and access to healthcare. The qualitative findings are examined here. Conclusions Three main themes emerged from the data: 1) gendered stigmatization of MA use; 2) MA related health risk behaviors; and 3) barriers to health and social services, which resulted in a domino effect that led to further life and health complications. When these factors are not effectively addressed, the result is more serious health problems for the women and their children. Implications for Practice This article offers awareness and assessment tools to provide NPs adequate knowledge about the factors associated with MA use in order to treat patients holistically. NPs are strategically positioned to effectively assess, diagnose, treat, and provide linkage to health and social services, especially for suburban females who are a hidden population of drug users. PMID:24510626

  17. Nurse Practitioner and Physician's Assistant Clinics in Rural California

    PubMed Central

    Morgan, Walter A.

    1980-01-01

    Twenty-six rural California clinics have employed nurse practitioners (NP's) or physician's assistants (PA's) to meet the primary health care needs of local communities. Of the 24 NP's and 5 PA's involved, 11 were men and 18 were women. Their average age was 37, and all but five were trained in California. The clinics, with less than 50 percent on-site physician supervision, averaged 19 miles in distance from the nearest physician (ranging up to 63 miles). More than half the clinics were satellites of central, physician-staffed, nonprofit clinics, a third were community-administered and two were private. Half served a whole community, a quarter were established to serve Indians and a quarter to serve Chicanos. Each NP or PA saw an average of 13 patients a day. All nonprivate clinics received subsidies from a variety of local, state and federal funds. Four of the clinics had closed or had no medical staff at the time of our survey. NP/PA clinics are proving to be a feasible and valuable means of offering essential health care needs to remote communities. PMID:6103602

  18. Vascular Neurology Nurse Practitioner Provision of Telemedicine Consultations

    PubMed Central

    Demaerschalk, Bart M.; Kiernan, Terri-Ellen J.; Investigators, STARR

    2010-01-01

    Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2 ± 9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0 ± 9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider. PMID:20811594

  19. Nurse Practitioners, Physician Assistants, and Certified Nurse-Midwives: A Policy Analysis. Health Technology Case Study 37.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This case study was conducted to analyze the cost-effectiveness of nurse practitioners (NPs), physicians' assistants (PAs), and certified nurse midwives (CNMs) by examining (1) the contributions of each group in meeting health-care needs; (2) the effect of changing the method of payment for their services on the health-care delivery system; and…

  20. Nurse practitioner management of acute in-hours home visit or assessment requests: a pilot study

    PubMed Central

    Edwards, Martin; Bobb, Carol; Robinson, Susan I

    2008-01-01

    Background GPs often perceive home-visit requests as a time-consuming aspect of general practice. The new general medical services contract provides for practices to be relieved of responsibility for home-visits, although there is no model for the transfer of care. One such model could be to employ nurse practitioners to manage such requests. Nurse practitioners can effectively substitute for GPs in managing same-day in-hours emergency care in the surgery, but their role in managing all such requests, including those requiring home visits, has not been assessed. Aim To explore the feasibility and clinical management outcomes of nurse practitioner management of same-day care requests, including those requiring home visits, to inform a proposed randomised controlled trial. Design of study Non-randomised comparative trial. Setting One large general practice (14 600 patients) in south London. Method Nurse practitioner assessment and management of all same-day care requests for 2 days per week was compared with normal GP management on another 2 days, over a 6-month period. Clinical management outcome data were collected from patient records and from data-collection forms completed by a nurse practitioner and GPs. Patient and staff satisfaction was assessed by questionnaire. Results The nurse practitioner was more likely than GPs to assess patients in person, less likely to give advice alone, and more likely to issue a prescription. There was no significant difference between the nurse practitioner and GPs regarding any other clinical management outcomes or patient satisfaction; however, the response rate of the patient satisfaction questionnaire in this pilot study was poor. Conclusion Nurse practitioner management of acute in-hours care requests, including home visits, appears feasible in practice and merits further assessment. PMID:19105910

  1. An ontological view of advanced practice nursing.

    PubMed

    Arslanian-Engoren, Cynthia; Hicks, Frank D; Whall, Ann L; Algase, Donna L

    2005-01-01

    Identifying, developing, and incorporating nursing's unique ontological and epistemological perspective into advanced practice nursing practice places priority on delivering care based on research-derived knowledge. Without a clear distinction of our metatheoretical space, we risk blindly adopting the practice values of other disciplines, which may not necessarily reflect those of nursing. A lack of focus may lead current advanced practice nursing curricula and emerging doctorate of nursing practice programs to mirror the logical positivist paradigm and perspective of medicine. This article presents an ontological perspective for advanced practice nursing education, practice, and research. PMID:16350595

  2. The role of nursing leadership in integrating clinical nurse specialists and nurse practitioners in healthcare delivery in Canada.

    PubMed

    Carter, Nancy; Martin-Misener, Ruth; Kilpatrick, Kelley; Kaasalainen, Sharon; Donald, Faith; Bryant-Lukosius, Denise; Harbman, Patricia; Bourgeault, Ivy; DiCenso, Alba

    2010-12-01

    Supportive nursing leadership is important for the successful introduction and implementation of advanced practice nursing roles in Canadian healthcare settings. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe and explore organizational leadership in planning and implementing advanced practice nursing roles. Leadership strategies that optimize successful role integration include initiating systematic planning to develop the roles based on patient and community needs, engaging stakeholders, using established Canadian role implementation toolkits, ensuring utilization of all dimensions of the role, communicating clear messages to increase awareness about the roles in the organization, creating networks and facilitating mentorship for those in the role, and negotiating role expectations with physicians and other members of the healthcare team. Leaders face challenges in creating and securing sustainable funding for the roles and providing adequate infrastructure support. PMID:21478692

  3. Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice

    PubMed Central

    Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung

    2016-01-01

    Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. PMID:27508923

  4. Online Faculty Mentoring and Transition Balance in Family Nurse Practitioner Students

    ERIC Educational Resources Information Center

    Poronsky, Cathlin B.

    2011-01-01

    The purpose of this study was to examine the effect of online faculty mentoring on Registered Nurse (RN) to Family Nurse Practitioner (FNP) role transition balance during graduate education. Making the transition from RN to an FNP can seem daunting and there is limited information in the literature about RN to FNP role transition during graduate…

  5. Does Contact by a Family Nurse Practitioner Decrease Early School Absence?

    ERIC Educational Resources Information Center

    Kerr, Jill; Price, Marva; Kotch, Jonathan; Willis, Stephanie; Fisher, Michael; Silva, Susan

    2012-01-01

    Chronic early school absence (preschool through third grade) is associated with school failure. The presence of school nurses may lead to fewer absences, and nurse practitioners in school-based health centers (SBHCs) can facilitate a healthier population resulting in improved attendance. Efforts to get students back to school are unexplored in…

  6. School Nurse Practitioners: Analysis of Questionnaire and Time/Motion Data.

    ERIC Educational Resources Information Center

    Dungy, Claibourne I.; Mullins, Ruth G.

    1981-01-01

    A study was done to determine how school nurse practitioners apply skills learned in training programs to their daily activities and to provide a greater understanding of their relationship to consulting physicians. Results indicate that the nurses' perceptions provide useful data on time allocation but do not give a good estimate of patient care…

  7. Cost-effectiveness of a WOC Advanced Practice Nurse in the Acute Care and Outpatient Setting

    PubMed Central

    2014-01-01

    Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767

  8. Cost-effectiveness of a WOC advanced practice nurse in the acute care and outpatient setting.

    PubMed

    Medley, Jenny A

    2014-01-01

    Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767

  9. Physician Assistants and Nurse Practitioners in Rural Washington Emergency Departments.

    PubMed

    Nelson, Scott C; Hooker, Roderick S

    2016-06-01

    One role of physician assistants (PAs) and nurse practitioners (NPs) is to meet the growing demand for access to rural health care. Critical Access Hospitals, those with less than 25 beds, are usually located in rural communities, often providing continuity of care that clinics cannot deliver. Because little is known about staffing in these small hospital emergency departments, an exploratory study was undertaken using a mixed-methods approach. In Washington State, 18 of the 39 Critical Access Hospitals staff their emergency departments with PAs and NPs. Utilization data were collected through structured interviews by phone or in person on site. Most PAs and NPs lived within the community and staffing tended to be either 24 hours in-house or short notice if they lived or worked nearby. Emergency department visits ranged from 200 to 25,000 per year. All sites were designated level V or IV trauma centers and often managed cardiac events, significant injuries and, in some larger settings, obstetrics. In most instances, PAs were the sole providers in the emergency departments, albeit with physician backup and emergency medical technician support if a surge of emergency cases arose. Two-thirds of the PAs had graduated within the last 5 years. Most preferred the autonomy of the emergency department role and all expressed job satisfaction. Geographically, the more remote a Washington State Critical Access Hospital is, the more likely it will be staffed by PAs/NPs. The diverse utilization of semiautonomous PAs and NPs and their rise in rural hospital employment is a new workforce observation that requires broader investigation. PMID:27183500

  10. Humor: a research and practice tool for nurse scholar-supervisors, practitioners, and educators.

    PubMed

    Yura-Petro, H

    1991-06-01

    The nurse scholar, whether a supervisor, an educator, or a practitioner, has a lifetime of research opportunities as well as personal experiences related to the human need for humor. We need to develop the means to assess the individual's and group's response to humor. Nurse scholars, particularly the nurse supervisor, can make a significant contribution in the search to harness some of the energy we use in laughing and direct it toward helping us heal our human conditions. PMID:10110633

  11. Evaluating newly acquired authority of nurse practitioners and physician assistants for reserved medical procedures in the Netherlands: a study protocol

    PubMed Central

    De Bruijn-Geraets, Daisy P; Van Eijk-Hustings, Yvonne JL; Vrijhoef, Hubertus JM

    2014-01-01

    Aim The study protocol is designed to evaluate the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Background Recent (temporarily) enacted legislation in Dutch health care authorizes nurse practitioners and physician assistants to indicate and perform specified medical procedures, i.e. catheterization, cardioversion, defibrillation, endoscopy, injection, puncture, prescribing and simple surgical procedures, independently. Formerly, these procedures were exclusively reserved to physicians, dentists and midwives. Design A triangulation mixed method design is used to collect quantitative (surveys) and qualitative (interviews) data. Methods Outcomes are selected from evidence-based frameworks and models for assessing the impact of advanced nursing on quality of health care. Data are collected in various manners. Surveys are structured around the domains: (i) quality of care; (ii) costs; (iii) healthcare resource use; and (iv) patient centredness. Focus group and expert interviews aim to ascertain facilitators and barriers to the implementation process. Data are collected before the amendment of the law, 1 and 2·5 years thereafter. Groups of patients, nurse practitioners, physician assistants, supervising physicians and policy makers all participate in this national study. The study is supported by a grant from the Dutch Ministry of Health, Welfare and Sport in March 2011. Research Ethics Committee approval was obtained in July 2011. Conclusion This study will provide information about the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Study findings aim to support policy makers and other stakeholders in making related decisions. The study design enables a cross-national comparative analysis. PMID:24684631

  12. Developing advanced nursing skills for frail older people.

    PubMed

    Goldberg, Sarah; Cooper, Jo; Russell, Catherine

    2014-05-01

    Improving hospital care for frail older people requires expertise, leadership and resources as these patients have multiple complex needs. One innovative solution to providing the skilled care necessary is to train experienced nurses to become advanced nurse practitioners (ANPs). Such roles encompass activity previously undertaken by medical staff, together with leadership, teaching, research and service development. Skills specific to caring for older people, such as comprehensive geriatric assessment, are also required. This article discusses the need for ANPs in this clinical area, a pilot that is under way in one acute trust to develop these roles, and the potential benefits and challenges that may accompany this development. PMID:24787943

  13. Discovering the nature of advanced nursing practice in high dependency care: a critical care nurse consultant's experience.

    PubMed

    Fairley, Debra

    2005-06-01

    This paper describes how a critical care nurse consultant's clinical role has evolved within a surgical high dependency unit (SHDU) in a large teaching hospitals trust. In order to provide some background to role development, an overview of the research exploring the nature of advanced nursing practice in the context of critical care will be presented. From the outset, advanced nursing practice was not perceived as the acquisition and application of technical procedures usually undertaken by doctors, but possibly an integration of medicine and nursing where holistic nursing assessment is combined with symptom-focused physical examination. A reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation will be presented. A model of working that can be applied to high dependency units, integrating the role of the advanced nurse practitioner within the clinical team, will be described. PMID:15907666

  14. Musculoskeletal Workforce Needs: Are Physician Assistants and Nurse Practitioners the Solution? AOA Critical Issues.

    PubMed

    Day, Charles S; Boden, Scott D; Knott, Patrick T; O'Rourke, Nancy C; Yang, Brian W

    2016-06-01

    Growth estimates and demographic shifts of the population of the United States foreshadow a future heightened demand for musculoskeletal care. Although many articles have discussed this growing demand on the musculoskeletal workforce, few address the inevitable need for more musculoskeletal care providers. As we are unable to increase the number of orthopaedic surgeons because of restrictions on graduate medical education slots, physician assistants (PAs) and nurse practitioners (NPs) represent one potential solution to the impending musculoskeletal care supply shortage. This American Orthopaedic Association (AOA) symposium report investigates models for advanced practice provider integration, considers key issues affecting PAs and NPs, and proposes guidelines to help to assess the logistical and educational possibilities of further incorporating NPs and PAs into the orthopaedic workforce in order to address future musculoskeletal care needs. PMID:27252443

  15. Educational Changes to Support Advanced Practice Nursing Education

    PubMed Central

    LeFlore, Judy L.; Thomas, Patricia E.

    2016-01-01

    Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system. PMID:27465446

  16. Educational role of nurse practitioners in a family practice centre

    PubMed Central

    Walsh, Allyn; Moore, Ainsley; Barber, Anne; Opsteen, Joanne

    2014-01-01

    Abstract Objective To examine the role of nurse practitioners (NPs) as educators of family medicine residents in order to better understand the interprofessional educational dynamics in a clinical teaching setting. Design A qualitative descriptive approach, using purposive sampling. Setting A family practice centre that is associated with an academic department of family medicine and is based in an urban area in southern Ontario. Participants First-year (8 of 9) and second-year (9 of 10) family medicine residents whose training program was based at the family practice centre, and all NPs (4 of 4) who worked at the centre. Methods Semistructured interviews were conducted, which were audiotaped and transcribed. An iterative approach was used for coding and analysis. Data management software guided organization and analysis of the data. Main findings Four interconnected themes were identified: role clarification, professional identity formation, factors that enhance the educational role of NPs, and factors that limit the educational role of NPs. Although residents recognized NPs’ value in team functioning and areas of specialized knowledge, they were unclear about NPs’ scope of practice. Depending on residents’ level of training, residents tended to respond differently to teaching by NPs. More of the senior residents believed they needed to think like physicians and preferred clinical teaching from physician teachers. Junior residents valued the step-by-step instructional approach used by NPs, and they had a decreased sense of vulnerability when being taught by NPs. Training in teaching skills was helpful for NPs. Barriers to providing optimal education included opportunity, time, and physician attitudes. Conclusion The lack of an intentional orientation of family medicine residents to NPs’ scope of practice and educational role can lead to difficulties in interprofessional education. More explicit recognition of the evolving professional identity of family

  17. Advancing the quality of oncology nursing care: Interlink Community Cancer Nurses' model for reflective practice.

    PubMed

    Howell, D; Pelton, B

    2001-01-01

    Since 1996, Interlink Community Cancer Nurses have been using reflective practice as a team to share knowledge and experience amongst peers. The use of reflective practice enables the nurse to examine decision-making in patient situations and uncover the knowledge and artistry that is embedded in nursing practice. This article describes how reflection is practised by specialist cancer nurses to advance the quality of caregiving. The use of a structured framework for reflection which incorporates ways of knowing in nursing is an essential feature of the Interlink model for reflection. The development of a process for reflection within the Interlink program has at times been challenging. However, the Interlink nurses' experience with reflection is believed to be critical to the ongoing development of the program and the individual nurse. Interlink nurses have found that guided reflection, the creation of an environmental milieu for reflection and personal knowing, and self-evaluation are critical to the process of becoming a self-reflective practitioner. PMID:11842450

  18. The HIV Primary Care Workforce of Tomorrow: The UCSF Integrated HIV/AIDS Primary Care Capacity Nurse Practitioner Program.

    PubMed

    Portillo, Carmen J; Stringari-Murray, Suzan; Fox, Christopher B; Monasterio, Erica; Rose, Carol Dawson

    2016-01-01

    The increasing demand for primary care services and the current health care workforce shortage is predicted to cause drastic reductions in the number of clinicians who are competent to provide HIV care. For the past decade, the University of California, San Francisco (UCSF) School of Nursing has provided HIV specialty education for Advanced Practice Nursing students in the Master's curriculum. In 2013, UCSF was funded by the Health Resources Services Administration to establish a nurse practitioner (NP) HIV primary care education program to expand the number of NPs prepared to provide culturally appropriate comprehensive HIV primary care. To this end, UCSF faculty have developed and validated a set of HIV Primary Care entry-level NP competencies, integrated general HIV knowledge into the NP curriculum, and enhanced our current HIV Specialty curriculum and clinical training. Described herein is UCSF's Integrated HIV/AIDS Primary Care Capacity Nurse Practitioner Program. PMID:27086186

  19. Predictors of practice patterns for lymphedema care among oncology advanced practice nurses.

    PubMed

    Ryan, Joanne C; Cleland, Charles M; Fu, Mei R

    2012-09-01

    Lymphedema, a debilitating and chronic condition, is considered to be one of the most distressing adverse effects of cancer treatment. The purpose of this study was to understand the practice patterns in lymphedema care and identify predictors influencing those patterns among oncology nurses, with a focus on advanced practice nurses. Random and purposive sampling was utilized to recruit 238 oncology nurses who completed the Web-based study. Participants included advanced practice nurses (nurse practitioners and clinical nurse specialists), nurse navigators/case managers, staff nurses, and directors/managers/coordinators. Data focused on perceived knowledge of and perceived competence in risk reduction, treatment, and self-management of lymphedema and practice patterns in lymphedema care. Actual knowledge of lymphedema care was evaluated. Descriptive, comparative, and regression analyses were performed. The study showed that perceived knowledge and perceived competence were highly correlated. Perceived competence was a predictor of practicing lymphedema care. Advanced practice nurses scored in the midrange for perceived knowledge and perceived competence in risk reduction and self-management, but obtained lower scores in perceived knowledge and perceived competence for treatment. The odds of advanced practice nurses delivering lymphedema care were less than those of staff nurses. This study identifies gaps and opportunities for advanced practice nurses to play an important role in providing lymphedema care, an essential aspect of cancer survivorship. PMID:25031960

  20. Predictors of Practice Patterns for Lymphedema Care Among Oncology Advanced Practice Nurses

    PubMed Central

    Ryan, Joanne C.; Cleland, Charles M.; Fu, Mei R.

    2012-01-01

    Lymphedema, a debilitating and chronic condition, is considered to be one of the most distressing adverse effects of cancer treatment. The purpose of this study was to understand the practice patterns in lymphedema care and identify predictors influencing those patterns among oncology nurses, with a focus on advanced practice nurses. Random and purposive sampling was utilized to recruit 238 oncology nurses who completed the Web-based study. Participants included advanced practice nurses (nurse practitioners and clinical nurse specialists), nurse navigators/case managers, staff nurses, and directors/managers/coordinators. Data focused on perceived knowledge of and perceived competence in risk reduction, treatment, and self-management of lymphedema and practice patterns in lymphedema care. Actual knowledge of lymphedema care was evaluated. Descriptive, comparative, and regression analyses were performed. The study showed that perceived knowledge and perceived competence were highly correlated. Perceived competence was a predictor of practicing lymphedema care. Advanced practice nurses scored in the midrange for perceived knowledge and perceived competence in risk reduction and self-management, but obtained lower scores in perceived knowledge and perceived competence for treatment. The odds of advanced practice nurses delivering lymphedema care were less than those of staff nurses. This study identifies gaps and opportunities for advanced practice nurses to play an important role in providing lymphedema care, an essential aspect of cancer survivorship. PMID:25031960

  1. Practice nurses and the effects of the new general practitioner contract in the English National Health Service: the extension of a professional project?

    PubMed

    McDonald, Ruth; Campbell, Stephen; Lester, Helen

    2009-04-01

    This paper reports the impact on nurses working in primary health care settings of changes to the general practitioner (GP) contract in England implemented in 2004. Previous changes to the GP contract in 1990, which gave financial rewards for health promotion activities, were seen as enabling nurses to take on work that GPs did not want and providing an impetus for the development of a professional project (Broadbent, J. (1998). Practice nurses and the effects of the new general practitioner contract in the British NHS: the advent of a professional project? Social Science & Medicine, 47(4), 497-506). Our study, which involved interviews with nurses from 20 practices, finds that nurses are taking on work which has previously been the exclusive preserve of medical professionals. An increasing emphasis in nurses' accounts on technical skills and knowledge may help decouple nursing from a narrative of caring, which has been seen as detracting from professional advancement. Our research suggests that practice nurse work is changing to reflect a more medical (and masculine) orientation to service delivery. At the same time, nursing work is described as routine and template driven, which may limit claims to 'professional' status. The reaction of some practice nurses to Health Care Assistants encroaching on what was previously practice nurse territory suggests a policing of boundaries, rather than an inclusive approach to colleagues within the nursing team. This resonates with Davies' (Davies, C. (1995). Gender and the professional predicament in nursing. Bucks: Open University Press) suggestion that professionalisation as a process involves compliance with a masculine notion of professionalism (autonomous, elite, individual, divisive, detached) which marginalises feminine attributes and devalues the work done by women. The study also raises questions about the role of caring in general practice settings where nurses choose to prioritise other concerns. PMID:19254819

  2. Lessons learned from advanced practice nursing payment.

    PubMed

    Sullivan-Marx, Eileen M

    2008-05-01

    For more than 25 years, advanced practice nurses have been incrementally included as a part of the health care financing structure. Following physician payment revisions at the federal level, advanced practice nurses were overtly recognized as Medicare providers and have participated in the establishment of current procedural terminology codes and the subsequent relative work values associated with payment. Success in this regard has been the result of business, political, and policy savvy that has important lessons for moving forward in any health care restructuring for both nurses and advanced practice nurses. Principles of valuing nurse work, time, and intensity in the Resource-Based Relative Value Scale are discussed with implications for future opportunities of measuring nursing work and any potential relationship to quality outcomes of care. PMID:18650417

  3. Physician Assistants and Nurse Practitioners as a Usual Source of Care

    ERIC Educational Resources Information Center

    Everett, Christine M.; Schumacher, Jessica R.; Wright, Alexandra; Smith, Maureen A.

    2009-01-01

    Purpose: To identify characteristics and outcomes of patients who use physician assistants and nurse practitioners (PA/NPs) as a usual source of care. Methods: Cross sectional analysis using the telephone and mail surveys of the Wisconsin Longitudinal Study (WLS), a prospective cohort study of Wisconsin high school graduates and selected siblings…

  4. 42 CFR Appendix B to Part 130 - Confidential Physician or Nurse Practitioner Affidavit

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Confidential Physician or Nurse Practitioner Affidavit B Appendix B to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. B Appendix B to...

  5. 42 CFR Appendix B to Part 130 - Confidential Physician or Nurse Practitioner Affidavit

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Confidential Physician or Nurse Practitioner Affidavit B Appendix B to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. B Appendix B to...

  6. 42 CFR Appendix B to Part 130 - Confidential Physician or Nurse Practitioner Affidavit

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Confidential Physician or Nurse Practitioner Affidavit B Appendix B to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. B Appendix B to...

  7. 42 CFR Appendix B to Part 130 - Confidential Physician or Nurse Practitioner Affidavit

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Confidential Physician or Nurse Practitioner Affidavit B Appendix B to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. B Appendix B to...

  8. 42 CFR Appendix B to Part 130 - Confidential Physician or Nurse Practitioner Affidavit

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Confidential Physician or Nurse Practitioner Affidavit B Appendix B to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. B Appendix B to...

  9. Designing and Evaluation for a Nurse Practitioner Program: Emphasis on Tailored, Functional Strategies.

    ERIC Educational Resources Information Center

    Repicky, Paul A.; And Others

    1981-01-01

    The design of a nurse practitioner program evaluation should (1) account for program complexity; (2) allow for judgmental and objective data; (3) provide formative data for decision making; (4) be tailored to the individual program; and (5) be relevant and meaningful to the audience. (SK)

  10. Attitudes of Adult Nurse Practitioner Students toward Women Experiencing Domestic Violence.

    ERIC Educational Resources Information Center

    Bessette, Heidi D.; Peterson, Sonja Stone

    2002-01-01

    A survey of 34 nurse practitioner graduate students (93% female) found that 32 had personal experience of abuse; 68% did not feel educational prepared to treat victims of domestic violence. Although a large majority was sympathetic toward victims, small percentages indicated abuse was sometimes justified and the victim bore some responsibility.…

  11. Expanding the Role of Nurse Practitioners: Effects on Rural Access to Care for Injured Workers

    ERIC Educational Resources Information Center

    Sears, Jeanne M.; Wickizer, Thomas M.; Franklin, Gary M.; Cheadle, Allen D.; Berkowitz, Bobbie

    2008-01-01

    Context: A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending…

  12. Factors Related to Successful Transition to Practice for Acute Care Nurse Practitioners.

    PubMed

    Dillon, Deborah L; Dolansky, Mary A; Casey, Kathy; Kelley, Carol

    2016-01-01

    The transition from student to acute care nurse practitioner (ACNP) has been recognized as a time of stress. The purpose of this descriptive, correlational-comparative design pilot study was to examine: (1) the relationships among personal resources, community resources, successful transition, and job retention; (2) the difference between ACNPs with 0 to 4 years and ACNPs with more than 4 years of prior experience as a registered nurse in an intensive care unit or emergency department; and (3) the skills/procedures that ACNPs found difficult to perform independently. Thirty-four participants were recruited from a social media site for nurse practitioners. Organizational support, communication, and leadership were the most important elements of successful transition into the ACNP role. This information can help ACNP faculty and hospital orientation/fellowship program educators to help ACNPs transition into their first position after graduation. PMID:27153306

  13. Nurse Practitioners in the Emergency Department: Barriers and Facilitators for Role Implementation.

    PubMed

    Doetzel, Catherine M; Rankin, James A; Then, Karen L

    2016-01-01

    Emergency department (ED) wait times, length of stay, and overcrowding are common issues in developed health care systems in many countries. These ED issues are multifactorial in nature and require further evaluation in an attempt to provide consistent, adequate health care to each patient. Authors in countries, such as Australia and the United Kingdom, have attempted to address the concerns of increasing wait times, length of stay, and overcrowding by establishing nurse practitioners (NPs) into the ED who practice in domains traditionally dominated by physicians. Unfortunately, Canadian health care system leaders lack experience in implementing the unique role of the NP in the ED. In addition, emergency department fast track (FT) models have been studied and operationalized in Australia and the United States to streamline care for less acute patients. However, it is evident from review of the literature that NPs, in the Canadian health care system, are underutilized within FT units. Despite the fact that NPs have been practicing since the 1960s, there remains confusion by the public and even health care professionals about their role, scope of practice, and capabilities. The purpose of this article is to provide a greater understanding of the NP role in Canada with the intent to elucidate current barriers and facilitators to having NPs practice in the ED setting through appraisal of national and international literature sources. The article also illustrates how FT units streamline patient care and are suitable areas for NP practice within the ED. In addition, the authors describe how assessment, implementation, and evaluation of the role of NPs in the ED might be facilitated through the use of a Participatory Evidence-informed Patient-focused Process for Advanced practice nursing role development, implementation, and evaluation (PEPPA framework). PMID:26817430

  14. Tobacco cessation education for advanced practice nurses.

    PubMed

    Whitehead, Diane; Zucker, Steven B; Stone, Jennifer

    2014-01-01

    The predicted shortfall of primary care physicians and the millions of newly insured beginning in 2014 call for an increase in the number of advanced practice nurses (APRNs). Advanced practice nurses can significantly improve their clients' quality of life and increase their life expectancy through tobacco cessation education. The purpose of this study was to educate APRN students on smoking information and techniques to assist clients with quitting smoking in the primary care setting. PMID:24867074

  15. Development of The Johns Hopkins University School of Nursing Adult/Geriatric Primary Care Nurse Practitioner Program in HIV Prevention, Treatment, and Care.

    PubMed

    Farley, Jason E; Stewart, Jennifer; Kub, Joan; Cumpsty-Fowler, Carolyn; Lowensen, Kelly; Becker, Kathleen

    2016-01-01

    In response to the call to create an AIDS Education and Training Center for Nurse Practitioner Education by the Health Resources and Services Administration, The Johns Hopkins University School of Nursing embarked on a transformative curriculum overhaul to integrate HIV prevention, treatment, and care into the Adult/Geriatric Nurse Practitioner Program. A six-step process outlined in the Curriculum Development for Medical Education was followed. A pilot cohort of Adult/Geriatric Nurse Practitioner students were enrolled, including 50% primary care setting and 50% HIV-focused primary care through a 12-month HIV continuity clinic experience. Through this pilot, substantive changes to the program were adopted. Programmatic outcomes were not compromised with the modification in clinical hours. The model of a 12-month HIV continuity clinical experience reduced the number of required preceptors. This model has important implications for the HIV workforce by demonstrating successful integration of HIV and primary care training for nurse practitioners. PMID:26852319

  16. Skeletal Health Part 2: Development of a Nurse Practitioner Bone Support Clinic for Urologic Patients.

    PubMed

    Turner, Bruce; Ali, Sacha; Drudge-Coates, Lawrence; Pati, Jhumur; Nargund, Vinod; Wells, Paula

    2016-01-01

    Part 1 of this article highlighted the potential negative effects of cancer on the skeleton and provided an overview of available treatment options. Part 2 presents a nurse practitioner-led Bone Support Clinic, which was developed for patients with cancer-induced bone disease and cancer therapy-induced bone loss. This clinic, started in 2011 in a university medical center urology/oncology outpatient center in London, England, United Kingdom, has been a collaborative effort among a multidisciplinary team of doctors, nurse practitioners and nurses. Patients have responded positively to the improved continuity of care, and we have been able to assess and treat impending skeletal-related events in a more timely manner The needs of our patient population and problems with the existing service are reviewed, and the importance of a multidisciplinary approach to these problems is discussed. Initiation of a nurse practitioner-led Bone Support Clinic and the impact of timely response to the effects of cancer and cancer therapies on the skeletal system are outlined and offered as a model. PMID:27093760

  17. Labour saver or building a cohesive interprofessional team? The role of the nurse practitioner within hospitals.

    PubMed

    Hurlock-Chorostecki, Christina; Forchuk, Cheryl; Orchard, Carole; van Soeren, Mary; Reeves, Scott

    2014-05-01

    Nurse practitioners (NP) are employed within hospital interprofessional (IP) teams in several countries worldwide. There have been some efforts to describe the nature of the NP role within IP teams largely focussing on how the role may augment care processes. Here, using a constructivist grounded theory approach, the perceptions of NPs about their role were compared and integrated into a previously published team perspective as the second phase of a larger study. Seventeen hospital-based (HB) NPs across Ontario, Canada, participated in group and individual interviews. The NP perspective substantiated and expanded the previously reported team perspective, resulting in an IP perspective. The three practice foci illustrating role value meaning of this perspective became: evolve NP role and advance the specialty, focus on team working, and hold patient care together. The IP perspective, juxtaposed with an existing contingency approach, revealed that NPs were promoting IP work, predominantly at the collaboration and teamwork levels, and aiding IP team transitions to appropriate forms of IP work. The practice, "focus on team working"' was strongly related to promoting IP work. The findings were consistent with HB NPs enacting a role in building IP team cohesiveness rather than merely acting as a labour saver. This is the first study to align NP and team understanding of HB NP role value using an IP framework. PMID:24344878

  18. New choices for continuing education: a statewide survey of the practices and preferences of nurse practitioners.

    PubMed

    Charles, Patricia A; Mamary, Edward M

    2002-01-01

    Technological innovations in the past decade have made possible several promising new modes for delivering continuing education (CE). Offering a wide variety of educational approaches is necessary to satisfy the different learning needs and preferences of program participants. Continuing education planners need to assess the preferences and practices of Advanced Practitioners of Nursing (APNs) when choosing the modes they will offer for delivering CE programs. A survey was conducted with the entire population of licensed APNs in Nevada to assess practices, preferences, and barriers to use of various CE delivery modes. In-person conferences and live satellite conferences were the most frequently used methods. The top three preferences, in rank order, were in-person conference, print-based self-study, and interactive video conference. Live satellite conference was the least preferred method of earning CE credits. Computer-based modes of CE delivery, which include the Internet and CD-ROM, were among the least used. Findings from this study provide useful information for planners of CE programs for APNs. Data acquired in this study also address the dearth of information related to computer use by APNs for obtaining CE. PMID:11916344

  19. Advanced Practice Nursing Education: Challenges and Strategies

    PubMed Central

    Fitzgerald, Cynthia; Kantrowitz-Gordon, Ira; Katz, Janet; Hirsch, Anne

    2012-01-01

    Nursing education programs may face significant difficulty as they struggle to prepare sufficient numbers of advanced practice registered nurses to fulfill the vision of helping to design an improved US healthcare system as described in the Institute of Medicine's “Future of nursing” report. This paper describes specific challenges and provides strategies to improve advanced practice nursing clinical education in order to ensure that a sufficient number of APRNs are available to work in educational, practice, and research settings. Best practices are identified through a review of classic and current nursing literature. Strategies include intensive interprofessional collaborations and radical curriculum revisions such as increased use of simulation and domestic and international service work. Nurse educators must work with all stakeholders to create effective and lasting change. PMID:22220273

  20. Re-envisioning clinical education for nurse practitioner programs: themes from a national leaders' dialogue.

    PubMed

    Giddens, Jean Foret; Lauzon-Clabo, Laurie; Morton, Patricia Gonce; Jeffries, Pamela; McQuade-Jones, Bambi; Ryan, Sandra

    2014-01-01

    As the need for primary care providers increases, nursing education programs face significant challenges to meet future workforce needs. A more resource-efficient approach for the clinical education of nurse practitioner students is needed. A think tank involving 20 thought leaders representing multiple disciplines was convened to discuss this issue. This article presents seven themes that emerged from this national leaders' dialog: academic practice co-design, standardized preclinical preparation, standardized student assessment, entrustable professional activities, immersive clinical experiences, interprofessional education for team-based care, and innovative education practices. PMID:24939338

  1. Development and evaluation of a pathophysiology CD-ROM for nurse practitioner distance education.

    PubMed

    Mangan, J M; van Soeren, M H

    2000-01-01

    Increasing interest in computer-mediated learning technologies has prompted educators to incorporate them into many learning environments; however, there is still little evaluative evidence to support their effectiveness. This report describes the development and evaluation of an instructional CD-ROM on pathophysiology for Nurse Practitioner students. Researcher-designed questionnaires were used to assess the characteristics of our students, and to solicit their ratings of the CD-ROM on ease of use, clarity of instruction, interest, and convenience of the program, using 5-point Likert scales. The respondents indicated that the package was easy and convenient to use, with high technical quality, and of a level challenging to some but not all of the students. On-line quizzes were most highly rated. There were also some indications of higher levels of achievement among users than among nonusers. These data suggest use of CD-ROM as a distance education strategy can be effective for Nurse Practitioner students. PMID:10740914

  2. Nurse Practitioner Mental Health Care in the Primary Context: A Californian Case Study

    PubMed Central

    Theophilos, Theane; Green, Roger; Cashin, Andrew

    2015-01-01

    In America, mental health needs surpass the availability of specialized providers. This vulnerable population also has other obstacles for comprehensive care including gaps in medical coverage, stigma, economic barriers, and a geographical mal-distribution of qualified mental health professionals. A wide availability of primary care providers, including primary care and family nurse practitioners, are well-positioned to deliver integrated mental and physical health care. A case study from a Southern California Coachella Valley primary care clinic with integrated services is used to demonstrate the much-needed approach of care to address health disparities that face low-income immigrants, migrant workers, and others without access to specialized care centers and providers. It is argued that mental health care should be part of all holistic treatment provided by primary care and family nurse practitioners. This has implications for curricula and practice development. PMID:27417754

  3. Effective case presentations--an important clinical skill for nurse practitioners.

    PubMed

    Coralli, Connie H

    2006-05-01

    Effective case presentations are an important component of the nurse practitioner's skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations, describes the organization of the presentation, and outlines the appropriate information to be included. The main components of a case presentation-introduction, history of the present illness, physical examination, diagnostic studies, differential diagnosis, management, and summary of the case-are discussed in detail. Examples of a formal and an informal case presentation are presented and used to illustrate key points in the text. PMID:16681708

  4. The courage of one's conviction: when do nurse practitioners report unsafe practices?

    PubMed

    Grube, Jean A; Piliavin, Jane A; Turner, Jeanine Warisse

    2010-03-01

    When and why do nurses report unsafe patient practices when they see them? This paper adds to our understanding of the characteristics of health care practitioners who report errors and their environment by introducing role identity as an important concept for understanding this communication behavior. We analyzed the results of a national survey of 330 nurses to address three questions: (1) What factors are associated with nurses stating that they have observed tolerance for unsafe practices; (2) what fosters reporting of unsafe practices; and (3) what is the impact on nurses' commitment to the organization and the profession as a result of observing unsafe practices? Results suggest that the probability of reporting unsafe practices increases as the frequency of unsafe practices increases; this relationship is moderated by nurse role identity and supervisory support for reporting. The probability of reporting of unsafe practices also increases when nurses have a strong role identity and strong organizational role identity. Surprisingly, the highest probability for reporting occurs when both organization and nurse role identities are low. Finally, we examine how risk propensity influences reporting and discuss potential strategies for improving reporting of unsafe practices. PMID:20390681

  5. The Process of Oncology Nurse Practitioner Patient Navigation: A Pilot Study.

    PubMed

    Johnson, Frances

    2016-04-01

    Oncology nurse practitioner (ONP) patient navigators may improve clinical outcomes. However, no standard measures of the process of oncology patient navigation or of related clinical outcomes exist, and research in this area is limited. The exploratory pilot study detailed in this article used grounded theory and interviews with three ONPs to define the processes employed by ONP patient navigators in caring for patients with cancer.
. PMID:26991716

  6. Becoming a primary care nurse practitioner: challenges of the initial year of practice.

    PubMed

    Brown, M A; Olshansky, E

    1998-07-01

    The transition from student to primary care practitioner is exciting and challenging and offers seemingly limitless opportunities. This article presents results of a model generated from a longitudinal study of 35 newly graduated primary care nurse practitioners during their first year of practice. Stages of development include laying the foundation (recuperating from school, negotiating the bureaucracy, looking for a Job, and worrying); launching (feeling real, getting through the day, battling time, and confronting anxiety); meeting the challenge (increasing competence, gaining confidence, and acknowledging system problems); and broadening the perspective (developing system savvy, affirming oneself, and upping the ante). Anticipatory guidance is offered for new graduates and their mentors and colleagues. Mentors can provide crucial information about appropriate expectations and create key structures to facilitate new practitioners' needs for consultation and advice. PMID:9695083

  7. The Nature of Advanced Practice Nursing.

    ERIC Educational Resources Information Center

    Oberle, Kathleen; Allen, Marion

    2001-01-01

    Advanced practice nurses are situated between general knowledge (knowing why, what, and how) and particular knowledge (knowing who--personal knowledge of patients). Integration of the two assists in knowing when a particular action would be most helpful. This practical wisdom is the hallmark of advanced practice. (Contains 45 references.) (SK)

  8. Effects of a small monetary incentive and follow-up mailings on return rates of a survey to nurse practitioners.

    PubMed

    Oden, L; Price, J H

    1999-12-01

    The purpose was to examine the effectiveness of a modest monetary incentive ($1) and none in increasing the response rate of a mail survey to 600 nurse practitioners. The response rate in the incentive group was 81% and 66% in the control group, significant by chi-square test. The most cost effective survey technique for increasing the response rate of nurse practitioners was to code the envelopes and eliminate the monetary incentive. PMID:10710970

  9. Population-based advanced practice nursing: where does oncology fit in?

    PubMed

    Lattimer, Jennie Greco

    2013-12-01

    A national work group met in 2004 to discuss the future of advanced practice nursing. The representatives were nursing education, certification, accreditation, and regulation experts, and the goal was to develop a consensus model for advanced practice nursing regulation (Nevidjon et al., 2010). As a result, a set of recommendations was published in an article that defined a new consensus model for advanced practice registered nurse (APRN) regulation (APRN Consensus Workgroup, 2008; Goudreau, 2009). The new model included six population-based focuses of practice (i.e., family and individual across the lifespan, adult and gerontology, neonatal, pediatrics, women's health- and gender-related, and psychiatric and mental health) (Johnson, Dawson, & Brassard, 2010). A goal of the new model was to standardize the licensure, certification, and regulation of nurse practitioners into specific focuses. State boards were facing an increasing number of requests to recognize nurse practitioner specialties (e.g., organ specific, body systems, diseases) (Johnson et al., 2010). The new model helped standardize education programs, which may help certifying agencies set up curriculum review processes to ensure appropriate credentials for APRNs (Johnson et al., 2010). It also supported the mission of nursing to meet future healthcare needs of the public and to protect the public (Johnson et al., 2010). Some advantages exist to delineating into population-based focuses, but the new model leaves out many specialties (e.g., oncology) that encompass the whole person as well as concentrate on certain diseases. PMID:24305476

  10. [Advanced directives: nurses' and physicians' representations in 2012].

    PubMed

    Ledoux, Mathilde; Rhondali, Wadih; Monnin, Luc; Thollet, Catherine; Gabon, Patricia; Filbet, Marilène

    2013-10-01

    In cancer patients, decision-making process is crucial and patient's involvement is described as a central component. In 2005, a new tool appears to convey patient's opinion even if he is not able to communicate anymore: advanced directives (AD). Unfortunately, their documentation is marginal. The objective of this study was to investigate nurses' and physicians' representations towards AD. A questionnaire had been sent to hospitals, public health facilities and liberal practitioners during February 2012. We collected responses from 42/251 physicians (17 %) and 80/198 nurses (40 %). Sixty percent of participants reported that they were not familiar with the legislative framework for AD. For physicians, main barriers were patient cognitive impairment (P = 0.004) and lack of information on the clinical situation (P = 0.004). For nurses, difficulties were toward end of life and prognosis discussion (P = 0.002), clinical situation evolution since AD documentation (P = 0.008), time frame for AD application (P < 0.001) and the fact that final decision is made by physician alone (P = 0.015). AD should be part of a good medical practice and literature has highlighted the benefit of AD on patient's quality of life. End of life discussion therefore requires dedicated time and specific training for physicians and nurses to improve the rate of patients with AD. PMID:24077035

  11. The Enigma of Graduate Nursing Education: Advanced Generalist? Specialist?

    ERIC Educational Resources Information Center

    Reed, Suellen B.; Hoffman, Sharon E.

    1986-01-01

    To pin down the appropriate parameters for graduate nursing education, the authors say we must explore the meanings of advanced generalist and specialist. They discuss the focus, scope, and depth of the community health major, psychiatric mental health nursing, nursing care of children, maternity nursing, medical-surgical nursing, and nursing…

  12. Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care.

    PubMed

    Fougère, Bertrand; Morley, John E; Decavel, Frédérique; Nourhashémi, Fati; Abele, Patricia; Resnick, Barbara; Rantz, Marilyn; Lai, Claudia Kam Yuk; Moyle, Wendy; Pédra, Maryse; Chicoulaa, Bruno; Escourrou, Emile; Oustric, Stéphane; Vellas, Bruno

    2016-09-01

    Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors and growing health care demand. The development of new nursing roles varies greatly from country to country. The United States and Canada established "nurse practitioners" (NPs) in the mid-1960s. The United Kingdom and Finland also have a long experience in using different forms of collaboration between doctors and nurses. In other countries, such as Australia, NPs were endorsed more recently in 2000. In France, Belgium, or Singapore, the formal recognition of advanced practice nurses is still in its infancy, whereas in other countries, such as Japan or China, advanced practice nurses are not licensed titles. The aims of this article were to define precisely what is meant by the term "advanced practice nurse (APN)," describe the state of development of APN roles, and review the main factors motivating the implementation of APN in different countries. Then, we examine the main factors that have hindered the development of APN roles. Finally, we explain the need for advanced practice roles in geriatrics. PMID:27321868

  13. Partnership in Education: Preparation of the Family Nurse-Practitioner for Primary Care in Rural Health Settings.

    ERIC Educational Resources Information Center

    Fullerton, Judith T.

    A model program to educate primary care nurse-practitioners for rural areas illustrates successful collaboration between university and rural health settings. Part of the Intercampus Graduate Studies program of the University of California--San Francisco School of Nursing and the University of California--San Diego School of Medicine, the model…

  14. [Advanced nursing practice: a must for the quality of care and mental health services].

    PubMed

    Ricard, Nicole; Page, Claire; Laflamme, France

    2014-01-01

    New professional legislation and reorganization of mental health services have had a significant influence on mental health nursing practice. Many nurses have demonstrated clinical leadership and have been able to adapt their services to the needs of the population specially in the primary health care setting. However, many believe that the role of nurses is not sufficiently known and optimally utilized in mental health services. In this article we take a critical look at the mental health nursing practice in Quebec and at the essential requirements for its development. This review aims to: 1) describe current trends in the changing roles and the modernization of mental health nursing practice in Quebec, 2) provide an overview of the development of advanced nursing practice and its impact on the quality of mental health services; 3) clarify the concept of advanced nursing practice and position its development in Quebec and 4) propose various strategies for optimizing the role of nurses and their complementarity with other professionals providing mental health services. This review presents innovative practices developed by nurses in the context of the restructuring of mental health services. For example, new nursing roles have been developed to improve the collaboration with general practitioners groups in primary care settings and facilitate the evaluation and monitoring of patient presenting medical and psychological problems. Another interesting innovation was set up by nurses in developing a new service to allow timely access to integrated care for patients with substance abuse and mental health problems. The various testimonies reported in this article illustrate the potential contribution of these nursing innovations in improving the mental health services in Quebec. Also, in few countries, the reform of mental health services has been a good time to recognize this potential. Thus, some countries have repositioned the role of mental health nurses and

  15. Occupational closure in nursing work reconsidered: UK health care support workers and assistant practitioners: A focus group study.

    PubMed

    Traynor, Michael; Nissen, Nina; Lincoln, Carol; Buus, Niels

    2015-07-01

    In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement of assistant, 'non-qualified' workers by governments and managers forms part of a reconfiguration of traditional professional work. This research used focus groups with three cohorts of healthcare support workers undertaking assistant practitioner training at a London university from 2011 to 13 (6 groups, n = 59). The aim was to examine how these workers positioned themselves as professionals and accounted for professional boundaries. A thematic analysis revealed a complex situation in which participants were divided between articulating an acceptance of a subordinate role within traditional occupational boundaries and a usurpatory stance towards these boundaries. Participants had usually been handpicked by managers and some were ambitious and confident in their abilities. Many aspired to train to be nurses claiming that they will gain recognition that they do not currently get but which they deserve. Their scope of practice is based upon their managers' or supervisors' perception of their individual aptitude rather than on a credentialist claim. They 'usurp' nurses claim to be the healthcare worker with privileged access to patients, saying they have taken over what nursing has considered its core work, while nurses abandon it for largely administrative roles. We conclude that the participants are the not unwilling agents of a managerially led project to reshape the workforce that cuts across existing occupational boundaries. PMID:25989001

  16. A case study of nurse practitioner role implementation in primary care: what happens when new roles are introduced?

    PubMed Central

    2013-01-01

    Background At the time of this study (2009) the role of the nurse practitioner was new to the province of British Columbia. The provincial government gave the responsibility for implementing the role to health authorities. Managers of health authorities, many of whom were unfamiliar with the role, were responsible for identifying the need for the NP role, determining how the NP would function, and gaining team members’ acceptance for the new role. Method The purpose of the study was to explain the process of nurse practitioner role implementation as it was occurring and to identify factors that could enhance the implementation process. An explanatory, single case study with embedded units of analysis was used. The technique of explanation building was used in data analysis. Three primary health care settings in one health authority in British Columbia were purposively selected. Data sources included semi-structured interviews with participants (n=16) and key documents. Results The results demonstrate the complexity of implementing a new role in settings unfamiliar with it. The findings suggest that early in the implementation process and after the nurse practitioner was hired, team members needed to clarify intentions for the role and they looked to senior health authority managers for assistance. Acceptance of the nurse practitioner was facilitated by team members’ prior knowledge of either the role or the individual nurse practitioner. Community health care providers needed to be involved in the implementation process and their acceptance developed as they gained knowledge and understanding of the role. Conclusion The findings suggest that the interconnectedness of the concepts of intention, involvement and acceptance influences the implementation process and how the nurse practitioner is able to function in the setting. Without any one of the three concepts not only is implementation difficult, but it is also challenging for the nurse practitioner to fulfill

  17. Long-term care legislation: an issue of concern for nurse practitioners.

    PubMed

    Jennings, J P

    1989-01-01

    Comprehensive long-term care policy has many hurdles to overcome before it becomes a reality. The biggest hurdle is the price tag! Estimates range from $6 billion (Pepper's home-care bill) to $46 billion (Stark's long-term care coverage bill). Congressional insiders predict that federal long-term care coverage must contain "pay-as-you-go" financing to win congressional passage. The medicare catastrophic health care act is cited by many in the Congress as establishing the precedent for self-financing of new federal benefits. In a pay-as-you-go era in public spending, any new program can only come from trimming existing programs and shifting those funds to new programs or from generating new revenues. The latter could result from increased beneficiary cost-sharing, an increase in the medicare payroll tax, or by eliminating the $45,000 cap on income exposed to the current 1.45% medicare payroll tax. Federal proposals to date build on existing medicare and medicaid programs. In them, quality assurance measures have been strengthened, consumer input encouraged, and a new layer of bureaucracy established to screen potential clients and provide case-management services. The scope of services is broad in most of the current proposals, and reimbursement is provided for respite care to allow family care givers relief and assistance. Access to nurse practitioners' services is an important feature of Kennedy's Lifecare proposal and is the focus of lobbying efforts for all public and private proposals. It is time for nurse practitioners to become involved in long-term care legislation. This may be initiated by reviewing current proposals and long-term care packages offered by major insurance companies. Any future long-term care benefit should bear the imprint of the nurse practitioner's professional perspective and the profession's commitment to humane, caring health policy. PMID:2517223

  18. Effectiveness of educational strategies preparing physician assistants, nurse practitioners, and certified nurse-midwives for underserved areas.

    PubMed Central

    Fowkes, V K; Gamel, N N; Wilson, S R; Garcia, R D

    1994-01-01

    A study of physician assistant, nurse practitioner, and certified nurse midwifery programs was undertaken to identify and assess the effectiveness of recruitment, educational, and deployment strategies that programs use to prepare practitioners for medically underserved areas. The 51 programs studied were those having mission statements or known track records relating to this goal. A total of 170 interviews were conducted with faculty, students, graduates, and employers from 9 programs visited on-site and 42 programs surveyed by telephone. All programs had some recruitment and training activities in underserved sites. Only about half of the programs were able to submit data on their graduates' practice settings and specialties. These data suggest that older students who have backgrounds in underserved areas and clearly identified practice goals are more likely to practice in underserved areas. Programs that actively promote service to the underserved do so through publicly stated missions and recruitment and educational strategies that complement these missions. Such programs also are more likely to evaluate and document their success than programs that lack strategies. PMID:7938389

  19. Recommendations On Educational Preparation And Definition Of The Expanded Role And Functions Of The School Nurse Practitioner. (A Joint statement of the American Nurse's Association and the American School Health Association)

    ERIC Educational Resources Information Center

    Journal of School Health, 1973

    1973-01-01

    This is a joint statement of the American Nurses Association and the American School Health Association endorsing expansion of the traditional role of school nurses so that they may serve as school nurse practitioners. Such practitioners (upon completion of a course of study outlined in the article) would assume a more direct and responsible…

  20. Technological Advances in Psychiatric Nursing: An update.

    PubMed

    Bostrom, Andrea C

    2016-06-01

    Understanding and treating mental illness has improved in many ways as a result of the fast pace of technological advances. The technologies that have the greatest potential impact are those that (1) increase the knowledge of how the brain functions and changes based on interventions, (2) have the potential to personalize interventions based on understanding genetic factors of drug metabolism and pharmacodynamics, and (3) use information technology to provide treatment in the absence of an adequate mental health workforce. Technologies are explored for psychiatric nurses to consider. Psychiatric nurses are encouraged to consider the experiences of psychiatric patients, including poor health, stigmatization, and suffering. PMID:27229272

  1. Patient-Centered Homes and Integrated Behavioral Health Care: Reclaiming the Role of "Consultant" for Psychiatric-Mental Health Nurse Practitioner.

    PubMed

    Soltis-Jarrett, Victoria

    2016-06-01

    The notion of patient-centered care has long been linked with nursing practice since Florence Nightingale. The discipline of nursing is focused on the holistic care of individuals, families, and communities in times of sickness and/or health. However, in psychiatric-mental health nursing, the concepts of mental health and psychiatric illness still remain marginalized in our health care delivery systems, as well as in nursing education, knowledge development, and practice. Even with the concept of patient-centered homes, acute and primary care providers are reluctant to embrace care of those with psychiatric illness in their respective settings. Psychiatric illness was and continues to be in the shadows, hidden and often ignored by the larger community as well as by health care providers. This paper describes a Health Resources Services Administration (HRSA) Advanced Nursing Education (ANE) training grant's objective of reintegrating psychiatric-mental health practice into ALL health care delivery systems using the concept of patient-centered nursing care as a foundation for, and promotion of, the Psychiatric-Mental Health Nurse Practitioner (PMH-NP) as the "navigator" for not only the patients and their families, but also for their acute and primary care colleagues using an Interprofessional Education Model. The major barriers and lessons learned from this project as well as the need for psychiatric-mental health nurses to reclaim their role as a consultant/liaison in acute, primary, and long-term care settings will be discussed. The PMHNP as a consultant/liaison is being revitalized as an innovative advanced practice nursing health care model in North Carolina. PMID:27144999

  2. [How to develop advanced practice nursing in complex health care systems?].

    PubMed

    Lecocq, Dan; Mengal, Yves; Pirson, Magali

    2015-01-01

    Over the last few decades, advanced nursing practitioners (ANP) have developed new roles in health care systems and this tendency is continuing to grow. Postgraduate trainedANP interact directly with the person, i.e. the individual and his/her family - in many fields of practice and in a context of collaboration withfellow nurses and other health care professionals. The potential benefits of ANP interventions have been demonstrated in many fields. In particular, ANP are public health actors, able to participate in the interdisciplinary response to supportive care ofpatients with chronic diseases. However, the development of advanced practice nursing (APN) in a complex health care system requires a systemic approach coordinated with the various levels of training of nursing practitioners and other health care professionals. This is an essential prerequisite to allow ANPs to develop new roles adapted to their capacities (legal qualification, high level, specialist training, modalities of collaboration, etc.). To achieve an added value for patients, for the health care system in terms ofresults and to ensure adequate nursing conditions, the authors emphasize the importance of structured development of APN and propose an awareness phase comprising adoption of a conceptual model of APN and the establishment of a structured list of existing nursing practices in order to prepare a methodical implementation strategy. PMID:26168623

  3. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... following limits: (1) For services furnished in a hospital (including assistant-at-surgery services), 75...-at-surgery services) furnished beginning January 1, 1998, allowed amounts for the services of a nurse... the service. For assistant-at-surgery services, allowed amounts for the services of a...

  4. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... exceed the following limits: (1) For services furnished in a hospital (including assistant-at-surgery...-at-surgery services) furnished beginning January 1, 1998, allowed amounts for the services of a nurse... the service. For assistant-at-surgery services, allowed amounts for the services of a...

  5. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... exceed the following limits: (1) For services furnished in a hospital (including assistant-at-surgery...-at-surgery services) furnished beginning January 1, 1998, allowed amounts for the services of a nurse... the service. For assistant-at-surgery services, allowed amounts for the services of a...

  6. Helping patients attain and maintain asthma control: reviewing the role of the nurse practitioner

    PubMed Central

    Rance, Karen S

    2011-01-01

    Nurse practitioners (NPs) have a unique opportunity as frontline caregivers and patient educators to recognize, assess, and effectively treat the widespread problem of uncontrolled asthma. This review provides a perspective on the role of the NP in implementing the revised National Asthma Education and Prevention Program (NAEPP) Guidelines put forth by the National Heart, Lung, and Blood Institute, thereby helping patients achieve and maintain asthma control. A literature search of PubMed was performed using the terms asthma, nurse practitioner, asthma control, burden, impact, morbidity, mortality, productivity, quality of life, uncontrolled asthma, NAEPP guidelines, assessment, pharmacotherapy, safety. Despite the increased morbidity and mortality and impaired quality of life attributable to uncontrolled asthma, the 2007 NAEPP asthma guidelines are greatly underused. NPs have an opportunity to identify patients at risk and provide enhanced care and education for asthma control. Often, NPs can prescribe medication for and manage these patients, but it is necessary to be able to discern which patients require referral to a specialist. PMID:21847352

  7. Development of the center for living donation: incorporating the role of the nurse practitioner as director.

    PubMed

    Rudow, Dianne Lapointe

    2011-12-01

    For decades, live organ donors have been cared for within the transplant program by the same team that cared for the recipient without any standardization, practice guidelines, or evidence-based evaluation. In an effort to improve the care of living donors, regulations and guidelines to dictate care and follow-up have been instituted. Practices still vary from center to center, and the quality of care that live donors receive also varies. A "Living Donor Center" focused solely on the care of actual and potential donors before and after donation is one way to provide the infrastructure to comply with regulatory mandates and deliver high-quality care to this specialized population of patients. A Center for Living Donation was developed within a Transplantation Institute to address the short- and long-term needs of live donors and confine all donor care to a team of experts led by a doctorally prepared nurse practitioner as the director. A transplant nurse practitioner is uniquely poised to assume such a role because of such competencies as clinical and professional leadership, ability to act as a change agent, communication skills, and ability to lead a multidisciplinary team. PMID:22548993

  8. Advanced nursing practice: old hat, new design.

    PubMed

    De Grasse, C; Nicklin, W

    2001-01-01

    Advanced practice nurses positively impact the delivery of healthcare and client outcomes. However, in the past these positions have been seen to have variable value and were often vulnerable during budget cuts. Lack of a clear advanced nursing practice (ANP) framework probably contributed to the compromised effectiveness of these roles and evolution of roles with different titles, scopes of practice and reporting structures. To build the foundation for developing an ANP framework, a task force at The Ottawa Hospital (TOH) conducted a literature review related to ANP roles and completed a review of all clinical nursing roles at TOH. In addition, focus groups with nurses and other health professionals elicited ANP perceptions. The ANP framework includes a standardized job description that details competencies under five role components: clinical practice; consultation; research; education; and, leadership. Recommendations for assessment, implementation and evaluation of ANP roles are identified. The process undertaken by our ANP task force proved to be thorough and sound in developing a framework within which to move forward with ANP role implementation throughout TOH. This article, describing the process, may assist other organizations in defining ANP roles to better meet patient needs in changing health care environments. PMID:11803945

  9. Stakeholders' conceptualizations of the nurse practitioner role in the pediatric emergency department.

    PubMed

    Murray, Louise; Reidy, Mary; Carnevale, Franco A

    2010-01-01

    In Quebec, as in the rest of Canada, the increasing service demands placed on emergency departments (EDs), and the dwindling resources of physicians, nurses and trainees, have obliged those managing EDs to question whether new roles need to be introduced. Increasing acuity and complexity of care, coupled with rising numbers of pediatric patients seeking care for non-urgent health issues, have created a need to address long waiting times for non-urgent patients, as well as more standardized care (using approved and evidence-based protocols) for acutely ill patients during their ED stay. Presently, the nurse practitioner (NP) role may be operationalized in Quebec EDs, as recent legislation has cleared the path for its introduction. Some theorists view the development of a new role such as the NP's as a dynamic process of shared conceptualizations (i.e., expectations and conceptions) that help maintain stable interaction. To succeed in introducing the NP role, and to minimize conflict in the post-implementation phase, it is important to understand the conceptualizations of those most closely involved: the stakeholders. Given the lack of Canadian literature on this subject, a qualitative descriptive design was effected to identify stakeholders' conceptualizations of the paediatric emergency nurse practitioner (ENP) role in the early stages of development. Stakeholders described it as a largely clinical role with other responsibilities, including teaching and mentoring, and minimal research responsibilities to ensure a clinical focus. The stakeholders agreed that they must be involved in the role development process, i.e., implementation must not be a top-down initiative. The results of this study support the view that stakeholders have conceptualizations of the role itself and of the role development process, and that these conceptions guide expectations of both the role and the process. It is imperative for those developing new roles to be well informed about

  10. Realising their potential? Exploring interprofessional perceptions and potential of the advanced practitioner role: a qualitative analysis

    PubMed Central

    Powell, Tom; Watkins, Dianne; Kelly, Daniel

    2015-01-01

    Objectives To explore perceptions of the current practice and future potential of advanced practitioners (APs) from the perspectives of different professional groups in Wales UK. Design A qualitative study consisting of nine focus group interviews. Methods Initially verbatim transcriptions of each focus group interviews were analysed thematically before themes were merged to represent perceptions for the whole data set. Participants Data were gathered from a total of 67 stakeholders—including APs from a variety of professional groups (eg, nursing, physiotherapy, paramedics) as well as managers, workforce developers, educators and medical staff who have a role developing and supporting APs in practice. Results The results are presented in four themes: (1) demand, policy context and future priorities, (2) role clarity and standardisation, (3) agreement and understanding of the role and (4) interprofessional working. The context within which current and future AP roles were considered was influenced by inexorable demands for healthcare and the requirements to meet health policy priorities. Developing AP roles were hampered currently by a lack of shared understanding and ‘joined-up’ working between different groups such as medical practitioners, managers, commissioners and educators. Conclusions For the AP role to flourish more ‘joined-up’ thinking, support and development opportunities are required between APs, managers, senior clinicians, commissioners and educators. Working together to plan and deliver education, innovation and service delivery is of prime importance to meeting ever increasing complex health needs. This will ensure that future APs are adequately prepared and supported to reach their full potential and help deliver necessary innovations in current models of care delivery. PMID:26656024

  11. Diabetes Mellitus Care Provided by Nurse Practitioners vs Primary Care Physicians

    PubMed Central

    Kuo, Yong-Fang; Goodwin, James S.; Chen, Nai-Wei; Lwin, Kyaw K.; Baillargeon, Jacques; Raji, Mukaila A.

    2016-01-01

    Objectives To compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). Design Retrospective cohort study. Setting Primary care in communities. Participants Individuals with a diagnosis of diabetes mellitus in 2009 who received all their primary care from NPs or PCPs were selected from a national sample of Medicare beneficiaries (N = 64,354). Measurements Propensity score matching within each state was used to compare these two cohorts with regard to rate of eye examinations, low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (HbA1C) testing, nephropathy monitoring, specialist consultation, and Medicare costs. The two groups were also compared regarding medication adherence and use of statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (for individuals with a diagnosis of hypertension), and potentially inappropriate medications (PIMs). Results Nurse practitioners and PCPs had similar rates of LDL-C testing (odds ratio (OR) = 1.01, 95% confidence interval (CI) = 0.94–1.09) and nephropathy monitoring (OR = 1.05, 95% CI = 0.98–1.03), but NPs had lower rates of eye examinations (OR = 0.89, 95% CI = 0.84– 0.93) and HbA1C testing (OR = 0.88, 95% CI = 0.79– 0.98). NPs were more likely to have consulted cardiologists (OR = 1.29, 95% CI = 1.21–1.37), endocrinologists (OR = 1.64, 95% CI = 1.48–1.82), and nephrologists (OR = 1.90, 95% CI = 1.67–2.17) and more likely to have prescribed PIMs (OR = 1.07, 95% CI = 1.01–1.12). There was no statistically significant difference in adjusted Medicare spending between the two groups (P = .56). Conclusion Nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline–concordant care. NPs used specialist consultations more often but had similar overall costs of care to PCPs. PMID:26480967

  12. Nurse Practitioners, Certified Nurse Midwives, and Physician Assistants in Physician Offices

    MedlinePlus

    ... Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard Technical Notes Other Publications Advance Data From Vital and ... Vital Statistics of the United States: 1890-1938 Technical Appendices Miscellaneous Publications National Conference on Health Statistics ...

  13. Prescribing Exercise for Older Adults: A Needs Assessment Comparing Primary Care Physicians, Nurse Practitioners, and Physician Assistants

    ERIC Educational Resources Information Center

    Dauenhauer, Jason A.; Podgorski, Carol A.; Karuza, Jurgis

    2006-01-01

    To inform the development of educational programming designed to teach providers appropriate methods of exercise prescription for older adults, the authors conducted a survey of 177 physicians, physician assistants, and nurse practitioners (39% response rate). The survey was designed to better understand the prevalence of exercise prescriptions,…

  14. Counseling and provision of long-acting reversible contraception in the US: National survey of nurse practitioners

    PubMed Central

    Harper, Cynthia C.; Stratton, Laura; Raine, Tina R.; Thompson, Kirsten; Henderson, Jillian T.; Blum, Maya; Postlethwaite, Debbie; Speidel, J Joseph

    2013-01-01

    Objective Nurse practitioners (NPs) provide frontline care in women’s health, including contraception, an essential preventive service. Their importance for contraceptive care will grow, with healthcare reforms focused on affordable primary care. This study assessed practice and training needs to prepare NPs to offer high-efficacy contraceptives - IUDs and implants. Method A US nationally representative sample of nurse practitioners in primary care and women’s health was surveyed in 2009 (response rate 69%, n=586) to assess clinician knowledge and practices, guided by the CDC US Medical Eligibility Criteria for Contraceptive Use. Results Two-thirds of women’s health NPs (66%) were trained in IUD insertions, compared to 12% of primary care NPs. Contraceptive counseling that routinely included IUDs was low overall (43%). Nurse practitioners used overly restrictive patient eligibility criteria, inconsistent with CDC guidelines. Insertion training (aOR=2.4, 95%CI: 1.10 5.33) and knowledge of patient eligibility (aOR=2.9, 95%CI: 1.91 4.32) were associated with IUD provision. Contraceptive implant provision was low: 42% of NPs in women’s health and 10% in primary care . Half of NPs desired training in these methods. Conclusion Nurse practitioners have an increasingly important position in addressing high unintended pregnancy in the U.S., but require specific training in long-acting reversible contraceptives. PMID:24128950

  15. Curriculum Guidelines & Regulatory Criteria for Family Nurse Practitioners Seeking Prescriptive Authority To Manage Pharmacotherapeutics in Primary Care. Summary Report 1998.

    ERIC Educational Resources Information Center

    National Council of State Boards of Nursing, Chicago, IL.

    This report describes a multi-organizational project to accomplish two goals: (1) to develop pharmacology/pharmacotherapeutics curriculum guidelines designed to prepare family nurse practitioners (FNPs) for full prescriptive authority; and (2) to develop regulatory criteria for evaluating the academic preparation and clinical competencies of FNPs…

  16. Testing a multi-group model of culturally competent behaviors among underrepresented nurse practitioners.

    PubMed

    Benkert, Ramona; Templin, Thomas; Schim, Stephanie Myers; Doorenbos, Ardith Z; Bell, Sue Ellen

    2011-08-01

    Diversifying the health professional workforce and enhancing cultural competence are recommended for decreasing health disparities. We tested a structural equation model of the predictors of culturally competent behaviors in a mailed survey of three groups of underrepresented nurse practitioners (n = 474). Our model had good fit and accounted for 29% of the variance in culturally competent behaviors. Life experiences with diversity had direct effects on awareness/sensitivity and behaviors, and diversity training had a direct effect on behaviors. Cultural awareness/sensitivity mediated the relationship between life experiences with diversity and culturally competent behaviors; all paths remained after controlling for covariates. For unique experiences that contribute to workplace diversity, life experiences with diversity, and diversity training are important for culturally competent behaviors. PMID:21656784

  17. States With The Least Restrictive Regulations Experienced The Largest Increase In Patients Seen By Nurse Practitioners

    PubMed Central

    Kuo, Yong-Fang; Loresto, Figaro L.; Rounds, Linda R.; Goodwin, James S.

    2013-01-01

    The use of nurse practitioners (NPs) is one way to address the shortage of physician primary care providers. NP training programs and the number of practicing NPs have increased in the past two decades. However, regulations limiting their scope of practice vary greatly by state. We assessed the impact of state regulations on the increase in care provided by NPs in the United States, using a 5 percent national sample of Medicare beneficiaries. We found that between 1998 and 2010 the number of Medicare patients receiving care from NPs increased fifteenfold. By 2010 states with the least restrictive regulations of NP practice had a 2.5-fold greater likelihood of patients’ receiving their primary care from NPs than did the most restrictive states. Relaxing state restrictions on NP practice should increase the use of NPs as primary care providers, which in turn would reduce the current national shortage of primary care providers. PMID:23836739

  18. Extending Nurse Practitioner Care Using the Virtual Reality World of Second Life

    PubMed Central

    Weiner, Elizabeth E.; Elasy, Tom; Lorenzi, Nancy M.; McNew, Ryan; Shackleford, Laura; Wolff, Kathleen; Martin, Stephanie; Benson, Christy

    2012-01-01

    The growth of Internet applications has substantially broadened the potential for its use in global telehealth. This pilot project used the virtual reality world of Second Life for diabetic patients to meet with their nurse practitioners for their maintenance visits. Using avatars and the online patient portal, these scheduled visits were designed to meet the needs of the patients as determined by the results from a questionnaire completed by patients prior to the visit. The virtual visits took place in the replicated building where patients typically receive their care, the Eskind Diabetes Clinic. Orientation sessions to Second Life were made available prior to the actual visit, and additional online resources were made available after the visit was over. Although only seven pilot patients have currently completed visits, data illustrate the positive potential use of this treatment modality for future study. PMID:24199137

  19. Experience of Psychiatric Mental Health Nurse Practitioners in Public Mental Health.

    PubMed

    Phoenix, Bethany J; Hurd, Manton; Chapman, Susan A

    2016-01-01

    Expansion of health insurance coverage under the Accountable Care Act has meant that millions of people are now insured for mental health treatment, but with no significant increase in the mental health workforce. Services of psychiatric mental health nurse practitioners (PMHNPs) may be best utilized to improve access to and quality of public mental health services if the financial, political, scope of practice, and treatment model barriers that limit their ability or willingness to practice in these settings are better understood. This article reports qualitative results from a study that assessed barriers and best practices in the use of PMHNPs in county mental health services in California. Results indicate that PMHNPs are valued for their "whole person" perspective, collaborative approach, and interpersonal communication skills, but that significant knowledge gaps, regulatory constraints, and bureaucratic barriers in public mental health systems inhibit PMHNPs from practicing at the top of their scope. PMID:27259125

  20. Specialty distribution of physician assistants and nurse practitioners in North Carolina.

    PubMed

    Fraher, Erin P; Morgan, Perri; Johnson, Anna

    2016-04-01

    Physician workforce projections often include scenarios that forecast physician shortages under different assumptions about the deployment of physician assistants (PAs) and nurse practitioners (NPs). These scenarios generally assume that PAs and NPs are an interchangeable resource and that their specialty distributions do not change over time. This study investigated changes in PA and NP specialty distribution in North Carolina between 1997 and 2013. The data show that over the study period, PAs and NPs practiced in a wide range of specialties, but each profession had a specific pattern. The proportion of PAs-but not NPs-reporting practice in primary care dropped significantly. PAs were more likely than NPs to report practice in urgent care, emergency medicine, and surgical subspecialties. Physician workforce models need to account for the different and changing specialization trends of NPs and PAs. PMID:26953672

  1. Patients' expectations of the health advice conversation with the diabetes nurse practitioner.

    PubMed

    Grund, Jeanette; Stomberg, Margareta Warrén

    2012-10-01

    Type 2-diabetes usually makes its first appearance in adult age. In order for patients to feel in control of the disease, they need support and information that can easily be understood and which is relevant for the individual. By educating and supporting them, patients can conduct self-care and take control. The aim of this study was to highlight the expectations that patients with type 2-diabetes have of the health advice conversation with the nurse practitioner. A qualitative method using interviews was conducted and the data material was analysed according to manifest and latent content analysis. Three categories emerged in the results. Firstly, providing good accessibility to the diabetes nurse practitioner is of importance. Secondly, there is a demand for group activities in which patients have the opportunity to talk with other individuals who have diabetes. Finally, knowledge about self-care means that the patients themselves are able to change the intake of medication, their eating habits, and exercise according to need, as this leads to increased independence and self-management. The latent content demonstrates that the patient is striving towards competence and self-confidence in order to achieve a balance between lifestyle and the normalisation of blood sugar levels, which means empowerment. In addition, the informants expressed a demand for group activities where they can discuss the disease with others in the same situation. A combination of knowledge about the disease, receiving individual advice, and participation in groups can be beneficial in order to motivate the informants about lifestyle changes and to gain the ability to manage the disease. PMID:23804165

  2. General practitioners' and district nurses' conceptions of the encounter with obese patients in primary health care

    PubMed Central

    2011-01-01

    Background Primary health care specialists have a key role in the management of obesity. Through understanding how they conceive the encounter with patients with obesity, treatment may be improved. The aim of this study was thus to explore general practitioners' and district nurses' conceptions of encountering patients with obesity in primary health care. Method Data were collected through semi-structured interviews, and analysed using a phenomenographic approach. The participants were 10 general practitioners (6 women, 4 men) and 10 district nurses (7 women, 3 men) from 19 primary health care centres within a well-defined area of Sweden. Results Five descriptive categories were identified: Adequate primary health care, Promoting lifestyle change, Need for competency, Adherence to new habits and Understanding patient attitudes. All participants, independent of gender and profession, were represented in the descriptive categories. Some profession and gender differences were, however, found in the underlying conceptions. The general staff view was that obesity had to be prioritised. However, there was also the contradictory view that obesity is not a disease and therefore not the responsibility of primary health care. Despite this, staff conceived it as important that patients were met with respect and that individual solutions were provided which could be adhered to step-by-step by the patient. Patient attitudes, such as motivation to change, evasive behaviour, too much trust in care and lack of self-confidence, were, however, conceived as major barriers to a fruitful encounter. Conclusions Findings from this study indicate that there is a need for development and organisation of weight management in primary health care. Raising awareness of staff's negative views of patient attitudes is important since it is likely that it affects the patient-staff relationship and staff's treatment efforts. More research is also needed on gender and profession differences in this

  3. Adherence to Precautionary Guidelines for Compounding Antineoplastic Drugs: A Survey of Nurses and Pharmacy Practitioners.

    PubMed

    Boiano, James M; Steege, Andrea L; Sweeney, Marie H

    2015-01-01

    Precautionary guidelines detailing standards of practice and equipment to eliminate or minimize exposure to antineoplastic drugs during handling activities have been available for nearly three decades. To evaluate practices for compounding antineoplastic drugs, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted among members of professional practice organizations representing primarily oncology nurses, pharmacists, and pharmacy technicians. This national survey is the first in over 20 years to examine self-reported use of engineering, administrative, and work practice controls and PPE by pharmacy practitioners for minimizing exposure to antineoplastic drugs. The survey was completed by 241 nurses and 183 pharmacy practitioners who compounded antineoplastic drugs in the seven days prior to the survey. They reported: not always wearing two pairs of chemotherapy gloves (85%, 47%, respectively) or even a single pair (8%, 10%); not always using closed system drug-transfer devices (75%, 53%); not always wearing recommended gown (38%, 20%); I.V. lines sometimes/always primed with antineoplastic drug (19%, 30%); and not always using either a biological safety cabinet or isolator (9%, 15%). They also reported lack of: hazard awareness training (9%, 13%); safe handling procedures (20%, 11%); and medical surveillance programs (61%, 45%). Both employers and healthcare workers share responsibility for adhering to precautionary guidelines and other best practices. Employers can ensure that: workers are trained regularly; facility safe-handling procedures reflecting national guidelines are in place and support for their implementation is understood; engineering controls and PPE are available and workers know how to use them; and medical surveillance, exposure monitoring, and other administrative controls are in place. Workers can seek out training, understand and follow facility procedures, be role models for junior staff, ask questions, and report

  4. Nurse practitioners in primary care iv. Impact of an interdisciplinary team on attitudes of a rural population.

    PubMed Central

    Batchelor, G. M.; Spitzer, W. O.; Comley, A. E.; Anderson, G. D.

    1975-01-01

    Attitudes toward the expanded role of nurse practitioners in primary care (family practice nurses) have been determined for persons from a semirural area who chose as their principal souce of care an interdisciplinary family medical centre (FMC) incorporating two nurse practitioners, and those for whom the FMC was not the usual source of care. Data were obtaine using"before-and-after" structured interviews of a random sample of persons living in a southern Ontario township. Slowly evolving, nonsignificant trends of greater acceptance were observed among patiens who had dealth with family practice nurses. The greatest change observed was an increased acceptance of the nnurse by FMC users as the person who would be contacted as a second choice if theirfirst choice, usually a physician, could not be reached in specific worrry-inducing situations. FMC users depended more on nurses to provide information. A conclusion of increased general acceptance of the family practive nurse by FMC users is supported by a 34 per cent higher use of nurses by FMC patients compared to other persons of comparable characteristics living in the same community. PMID:1139486

  5. Clinical practice: new challenges for the advanced practice nurse.

    PubMed

    Bartel, J C; Buturusis, B

    2000-12-01

    This report describes the challenges for advanced practice nurses (APNs) relative to supply and demand issues. The article also includes opportunities with the Balanced Budget Act, physician acceptance of Advanced Practice Nurses, and expanding practice opportunities. The challenges include the nursing shortage (both in nursing students and faculty), the aging of the nursing workforce, and a lag in nursing salaries; increased demand for nursing based on aging baby boomers, increasing patient acuity and technology, and new arenas for practice. The Balanced Budget Act of 1997 provided new opportunities for advanced practice nurses, including enhanced autonomy to provide services and bill independently of physicians. With these changes come new opportunities for advanced practice nurse entrepreneurs in the areas of independent practice, including opportunities to positively impact the health of families and communities in alignment with the Federal government's vision for "Healthy People 2010." As physician acceptance of advanced practice nurses continues to grow and in light of the changes in medical practice and education (residency reduction), opportunities to expand collaborative practice arrangements also exist. APNs are best suited to make the most of these changes. One example of an opportunity for independent practice, a Community Wellness Center, is developed as an entrepreneurial venture benefiting both the APN and the health of a community. Who better than registered nurses (RNs), especially those practicing at the advanced level, can ensure that these opportunities and challenges are addressed in an ethical manner and focused on the needs and health of the community? PMID:12029667

  6. More than a prescriber: gerontological nurse practitioners' perspectives on prescribing and pharmaceutical marketing.

    PubMed

    Mahoney, Diane Feeney; Ladd, Elissa

    2010-01-01

    The purpose of this study was to gain understanding about nurse practitioners' (NPs') prescriptive decision making for geriatric patients with attention to pharmaceutical marketing influences. Prior research has focused on physician prescribers and identified suboptimal practices. Because the majority of medications are prescribed to older adults, NPs in geriatric practice were targeted as an information-rich group to interview about prescribing issues. Given the exploratory nature of this research, qualitative focus group methods were employed using content analysis. Fifteen NPs were recruited at an annual national geriatric NP conference. They worked in all regions of the United States, had an average of 9 years prescribing experience, and participated in 1 of the 2 focus groups. The key theme that emerged was that they were more than a prescriber. Findings revealed overwhelming consistency among the NP participants that their nursing background instilled a holistic approach that encompassed both nondrug and therapeutic drug options and skepticism about drug marketing, as well as offered a positive difference by tailoring to their patients' biophysical, psychological, and economic needs with an involvement in the interplay of geriatric care issues not typically addressed by physicians. The participants' reported approaches were in alignment with geriatric prescribing recommendations. PMID:20159350

  7. Penn Macy Initiative To Advance Academic Nursing Practice.

    ERIC Educational Resources Information Center

    Lang, Norma M.; Evans, Lois K.; Swan, Beth Ann

    2002-01-01

    The Penn School of Nursing and the Macy Foundation established a comprehensive institute and technical assistance program to help nursing schools advance academic nursing practice. The Penn School consulted with 21 participating schools, providing institutes, conferences, a listserv and a web-based knowledge center focused on integrating research,…

  8. The Future of Nursing: Leading Change, Advancing Health

    ERIC Educational Resources Information Center

    National Academies Press, 2011

    2011-01-01

    "The Future of Nursing" explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single…

  9. Teaching Pediatric Nursing Concepts to Non-Pediatric Nurses Using an Advance Organizer

    ERIC Educational Resources Information Center

    Bell, Julie Ann

    2013-01-01

    Non-pediatric nurses in rural areas often care for children in adult units, emergency departments, and procedural areas. A half-day program about pediatric nursing using constructivist teaching strategies including an advance organizer, case studies, and simulation was offered at a community hospital in Western North Carolina. Nurses reported a…

  10. Utilization of nurse practitioners to increase patient access to primary healthcare in Canada--thinking outside the box.

    PubMed

    DiCenso, Alba; Bourgeault, Ivy; Abelson, Julia; Martin-Misener, Ruth; Kaasalainen, Sharon; Carter, Nancy; Harbman, Patricia; Donald, Faith; Bryant-Lukosius, Denise; Kilpatrick, Kelley

    2010-12-01

    In the past decade, all Canadian provinces and territories have launched various team-based primary healthcare initiatives designed to improve access and continuity of care. Nurse practitioners (NPs) are increasingly becoming integral members of primary healthcare teams across the country. This paper draws on the results of a scoping review of the literature and qualitative key informant interviews conducted for a decision support synthesis about advanced practice nursing in Canada. We describe and analyze two novel approaches to NP integration designed to address the gap in patient access to primary healthcare: (1) the integration of NPs in traditional fee-for-service practices in British Columbia, and (2) the creation of NP-led clinics in Ontario. Although fee-for-service remuneration has been a barrier to collaborative practice, the integration of government-salaried NPs into fee-for-service practices in British Columbia has enabled the creation of inter-professional teams, and based on early evaluation findings, has increased patient access to care and patient and provider satisfaction. NP-led clinics are designed to provide inter-professional care in communities with high numbers of patients who do not have a regular primary healthcare provider. Given the shortage of physicians in communities where these clinics are being introduced, the ratio of physicians to NPs is lower than in other primary healthcare delivery models, and physicians function in more of a consulting role. Initial evaluation of the first of 26 NP-led clinics indicates increased access to care and high levels of patient and provider satisfaction. Implementing a creative mosaic of collaborative primary healthcare models that are responsive to patient needs challenges traditional assumptions about professional roles and responsibilities. To address this challenge, we endorse a recommendation that governments establish a mechanism to bring together both physician and non-physician primary

  11. The effect of nurses’ preparedness and nurse practitioner status on triage call management in primary care: A secondary analysis of cross-sectional data from the ESTEEM trial

    PubMed Central

    Varley, Anna; Warren, Fiona C.; Richards, Suzanne H.; Calitri, Raff; Chaplin, Katherine; Fletcher, Emily; Holt, Tim A.; Lattimer, Valerie; Murdoch, Jamie; Richards, David A.; Campbell, John

    2016-01-01

    Background Nurse-led telephone triage is increasingly used to manage demand for general practitioner consultations in UK general practice. Previous studies are equivocal about the relationship between clinical experience and the call outcomes of nurse triage. Most research is limited to investigating nurse telephone triage in out-of-hours settings. Objective To investigate whether the professional characteristics of primary care nurses undertaking computer decision supported software telephone triage are related to call disposition. Design Questionnaire survey of nurses delivering the nurse intervention arm of the ESTEEM trial, to capture role type (practice nurse or nurse practitioner), prescriber status, number of years’ nursing experience, graduate status, previous experience of triage, and perceived preparedness for triage. Our main outcome was the proportion of triaged patients recommended for follow-up within the practice (call disposition), including all contact types (face-to-face, telephone or home visit), by a general practitioner or nurse. Settings 15 general practices and 7012 patients receiving the nurse triage intervention in four regions of the UK. Participants 45 nurse practitioners and practice nurse trained in the use of clinical decision support software. Methods We investigated the associations between nursing characteristics and triage call disposition for patient ‘same-day’ appointment requests in general practice using multivariable logistic regression modelling. Results Valid responses from 35 nurses (78%) from 14 practices: 31/35 (89%) had ≥10 years’ experience with 24/35 (69%) having ≥20 years. Most patient contacts (3842/4605; 86%) were recommended for follow-up within the practice. Nurse practitioners were less likely to recommend patients for follow-up odds ratio 0.19, 95% confidence interval 0.07; 0.49 than practice nurses. Nurses who reported that their previous experience had prepared them less well for triage were more

  12. Use of the consultation satisfaction questionnaire to examine patients' satisfaction with general practitioners and community nurses: reliability, replicability and discriminant validity.

    PubMed Central

    Poulton, B C

    1996-01-01

    BACKGROUND: Primary health care services are the most frequently used in the health care system. Consumer feedback on these services is important. Research in this area relates mainly to doctor-patient relationships which fails to reflect the multidisciplinary nature of primary health care. AIM: A pilot study aimed to examine the feasibility of using a patient satisfaction questionnaire designed for use with general practitioner consultations as an instrument for measuring patient satisfaction with community nurses. METHOD: The questionnaire measuring patient satisfaction with general practitioner consultations was adapted for measuring satisfaction with contacts with a nurse practitioner, district nurses, practice nurses and health visitors. A total of 1575 patients in three practices consulting general practitioners or community nurses were invited to complete a questionnaire. Data were subjected to principal components analysis and the dimensions identified were tested for internal reliability and replicability. To establish discriminant validity, patients' mean satisfaction scores for consultations with general practitioners, the nurse practitioner, health visitors and nurses (district and practice nurses) were compared. RESULTS: Questionnaires were returned relating to 400 general practitioner, 54 nurse practitioner, 191 district/practice nurse and 83 health visitor consultations (overall response rate 46%). Principal components analysis demonstrated a factor structure similar to that found in an earlier study of the consultation satisfaction questionnaire. Three dimensions of patient satisfaction were identified: professional care, depth of relationship and perceived time spent with the health professional. The dimensions were found to have acceptable levels of reliability. Factor structures obtained from data relating to general practitioner and community nurse consultations were found to correlate significantly. Comparison between health professionals

  13. A randomised controlled crossover trial of nurse practitioner versus doctor led outpatient care in a bronchiectasis clinic

    PubMed Central

    Sharples, L; Edmunds, J; Bilton, D; Hollingworth, W; Caine, N; Keogan, M; Exley, A

    2002-01-01

    Background: With the decrease in junior doctor hours, the advent of specialist registrars, and the availability of highly trained and experienced nursing personnel, the service needs of patients with chronic respiratory diseases attending routine outpatient clinics may be better provided by appropriately trained nurse practitioners. Methods: A randomised controlled crossover trial was used to compare nurse practitioner led care with doctor led care in a bronchiectasis outpatient clinic. Eighty patients were recruited and randomised to receive 1 year of nurse led care and 1 year of doctor led care in random order. Patients were followed up for 2 years to ensure patient safety and acceptability and to assess differences in lung function. Outcome measures were forced expiratory volume in 1 second (FEV1), 12 minute walk test, health related quality of life, and resource use. Results: The mean difference in FEV1 was 0.2% predicted (95% confidence interval –1.6 to 2.0%, p=0.83). There were no significant differences in the other clinical or health related quality of life measures. Nurse led care resulted in significantly increased resource use compared with doctor led care (mean difference £1497, 95% confidence interval £688 to £2674, p<0.001), a large part of which resulted from the number and duration of hospital admissions. The mean difference in resource use was greater in the first year (£2625) than in the second year (£411). Conclusions: Nurse practitioner led care for stable patients within a chronic chest clinic is safe and is as effective as doctor led care, but may use more resources. PMID:12149523

  14. Describing a residency program developed for newly graduated nurse practitioners employed in retail health settings.

    PubMed

    Thabault, Paulette; Mylott, Laura; Patterson, Angela

    2015-01-01

    Retail health clinics are an expanding health care delivery model and an emerging new practice site for nurse practitioners (NPs). Critical thinking skills, clinical competence, interprofessional collaboration, and business savvy are necessary for successful practice in this highly independent and autonomous setting. This article describes a pilot residency partnership program aimed at supporting new graduate NP transition to practice, reducing NP turnover, and promoting academic progression. Eight new graduate NPs were recruited to the pilot and paired with experienced clinical NP preceptors for a 12-month program that focused on increasing clinical and business competence in the retail health setting. The residency program utilized technology to facilitate case conferences and targeted Webinars to enhance learning and peer-to-peer sharing and support. An on-line doctoral-level academic course that focused on interprofessional collaboration in health care, population health, and business concepts was offered. Both NPs and preceptors were highly satisfied with the academic-service residency program between MinuteClinic and Northeastern University School of Nursing in Boston, MA. New NPs particularly valued the preceptor model, the clinical case conferences, and business Webinars. Because their priority was in gaining clinical experience and learning the business acumen relevant to managing the processes of care, they did not feel ready for the doctoral course and would have preferred to take later in their practice. The preceptors valued the academic course and felt that it enhanced their precepting and leadership skills. At the time of this article, 6 months post completion of the residency program, there has been no turnover. Our experience supports the benefits for residency programs for newly graduated NPs in retail settings. The model of partnering with academia by offering a course within a service organization's educational programs can enable academic

  15. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey

    PubMed Central

    Xing, Kai; Jiao, Mingli; Ma, Hongkun; Qiao, Hong; Hao, Yanhua; Li, Ye; Gao, Lijun; Sun, Hong; Kang, Zheng; Liang, Libo; Wu, Qunhong

    2015-01-01

    Purpose The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals. Methods A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%). Results A total of 106 of the 840 (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients’ relatives (62.3%), followed by the patient (22.6%); 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60) resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%). Most respondents (62.8%) did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats) was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc.). Conclusions Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue. PMID:26571388

  16. It's just too hard! Australian health care practitioner perspectives on barriers to advance care planning.

    PubMed

    Boddy, Jennifer; Chenoweth, Lesley; McLennan, Vanette; Daly, Michelle

    2013-01-01

    This article presents findings from six focus groups with health care practitioners in an Australian hospital during 2010, which sought to elicit their perspectives on the barriers for people to plan their future health care should they become unwell. Such knowledge is invaluable in overcoming the barriers associated with advance care planning and enhancing the uptake of advance directives and the appointment of an enduring power of attorney for people of all ages. A person's rights to self-determination in health care, including decision making about their wishes for future care in the event they lose cognitive capacity, should not be overlooked against the backdrop of increasing pressure on health care systems. Findings suggest that multiple barriers exist, from practitioners' perspectives, which can be divided into three major categories, namely: patient-centred, practitioner-centred and system-centred barriers. Specifically, patient-centred barriers include lack of knowledge, accessibility concerns, the small 'window of opportunity' to discuss advance care planning, emotional reactions and avoidance when considering one's mortality, and demographic influences. At the practitioner level, barriers relate to a lack of knowledge and uncertainty around advance care planning processes. Systemically, legislative barriers (including a lack of a central registry and conflicting state legislation), procedural issues (particularly in relation to assessing cognitive capacity and making decisions ad hoc) and questions about delegation, roles and responsibilities further compound the barriers to advance care planning. PMID:22951247

  17. [Chronic surplus of Japanese cardiac surgeon--ideal nurse practitioner for cardiac surgery, cardiac surgeon's attitude toward the future].

    PubMed

    Ikegami, Hirohisa

    2014-03-01

    It is chronically surplus of doctors in the world of cardiac surgery. There are too many cardiac surgeons because cardiac surgery requires a large amount of manpower resources to provide adequate medical services. Many Japanese cardiac surgeons do not have enough opportunity to perform cardiac surgery operations, and many Japanese cardiac surgery residents do not have enough opportunity to learn cardiac surgery operations. There are physician assistants and nurse practitioners in the US. Because they provide a part of medical care to cardiac surgery patients, American cardiac surgeons can focus more energy on operative procedures. Introduction of cardiac surgery specialized nurse practitioner is essential to deliver a high quality medical service as well as to solve chronic problems that Japanese cardiac surgery has had for a long time. PMID:24749334

  18. Nurse Practitioners' Use of Communication Techniques: Results of a Maryland Oral Health Literacy Survey

    PubMed Central

    Koo, Laura W.; Horowitz, Alice M.; Radice, Sarah D.; Wang, Min Q.; Kleinman, Dushanka V.

    2016-01-01

    Objectives We examined nurse practitioners’ use and opinions of recommended communication techniques for the promotion of oral health as part of a Maryland state-wide oral health literacy assessment. Use of recommended health-literate and patient-centered communication techniques have demonstrated improved health outcomes. Methods A 27-item self-report survey, containing 17 communication technique items, across 5 domains, was mailed to 1,410 licensed nurse practitioners (NPs) in Maryland in 2010. Use of communication techniques and opinions about their effectiveness were analyzed using descriptive statistics. General linear models explored provider and practice characteristics to predict differences in the total number and the mean number of communication techniques routinely used in a week. Results More than 80% of NPs (N = 194) routinely used 3 of the 7 basic communication techniques: simple language, limiting teaching to 2–3 concepts, and speaking slowly. More than 75% of respondents believed that 6 of the 7 basic communication techniques are effective. Sociodemographic provider characteristics and practice characteristics were not significant predictors of the mean number or the total number of communication techniques routinely used by NPs in a week. Potential predictors for using more of the 7 basic communication techniques, demonstrating significance in one general linear model each, were: assessing the office for user-friendliness and ever taking a communication course in addition to nursing school. Conclusions NPs in Maryland self-reported routinely using some recommended health-literate communication techniques, with belief in their effectiveness. Our findings suggest that NPs who had assessed the office for patient-friendliness or who had taken a communication course beyond their initial education may be predictors for using more of the 7 basic communication techniques. These self-reported findings should be validated with observational studies

  19. Nurse Practitioners' Knowledge, Experience, and Intention to Use Health Literacy Strategies in Clinical Practice

    PubMed Central

    Cafiero, Madeline

    2013-01-01

    Nurse practitioners' (NPs) knowledge, experience, and intention to use health literacy strategies in practice were investigated using the Theory of Planned Behavior as the theoretical framework. NPs who work in outpatient settings were recruited at a national NP conference. Participants were administered 3 self-report instruments: Health Literacy Knowledge and Experience Survey, Parts I and II; and the Health Literacy Strategies Behavioral Intention Questionnaire. Overall knowledge of health literacy and health literacy strategies was found to be low. Screening patients for low health literacy and evaluating patient education materials were found to be areas of knowledge deficit. Most NP participants used written patient education materials with alternate formats for patient education, such as audiotapes, videotapes, or computer software rarely used. Statistically significant differences were found in mean experience scores between NP level of educational preparation and NP practice settings. The intention to use health literacy strategies in practice was found to be strong. The findings of this investigation offer implications for enhancing NP curriculum and for continuing education opportunities. Increasing NPs' knowledge of health literacy and facilitating the use of health literacy strategies has the potential to change clinical practice and support improved patient outcomes. PMID:24093347

  20. Asking questions of a palliative care nurse practitioner on a pancreatic cancer website

    PubMed Central

    GRANT, MARIAN S.; WIEGAND, DEBRA L.; DY, SYDNEY M.

    2015-01-01

    Objective Increasing evidence demonstrates the benefits of online cancer interventions but very little about the needs of those with pancreatic cancer or interaction with online providers. Our study was done to (1) see how many people would visit a webpage where they could interact with a palliative care nurse practitioner (PCNP), (2) see how many would ask the PCNP questions, (3) determine the type of questions, and (4) obtain feedback regarding the usefulness of the webpage. Method Mixed-methods descriptive design. Results There were 2174 visits to the webpage, and a total of 84 participants sent 110 questions/comments. Some 28 (33%) were people worried that they might have pancreatic cancer. Most questions (59, 53%) had to do with palliative care issues, with the largest subgroup (26, 23%) involving psychological concerns. A total of 39 completed an online survey and were relatives (20, 52%), or patients (17, 44%). They rated the webpage at 3.3/4 as being helpful at learning about the physical symptoms/treatments of pancreatic cancer, at 3.1/4 for learning about emotional issues, at 3/4 for learning about palliative care, at 2.8/4 for learning about hospice, and at 3.3/4 for reading other people’s questions. Significance of results The PCNP webpage was a helpful resource. Most asking questions were worried about having or getting pancreatic cancer. More research is needed into online providers, interventions, and conducting research online. PMID:24909893

  1. Veteran Affairs Centers of Excellence in Primary Care Education: transforming nurse practitioner education.

    PubMed

    Rugen, Kathryn Wirtz; Watts, Sharon A; Janson, Susan L; Angelo, Laura A; Nash, Melanie; Zapatka, Susan A; Brienza, Rebecca; Gilman, Stuart C; Bowen, Judith L; Saxe, JoAnne M

    2014-01-01

    To integrate health care professional learners into patient-centered primary care delivery models, the Department of Veterans Affairs has funded five Centers of Excellence in Primary Care Education (CoEPCEs). The main goal of the CoEPCEs is to develop and test innovative structural and curricular models that foster transformation of health care training from profession-specific "silos" to interprofessional, team-based educational and care delivery models in patient-centered primary care settings. CoEPCE implementation emphasizes four core curricular domains: shared decision making, sustained relationships, interprofessional collaboration, and performance improvement. The structural models allow interprofessional learners to have longitudinal learning experiences and sustained and continuous relationships with patients, faculty mentors, and peer learners. This article presents an overview of the innovative curricular models developed at each site, focusing on nurse practitioner (NP) education. Insights on transforming NP education in the practice setting and its impact on traditional NP educational models are offered. Preliminary outcomes and sustainment examples are also provided. PMID:24630678

  2. Physician assistants and nurse practitioners: a missing component in state workforce assessments.

    PubMed

    Morgan, Perri; Strand De Oliveira, Justine; Short, Nancy M

    2011-07-01

    Due to current or predicted health workforce shortages, policy makers worldwide are addressing issues of task allocation, skill mix, and role substitution. This article presents an example of this process in the United States (US). Health workforce analysts recommend that US physician workforce planning account for the impact of physician assistants (PAs) and nurse practitioners (NPs). We examined 40 state workforce assessments in order to identify best practices for including PAs/NPs. Most assessments (about 60%) did not include PAs/NPs in provider counts, workforce projections or recommendations. Only 35% enumerated PAs/NPs. Best practices included use of an accurate data source, such as state licensing data, and combined workforce planning for PAs, NPs, and physicians. Our findings suggest that interprofessional medical workforce planning is not the norm among the states in the US. The best practices that we identify may be instructive to states as they develop methods for assessing workforce adequacy. Our discussion of potential barriers to interprofessional workforce planning may be useful to policy makers worldwide as they confront issues related to professional boundaries and interprofessional workforce planning. PMID:21043554

  3. A safety audit of the first 10 000 intravitreal ranibizumab injections performed by nurse practitioners

    PubMed Central

    Simcock, P; Kingett, B; Mann, N; Reddy, V; Park, J

    2014-01-01

    Purpose To evaluate the safety of a nurse practitioner (NP)-delivered injection service for the treatment of wet age-related macular degeneration (wAMD) with ranibizumab. Methods An evaluation of medical staffing resources for providing an injection service for wAMD highlighted difficulties covering lists. An alternative strategy of an NP-delivered injection service was evaluated. Two suitable NPs with previous extensive experience in minor surgical procedures were identified. The department's senior vitreo-retinal consultant supervised the NP's training programme. A prospective safety audit was conducted for the first 5.5 years of the service. Results The NPs administered 10 006 injections in the first 5.5 years of the service (1 May 2008 to 8 October 2013). This represented 84.1% of the total injections performed during this period. Four patients developed presumed infectious endophthalmitis (1 was culture positive and 3 were culture negative). The incidence of post-injection endophthalmitis was 0.04%. There was no evidence of lens touch, retinal detachment, or systemic thrombo-embolic events. Conclusions Carefully selected and well-trained NPs are capable of delivering a safe and effective wAMD injection treatment service. This work demonstrates how such a service can be established and provides safety data that other units can use as a benchmark when evaluating their own practice. PMID:25033899

  4. Open Mouth, Open Mind: Expanding the Role of Primary Care Nurse Practitioners.

    PubMed

    Clark, Carol A; Kent, Kathleen A; Jackson, Richard D

    2016-01-01

    Oral health is essential to overall health at any age, although in children it is particularly important because poor oral health can have a deleterious effect on deciduous and permanent dentition. For decades, oral health providers have urged primary care providers to incorporate oral health assessment, risk factor identification, parent education, and preventive therapy into routine well-child visits. Despite recommendations from various professional associations and governmental organizations, the incidence of dental disease in young children remains relatively unchanged. Although the literature has clearly demonstrated that preventive care treatments, such as the application of fluoride varnish performed in the primary care setting, improve oral health in children, very few primary care providers include oral health services in their well-child visits. The purpose of this article is to reduce the barriers and knowledge gaps identified in recent pediatric oral health research and educate primary care nurse practitioners on the application of fluoride varnish to reduce the risk of the development of dental caries in young children. PMID:27554397

  5. Identifying and evaluating electronic learning resources for use in adult-gerontology nurse practitioner education.

    PubMed

    Thompson, Hilaire J; Belza, Basia; Baker, Margaret; Christianson, Phyllis; Doorenbos, Ardith; Nguyen, Huong

    2014-01-01

    Enhancing existing curricula to meet newly published adult-gerontology advanced practice registered nurse (APRN) competencies in an efficient manner presents a challenge to nurse educators. Incorporating shared, published electronic learning resources (ELRs) in existing or new courses may be appropriate in order to assist students in achieving competencies. The purposes of this project were to (a) identify relevant available ELR for use in enhancing geriatric APRN education and (b) to evaluate the educational utility of identified ELRs based on established criteria. A multilevel search strategy was used. Two independent team members reviewed identified ELR against established criteria to ensure utility. Only resources meeting all criteria were retained. Resources were found for each of the competency areas and included formats such as podcasts, Web casts, case studies, and teaching videos. In many cases, resources were identified using supplemental strategies and not through traditional search or search of existing geriatric repositories. Resources identified have been useful to advanced practice educators in improving lecture and seminar content in a particular topic area and providing students and preceptors with additional self-learning resources. Addressing sustainability within geriatric APRN education is critical for sharing of best practices among educators and for sustainability of teaching and related resources. PMID:24720944

  6. An Infrastructure to Advance the Scholarly Work of Staff Nurses

    PubMed Central

    Parkosewich, Janet A.

    2013-01-01

    The traditional role of the acute care staff nurse is changing. The new norm establishes an expectation that staff nurses base their practice on best evidence. When evidence is lacking, nurses are charged with using the research process to generate and disseminate new knowledge. This article describes the critical forces behind the transformation of this role and the organizational mission, culture, and capacity required to support practice that is based on science. The vital role of senior nursing leaders, the nurse researcher, and the nursing research committee within the context of a collaborative governance structure is highlighted. Several well-known, evidence-based practice models are presented. Finally, there is a discussion of the infrastructure created by Yale-New Haven Hospital to advance the scholarly work of the nursing staff. PMID:23482435

  7. Advancing Nursing Research in Hospitals Through Collaboration, Empowerment, and Mentoring.

    PubMed

    Berger, Jill; Polivka, Barbara

    2015-12-01

    Meeting the Magnet Recognition Program® requirements for integrating research into practice can be daunting, particularly for nonacademic hospitals. The authors describe 1 healthcare system's approach to advancing nursing research in 5 hospitals through collaboration with a local university school of nursing and development of an infrastructure to support, empower, and mentor clinical nurses in the conduct of research. Outcomes include completed research, presentations, publications, practice change, and professional development. PMID:26565639

  8. Development of the role of director of advanced practice nursing.

    PubMed

    Rhodes, Catherine A; Fusilero, Jane; Williams, Christine M

    2010-01-01

    Advanced practice nurses (APNs) are integral to cost-effective delivery of health care in large health care organizations. Development of the leadership position of director of advanced practice nurses in a large teaching institution provides leadership to APNs in various settings, contributes to staff satisfaction, facilitates increased professional growth, and provides improved quality and fiscal outcomes. Job satisfaction, productivity, accountability, and communication may be enhanced through implementation of the role of director of advanced practice nursing and a committee structure of APNs, as was found in this academic health system. PMID:20306882

  9. The Relationship between Practitioners and Academics--Anti-Academic Discourse Voiced by Finnish Nurses

    ERIC Educational Resources Information Center

    Laiho, Anne; Ruoholinna, Tarita

    2013-01-01

    Nursing in Western countries has become increasingly more theoretical, and nurse education has been integrated more often with the higher education system. Historically, nursing has been viewed as a non-academic domain. Establishing Nursing Science (NS) in Finland in the 1970s has meant that the new discipline is defined as the core of nurse…

  10. The utility of standardized advance directives: the general practitioners' perspective.

    PubMed

    Otte, Ina Carola; Elger, Bernice; Jung, Corinna; Bally, Klaus Walter

    2016-06-01

    Advance directives (AD) are written documents that give patients the opportunity to communicate their preferences regarding treatments they do or do not want to receive in case they become unable to make decisions. Commonly used pre-printed forms have different formats. Some offer space for patients to (a) appoint a surrogate decision maker, and/or (b) to determine future medical treatments and/or (c) give a statement of personal values. So far it is unknown which forms GPs preferably use and why they decide to do so. 23 semi-structured interviews with GPs were analysed using content analysis. Interviewees mainly use short templates (to appoint surrogate decision makers) and medium length templates with checkboxes to indicate patients' preferences in regards to life prolonging measures. Especially when patients faced the progression of a disease, participants use the latter version. Only then, the interviewees remarked, patients are capable to rate concrete situations reliably. GPs also realize the importance of the verbal assessment of patients' preferences; however they rarely keep a written form of the conversation. Some GPs hand out one or more templates and ask their patients to read and think about them at home with the option to talk to them about it later on, while others prefer their patients to fill them out alone at home. Regardless of template usage, most GPs emphasize that ADs require regular updates. GPs tend to see standardized advance directives mainly as a tool to start a conversation with their patients and to identify their real preferences and values. When the patient is still not facing the progression of an already existing disease it could be sufficient to only appoint a surrogate decision maker instead of creating a full AD. However, in all other situations, appointing a surrogate decision maker should be backed up by a written statement of a patient's general values. Patients and their relatives should always have the opportunity to ask

  11. Knowledge Elicitation and Techniques of Representing Nurse Practitioner Knowledge Use: Establishing Capability and Social Integration within Busy Nursing Contexts.

    ERIC Educational Resources Information Center

    Fessey, Christine

    The progression of qualified surgical nurses toward capable proficiency was examined in an ethnographic study during which 25 nurses, including 4 who transferred to other wards, were observed to determine whether social mediation affects the process of proficiency development. The nurses were observed for 18 months. Data were also gathered through…

  12. Breast augmentation: motives and the role of the family nurse practitioner.

    PubMed

    Howerton, Christopher R; Ellington, Betty Jo; Henley, Carolanne

    2011-01-01

    Humans tend to compare themselves to their surrounding culture's idea of beauty. As a result of the influence exerted by the mass media, the American woman's breast is closely linked to womanhood; the fuller the woman's bosom, the sexier and more womanly she feels, or is perceived to be by individuals of both sexes. Because of these cultural expectations, small-breasted women often experience feelings of inadequacy compared with their larger-breasted counterparts, and may seek methods of increasing their breast size, such as breast augmentation. An estimated 5 million to 7 million women have opted to have this elective surgery since its development in 1963. In 2009, nearly 300,000 women chose to undergo breast augmentation--an increase of 36% from 2000, and an impressive 787% since 1992, when the American Society of Plastic Surgeons began formulating yearly national cosmetic surgical statistics. These statistical findings reveal that a significant number of women are interested in this topic, and health care providers need an operational understanding of what is influencing these women's health care decisions. As a result of this need, the motives for breast augmentation have been researched and classified as either internal or external. Internal motives include low levels of self-esteem, body image dissatisfaction, and body dysmorphic disorder, whereas external motives are the desire to attract and retain a romantic partner, pressures from others, and occupational requirements. Understanding these motives allows primary care nurse practitioners to focus their assessments on these areas and to provide the appropriate counseling or referrals as needed. PMID:21876413

  13. Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania

    PubMed Central

    2013-01-01

    Background A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Methods Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. Results The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors. Conclusions The need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself. PMID:23945286

  14. The effects of clinical decision making on nurse practitioners' clinical productivity.

    PubMed

    Chumbler, N R; Geller, J M; Weier, A W

    2000-09-01

    The degree of clinical decision making and clinical productivity among nurse practitioners (NPs) is of great interest to policy makers and planners involved in providing appropriate outpatient primary care services. The authors performed a statewide mailed survey of all NPs practicing either full-time or part-time in Wisconsin (response rate of 72.1%) to address the following research questions: Do the demographic characteristics, practice attributes, and primary practice settings of NPs impact their level of clinical decision making (e.g., the autonomy to order laboratory and radiological tests or to refer a patient to a physician specialist other than their collaborating physician)? Do NPs' levels of clinical decision making correlate with their outpatient clinical productivity, adjusting for demographic characteristics, practice attributes, and primary practice settings? The multiple linear regression results indicated that having more years in practice as an NP, practicing in the family specialty area (vs. a combined other category, which included pediatrics, acute care, geriatrics, neonatal, and school), treating patients according to clinical guidelines, practicing in settings with a fewer number of physicians, and practicing in a multispecialty group practice versus a single-specialty group practice were associated with greater levels of clinical decision making. However, NPs who primarily practiced in a hospital/facility-based practice, as compared with a single-specialty group practice, had lower levels of clinical decision making. After adjusting for demographic characteristics, practice attributes, and primary practice settings, NPs with greater clinical decision-making authority had greater outpatient clinical productivity. The conclusions discuss the policy implications of the findings. PMID:11067192

  15. Problems and needs for improving primary care of osteoarthritis patients: the views of patients, general practitioners and practice nurses

    PubMed Central

    Rosemann, Thomas; Wensing, Michel; Joest, Katharina; Backenstrass, Matthias; Mahler, Cornelia; Szecsenyi, Joachim

    2006-01-01

    Background Osteoarthritis (OA) is highly prevalent and has substantial impact on quality of life as well as on healthcare costs. The general practitioner (GP) often is the first care provider for patients with this chronic disease. The aim of this study was to identify health care needs of patients with OA and to reveal possible obstacles for improvements in primary care management of OA patients. Methods We performed semi-structured interviews with a stratified sample of 20 patients, 20 GPs and 20 practice nurses. Results Diagnosing OA posed no major problem, but during the course of OA, GPs found it difficult to distinguish between complaints resulting from the affection of the joints and complaints related to a concomitant depression. Patients felt to be well informed about the degenerative nature of the disease and possible side effects of medications, but they lacked information on individual consequences of the disease. Therefore, the most important concerns of many patients were pain and fear of disability which they felt to be addressed by GPs only marginally. Regarding pain treatment, physicians and patients had an ambivalent attitude towards NSAIDs and opiates. Therefore, pain treatment was not performed according to prevailing guidelines. GPs felt frustrated about the impact of counselling regarding life style changes but on the other hand admitted to have no systematic approach to it. Patients stated to be aware of the impact of life style on OA but lacked detailed information e.g. on how to exercise. Several suggestions were made concerning improvement. Conclusion GPs should focus more on disability and pain and on giving information about treatment since these topics are inadequately addressed. Advanced approaches are needed to increase GPs impact on patients' life style. Being aware of the problem of labelling patients as chronically ill, a more proactive, patient-centred care is needed. PMID:16749935

  16. [Nurses' knowledge about the health care proxy and advance directives].

    PubMed

    Georget, Jean-Philippe; Cecire-Denoyer, Catherine

    2015-06-01

    The Basse-Normandie palliative care nurses' group carried out a survey regarding nurses' knowledge of the health care proxy and advance directives. The study revealed a lack of connection between these two arrangements, poor knowledge about advance directives but an understanding of the role of the health care proxy. How, therefore, can patients be effectively informed? How should they be supported in this process of determining themselves the conditions of their end of life? PMID:26146326

  17. Advance Care Planning in Nursing Homes: Correlates of Capacity and Possession of Advance Directives

    ERIC Educational Resources Information Center

    Allen, Rebecca S.; DeLaine, Shermetra R.; Chaplin, William F.; Marson, Daniel C.; Bourgeois, Michelle S.; Dijkstra, Katinka; Burgio, Louis D.

    2003-01-01

    Purpose: The identification of nursing home residents who can continue to participate in advance care planning about end-of-life care is a critical clinical and bioethical issue. This study uses high quality observational research to identify correlates of advance care planning in nursing homes, including objective measurement of capacity. Design…

  18. Difficult-to-manage HIV/AIDS clients with psychiatric illness and substance abuse problems: a collaborative practice with psychiatric advanced practice nurses.

    PubMed

    Morgan, Betty D; Rossi, Anne P

    2007-01-01

    Complex clients with comorbid HIV disease, other medical illness, psychiatric illness, and substance abuse problems present tremendous challenges to providers. Medication adherence and case management become vital issues in providing comprehensive care to this population. This report describes the practice of two advanced practice psychiatric registered nurses who worked collaboratively with each other and with nurse practitioners to provide care to such complex clients. Description of collaborative practices and the model of collaboration used by the two practitioners are highlighted through three case studies. Conclusions about the practice and its use with complex clients are provided. PMID:17991601

  19. Advanced practice: the clinical nurse specialist.

    PubMed

    Sparacino, P

    1992-01-01

    Historically, the clinically expert nurse who wanted to continue in direct patient care had few career options. That dilemma is changing in response to the recognised need for greater knowledge and clinical expertise in the domain of patient care. The clinical nurse specialist role is an answer to this concern. The clinical nurse specialist practices within a framework of theoretically-based knowledge and combines that knowledge with clinical expertise. The role is also pivotal in the promotion of patient care focused scientific inquiry and in the generation and refinement of nursing theories. Career options are more versatile than for the educator, researcher, or administrator. While the clinical nurse specialist is an essential person in influencing quality care in the traditional practice settings, there are now opportunities with clientele and practice settings which have expanded beyond the conventional boundaries. PMID:1528295

  20. Skills Required for Nursing Career Advancement: A Qualitative Study

    PubMed Central

    Sheikhi, Mohammad Reza; Fallahi-Khoshnab, Masoud; Mohammadi, Farahnaz; Oskouie, Fatemeh

    2016-01-01

    Background Nurses require certain skills for progression in their field. Identifying these skills can provide the context for nursing career advancement. Objectives This study aimed to identify the skills needed for nurses’ career advancement. Materials and Methods A qualitative approach using content analysis was adopted to study a purposive sample of eighteen nurses working in teaching hospitals affiliated with the Qazvin, Shahid Beheshti, and Iran Universities of Medical Sciences. The data were collected through semi-structured interviews, and analyzed using conventional content analysis. Results The three themes extracted from the data included interpersonal capabilities, competency for career success, and personal capacities. The results showed that acquiring a variety of skills is essential for career advancement. Conclusions The findings showed that personal, interpersonal, and functional skills can facilitate nurses’ career advancement. The effects of these skills on career advancement depend on a variety of conditions that require further studies. PMID:27556054

  1. Evaluation of the efficacy of a nurse practitioner-led home-based congestive heart failure clinical pathway.

    PubMed

    Moore, Jo-Ann Mary

    2016-01-01

    Frequent exacerbations of symptoms and financial penalties for 30-day hospital readmissions of patients with congestive heart failure (CHF) have led to new disease management approaches. A nurse practitioner (NP)-led interdisciplinary program for CHF management that included home telemonitoring and early NP assessments and interventions was piloted by a home health agency. A 4-month evaluation of the efficacy of a clinical pathway for CHF patients resulted in the enrollment of 22 CHF patients in the program. Two clients were readmitted within 30 days. The new program was effective in reducing 30-day readmission rates to 9% compared to the national average of 23%. PMID:27064361

  2. Patient-care time allocation by nurse practitioners and physician assistants in the intensive care unit

    PubMed Central

    2012-01-01

    Introduction Use of nurse practitioners and physician assistants ("affiliates") is increasing significantly in the intensive care unit (ICU). Despite this, few data exist on how affiliates allocate their time in the ICU. The purpose of this study was to understand the allocation of affiliate time into patient-care and non-patient-care activity, further dividing the time devoted to patient care into billable service and equally important but nonbillable care. Methods We conducted a quasi experimental study in seven ICUs in an academic hospital and a hybrid academic/community hospital. After a period of self-reporting, a one-time monetary incentive of $2,500 was offered to 39 affiliates in each ICU in which every affiliate documented greater than 75% of their time devoted to patient care over a 6-month period in an effort to understand how affiliates allocated their time throughout a shift. Documentation included billable time (critical care, evaluation and management, procedures) and a new category ("zero charge time"), which facilitated record keeping of other patient-care activities. Results At baseline, no ICUs had documentation of 75% patient-care time by all of its affiliates. In the 6 months in which reporting was tied to a group incentive, six of seven ICUs had every affiliate document greater than 75% of their time. Individual time documentation increased from 53% to 84%. Zero-charge time accounted for an average of 21% of each shift. The most common reason was rounding, which accounted for nearly half of all zero-charge time. Sign out, chart review, and teaching were the next most common zero-charge activities. Documentation of time spent on billable activities also increased from 53% of an affiliate's shift to 63%. Time documentation was similar regardless of during which shift an affiliate worked. Conclusions Approximately two thirds of an affiliate's shift is spent providing billable services to patients. Greater than 20% of each shift is spent providing

  3. Parental Evaluation of a Nurse Practitioner-Developed Pediatric Neurosurgery Website

    PubMed Central

    Vogel, Tina Kovacs; Kleib, Manal; Davidson, Sandra J

    2016-01-01

    Background Parents often turn to the Internet to seek health information about their child’s diagnosis and condition. Information, support, and resources regarding pediatric neurosurgery are scarce, hard to find, and difficult to comprehend. To address this gap, a pediatric nurse practitioner designed a website called the Neurosurgery Kids Fund (NKF). Analyzing the legitimacy of the NKF website for parents seeking health information and fulfilling their social and resource needs is critical to the website’s future development and success. Objective To explore parental usage of the NKF website, track visitor behavior, evaluate usability and design, establish ways to improve user experience, and identify ways to redesign the website. The aim of this study was to assess and evaluate whether a custom-designed health website could meet parents’ health information, support, and resource needs. Methods A multimethod approach was used. Google Analytic usage reports were collected and analyzed for the period of April 23, 2013, to November 30, 2013. Fifty-two online questionnaires that targeted the website’s usability were collected between June 18, 2014, and July 30, 2014. Finally, a focus group was conducted on August 20, 2014, to explore parents’ perceptions and user experiences. Findings were analyzed using an inductive content analysis approach. Results There were a total of 2998 sessions and 8818 page views, with 2.94 pages viewed per session, a 56.20% bounce rate, an average session duration of 2 minutes 24 seconds, and a 56.24% new sessions rate. Results from 52 eligible surveys included that the majority of NKF users were Caucasian (90%), females (92%), aged 36-45 years (48%), with a university or college degree or diploma (69%). Half plan to use the health information. Over half reported turning to the Internet for health information and spending 2 to 4 hours a day online. The most common reasons for using the NKF website were to (1) gather information

  4. Advanced nursing roles in critical care--a natural or forced evolution?

    PubMed

    Coombs, Maureen; Chaboyer, Wendy; Sole, Mary Lou

    2007-01-01

    Meeting the expectation of delivering safe, effective, and timely health care services within current financial and workforce envelopes requires all health care clinicians to refine and adapt to their clinical roles. The arena of critical care is currently receiving increasing scrutiny regarding developing dedicated advanced practice roles. This is challenging to critical care nurses who historically neither have been exposed to nor have chosen to engage in such specific role developments. The critical care nursing community has, on the whole, embraced previous role expansions within the limits of existing group practices rather than an evolution of new subspecialties. International comparisons demonstrate that critical care nurses in the United States, the United Kingdom, and Australia are all facing common health policy drivers. Although there are some similarities in addressing these challenges, the solutions remain at various stages of development. The natural history framework of Bucher [Work and Occupations 1988;15:131-147] provides a useful and supportive tool to understand how it is necessary and natural for specialties within occupational groups to emerge to meet changing health care needs. A shared concern providing challenges at national and international levels involves the coordination of educational standards as well as competencies and clear articulation of the leadership component of advanced practice roles. These areas must be addressed to enable the international critical care community to naturally transform and evolve into fully established and legitimate advanced practitioners. PMID:17383600

  5. The covered wagon journey: student chronicles in advanced holistic nursing.

    PubMed

    Purnell, Marguerite J; Lange, Bernadette; Bailey, Christie; Drozdowicz, Aleida; Eckes, Shirley; Kinchen, Elizabeth; Smith-Atkinson, Nikkisha

    2013-01-01

    This article recounts the experiences of a first cohort of graduate students in a newly implemented advanced holistic nursing (AHN) track, one of only a handful in the nation, and the first in Florida. The increasing popularity of complementary and alternative healing processes represents the insufficiency of a health system of fragmented care and a desire for holistic healing that is beyond mainstream allopathic care. Graduate holistic nurse education equips nurses to explore the commitment needed to advance the evolution of health care. The covered wagon journey is a metaphor for this meaningful participation. Students journaled their experiences as cotravelers in a lone wagon: embarking on a courageous journey, forging a path of discovery, and reaching their destination as pioneers. This cohort experience embodied the central tenets of holistic nursing, thus creating conscious change and unity within a learning community. The future of AHN is addressed in the context of the contemporary health care environment. PMID:23600022

  6. Advancing the education of nurses: a call for action.

    PubMed

    Zimmermann, Deborah T; Miner, Dianne Cooney; Zittel, Barbara

    2010-12-01

    The debate over the educational preparation of RNs has raged for over a century. In New York, chief nursing officers are partnering with academic colleagues and successfully implementing a model that standardizes education requirements, supports seamless transition from associate to baccalaureate degree programs, addresses financial barriers, and identifies expected outcomes of a more educated workforce. Nursing leaders are perfectly positioned to advance the educational standards of the profession in the United States. PMID:21084888

  7. Entry-Level Competencies Required of Primary Care Nurse Practitioners Providing HIV Specialty Care: A National Practice Validation Study.

    PubMed

    Relf, Michael V; Harmon, James L

    2016-01-01

    In the United States, only 30% of HIV-infected persons are diagnosed, engaged in care, provided antiretroviral therapy, and virologically suppressed. Competent HIV care providers are needed to achieve optimal clinical outcomes for all people living with HIV, but 69% of Ryan White Clinics in the United States report difficulty recruiting HIV clinicians, and one in three current HIV specialty physicians are expected to retire in the next decade. Nurse practitioners who specialize in HIV and have caseloads with large numbers of HIV-infected patients have care outcomes that are equal to or better than that provided by physicians, especially generalist non-HIV specialist physicians. We designed a national practice validation study to help prepare the next generation of primary care nurse practitioners who desire to specialize in HIV. This manuscript reports the results of the national study and identifies entry-level competencies for entry-level primary care nurse practitioners specializing in HIV. PMID:26803386

  8. An evaluation of factors influencing the assessment time in a nurse practitioner-led anaesthetic pre-operative assessment clinic.

    PubMed

    Hawes, R H; Andrzejowski, J C; Goodhart, I M; Berthoud, M C; Wiles, M D

    2016-03-01

    Elective patients undergoing anaesthetic pre-operative assessment are usually allocated the same period of time with a nurse practitioner, leading to potential inefficiencies in patient flow through the clinic. We prospectively collected data on 8519 patients attending a pre-operative assessment clinic. The data set were split into derivation and validation cohorts. Standard multiple regressions were used to construct a model in the derivation cohort, which was then tested in the validation cohort. Due to missing data, 2457 patients were not studied, leaving 5892 for analysis (3870 in the derivation cohort and 2022 in the validation cohort). The mean (SD) pre-operative assessment time was 46 (12) min. Age, ASA physical status, nurse practitioner and surgical specialty all influenced the time spent in pre-operative assessment. The predictive equations calculated using the derivation cohort, based on age and ASA physical status, correctly estimated duration of consultation to within 20% of the maximum predicted time in 74.2% of the validation cohort. We conclude that if age and ASA physical status are known before the pre-operative assessment consultation, it could allow appointment times to be allocated more accurately. PMID:26684961

  9. An overview of Medicare reimbursement regulations for advanced practice nurses.

    PubMed

    Frakes, Michael A; Evans, Tracylain

    2006-01-01

    The federal government spends nearly 15% of the budget on Medicare services annually, and advanced practice nurses are eligible for reimbursement from that pool. The regulations governing reimbursement are complex because of the social, political, and financial pressures involved in their development. Although economic viability and due diligence considerations make it incumbent on advanced practice nurses to understand the rules, the profession, as a whole, has knowledge deficits in this area. The essentials of regulatory development and structure are reviewed and considerations for optimizing reimbursement are described. PMID:16676748

  10. Knowledge of Community General Practitioners and Nurses on Pre-Hospital Stroke Prevention and Treatment in Chongqing, China

    PubMed Central

    Yang, Juan; Zhang, Jie; Ou, Shu; Wang, Ni; Wang, Jian

    2015-01-01

    Background and Purpose This study aimed to investigate the knowledge of community general practitioners (GPs) and nurses about pre-hospital stroke recognition, treatment and management and secondary stroke prevention; to identify the sociodemographic and educational factors influencing knowledge. Methods A self-designed test questionnaire was applied in a self-administered close-exam setting among 480 GPs and nurses working in community health centers (stations) in eight urban districts of Chongqing. Results A total of 331 (69%) valid test questionnaires were returned. Of the 331 participants, 39% were aware of the clinical guidelines for cerebrovascular diseases, whereas 48% considered themselves to have stroke management capabilities. The correct rate of answering questions of pre-hospital recognition and management knowledge was as low as 24%, the correct rate of secondary stroke prevention knowledge was only 38%. In terms of the total score for stroke prevention and treatment knowledge, there were significant differences between the medical staff with different specialties before engaging in community health services and whether they have received GP training (P <0.05). Conclusion The community GPs and nurses in the urban districts of Chongqing clearly lack knowledge of stroke, and the levels of stroke prevention and treatment urgently need to be improved. PMID:26384330

  11. Advanced nursing practice and Newton's three laws of motion.

    PubMed

    Sturgeon, David

    This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries. PMID:18773586

  12. Kenya and distance education: a model to advance graduate nursing.

    PubMed

    Mutea, Naomi; Cullen, Deborah

    2012-08-01

    Africa is faced with a myriad of challenges, such as HIV/AIDS, malaria, tuberculosis, and a variety of political and historical complications that have affected the educational system for advanced nursing practice. In Kenya, the current situation in the higher education sector does not give nurses an opportunity to pursue graduate education after they have acquired the basic diploma in nursing due to limited government support and the type of education system existing in the country today. Although distance education has been available in Kenya for professionals such as teachers, in public universities, this kind of opportunity is unreachable for nurses who are working and need to further their education. Nurses desire to have access to advanced practice education to equip them with the relevant knowledge to cope and address the complex health issues arising in the management and care of patients. A collaborative model is presented as a potential solution for this need. Four major constituents are identified including hospitals and agencies, communities of interest, Kenyan universities and international education partners. Each has a part to play including contributions to information, communication of opinion and expertise, money and support, infrastructure and in-kind resources. Distance education is cost-effective and will help in building capacity at various levels of nursing including leadership in clinical practice, teaching, administration and research. PMID:22845642

  13. Specialty practice entrepreneur: the advanced practice nurse.

    PubMed

    Kowal, N

    1998-01-01

    There are many opportunities in the health care arena to make a difference. The structured sense of change is "old school." New "surfers" of the system will be entrepreneurial in spirit, energy, and flexibility. There is no job description for the perfect person, only a sense of excitement and innovation that gives one the feeling energetic change is about to happen. In nursing, the risk takers are abundant in the APN role. It is the reason why they walk the line of provider/nurse. Making a difference to patients is important. Riding the waves of clinical care is the excitement. The final results are "the big waves" of life--a patient's life. A provider who defines the reality of practice creates a vision and skillfully bridges the road between the two. Design the surfboard--catch the wave. PMID:9987328

  14. Missouri Responses to the Advanced Practice Nurse Role.

    ERIC Educational Resources Information Center

    Armer, Jane M.

    1997-01-01

    A randomly drawn statewide sample of 891 Missouri consumers revealed overall support for the advance practice nurse role to be greater than 75%. Seeking health care consumers' reactions to proposed alternatives is a crucial step in planning and implementing a program of health care reform that will meet current and future health needs. (Author)

  15. Advancing Your Career: Concepts of Professional Nursing. Second Edition.

    ERIC Educational Resources Information Center

    Kearney, Rose

    This textbook, intended for registered nurses (RN's) returning to school, is designed to provide practicing RN's with professional concepts to advance their careers. The book contains 22 chapters organized in five sections. Each chapter includes chapter objectives, key terms, key points, chapter exercises, references, and a bibliography. Section I…

  16. Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

    PubMed

    Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

    2014-07-01

    Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs. PMID:24814999

  17. Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial

    PubMed Central

    Broderick, Joan E.; Keefe, Francis J.; Bruckenthal, Patricia; Junghaenel, Doerte U.; Schneider, Stefan; Schwartz, Joseph E.; Kaell, Alan T.; Caldwell, David S.; McKee, Daphne; Reed, Shelby; Gould, Elaine

    2014-01-01

    A multisite, randomized, controlled clinical effectiveness trial was conducted for osteoarthritis patients with chronic pain of the knee or hip. Adult health nurse practitioners provided a 10-session intervention, pain coping skills training (PCST), in patients’ doctors’ offices (N = 129 patients); the control group received usual care (N = 127 patients). Primary outcomes assessed at baseline, posttreatment, 6-month follow-up, and 12-month follow-up were: pain intensity, physical functioning, psychological distress, self-efficacy, catastrophizing, use of coping strategies, and quality of life. Secondary measures included fatigue, social functioning, health satisfaction, and use of pain medication. Methods favoring external validity, consistent with pragmatic, effectiveness research, were utilized. Primary ITT and secondary per-protocol analyses were conducted. Attrition was within the expected range: 11% at posttreatment and 29% at 12-month follow-up; rates did not differ between groups. Omnibus ITT analyses across all assessment points indicated significant improvement for the PCST group compared with the control group for pain intensity, physical functioning, psychological distress, use of pain coping strategies, and self-efficacy, as well as fatigue, satisfaction with health, and reduced use of pain medication. Treatment effects were robust to covariates (demographics and clinical sites). Trends in the outcomes across the assessments were examined. All outcomes, except for self-efficacy, were maintained through the 12-month follow-up; effects for self-efficacy degraded over time. Per-protocol analyses did not yield greater effect sizes. Comparisons of PCST patients who were more vs less treatment adherent suggested greater effectiveness for patients with high adherence. Results support the effectiveness of nurse practitioner delivery of PCST for chronic osteoarthritis pain. PMID:24865795

  18. Nursing entrepreneurship: motivators, strategies and possibilities for professional advancement and health system change.

    PubMed

    Wall, Sarah

    2013-06-01

    In Canada, as well as internationally, efficiency-focused organizational restructuring in healthcare has resulted in stressful job change for nurses, although nurses continue to work in a system that values technology-based, physician-provided services. Employed nurses have had to participate in organizational activities that undermine their professional values and goals. Nursing entrepreneurship presents an opportunity to explore nursing's professional potential in nursing practice that is uniquely independent. In this study, a focused ethnographic approach was used to explore the experiences of self-employed nurses, who see themselves as leaders in advancing the profession of nursing and its contribution to healthcare. Key themes in the findings include the responses of self-employed nurses to health system change, expanded roles for nurses, the consequences of this non-traditional approach to nursing work and the possibilities for change that arise from nursing entrepreneurship. This research has implications for healthcare policy, professional advocacy and nursing education. PMID:23809640

  19. Transnationalism: A Framework for Advancing Nursing Research With Contemporary Immigrants.

    PubMed

    Rosemberg, Marie-Anne S; Boutain, Doris M; Mohammed, Selina A

    2016-01-01

    This article advances nursing research by presenting transnationalism as a framework for inquiry with contemporary immigrants. Transnationalism occurs when immigrants maintain relationships that transcend the geographical borders of their origin and host countries. Immigrants use those relationships to experience health differently within concurrent socioeconomic, political, and cultural contexts than national situated populations. Nurse researchers are called upon to consider these trans-border relationships when exploring the health of contemporary immigrants. Such consideration is needed to develop relevant research designs, methods, analysis, and dissemination strategies. PMID:26836998

  20. Minimal changes and missed opportunities: a decade look at nurse practitioners in the lower Mississippi River Delta states.

    PubMed

    Kippenbrock, Thomas; Buron, Bill; Odell, Ellen; Narcisse, Marie-Rachelle

    2014-01-01

    The U.S. southern region has one of most socioeconomically deprived and poorest health care outcomes in the county. The aims of this study were to determine changes of nurse practitioners (NPs) and their practice in lower Mississippi River Delta over the past decade and to examine differences of NPs' employment in health professional storage areas (HPSAs) and rural areas. A nonexperimental quantitative survey technique was used in the years 2000 and 2010. Other data sources included Health Resources and Services Administration that identified HPSA and the U.S. Census Bureau used to distinguish urban and rural areas. NPs are younger, and more are graduates of master's and doctorate degrees, but they are not reflective of the race they serve. Approximately, 25% of NPs worked in HPSA, and 50% worked in the rural area both in 2000 and in 2010. This proportion has remained blatantly steady during the past decade. Employment in rural health centers and family practice as a specialty declined; however, self-employment was on the rise. Nursing schools and health care institutions should be collaborating to develop plans and implementation strategies to recruit and retain NPs in the Mississippi River Delta rural and HPSAs. PMID:24939337

  1. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies

    PubMed Central

    Liu, He; Gao, Lijun; Jiao, Mingli; Liu, Jinghua; Liang, Libo; Zhao, Yanming; Wu, Qunhong

    2016-01-01

    The study’s objectives were to: 1) use social support theory to examine factors influencing healthcare workers’ opinions about workplace violence (WPV) prevention strategies, and 2) to determine the types of support that general practitioners (GPs) and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention. PMID:27326460

  2. Coping with Workplace Violence against General Practitioners and Nurses in Heilongjiang Province, China: Social Supports and Prevention Strategies.

    PubMed

    Zhao, Siqi; Qu, Lijun; Liu, He; Gao, Lijun; Jiao, Mingli; Liu, Jinghua; Liang, Libo; Zhao, Yanming; Wu, Qunhong

    2016-01-01

    The study's objectives were to: 1) use social support theory to examine factors influencing healthcare workers' opinions about workplace violence (WPV) prevention strategies, and 2) to determine the types of support that general practitioners (GPs) and general nurses sought and expected to use after WPV exposure. A cross-sectional survey was used to assess a sample of 448 GPs and 412 general nurses from 90 township hospitals located in Heilongjiang province, China. Results revealed that workers exposed to physical, psychological or both WPV types had a strong opinion about the necessity of improving diagnosis/treatment competence, developing violence prevention guidelines and plans, using protective equipment, and reinforcing staff by providing back-up support. The last two strategies were also selected by tertiary hospital workers in our previous study. In addition, workers with high anxiety selected the following prevention strategies as most effective: improving doctor-patient communication skills; installing cameras on wards; keeping work areas bright; improvements in violence reporting, statistics, and interventions; security patrols in the key departments; reinforcing staff; and correcting inaccurate media perspectives and reports. The last four strategies were also selected by tertiary hospital workers. All respondents expected to receive organisational and social support. In conclusion, these prevention strategies should be tailored to the different requirements of specific populations. Furthermore, it is necessary for organisations, the public, and policymakers to provide powerful support in WPV prevention. PMID:27326460

  3. A Systematic Review of the Cost-Effectiveness of Nurse Practitioners and Clinical Nurse Specialists: What Is the Quality of the Evidence?

    PubMed Central

    Martin-Misener, Ruth; Kaasalainen, Sharon; Marshall, Deborah A.; Donald, Erin E.; Yost, Jennifer; Hubley, Pamela; Laflamme, Célyne; Campbell–Yeo, Marsha; Price, Sheri; Boyko, Jennifer

    2014-01-01

    Background. Improved quality of care and control of healthcare costs are important factors influencing decisions to implement nurse practitioner (NP) and clinical nurse specialist (CNS) roles. Objective. To assess the quality of randomized controlled trials (RCTs) evaluating NP and CNS cost-effectiveness (defined broadly to also include studies measuring health resource utilization). Design. Systematic review of RCTs of NP and CNS cost-effectiveness reported between 1980 and July 2012. Results. 4,397 unique records were reviewed. We included 43 RCTs in six groupings, NP-outpatient (n = 11), NP-transition (n = 5), NP-inpatient (n = 2), CNS-outpatient (n = 11), CNS-transition (n = 13), and CNS-inpatient (n = 1). Internal validity was assessed using the Cochrane risk of bias tool; 18 (42%) studies were at low, 17 (39%) were at moderate, and eight (19%) at high risk of bias. Few studies included detailed descriptions of the education, experience, or role of the NPs or CNSs, affecting external validity. Conclusions. We identified 43 RCTs evaluating the cost-effectiveness of NPs and CNSs using criteria that meet current definitions of the roles. Almost half the RCTs were at low risk of bias. Incomplete reporting of study methods and lack of details about NP or CNS education, experience, and role create challenges in consolidating the evidence of the cost-effectiveness of these roles. PMID:25258683

  4. Reflections on ethnocentrism and racism: a challenge for advanced practice nurses.

    PubMed

    Harris, S H; Cummings, S H

    1996-01-01

    As nurses and patient populations increasingly reflect the changing demographics of the United States, it will be necessary for nurses to address the critical issues surrounding a multicultural society. Nurses have been relatively quiet on the topic of ethnocentric and racist behavior. If advanced practice nurses are to be successful in assisting nurses and organizations to embrace cultural diversity, understanding ethnocentric and racist behaviors is key to developing strategies to facilitate the provision of culturally competent care. PMID:9447077

  5. Developing clinical competency: Experiences and perceptions of Advanced Midwifery Practitioners in training.

    PubMed

    Gaskell, Lynne; Beaton, Susan

    2015-07-01

    This paper will describe the experiences and perception of a cohort of trainee Advanced Midwifery Practitioners (AMP's) during their training on an MSc in Advanced Practice. The educational philosophy underpinning the master's programme is interprofessional learning linked closely to work based learning and assessment. The focus group explored how the AMP's were developing core competencies within four domains: The links between the university and clinical assessments were instrumental in developing both midwifery and specialised skills required for extending their scope of practice. The changing demographics of their client group facilitated the need to provide safe assessment and management of ladies with complex health and social needs in pregnancy and childbirth; provide specialised clinics and the development of a robust staff training and assessment process. The generic competencies they gained improved collaborative working with their medical colleagues, raising the trainees profile and acceptance of their extended role. In addition to this, development of specialised midwifery skills promoted a high degree of decision making responsibilities within midwifery to facilitate service development and promote evidence based care. PMID:25892367

  6. [The strict sense nursing postgraduation in Brazil: advances and perspectives].

    PubMed

    Scochi, Carmen Gracinda Silvan; Munari, Denize Bouttelet; Gelbcke, Francine Lima; Erdmann, Alacoque Lorenzini; de Gutiérrez, Maria Gaby Rivero; Rodrigues, Rosalina Aparecida Partezani

    2013-09-01

    Nursing is a specific field of knowledge and social practice that has been consolidated and strengthened as science. In Brazil, it has been developed due to the increase and qualification of strict sense post-graduate programs. This study aims to present a historical review of the strict sense post-graduate nursing courses in Brazil and to reflect on their evolution, progress, challenges and future perspectives. It explores the creation of strict sense post-graduate courses, highlighting the movement to build a culture of academic and professional post-graduation in nursing. The historical path of their consolidation, expansion, conquest of excellence and international visibility over four decades, and the challenges and future perspectives are showed. It is found that the post-graduate programs in the field has contributed to the advancement and consolidation of scientific, technological knowledge and innovation in nursing and health care, having as philosophy the respect for diversity and the free exchange of ideas, the improvement of quality of life and health, and the effectiveness of citizenship. PMID:24092314

  7. Exploring the beliefs underlying attitudes to active voluntary euthanasia in a sample of Australian medical practitioners and nurses: a qualitative analysis.

    PubMed

    White, Katherine M; Wise, Susi E; Young, Ross McD; Hyde, Melissa K

    A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values. PMID:19112873

  8. Nurse practitioner coverage is associated with a decrease in length of stay in a pediatric chronic ventilator dependent unit

    PubMed Central

    Rowan, Courtney M; Cristea, A Ioana; Hamilton, Jennifer C; Taylor, Nicole M; Nitu, Mara E; Ackerman, Veda L

    2016-01-01

    AIM: To hypothesize a dedicated critical care nurse practitioner (NP) is associated with a decreased length of stay (LOS) from a pediatric chronic ventilator dependent unit (PCVDU). METHODS: We retrospectively reviewed patients requiring care in the PCVDU from May 2001 through May 2011 comparing the 5 years prior to the 5 years post implementation of the critical care NP in 2005. LOS and room charges were obtained. RESULTS: The average LOS decreased from a median of 55 d [interquartile range (IQR): 9.8-108.3] to a median of 12 (IQR: 4.0-41.0) with the implementation of a dedicated critical care NP (P < 1.0001). Post implementation of a dedicated NP, a savings of 25738049 in room charges was noted over 5 years. CONCLUSION: Our data demonstrates a critical care NP coverage model in a PCVDU is associated with a significantly reduced LOS demonstrating that the NP is an efficient and likely cost-effective addition to a medically comprehensive service. PMID:27170929

  9. Advanced dementia research in the nursing home: the CASCADE study.

    PubMed

    Mitchell, Susan L; Kiely, Dan K; Jones, Richard N; Prigerson, Holly; Volicer, Ladislav; Teno, Joan M

    2006-01-01

    Despite the growing number of persons with advanced dementia, and the need to improve their end-of-life care, few studies have addressed this important topic. The objectives of this report are to present the methodology established in the CASCADE (Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life) study, and to describe how challenges specific to this research were met. The CASCADE study is an ongoing, federally funded, 5-year prospective cohort study of nursing [nursing home (NH)] residents with advanced dementia and their health care proxies (HCPs) initiated in February 2003. Subjects were recruited from 15 facilities around Boston. The recruitment and data collection protocols are described. The demographic features, ownership, staffing, and quality of care of participant facilities are presented and compared to NHs nationwide. To date, 189 resident/HCP dyads have been enrolled. Baseline data are presented, demonstrating the success of the protocol in recruiting and repeatedly assessing NH residents with advanced dementia and their HCPs. Factors challenging and enabling implementation of the protocol are described. The CASCADE experience establishes the feasibility of conducting rigorous, multisite dementia NH research, and the described methodology serves as a detailed reference for subsequent CASCADE publications as results from the study emerge. PMID:16917187

  10. A survey of oncology advanced practice nurses in Ontario: profile and predictors of job satisfaction.

    PubMed

    Bryant-Lukosius, Denise; Green, Esther; Fitch, Margaret; Macartney, Gail; Robb-Blenderman, Linda; McFarlane, Sandra; Bosompra, Kwadwo; DiCenso, Alba; Matthews, Susan; Milne, Harry

    2007-01-01

    The purpose of this study was to examine role structures and processes and their impact on job satisfaction for oncology advanced practice nurses (APNs) in Ontario. APNs caring for adult, paediatric or palliative patients in integrated regional cancer programs, tertiary care hospitals or community hospitals and agencies were invited to complete a mailed self-report questionnaire. A total of 73 of 77 APNs participated in the study. Most APNs (55%) were acute care nurse practitioners employed by regional cancer programs or tertiary care hospitals. Adult patients with breast or haematological cancers and those receiving initial treatment or palliative care were the primary focus of APN roles. APN education needs related to specialization in oncology, leadership and research were identified. Overall, APNs were minimally satisfied with their roles. Role confidence (beta = .404, p = .001) and the number of overtime hours (beta = -.313, p = .008) were respective positive and negative predictors of APN job satisfaction. Progress in role development is described, and recommendations for improving role development and expanding the delivery of oncology APN services are provided. PMID:17619596

  11. Nonurgent Use of the Emergency Department by Pediatric Patients: A Theory-Guided Approach for Primary and Acute Care Pediatric Nurse Practitioners.

    PubMed

    Ohns, Mary Jean; Oliver-McNeil, Sandra; Nantais-Smith, Leanne M; George, Nancy M

    2016-01-01

    Providing quality, cost-effective care to children and their families in the appropriate setting is the goal of nurse practitioners in primary and acute care. However, increased utilization of the emergency department (ED) for nonurgent care threatens cost-effective quality care, interrupts continuity of care, and contributes to ED overcrowding. To date, descriptive research has identified demographics of those using the ED for nonurgent care, the chief complaints of children seeking nonurgent care, the cost to the health care system of pediatric nonurgent care, and characteristics of associated primary care settings. Using Donabedian's Model of Quality of Healthcare and a Theory of Dependent Care by Taylor and colleagues, acute and primary care pediatric nurse practitioners can incorporate interventions that will channel care to the appropriate setting and educate caregivers regarding common childhood illnesses and the value of continuity of care. By using a theoretical framework as a guide, this article will help both acute and primary care pediatric nurse practitioners understand why parents seek nonurgent care for their children in the ED and actions they can take to ensure that care is provided in an optimal setting. PMID:26489793

  12. [Breast Care Nurses - nursing experts for breast cancer care. A path to "Advanced Nursing Practice" in Germany?].

    PubMed

    Gerlach, Anja; Wiedemann, Regina

    2010-12-01

    The role of Breast Care Nurses (BCNs) has been discussed since Breast Centres have been opened in Germany. This article introduces the concept of the Breast Care Nurses on a national and an international level in the context of Advanced Nursing Practice (ANP). Within a descriptive study, graduates of a German BCN-education programme were interrogated regarding their current work, their main activities as a BCN, about general conditions in their work environment, experienced barriers, and supporting factors. 122 questionnaires were evaluated. The return rate was 71 % (n = 171). Results showed that 58.1 % (n = 71) of the graduates were employed as a Breast Care Nurse, however only 28.1 % (n = 20) in a full-time and 35.2 % (n = 25) in a part-time position. This first German study about BCN-services showed a lack of basic work conditions, for example regarding a consultation room, access to literature, or templates for documentation. In the discussion part, the situation of the BCNs is reviewed in the German context and in relation to ANP concepts as well as regarding future demands for the position of a BCN. PMID:21154250

  13. Data mining results from an electronic clinical log for nurse practitioner students.

    PubMed

    Trangenstein, Patricia; Weiner, Elizabeth; Gordon, Jeffry; McNew, Ryan

    2007-01-01

    Traditional techniques for collecting data on clinical experiences have been greatly flawed. Data cannot be easily collected in real time to make programmatic or placement changes "on the fly". Furthermore, it is difficult to look at data across students, specialty areas, and years because the data is typically not in a digital format. In response to this problem, the Vanderbilt University School of Nursing has created a web/PDA based clinical log to document the kinds of clinical experiences the students are having. Since our initial report, three years ago, we have collected three years worth of data, over 220,000 different patient encounters. This past year the data has been very complete, giving a full picture of the types of experiences the students are having. Our faculty have begun to analyze the data in the clinical log to examine the kind of experiences the students are having and to make programmatic changes and placement adjustments in real time. In general, the results supported that students in the various specialties managed patients and performed services appropriate to their specialty. Patients varied in ages, ethnic groups, payment sources, and medical diagnoses. Students did progress from an observer role to a more independent role in either a linear fashion or in a more biphasic mode with an increase in the observer role at the start of a new semester. PMID:17911941

  14. Recent Trends in Advance Directives at Nursing Home Admission and One Year after Admission

    ERIC Educational Resources Information Center

    McAuley, William J.; Buchanan, Robert J.; Travis, Shirley S.; Wang, Suojin; Kim, MyungSuk

    2006-01-01

    Purpose: Advance directives are important planning and decision-making tools for individuals in nursing homes. Design and Methods: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. Results: The prevalence of having any advance directive at admission declined…

  15. Responding to the 2015 CMS Proposed Rule Changes for LTC Facilities: A Call to Redouble Efforts to Prepare Students and Practitioners for Nursing Homes.

    PubMed

    Bern-Klug, Mercedes; Connolly, Robert; Downes, Deirdre; Galambos, Colleen; Kusmaul, Nancy; Kane, Rosalie; Hector, Paige; Beaulieu, Elise

    2016-01-01

    In July of 2015, the Federal Register published for public comment proposed rule changes for nursing homes certified to receive Medicare and/or Medicaid. If the final rules are similar to the proposed rules, they will represent the largest change in federal rules governing nursing homes since the Nursing Home Reform Act which was part of OBRA 1987. The proposed changes have the potential to enhance the quality of care and quality of life of nursing home residents. Many of the proposed changes would directly affect the practice of social work and would likely expand the role for nursing home social workers. This article discusses the role that members of the National Nursing Home Social Work Network (NNHSW Network) played in developing and submitting a response to CMS. The article provides the context for the publication of the proposed rules, describes the process used by the NNHSW Network to develop and build support for comments on these rules, and also includes the actual comments submitted to CMS. Social work education programs and continuing education programs throughout the country will continue to have an important role to play in helping to prepare social work students and practitioners for a career in long-term care. PMID:26913558

  16. Addressing Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Advanced Practice Nursing Education.

    ERIC Educational Resources Information Center

    Nokes, Kathleen M.; Stein, Gary L.

    1997-01-01

    A survey of 23 advanced practice nursing programs showed only 3 had HIV-specific graduate-level nursing courses. Recommendations were made for HIV-specific courses, integration of HIV content into other courses, use of Centers for Disease Control and Occupational Safety and Health Administration guidelines, and subspecialties in HIV nursing. (SK)

  17. The place and barriers of evidence based practice: knowledge and perceptions of medical, nursing and allied health practitioners in malaysia

    PubMed Central

    2010-01-01

    Background Despite a recent increase in activities to promote evidence-based practice (EBP), it was unclear how Malaysian hospital practitioners received this new approach in medicine. This study examines their confidence and perceptions on EBP. Findings We conducted cross-sectional surveys using a self-administered questionnaire during two EBP training courses in two Malaysian hospitals in January and June 2007. Our subjects (n = 144) were doctors and nursing and allied health staff (NAH) participating in the EBP courses. Our questionnaire covered three domains: confidence and understanding (six items), attitude (five items) and barriers to practice (four items). We presented simple descriptive statistics, including the sum ratings and the proportions with different responses for each item, and compared different groups using Mann-Whitney U test for scaled ratings and Chi-square test for dichotomous responses. Ninety-two doctors and 52 NAH staff completed the surveys. Overall, doctors expressed slightly higher confidence on EBP compared to NAH staff. Out of a maximum sum rating of 27 over six items, doctors reported an average of 18.3 (SD 3.2) and NAH staff reported an average of 16.0 (SD 3.4), p = 0.002. Doctors were also more positive in their views on EBP. For example, 67.4% of doctors disagreed, but 61% of NAH staff agreed that "the importance of EBP in patient care is exaggerated", and 79.3% of doctors disagreed, but 46.2% of NAH staff agreed that "EBP is too tedious and impractical". Similar responses were observed for other items in the domain. Doctors and NAH staff shared similar concerns on barriers to evidence-based practice. The highest proportions considered poor facilities to access evidence a barrier (76% of doctors and 90% of NAH), followed by poor awareness of evidence (62% of doctors and 70% of NAH) and time constraints (63% of doctors and 68% of NAH), p = 0.09 for the combined rating of four items in the domain. Conclusions The findings of our

  18. Career advancement and educational opportunities: experiences and perceptions of internationally educated nurses.

    PubMed

    Salma, Jordana; Hegadoren, Kathleen M; Ogilvie, Linda

    2012-01-01

    The number of internationally educated nurses is increasing in the Canadian workforce. Recruitment of internationally educated nurses is often seen as a solution to ongoing nursing shortages. However, international recruitment needs to be accompanied by strategies to ensure long-term retention. One of the criteria for successful retention is the availability and accessibility of career advancement and educational opportunities. Little research exists on the opportunities for career advancement and education for internationally educated nurses in Canada. This interpretive descriptive study was conducted to look at the perceptions of internationally educated nurses regarding career advancement and educational opportunities in Alberta, Canada. Eleven internationally educated nurses, working as registered nurses in Alberta, were interviewed using semi-structured interviews. Five themes were identified: motherhood as a priority, communication and cultural challenges, process of skill recognition, perceptions of opportunity and need for mentorship. PMID:23010920

  19. Resident and family perceptions of the nurse practitioner role in long term care settings: a qualitative descriptive study

    PubMed Central

    2013-01-01

    Background Research evidence supports the positive impact on resident outcomes of nurse practitioners (NPs) working in long term care (LTC) homes. There are few studies that report the perceptions of residents and family members about the role of the NP in these settings. The purpose of this study was to explore the perceptions of residents and family members regarding the role of the NP in LTC homes. Methods The study applied a qualitative descriptive approach. In-depth individual and focus group interviews were conducted with 35 residents and family members from four LTC settings that employed a NP. Conventional content analysis was used to identify themes and sub-themes. Results Two major themes were identified: NPs were seen as providing resident and family-centred care and as providing enhanced quality of care. NPs established caring relationships with residents and families, providing both informational and emotional support, as well as facilitating their participation in decision making. Residents and families perceived the NP as improving availability and timeliness of care and helping to prevent unnecessary hospitalization. Conclusions The perceptions of residents and family members of the NP role in LTC are consistent with the concepts of person-centred and relationship-centred care. The relationships NPs develop with residents and families are a central means through which enhanced quality of care occurs. Given the limited use of NPs in LTC settings, there is an opportunity for health care policy and decision makers to address service inadequacies through strategic deployment of NPs in LTC settings. NPs can use their expert knowledge and skill to assist residents and families to make informed choices regarding their health care and maintain a positive care experience. PMID:24074157

  20. The feasibility of nurse practitioner-performed, telementored lung telesonography with remote physician guidance - ‘a remote virtual mentor’

    PubMed Central

    2013-01-01

    Background Point-of-care ultrasound (POC-US) use is increasingly common as equipment costs decrease and availability increases. Despite the utility of POC-US in trained hands, there are many situations wherein patients could benefit from the added safety of POC-US guidance, yet trained users are unavailable. We therefore hypothesized that currently available and economic ‘off-the-shelf’ technologies could facilitate remote mentoring of a nurse practitioner (NP) to assess for recurrent pneumothoraces (PTXs) after chest tube removal. Methods The simple remote telementored ultrasound system consisted of a handheld ultrasound machine, head-mounted video camera, microphone, and software on a laptop computer. The video output of the handheld ultrasound machine and a macroscopic view of the NP's hands were displayed to a remote trauma surgeon mentor. The mentor instructed the NP on probe position and US machine settings and provided real-time guidance and image interpretation via encrypted video conferencing software using an Internet service provider. Thirteen pleural exams after chest tube removal were conducted. Results Thirteen patients (26 lung fields) were examined. The remote exam was possible in all cases with good connectivity including one trans-Atlantic interpretation. Compared to the subsequent upright chest radiograph, there were 4 true-positive remotely diagnosed PTXs, 2 false-negative diagnoses, and 20 true-negative diagnoses for 66% sensitivity, 100% specificity, and 92% accuracy for remotely guided chest examination. Conclusions Remotely guiding a NP to perform thoracic ultrasound examinations after tube thoracostomy removal can be simply and effectively performed over encrypted commercial software using low-cost hardware. As informatics constantly improves, mentored remote examinations may further empower clinical care providers in austere settings. PMID:23805869

  1. Advancing a program of research within a nursing faculty role.

    PubMed

    Nolan, Marie T; Wenzel, Jennifer; Han, Hae-Ra; Allen, Jerilyn K; Paez, Kathryn A; Mock, Victoria

    2008-01-01

    Doctoral students and new faculty members often seek advice from more senior faculty on how to advance their program of research. Students may ask whether they should choose the manuscript option for their dissertation or whether they should seek a postdoctoral fellowship. New faculty members wonder whether they should pursue a career development award and whether they need a mentor as they strive to advance their research while carrying out teaching, service, and practice responsibilities. In this article, we describe literature on the impact of selected aspects of pre- and postdoctoral training and faculty strategies on scholarly productivity in the faculty role. We also combine our experiences at a school of nursing within a research-intensive university to suggest strategies for success. Noting the scarcity of research that evaluates the effect of these strategies, we are actively engaged in collecting data on their relationship to the scholarly productivity of students and faculty members within our own institution. PMID:19022210

  2. Advancing a Program of Research within a Nursing Faculty Role

    PubMed Central

    Nolan, Marie T.; Wenzel, Jennifer; Han, Hae-Ra.; Allen, Jerilyn K.; Paez, Kathryn A.; Mock, Victoria

    2008-01-01

    Doctoral students and new faculty members often seek advice from more senior faculty on how to advance their program of research. Students may ask whether they should choose the manuscript option for their dissertation or whether they should seek a postdoctoral fellowship. New faculty members wonder whether they should pursue a career development (K) award and whether they need a mentor as they strive to advance their research while carrying out teaching, service, and practice responsibilities. In this paper, we describe literature on the impact of selected aspects of pre and postdoctoral training and faculty strategies on scholarly productivity in the faculty role. We also combine our experiences at a school of nursing within a research-intensive university to suggest strategies for success. Noting the scarcity of research that evaluates the effect of these strategies we are actively engaged in collecting data on their relationship to the scholarly productivity of students and faculty members within our own institution. PMID:19022210

  3. Spasm or transformation? Advanced practice psychiatric nursing education in the United States.

    PubMed

    Olson, Tom

    2004-08-01

    Psychiatric nursing graduate programs are in precipitous decline in the United States, leading many advanced practice psychiatric nurses to question the viability of their field. This article examines the current crisis in advanced practice psychiatric nursing education in the United States by identifying core concerns and exploring the reasons for these concerns. Suggestions for securing the future of this practice area are also discussed. These suggestions include identifying a more clearly focused role for advanced practice psychiatric nurses, development of realistic educational expectations, achievement of greater uniformity in curricula, and the establishment of a strong and rigorous process of accreditation. PMID:15468608

  4. Effectiveness of Advanced Illness Care Teams for Nursing Home Residents with Dementia

    ERIC Educational Resources Information Center

    Chapman, Dennis G.; Toseland, Ronald W.

    2007-01-01

    This study evaluated the effectiveness of advanced illness care teams (AICTs) for nursing home residents with advanced dementia. The AICTs used a holistic approach that focused on four domains: (1) medical, (2) meaningful activities, (3) psychological, and (4) behavioral. The authors recruited 118 residents in two nursing homes for this study and…

  5. Emerging areas of science: Recommendations for Nursing Science Education from the Council for the Advancement of Nursing Science Idea Festival.

    PubMed

    Henly, Susan J; McCarthy, Donna O; Wyman, Jean F; Heitkemper, Margaret M; Redeker, Nancy S; Titler, Marita G; McCarthy, Ann Marie; Stone, Patricia W; Moore, Shirley M; Alt-White, Anna C; Conley, Yvette P; Dunbar-Jacob, Jacqueline

    2015-01-01

    The Council for the Advancement of Nursing Science aims to "facilitate and recognize life-long nursing science career development" as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee (IFAC) to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2005 National Research Council report Advancing The Nation's Health Needs and the 2010 American Association of Colleges of Nursing Position Statement on the Research-Focused Doctorate Pathways to Excellence, the IFAC specifically addressed the capacity of PhD programs to prepare nursing scientists to conduct cutting-edge research in the following key emerging and priority areas of health sciences research: omics and the microbiome; health behavior, behavior change, and biobehavioral science; patient-reported outcomes; big data, e-science, and informatics; quantitative sciences; translation science; and health economics. The purpose of this article is to (a) describe IFAC activities, (b) summarize 2014 discussions hosted as part of the Idea Festival, and (c) present IFAC recommendations for incorporating these emerging areas of science and technology into research-focused doctoral programs committed to preparing graduates for lifelong, competitive careers in nursing science. The recommendations address clearer articulation of program focus areas; inclusion of foundational knowledge in emerging areas of science in core courses on nursing science and research methods; faculty composition; prerequisite student knowledge and skills; and in-depth, interdisciplinary training in supporting area of science content and methods. PMID:26187079

  6. [Briefly summarized nursing card for patients with advanced cancer receiving out hospital management].

    PubMed

    Hayashi, Y; Andoh, M; Hioki, M; Sugitoh, Y; Hyoudoh, C

    1994-12-01

    Briefly summarized nursing card to perform adequate nursing for readmission patients with advanced cancer receiving outhospital management was developed and its clinical usefulness for nursing is discussed. The card is 18 cm x 13 cm, differential colored for diseases, and written only necessary summarized informations for adequate nursing at the patient's emergent readmission. By using this card for 24 patients, it was very useful because of its very selected, brief and summarized information. This card has much usefulness for nursing of such patients. PMID:7802460

  7. Find a Nurse Practitioner

    MedlinePlus

    ... Hematology Dermatology Ortho Neurology Psychiatric OB/GYN Pain Respiratory Urolory / Nephrology Ear, Nose, and Throat Complementary / Alternative Therapies End-of-life Care Other Genetics Occupational Health ...

  8. Advanced practice nursing in performing arts health care.

    PubMed

    Weslin, Anna T; Silva-Smith, Amy

    2010-06-01

    Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care. PMID:20644180

  9. Meaningful Use of Data in Care Coordination by the Advanced Practice Registered Nurse: The TeleFamilies Project

    PubMed Central

    Looman, Wendy S.; Erickson, Mary M.; Garwick, Ann W.; Cady, Rhonda G.; Kelly, Anne; Pettey, Carrie; Finkelstein, Stanley M.

    2012-01-01

    Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special health care needs. The purpose of this paper is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special health care needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special health care needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse’s ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data. PMID:22948406

  10. Drug information resources used by nurse practitioners and collaborating physicians at the point of care in Nova Scotia, Canada: a survey and review of the literature

    PubMed Central

    Murphy, Andrea L; Fleming, Mark; Martin-Misener, Ruth; Sketris, Ingrid S; MacCara, Mary; Gass, David

    2006-01-01

    Background Keeping current with drug therapy information is challenging for health care practitioners. Technologies are often implemented to facilitate access to current and credible drug information sources. In the Canadian province of Nova Scotia, legislation was passed in 2002 to allow nurse practitioners (NPs) to practice collaboratively with physician partners. The purpose of this study was to determine the current utilization patterns of information technologies by these groups of practitioners. Methods Nurse practitioners and their collaborating physician partners in Nova Scotia were sent a survey in February 2005 to determine the frequency of use, usefulness, accessibility, credibility, and current/timeliness of personal digital assistant (PDA), computer, and print drug information resources. Two surveys were developed (one for PDA users and one for computer users) and revised based on a literature search, stakeholder consultation, and pilot-testing results. A second distribution to nonresponders occurred two weeks following the first. Data were entered and analysed with SPSS. Results Twenty-seven (14 NPs and 13 physicians) of 36 (75%) recipients responded. 22% (6) returned personal digital assistant (PDA) surveys. Respondents reported print, health professionals, and online/electronic resources as the most to least preferred means to access drug information, respectively. 37% and 35% of respondents reported using "both print and electronic but print more than electronic" and "print only", respectively, to search monograph-related drug information queries whereas 4% reported using "PDA only". Analysis of respondent ratings for all resources in the categories print, health professionals and other, and online/electronic resources, indicated that the Compendium of Pharmaceuticals and Specialties and pharmacists ranked highly for frequency of use, usefulness, accessibility, credibility, and current/timeliness by both groups of practitioners. Respondents

  11. Quality Nursing Care for Hospitalized Patients with Advanced Illness: Concept Development

    PubMed Central

    Izumi, Shigeko; Baggs, Judith G.; Knafl, Kathleen A.

    2011-01-01

    The quality of nursing care as perceived by hospitalized patients with advanced illness has not been examined. A concept of quality nursing care for this population was developed by integrating the literature on constructs defining quality nursing care with empirical findings from interviews of 16 patients with advanced illness. Quality nursing care was characterized as competence and personal caring supported by professionalism and delivered with an appropriate demeanor. Although the attributes of competence, caring, professionalism, and demeanor were identified as common components of quality care across various patient populations, the caring domain increased in importance when patients with advanced illness perceived themselves as vulnerable. Assessment of quality nursing care for patients with advanced illness needs to include measures of patient perceptions of vulnerability. PMID:20572095

  12. Internet-based self-management support for adults with asthma: a qualitative study among patients, general practitioners and practice nurses on barriers to implementation

    PubMed Central

    van Gaalen, Johanna L; van Bodegom-Vos, Leti; Bakker, Moira J; Snoeck-Stroband, Jiska B; Sont, Jacob K

    2016-01-01

    Objectives The aim of this study was to explore barriers among patients, general practitioners (GPs) and practice nurses to implement internet-based self-management support as provided by PatientCoach for asthma in primary care. Setting Primary care within South Holland, the Netherlands. Participants Twenty-two patients (12 women, mean age 38 years), 21 GPs (6 women, mean age 52 years) and 13 practice nurses (all women, mean age 41 years). Design A qualitative study using focus groups and interviews. Outcomes Barriers as perceived by patients, GPs and practice nurses to implementation of PatientCoach. Methods 10 focus groups and 12 interviews were held to collect data: 4 patient focus groups, 4 GP focus groups, 2 practice nurse focus group, 2 patient interviews, 5 GP interviews and 5 practice nurse interviews. A prototype of PatientCoach that included modules for coaching, personalised information, asthma self-monitoring, medication treatment plan, feedback, e-consultations and a forum was demonstrated. A semistructured topic guide was used. Directed content analysis was used to analyse data. Reported barriers were classified according to a framework by Grol and Wensing. Results A variety of barriers emerged among all participant groups. Barriers identified among patients include a lack of a patient–professional partnership in using PatientCoach and a lack of perceived benefit in improving asthma symptoms. Barriers identified among GPs include a low sense of urgency towards asthma care and current work routines. Practice nurses identified a low level of structured asthma care and a lack of support by colleagues as barriers. Among all participant groups, insufficient ease of use of PatientCoach, lack of financial arrangements and patient characteristics such as a lack of asthma symptoms were reported as barriers. Conclusions We identified a variety of barriers to implementation of PatientCoach. An effective implementation strategy for internet-based self

  13. Relationships among moral distress, level of practice independence, and intent to leave of nurse practitioners in emergency departments: results from a national survey.

    PubMed

    Trautmann, Jennifer; Epstein, Elizabeth; Rovnyak, Virginia; Snyder, Audrey

    2015-01-01

    The aims of this research study were to investigate moral distress among emergency department (ED) nurse practitioners (NPs) and examine relationships between moral distress and level of practice independence as well as intent to leave a position. Moral distress has been studied regarding registered nurses and physicians (MDs) but less so in NPs. It is important to explore moral distress in NPs because they tread a unique path between nursing and physician roles. Moral distress may play a significant role in staff nurses' intention to leave practice, and level of practice independence is found to have a relationship with NPs' intention to leave. A convenience sample of ED NPs was obtained from a mailing list of a national nursing specialty organization, the Emergency Nurses Association. Using a correlational design, survey methods assessed moral distress with the Moral Distress Scale-Revised (MDS-R), level of practice independence with the Dempster Practice Behavior Scale, and intent to leave with self-report. Correlational and regression analyses of data were conducted to characterize moral distress among ED NPs and associations between moral distress, level of practice independence, and intent to leave. Results found ED NPs do experience moral distress with poor patient care results from inadequate staff communication and working with incompetent coworkers in their practice. The MDS-R was a significant predictor of intention to leave among respondents. This study is the first of its kind to explore moral distress in ED NPs. Results suggest moral distress influences ED NPs' intent to leave their position. Further studies are needed to explore the findings from this research and to formulate interventions to alleviate moral distress in ED NPs and improve retention in the clinical setting. PMID:25929224

  14. Type 2 diabetes, genomics, and nursing: necessary next steps to advance the science into improved, personalized care.

    PubMed

    Underwood, Patricia C

    2011-01-01

    Type 2 diabetes mellitus (T2DM) is an inherited, chronic disorder with long-term complications; including cardiovascular disease the leading cause of mortality in the United States. The prevalence of T2DM and its complications are on the rise in the United States, highlighting the need for improved individualized prevention and treatment strategies. Exciting advancements in the field of genomics has led to the recent discovery of numerous genetic markers for T2DM; completing a promising first step toward improved, individualized prevention and treatment strategies for T2DM. These genomic markers, identified using genome-wide association studies (GWAS), candidate gene, and rare variant methodology, identify new physiologic pathways underlying the development of T2DM. Much more work is needed to successfully translate the identification of genetic markers for T2DM into improved, individualized prevention and treatment strategies. As front line providers and leaders of prevention and treatment strategies for chronic disease, nurses, nurse practitioners, and nurse scientists must contribute to this translational effort. Thus, it is important for nurses at all levels to (a) be aware of the current science of genetics and T2DM and (b) participate in the translation of this genetic information into improved, personalized patient care. The aim of this review is to (a) provide an overview of the current state of the science of genetic markers and T2DM and (b) highlight essential next steps to successfully translate the identification of genetic markers for T2DM into improved prevention and treatment strategies; focusing particularly on the role of nursing in this process. PMID:22891509

  15. The Development of Evidence Briefs to Transfer Knowledge About Advanced Practice Nursing Roles to Providers, Policymakers and Administrators.

    PubMed

    Kilpatrick, Kelley; Carter, Nancy; Bryant-Lukosius, Denise; Charbonneau-Smith, Renee; DiCenso, Alba

    2015-03-01

    The transfer of health-related research knowledge between producers and users is a complex, dynamic and iterative process. There has been little research describing the preferred knowledge transfer strategies used by different stakeholder groups, including healthcare providers, policymakers and administrators. The purpose of the survey was to gain an understanding of the content and preferred dissemination strategies of knowledge users of briefing notes about the effectiveness of advanced practice nursing (APN) roles in Canada. An on-line cross-sectional survey was conducted from December 2011 to January 2012. Purposeful sampling was used to identify the target audience. The questionnaire included six items. The response rate was 44% (n=75/170). Participants identified that the briefing note should concisely summarize definitions for APN roles and information about the safety, effectiveness, cost savings and effective role implementation strategies. Multiple approaches were favoured to disseminate the information. Preferred dissemination strategies included personalized emails, meeting with briefing note recipients, engaging nurse practitioners and clinical nurse specialists in organizations where APN roles have been successfully implemented, engaging the media and using social media. The use of briefing notes has shown promise. More research is needed to evaluate the effectiveness of tailored briefing notes. PMID:26154117

  16. Predictors for Assessing Electronic Messaging Between Nurses and General Practitioners as a Useful Tool for Communication in Home Health Care Services: A Cross-Sectional Study

    PubMed Central

    Hofoss, Dag; Grimsmo, Anders; Hellesø, Ragnhild

    2015-01-01

    Background Nurses providing home health care services are dependent on access to patient information and communicating with general practitioners (GPs) to deliver safe and effective health care to patients. Information and communication technology (ICT) systems are viewed as powerful tools for this purpose. In Norway, a standardized electronic messaging (e-messaging) system is currently being established in health care. Objective The aim of this study was to explore home health care nurses’ assessments of the utility of the e-messaging system for communicating with GPs and identify elements that influence the assessment of e-messaging as a useful communication tool. Methods The data were collected using a self-developed questionnaire based on variables identified by focus group interviews with home health care nurses (n=425) who used e-messaging and existing research. Data were analyzed using logistic regression analyses. Results Over two-thirds (425/632, 67.2%) of the home health care nurses returned the questionnaire. A high proportion (388/399, 97.2%) of the home health care nurses who returned the questionnaire found the e-messaging system to be a useful tool for communication with GPs. The odds of reporting that e-messaging was a useful tool were over five times higher (OR 5.1, CI 2.489-10.631, P<.001) if the nurses agreed or strongly agreed that e-messaging was easy to use. The odds of finding e-messaging easy to use were nearly seven times higher (OR 6.9, CI 1.713-27.899, P=.007) if the nurses did not consider the system functionality poor. If the nurses had received training in the use of e-messaging, the odds were over six times higher (OR 6.6, CI 2.515-17.437, P<.001) that they would consider e-messaging easy to use. The odds that a home health care nurse would experience e-messaging as easy to use increased as the full-time equivalent percentage of the nurses increased (OR 1.032, CI 1.001-1.064, P=.045). Conclusions This study has shown that technical

  17. Advanced practice nurse entrepreneurs in a multidisciplinary surgical-assisting partnership.

    PubMed

    DeCarlo, Linda

    2005-09-01

    CHANGES IN THE HEALTH CARE environment and reimbursement practices are creating opportunities for nurse entrepreneurs to be partners with other professional nurses and physicians. Advanced practice nurses (APNs) who want to step into an entrepreneurial role must have strong clinical expertise, specific personal characteristics, interpersonal skills, and business acumen. ESTABLISHING A MULTIDISCIPLINARY partnership for providing surgical assisting services has many benefits and presents many challenges. PMID:16309068

  18. The 2015 NASN School Nurse Survey: Developing and Providing Leadership to Advance School Nursing Practice.

    PubMed

    Mangena, Anantha Sameera; Maughan, Erin

    2015-11-01

    This article summarizes the results of the 2015 NASN School Nurse Survey, identifies similarities and differences between this survey and the 2013 NASN School Nurse Survey, and evaluates the possible impacts of this data on the organization. PMID:26515570

  19. Role performance of psychiatric nurses in advanced practice: a systematic review of the literature.

    PubMed

    Fung, Y L; Chan, Z; Chien, W T

    2014-10-01

    This paper discusses findings from a systematic review of literature pertaining to the role performance of psychiatric nurses in advanced practice. A search of 11 electronic databases was conducted to identify research involving interventions by psychiatric (or mental health) nurses in advanced practice. A total of 14 studies were identified. In this review, the role performance of psychiatric nurses in advanced practice was categorized into three themes: (1) the provision of psychosocial interventions; (2) the provision of nurse-directed services in health-care contexts; and (3) the provision of psychiatric nursing consultation services. Our results document that psychiatric nurses in advanced practice perform multifaceted roles and provide mental health-care services in various contexts. This systematic review reveals that the nurses obtain significant results in managing clients with depression and psychological stress, and demonstrates their value when developing partnerships with non-mental health service providers. One study, however, showed that the nurses had insignificant results in performing transitional care for pre-discharged mental health service users. PMID:24299195

  20. The views of general practitioners and practice nurses towards the barriers and facilitators of proactive, internet-based chlamydia screening for reaching young heterosexual men

    PubMed Central

    2014-01-01

    Background Chlamydia trachomatis is a common bacterial sexually transmitted infection (STI), which disproportionately affects young people under 25 years. Commonly, more women are offered screening than men. This study obtained the views of general practitioners and practice nurses towards Internet-based screening and assessed levels of support for the development of proactive screening targeting young heterosexual men via the Internet. Methods Semi-structured telephone interviews with 10 general practitioners and 8 practice nurses, across Central Scotland. Topics covered: experience of screening heterosexual men for chlamydia, views on the use of the Internet as a way to reach young men for chlamydia screening, beliefs about the potential barriers and facilitators to Internet-based screening. Transcripts from audio recordings were analysed with Framework Analysis, using QSR NVivo10. Results Experiences of chlamydia screening were almost exclusively with women, driven by the nature of consultations and ease of raising sexual health issues with female patients; few practice nurses reported seeing men during consultations. All participants spoke in favour of Internet-based screening for young men. Participants reported ease of access and convenience as potential facilitators of an Internet-based approach but anonymity and confidentiality could be potential barriers and facilitators to the success of an Internet approach to screening. Concerns over practical issues as well as those pertaining to gender and socio-cultural issues were raised. Conclusions Awareness of key barriers and facilitators, such as confidentiality, practicality and socio-cultural influences, will inform the development of an Internet-based approach to screening. However, this approach may have its limits in terms of being able to tackle wider social and cultural barriers, along with shifts in young people’s and health professionals’ attitudes towards screening. Nevertheless, employing

  1. Hospital clinical career advancement programs: comparing perceptions of nurse participants and nonparticipants.

    PubMed

    Thornhill, S K

    1994-09-01

    The study reported in this article describes nurse participants and nonparticipants in hospital clinical career advancement programs (clinical ladders) and compares perceptions in relation to program intrinsic outcomes, needs, and criteria for level advancement. A stratified random sample consisted of 120 participants and 480 nonparticipants drawn from 1,769 clinical nurses employed full time at five regional general hospitals. The findings suggest that nurses' demographic characteristics do not influence program participation status and that clinical advancement programs have limited impact upon job enrichment designed to recruit and retain clinical nurses providing direct patient care. Program participants (106; 88.3 percent) differed significantly at the .05 level from nonparticipants (385; 80.2 percent) on each factor area measuring perceptions of clinical advancement programs. PMID:10136982

  2. Online, directed journaling in community health advanced practice nursing clinical education.

    PubMed

    Daroszewski, Ellen Beth; Kinser, Anita G; Lloyd, Susan L

    2004-04-01

    The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education. PMID:15098912

  3. Gerontological nursing leadership in the Advancing Excellence Campaign: moving interdisciplinary collaboration forward.

    PubMed

    Bakerjian, Debra; Beverly, Claudia; Burger, Sarah Greene; Carter, Diane; Dornberger, Sherrie; Eliopoulos, Charlotte; Remsburg, Robin

    2014-01-01

    Nursing was not a part of the coalition of multiple nursing home stakeholders at the roll out of the Advancing Excellence Campaign (AEC). In January 2007, several nurse organizations proactively approached the AEC leadership, were welcomed and immediately began to volunteer for leadership positions such as committee chairs and conference coordinators. This paper presents an exemplar of how a proactive stance, even when not initially included, allowed nurses to secure chairs at the decision making table of this quality campaign and contribute to improved resident outcomes. PMID:24970338

  4. [Necessary changes for advancing nursing as caring science].

    PubMed

    de Pires, Denise Elvira Pires

    2013-09-01

    The article aimed to reflect upon the challenges involved in strengthening Nursing as a caring science. It is founded on the sociological theory, connecting three approaches: the historical-dialectic materialism perspective about the working process in health care and nursing; the sociology of professions from a critical perspective; and the philosophy of science. The discussion is organized considering the aspects of Nursing as a discipline, work and health care profession. It sustains that knowledge production should be driven both by the purpose of Nursing work which is providing care to human beings with health needs and to advocate for the indispensable work conditions to a safe and responsible practice. It concludes that to strengthening Nursing it is necessary to produce knowledge to support nursing care and the political actions defending safe work conditions, the universal right to health as well safe and high quality care. PMID:24092308

  5. Applying the Advancing Excellence in America's Nursing Homes Circle of Success to improving and sustaining quality.

    PubMed

    Bakerjian, Debra; Zisberg, Anna

    2013-01-01

    Looking forward to the Quality Assurance Performance Improvement (QAPI) program to be implemented and required in 2014, and as nursing home staff provide care for residents with increasingly complex health issues, knowledge of how to implement quality improvement (QI) is imperative. The nursing home administrator and director of nursing (DON) provide overall leadership, but it is the primary responsibility of the DON and other registered nurse staff to implement and manage the day to day QI process. This article describes potential roles of nursing leaders and key components of a QI project using a pressure ulcer case study exemplar to illustrate a quality improvement process. The authors suggest specific methods that RN leaders can employ using the Advancing Excellence Campaign Circle of Success as an organizing framework along with evidence-based resources. Nursing home leaders could use this article as a guideline for implementing any clinical quality improvement process. PMID:23870372

  6. Advancing Nursing Informatics in the Next Decade: Recommendations from an International Survey.

    PubMed

    Topaz, Maxim; Ronquillo, Charlene; Peltonen, Laura-Maria; Pruinelli, Lisiane; Sarmiento, Raymond Francis; Badger, Martha K; Ali, Samira; Lewis, Adrienne; Georgsson, Mattias; Jeon, Eunjoo; Tayaben, Jude L; Kuo, Chiu-Hsiang; Islam, Tasneem; Sommer, Janine; Jung, Hyunggu; Eler, Gabrielle Jacklin; Alhuwail, Dari

    2016-01-01

    In the summer of 2015, the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA NISIG) Student Working Group developed and distributed an international survey of current and future trends in nursing informatics. The survey was developed based on current literature on nursing informatics trends and translated into six languages. Respondents were from 31 different countries in Asia, Africa, North and Central America, South America, Europe, and Australia. This paper presents the results of responses to the survey question: "What should be done (at a country or organizational level) to advance nursing informatics in the next 5-10 years?" (n responders = 272). Using thematic qualitative analysis, responses were grouped into five key themes: 1) Education and training; 2) Research; 3) Practice; 4) Visibility; and 5) Collaboration and integration. We also provide actionable recommendations for advancing nursing informatics in the next decade. PMID:27332175

  7. Using evidence-based practice for managing clinical outcomes in advanced practice nursing.

    PubMed

    Glanville, I; Schirm, V; Wineman, N M

    2000-10-01

    Preparation of advanced practice nurses to assume leadership positions for clinical decision making requires that traditional ways of solving clinical problems be augmented with information from relevant, research-derived evidence. In this article, the authors describe how one graduate program prepares advanced practice nurses to use the best scientific evidence with clinical expertise to influence patient outcomes. The assignments that students complete in their program provide examples of evidence-based practice that apply quality improvement principles and science-based nursing interventions to create best practices. PMID:11008434

  8. Preserving the Art and Science of Psychotherapy for Advance Practice Psychiatric Mental Health Nurses.

    PubMed

    Caughill, Ann

    2016-04-01

    Psychiatric Mental Health (PMH) Nurses are challenged to maintain the viability of their roles in today's healthcare climate as advances in research and complexity of mental healthcare needs of society continue to unfold. Today's mental health practice environment includes disciplines with marketable credentials. Roles for PMH nurses in recent decades are less clearly defined than for other disciplines, much of this related to changes in educational and practice settings. This article reviews literature on the topic of psychotherapy and a call for a renewed emphasis on this mode of treatment for psychiatric mental health advance practice nurses. PMID:27077508

  9. Enhancing Success in Advanced Practice Nursing: a grant-funded project.

    PubMed

    McNeal, Gloria J; Walker, Donita

    2006-01-01

    The Enhancing Success in Advanced Practice Nursing (ESAPN) Project is designed to improve access to a diverse and culturally competent and sensitive health professions workforce by increasing the number of Hispanic, African-American and Asian nurses recruited, enrolled in and graduated from the MSN program at the University of Medicine and Dentistry of New Jersey-School of Nursing (UMDNJ-SN). In addition, the project plan includes the development and implementation of a comprehensive program that incorporates academic support services, career advisement and mentoring activities to retain and graduate an increased number of culturally, racially and ethnically diverse advanced practice nurses for the State of New Jersey. The project also seeks to improve the quality of care by preparing advanced practice nurses to provide culturally competent and sensitive care by assuring that the MSN curriculum includes content and clinical experiences relevant to the development of cultural competence. Faculty participation in workshops, designed to increase knowledge of cultural competence, is a key component. The success of the project will be evaluated using a variety of measures that track increases in the number of diverse students recruited and enrolled, the number of students accessing services associated with the ESAPN program, and increased retention and graduation of Hispanic, African-American and Asian nurses prepared as advanced practice nurses. PMID:16696540

  10. Pathways to Results: How Practitioners Address Student Access, Outcomes, and Equity in an Associate Degree Nursing Program

    ERIC Educational Resources Information Center

    Pickel, Jessica; Bragg, Debra D.

    2015-01-01

    At a time when the nation is focusing so much attention on college completion, what do we know about how students are completing their community college programs? Does the open-access mission of community colleges translate into equitable outcomes? Pathways to Results (PTR) engages practitioners in using data to close equity gaps for student…

  11. Advanced Practice Registered Nurses and Physician Assistants in Sleep Centers and Clinics: A Survey of Current Roles and Educational Background

    PubMed Central

    Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E.; Rogers, Ann E.

    2014-01-01

    Study Objectives: To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Methods: Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Results: Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through “on the job” training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. Conclusions: APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap. Citation: Colvin L, Cartwright Ann, Collop N, Freedman N, McLeod D, Weaver TE, Rogers AE. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background. J Clin Sleep Med 2014;10(5):581-587. PMID:24812545

  12. [Domains in the clinical practice of Clinical Nursing Experts in Germany and their correspondence with the internationally described "Advanced Nursing Practice"].

    PubMed

    Mendel, Simon; Feuchtinger, Johanna

    2009-06-01

    In spite of a growing trend toward academic education and increasing numbers of "nursing experts" functioning as change agents in Germany, actual nursing experts as in the internationally described Advanced Nursing Practice (ANP) are scarce. Drawing from a ten-year experience in implementing the international concept, the University Hospital Freiburg (UKF), Germany, constitutes a notable exception, as it presently employs ten clinically practicing nursing experts. Based on this background of educating nursing experts, this presentation aims at describing the implementation of the nursing expert's role and its fit and conformance with the international ANP. A 3-stage Delphi design was used for interviewing all the nursing experts at the hospital (n = 10) about their expert opinions; in addition, all nursing managers (n = 7) as well as unit and team leaders (n = 49) were asked about their opinion to relevant functions and domains of nursing experts. The following clinical practice domains of nursing experts were identified: Direct patient care, patient education, support and supervision of nurses, maintenance and expansion of professional skills and knowledge of the nursing staff, counselling of managers, quality assurance and organizational development, theory to practice transfer, nursing research, maintenance of own professional skills and knowledge and continuing education, and publicity work. Additionally, a three-year nursing education, a longer lasting professional experience, a degree in nursing science or nursing education, and specialist skills in the respective area of expertise were identified as credentials for nursing expert practice. The nursing expert concept at UKF shows elements of the international ANP with similarities to the role of a Clinical Nurse Specialist. PMID:19496033

  13. Reaching for the stars: career advancement and the registered nurse.

    PubMed

    Walker, Kim

    2005-08-01

    Clinical nursing has long struggled to secure the place of primacy it deserves in the profession's hierarchy of importance and worth. It is ironic that, even at the beginning of the 21st century, a clinical nurse is generally not as well-recognized, rewarded or remunerated as a colleague working in nursing management, education or research. Until the profession recognizes and takes serious action to remedy this situation, the crisis of recruitment and retention in nursing currently ravaging the globe is likely to continue. In this paper, I present a discursive account of an exciting initiative by a leading private, acute-care hospital which addresses this very problem. A new ladder for clinical nurse specialists (CNSs) introduces a rigorous and systematic approach to the appointment of three classifications of CNS, each requiring evidence of successively higher levels of competency, and which are accompanied by fiscal reward and stronger peer recognition. PMID:15985097

  14. Screening, assessment, and treatment of osteoporosis for the nurse practitioner: Key questions and answers for clinical practice—A Canadian perspective

    PubMed Central

    Rice, Peggy; Mehan, Upender; Hamilton, Celeste; Kim, Sandra

    2014-01-01

    Purpose Using a case-based approach, we review key clinical questions relevant to nurse practitioners (NPs) regarding the screening, assessment, and treatment of patients at risk for osteoporosis and fractures in a Canadian general practice setting. Data sources A case presentation with relevant questions and answers to guide management of a patient. Conclusions Osteoporosis is a common condition in both the aging male and female populations. Screening, diagnosis, and treatment of osteoporosis is lagging behind relative to other chronic disease states. NPs have a unique opportunity to help reduce this care gap by playing an integral role in the identification, risk stratification, and treatment of patients at risk for osteoporosis and fractures. Implications for practice This case highlights the important role an NP can have in screening a patient previously not diagnosed or managed for osteoporosis. Performing a focused history and physical exam of the patient to determine appropriate screening tests and fracture risk will help in guiding treatment decisions. PMID:24911524

  15. Professional Nurse Coaching: Advances in National and Global Healthcare transformation

    PubMed Central

    Hess, Darlene

    2013-01-01

    Nurse coaches are responding to the mandate of Florence Nightingale (1820-1910)—the foundational philosopher of modern nursing—to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities that are recognized today as environmental and social determinants of health.1,2 The Institute of Medicine report3 and other health initiatives suggest the need for increased education and leadership from nurses to address the healthcare needs of our nation and world. Nurse coaches are strategically pos-i tioned and equipped to implement health-promoting and evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being. With possibilities not yet imagined, employment opportunities for nurses who incorporate coaching into professional practice are developing across the entire spectrum of health, well-ness, and healing. PMID:24416681

  16. Advancing the Digital Health Discourse for Nurse Leaders.

    PubMed

    Remus, Sally

    2016-01-01

    Limited informatics competency uptake is a recognized nursing leadership challenge impacting digital practice settings. The health system's inability to reap the promised benefits of EHRs is a manifestation of inadequate development of informatics competencies by chief nurse executives (CNEs) and other clinicians. Through the application of Transformational Leadership Theory (TL), this discussion paper explains how informatics competencies enable CNEs to become transformational nursing leaders in digital health allowing them to meet their accountabilities to lead integrated, high-quality care delivery through evidence based practices (EBPs). It is proposed that successful CNE eHealth sponsors will be those armed with informatics competencies who can drive health organizations' investment in technology and innovation. Finally, some considerations are suggested in how nurse informaticists globally play a critical role in preparing our existing and future CNEs to fulfill their transformational leader roles in the digital age. PMID:27332233

  17. The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia.

    PubMed

    Maier, Claudia B

    2015-12-01

    Task-shifting from physicians to nurses is increasing worldwide; however, research on how it is governed is scarce. This international study assessed task-shifting governance models and implications on practice, based on a literature scoping review; and a survey with 93 country experts in 39 countries (response rate: 85.3%). Governance was assessed by several indicators, regulation of titles, scope of practice, prescriptive authority, and registration policies. This policy analysis focused on eleven countries with task-shifting at the Advanced Practice Nursing/Nurse Practitioner (APN/NP) level. Governance models ranged from national, decentralized to no regulation, but at the discretion of employers and settings. In countries with national or decentralized regulation, restrictive scope of practice laws were shown as barrier, up-to-date laws as enablers to advanced practice. Countries with decentralized regulation resulted in uneven levels of practice. In countries leaving governance to individual settings, practice variations existed, moreover data availability and role clarity was limited. Policy options include periodic reviews to ensure laws are up to date, minimum harmonization in decentralized contexts, harmonized educational and practice-level requirements to reduce practice variation and ensure quality. From a European Union (EU) perspective, regulation is preferred over non-regulation as a first step toward the recognition of qualifications in countries with similar levels of advanced practice. Countries early on in the process need to be aware that different governance models can influence practice. PMID:26474745

  18. Advanced practice psychiatric nurses legislative update: State of the States, 2010.

    PubMed

    Oleck, Leslie G; Retano, Angela; Tebaldi, Christine; McGuinness, Teena M; Weiss, Steven; Carbray, Julie; Rodgers, Laura; Donelson, Emily E; Ashton, Lisa Lynn; Koehn, Darcy; McCoy, Patricia

    2011-01-01

    This article provides an update regarding individual state legislation for advanced practice psychiatric nursing, building on previous briefings. Specific attention is given to independent versus collaborative practice regulations, titling, and prescriptive authority. There is review of contemporary issues and focus on scope and standards of practice, workforce data, certification, and advanced practice regulatory models. PMID:21659307

  19. Education and Advance Care Planning in Nursing Homes: The Impact of Ownership Type.

    ERIC Educational Resources Information Center

    Walker, Leslie C.; Bradley, Elizabeth H.

    1998-01-01

    A study of 25 nonprofit and 87 for-profit nursing homes showed both types likely to offer education on advance care planning. However, nonprofits were more likely to have ongoing discussions that covered more than life support decisions and to have ethics committees to support advance care planning. (SK)

  20. [Brazilian technological output in the area of nursing: advances and challenges].

    PubMed

    Koerich, Micheline Henrique Araujo da Luz; Vieira, Raquel Heloisa Guedes; Silva, Daniela Eda; Erdmann, Alacoque Lorenzini; Meirelles, Betina Horner Shlindwein

    2011-12-01

    This article aims to analyze the patents registered in the nursing area, since these patents may be used as an indicator of the technological development in the area. It presents and discusses national technological productions, tracked through the "nursing" keyword, patented in the period from 1990-2009. This is a retrospective documental research, using, as a source, data from the National Industrial Property Institute (INPI). The information gathered is discussed in relation to the appropriation of the technologies, the incentive to develop them and register them as a source of knowledge in the nursing field, aiming the practice of care. Light and light hard technology productions are increasing in the nursing field. However, these are not registered and patented. The technological advance in the nursing field is emergent and needs policies for its development. PMID:22299276

  1. Communicating with patients who have advanced dementia: training nurse aide students.

    PubMed

    Beer, Laura E; Hutchinson, Susan R; Skala-Cordes, Kristine K

    2012-01-01

    The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students' perceptions of dementia and their ability to care for patients with dementia. The results indicated the training was effective regarding nurse aides' understanding of residual cognitive abilities and need for meaningful contact among patients with advanced dementia; however, the training was not successful in terms of nurse aides' comfort level or perceived skills in working with this population of patients. The findings suggest a need to transform how caregivers are trained in communication techniques. Incorporating this training into nurse aide education has the potential to increase quality of life for people with dementia. PMID:23095223

  2. Contemporary theories and contemporary nursing--advancing nursing care for those who are marginalized.

    PubMed

    Davis, K; Glass, N

    1999-06-01

    This paper critiques the topic of postmodernism and how it is represented in nursing and social science literature. This critique classified the debates into three identifiable constructs, those being: dissatisfaction; fragmentation and integration. The authors propose a solution from the integration debate by putting forward the notion of an 'integrated postmodern turn'. The 'solution' is situated within feminism and draws on modernist and postmodernist theory. The integrated model is grounded in nursing clinical examples which demonstrate the usefulness and workability of this approach when caring for those who are marginalized by nurses because of their ethnicity, gender, cultural and/or spiritual beliefs. PMID:11096793

  3. Forecasting the nursing workforce in a dynamic health care market.

    PubMed

    Dumpe, M L; Herman, J; Young, S W

    1998-01-01

    The ability to discern the interacting factors that affect supply and demand for nurses could help nurse educators and nurse leaders allocate resources to meet these needs. Forecasting models must take into account the interactions of three crucial groups of health care providers--physicians, nurse practitioners, and physician's assistants. Buerhaus has noted that market size, wages, preferences for nursing services, and availability of substitutes influence the demand for nursing services. Changes in nurse supply resulting from Medicare reimbursement for nursing services have not been studied, though it could safely be projected that such reimbursement will increase nurse supply. Nurses with baccalaureate degrees and advanced practice preparation will be in the greatest demand in ambulatory care, managed care, public health, and home care settings, raising concerns again that the educational mix is in need of adjustment upwards. PMID:9748982

  4. Advancing nursing leadership in long-term care.

    PubMed

    O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

    2010-05-01

    Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention. PMID:20463447

  5. Exploring Advance Care Planning from the Nephrology Nurse Perspective: A Literature Review.

    PubMed

    Haras, Mary S; Astroth, Kim S; Woith, Wendy L; Kossman, Susan P

    2015-01-01

    Advance care planning is a process that engages healthcare providers and patients to articulate wishes of patients as their illness progresses. Persons with chronic kidney disease require earlier and more frequent advance care planning conversations because they are faced with increased co-morbidities and a shortened lifespan. This literature review explores the phenomenon of advance care planning and the potential factors affecting nephrology nurse engagement in these discussions. PMID:26290915

  6. How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study

    PubMed Central

    De Vleminck, Aline; Pardon, Koen; Beernaert, Kim; Houttekier, Dirk; Vander Stichele, Robert; Deliens, Luc

    2016-01-01

    Objectives To explore how GPs conceptualise advance care planning (ACP), based on their experiences with ACP in their practice. Methods Five focus groups were held with 36 GPs. Discussions were analysed using a constant comparative method. Results Four overarching themes in the conceptualisations of ACP were discerned: (1) the organisation of professional care required to meet patients’ needs, (2) the process of preparing for death and discussing palliative care options, (3) the discussion of care goals and treatment decisions, (4) the completion of advance directives. Within these themes, ACP was both conceptualised in terms of content of ACP and/or in terms of tasks for the GP. A specific task that was mentioned throughout the discussion of the four different themes was (5) the task of actively initiating ACP by the GP versus passively waiting for patients’ initiation. Conclusions This study illustrates that GPs have varying conceptualisations of ACP, of which some are more limited to specific aspects of ACP. A shared conceptualisation and agreement on the purpose and goals of ACP is needed to ensure successful implementation, as well as a systematic integration of ACP in routine practice that could lead to a better uptake of all the important elements of ACP. PMID:27096846

  7. Implementing advance care planning: a qualitative study of community nurses' views and experiences

    PubMed Central

    2010-01-01

    Background Advance care planning (ACP) is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by policy makers. This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs. Methods An action research strategy was employed. 23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach. Findings Nurses understood ACP to be an important part of practice and to have the potential to be a celebration of good nursing care. Nurses saw their roles in ACP as engaging with patients to elicit care preferences, facilitate family communication and enable a shift of care focus towards palliative care. They perceived challenges to ACP including: timing, how to effect team working in ACP, the policy focus on instructional directives which related poorly to patients' concerns; managing differences in patients' and families' views. Perceived barriers included: lack of resources; lack of public awareness about ACP; difficulties in talking about death. Nurses recommended the following to be included in education programmes: design of realistic scenarios; design of a flow chart; practical advice about communication and documentation; insights into the need for clinical supervision for ACP practice. Conclusions Nurses working in the community are centrally involved with patients with palliative care needs who may wish to set on record their views about future care and treatment. This study reveals some important areas for practice and educational development to enhance nurses' use and understanding of ACP. PMID:20377876

  8. Effects of an advanced surgical nursing module on clinical practice.

    PubMed

    Frost, J

    1994-04-01

    1. Innovation and changes in practice can be developed through continuing education. 2. By adapting appropriate change strategies, theories learned in class can be applied in practice. 3. Excellence in quality can be achieved by all qualified nurses by applying theory to practice. PMID:7513891

  9. Laptops and Learning: Evaluating Advances in Nurse Education.

    ERIC Educational Resources Information Center

    Geertshuis, Susan A.; Holmes, Mary E. A.; Thomas, A.; Sandercock, L.; Krayer, A.; Iphofen, R.; Allsup, D.; Godwin, M.

    2002-01-01

    Describes the use of information and communication technologies (ICT) in nurse education at the University of Wales Bangor. Explains the evaluation strategy for a longitudinal study of ICT, summarizes emerging trends in learning evaluation, discusses best practices in evaluation, and considers the expanding role of the evaluator. (Author/LRW)

  10. The Effects upon Advanced Placement Licensed Vocational Nursing Students When Integrated with Generic Students in the Second Year of a Registered Nursing Program.

    ERIC Educational Resources Information Center

    Balint, Marilyn

    A study was conducted to evaluate the effect of integrating advanced placement licensed vocational nursing (APLVN) students with generic students in the second year of the registered nursing program at Long Beach City College. It was hypothesized that the academic achievement of the APLVN students who were taught as a separate group for the first…

  11. Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care.

    PubMed

    Delaney, Colleen; Barrere, Cynthia

    2012-01-01

    The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented. PMID:22694866

  12. Quality of non-mydriatic digital fundus photography obtained by nurse practitioners in the emergency department: the FOTO-ED study

    PubMed Central

    Lamirel, Cédric; Bruce, Beau B.; Wright, David W.; Delaney, Kevin P.; Newman, Nancy J.; Biousse, Valérie

    2011-01-01

    Objective Non-mydriatic fundus photography by non-ophthalmic trained personnel has recently been shown to be a potential alternative to direct ophthalmoscopy in the emergency department (ED). We evaluated the reliability of a novel quality rating scale and applied this scale to non-mydriatic fundus photographs taken during routine ED patient encounters to determine factors associated with diminished photograph quality. Design Prospective, cross-sectional Participants 350 patients enrolled in the Fundus photography vs. Ophthalmoscopy Trials Outcomes in the Emergency Department (FOTO-ED) study were photographed by nurse practitioners after <30 minutes of training followed by supervision. Methods Photographs of both eyes were graded for quality on two occasions by two neuro-ophthalmologists. Four regions were independently evaluated for quality: optic disc, macula, superior and inferior vascular arcades. Quality as a function of the number of photographs taken was evaluated by Kaplan-Meier analysis. Mixed effects ordinal logistic regression was used to evaluate for predictors of image quality while accounting for the repeated measures design. Main Outcome Measure Overall photographic quality (1–5 scale, 5 best). Results We evaluated 1734 photographs. Inter- and intra-observer agreements between neuro-ophthalmologists were very good (weighted kappa:0.84–0.87). Quality of the optic disc area was better than those of other retinal areas (p<0.002). Kaplan-Meier analysis showed that if a high-quality photograph of an eye was not obtained by the third attempt it was unlikely that one would be obtained at all. A 10 second increase in the inter-photograph interval before a total of forty seconds increased the odds of a one unit higher quality rating by 1.81 times (95%CI: 1.68–1.98), and a ten year increase in age decreased the odds by 0.76 times (95%CI: 0.69–0.85). Black patients had 0.42 times (95%CI: 0.28–0.63) the odds of a one unit higher quality rating compared

  13. Barriers and facilitators for general practitioners to engage in advance care planning: A systematic review

    PubMed Central

    2013-01-01

    Abstract Objective The aim of this systematic review is to identify the perceived factors hindering or facilitating GPs in engaging in advance care planning (ACP) with their patients about care at the end of life. Design Studies from 1990 to 2011 were found in four electronic databases (PubMed, CINAHL, EMBASE, PsycINFO); by contacting first authors of included studies and key experts; and searching through relevant journals and reference lists. Studies were screened, graded for quality, and analysed independently by two authors; those reporting the perception by GPs of barriers and facilitators to engagement in ACP were included. Results Eight qualitative studies and seven cross-sectional studies were included for data extraction. All barriers and facilitators identified were categorized as GP characteristics, perceived patient factors, or health care system characteristics. Stronger evidence was found for the following barriers: lack of skills to deal with patients’ vague requests, difficulties with defining the right moment, the attitude that it is the patient who should initiate ACP, and fear of depriving patients of hope. Stronger evidence was found for the following facilitators: accumulated skills, the ability to foresee health problems in the future, skills to respond to a patient's initiation of ACP, personal convictions about who to involve in ACP, and a longstanding patient–GP relationship and the home setting. Conclusion Initiation of ACP in general practice may be improved by targeting the GPs’ skills, attitudes, and beliefs but changes in health care organization and financing could also contribute. PMID:24299046

  14. Advance Care Planning in Norwegian nursing homes-Who is it for?

    PubMed

    Thoresen, Lisbeth; Ahlzén, Rolf; Solbrække, Kari Nyheim

    2016-08-01

    Advance care planning (ACP) is an international concept for improving patient autonomy and communication in the context of anticipated deterioration and end-of-life care. In a preparatory conversation, health care professionals facilitate one or more conversations where nursing home residents are invited to reflect on, and articulate wishes and preferences concerning future medical treatment and end-of-life care. Our aim with this study was to increase knowledge of existing ACP practices in Norwegian nursing homes. We wanted to know how nursing home residents, relatives and nursing home staff take part in the conversations, and to what extent these conversations can be regarded as promoting autonomy, legal rights and individual needs for the residents. We conducted participant observation of seven preparatory conversations, followed by interviews with health care staff (together) and resident and relative (together). In the result section, we present an informative case example of an ACP conversation where common and important characteristics running through our data are present. These are further elaborated under the following headings: Life critical questions, Residents' quiet participation in the conversations, the Dying phase - a clinical issue, Nurses and physicians; different domains and Timing. We find that nursing home staff in our study wants to contribute to open awareness, autonomy and a good death, but there are little reflections about the purpose and content of the conversations, how they should be carried out and when, and what frail nursing home residents are able to understand and express in ACP conversations. PMID:27531449

  15. ‘It is a dilemma’: perspectives of nurse practitioners on health screening of newly arrived migrants

    PubMed Central

    Kalengayi, Faustine K. Nkulu; Hurtig, Anna-Karin; Nordstrand, Annika; Ahlm, Clas; Ahlberg, Beth M.

    2015-01-01

    Background Screening newly arrived migrants from countries with high burden of communicable diseases of public health significance is part of the Swedish national strategy against the spread of these diseases. However, little is known about its implementation. Objective This study aimed at exploring caregivers’ experiences in screening newly arrived migrants to generate knowledge that could inform policy and clinical practice. Design Using an interpretive description framework, we conducted semistructured interviews between November and December 2011 in four Swedish counties, with 15 purposively selected nurses with experience in screening migrants. Data were analyzed using thematic analysis. Results Participants described a range of challenges including discordant views between migrants and the nurses about medical screening, inconsistencies in rules and practices, and conflicting policies. Participants indicated that sociocultural differences resulted in divergent expectations with migrants viewing the participants as agents of migration authorities. They also expressed concern over being given a new assignment without training and being expected to share responsibilities with staff from other agencies without adequate coordination. Finally, they indicated that existing policies can be confusing and raise ethical issues. All these were compounded by language barriers, making their work environment extremely complex and stressful. Conclusions These findings illuminate complex challenges that could limit access to, uptake, and delivery of health screening and undermine public health goals, and highlight the need for a multilevel approach. This entails avoiding the conflation of migration with health issues, harmonizing existing policies to make health care services more accessible and acceptable to migrants, and facilitating health professionals’ work in promoting public health, improving interagency collaboration and the skills of all staff involved in

  16. [Therapeutic advances and nursing practices, 1914-1918].

    PubMed

    Debout, Christophe

    2014-06-01

    The production and transfer of knowledge in the healthcare field were key factors which enabled the fight against morbidity and mortality during the First World War to be carried out efficiently. The knowledge used to train nurses before the war soon became obsolete and had to be updated. Knowledge and practices were developed in order to meet as best as possible the specific needs of patients in the particular context of this war. PMID:25069355

  17. COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design

    PubMed Central

    Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

    2011-01-01

    Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. PMID:21241828

  18. A pilot project in distance education: nurse practitioner students' experience of personal video capture technology as an assessment method of clinical skills.

    PubMed

    Strand, Haakan; Fox-Young, Stephanie; Long, Phil; Bogossian, Fiona

    2013-03-01

    This paper reports on a pilot project aimed at exploring postgraduate distance students' experiences using personal video capture technology to complete competency assessments in physical examination. A pre-intervention survey gathered demographic data from nurse practitioner students (n=31) and measured their information communication technology fluency. Subsequently, thirteen (13) students were allocated a hand held video camera to use in their clinical setting. Those participating in the trial completed a post-intervention survey and further data were gathered using semi-structured interviews. Data were analysed by descriptive statistics and deductive content analysis, and the Unified Theory of Acceptance and Use of Technology (Venkatesh et al., 2003) were used to guide the project. Uptake of the intervention was high (93%) as students recognised the potential benefit. Students were video recorded while performing physical examinations. They described high level of stress and some anxiety, which decreased rapidly while assessment was underway. Barriers experienced were in the areas of facilitating conditions (technical character e.g. upload of files) and social influence (e.g. local ethical approval). Students valued the opportunity to reflect on their recorded performance with their clinical mentors and by themselves. This project highlights the demands and difficulties of introducing technology to support work-based learning. PMID:22154874

  19. Effectiveness of Nurse-Practitioner-Delivered Brief Motivational Intervention for Young Adult Alcohol and Drug Use in Primary Care in South Africa: A Randomized Clinical Trial

    PubMed Central

    Mertens, Jennifer R.; Ward, Catherine L.; Bresick, Graham F.; Broder, Tina; Weisner, Constance M.

    2014-01-01

    Aims: To assess the effectiveness of brief motivational intervention for alcohol and drug use in young adult primary care patients in a low-income population and country. Methods: A randomized controlled trial in a public-sector clinic in Delft, a township in the Western Cape, South Africa recruited 403 patients who were randomized to either single-session, nurse practitioner-delivered Brief Motivational Intervention plus referral list or usual care plus referral list, and followed up at 3 months. Results: Although rates of at-risk alcohol use and drug use did not differ by treatment arm at follow-up, patients assigned to the Brief Motivational Intervention had significantly reduced scores on ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) for alcohol—the most prevalent substance. Conclusion: Brief Motivational Intervention may be effective at reducing at-risk alcohol use in the short term among low-income young adult primary care patients; additional research is needed to examine long-term outcomes. PMID:24899076

  20. A Qualitative Analysis of an Advanced Practice Nurse-Directed Transitional Care Model Intervention

    ERIC Educational Resources Information Center

    Bradway, Christine; Trotta, Rebecca; Bixby, M. Brian; McPartland, Ellen; Wollman, M. Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D.

    2012-01-01

    Purpose: The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). Design and Methods: APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An…

  1. Communicating with Patients Who Have Advanced Dementia: Training Nurse Aide Students

    ERIC Educational Resources Information Center

    Beer, Laura E.; Hutchinson, Susan R.; Skala-Cordes, Kristine K.

    2012-01-01

    The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students'…

  2. What Is Nursing Informatics?

    ERIC Educational Resources Information Center

    McGonigle, D.; And Others

    Information technology has developed to the point of providing a means to manage nursing and related health-care data effectively for nursing administrators, educators, practitioners, and researchers. Therefore, the newly recognized area of nursing informatics is important to the nursing profession as a whole. Nursing informatics is defined as the…

  3. Leaders from Nursing's History.

    ERIC Educational Resources Information Center

    Fondiller, Shirley H.; And Others

    1995-01-01

    Looks at the lives and accomplishments of four leaders in professional nursing: (1) Loretta Ford, who championed the cause of nurse practitioners; (2) Mable Staupers, a pioneer in community health and nursing; (3) Janet Geister, a leader in private nursing; and (4) Isabel Stewart, who led the movement to standardize nursing education. (JOW)

  4. Master’s programs in advanced nursing practice: new strategies to enhance course design for subspecialty training in neonatology and pediatrics

    PubMed Central

    Morgan, Colin; Barry, Catherine; Barnes, Katie

    2012-01-01

    The advanced nurse practitioner (ANP) role first developed in the USA in the 1960s in primary care. Since then, it has evolved in many different countries and subspecialties, creating a variety of challenges for those designing and implementing master’s programs for this valuable professional group. We focus on ANPs in the neonatal and pediatric intensive care setting to illustrate the complexity of issues faced by both faculty and students in such a program. We review the impact of limited resources, faculty recruitment/accreditation, and the relationship with the medical profession in establishing a curriculum. We explore the evidence for the importance of ANP role definition, supervision, and identity among other health professionals to secure a successful role transition. We describe how recent advances in technology can be used to innovate with new styles of teaching and learning to overcome some of the difficulties in running master’s programs for small subspecialties. We illustrate, through our own experience, how a thorough assessment of the available literature can be used to innovate and develop strategies to create an individual MSc programs that are designed to meet the needs of highly specialized advanced neonatal and pediatric nursing practice. PMID:23762011

  5. Globalization and advances in information and communication technologies: the impact on nursing and health.

    PubMed

    Abbott, Patricia A; Coenen, Amy

    2008-01-01

    Globalization and information and communication technology (ICT) continue to change us and the world we live in. Nursing stands at an opportunity intersection where challenging global health issues, an international workforce shortage, and massive growth of ICT combine to create a very unique space for nursing leadership and nursing intervention. Learning from prior successes in the field can assist nurse leaders in planning and advancing strategies for global health using ICT. Attention to lessons learned will assist in combating the technological apartheid that is already present in many areas of the globe and will highlight opportunities for innovative applications in health. ICT has opened new channels of communication, creating the beginnings of a global information society that will facilitate access to isolated areas where health needs are extreme and where nursing can contribute significantly to the achievement of "Health for All." The purpose of this article is to discuss the relationships between globalization, health, and ICT, and to illuminate opportunities for nursing in this flattening and increasingly interconnected world. PMID:18922277

  6. A Graduate Nursing Curriculum for the Evaluation and Management of Urinary Incontinence

    ERIC Educational Resources Information Center

    Rogalski, Nicole

    2005-01-01

    Geriatric nurse practitioners should be educated in the evaluation and treatment of common geriatric syndromes like urinary incontinence. However, many advanced-practice nursing programs do not place an educational emphasis on urinary incontinence management. The purpose of this project is to provide information that supports the need for…

  7. Impact of new regulatory standards on advanced practice registered nursing: the APRN Consensus Model and LACE.

    PubMed

    Stanley, Joan M

    2012-06-01

    Advanced practice registered nurses (APRNs) represent a crucial resource to meeting growing health care needs. Such resources must be used to the full extent and in the most effective way possible. Through the development of the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (LACE), nursing is assuming a leadership role within the health care system and participating as an equal partner in redesigning health care. When fully implemented, the Consensus Model will allow APRNs to practice to the full scope of their education and more easily move from one state to another, increasing access to quality health care for all populations. PMID:22579059

  8. Exploring the district nurse role in facilitating individualised advance care planning.

    PubMed

    Boot, Michelle

    2016-03-01

    Health-care policy recognises the importance of engaging people in making decisions related to the management of their health. Advance care planning (ACP) offers a framework for decision making on end-of-life care. There are positive indicators that ACP enables health professionals to meet people's preferences. However, there are reports of insensitive attempts to engage people in end-of-life care decision making. District nurses are in the ideal position to facilitate ACP, as they have the opportunity to build relationships with the people they are caring for--an antecedent to sensitive ACP--and in recognising and fulfilling this role, they could ameliorate the risk of insensitive ACP. Distric nurse leaders also have a role to play in ensuring that organisational and environmental factors support appropriate ACP facilitation including: training, fostering a team culture that empowers district nurses to recognise and meet their ACP role, and advocating for appropriate ACP evaluation outcome measures. PMID:26940617

  9. Health Care Reform and the Federal Transformation Initiatives: Capitalizing on the Potential of Advanced Practice Psychiatric Nurses

    PubMed Central

    Hanrahan, Nancy P.; Delaney, Kathleen; Merwin, Elizabeth

    2012-01-01

    In the last decade the US federal government proposed a transformation vision of mental health service delivery; patient-centered, evidence-based and recovery oriented treatment models. Health care reform brings additional expectations for innovation in mental/substance use service delivery, particularly the idea of creating systems where physical health, mental health and substance use treatment is fully integrated. Psychiatric nurses, as one of the four core US mental health professions, have the potential to play a significant role in the both the transformation initiative and health care reform vision. However, psychiatric nurses, particularly advanced practice psychiatric nurses, are an untapped resource due in part to significant state regulatory barriers that limit their scope of practice in many states. The purpose of this paper is to document what is currently known about advanced practice psychiatric nurses and discuss policy implications for tapping into the strengths of this workforce. Strategies for facilitating utilization of advanced practice psychiatric nurses discussed. PMID:21233135

  10. An innovative care model coordinated by a physical therapist and nurse practitioner for osteoarthritis of the hip and knee in specialist care: a prospective study.

    PubMed

    Voorn, Veronique M A; Vermeulen, Henricus M; Nelissen, Rob G H H; Kloppenburg, Margreet; Huizinga, Tom W J; Leijerzapf, Nicolette A C; Kroon, Herman M; Vliet Vlieland, Thea P M; van der Linden, Henrica M J

    2013-07-01

    The subject of the study is to investigate whether health-related quality of life (HRQoL), pain and function of patients with hip or knee osteoarthritis (OA) improves after a specialist care intervention coordinated by a physical therapist and a nurse practitioner (NP) and to assess satisfaction with this care at 12 weeks. This observational study included all consecutive patients with hip or knee OA referred to an outpatient orthopaedics clinic. The intervention consisted of a single, standardized visit (assessment and individually tailored management advice, to be executed in primary care) and a telephone follow-up, coordinated by a physical therapist and a NP, in cooperation with an orthopaedic surgeon. Assessments at baseline and 10 weeks thereafter included the short form-36 (SF-36), EuroQol 5D (EQ-5D), hip or knee disability and osteoarthritis outcome score (HOOS or KOOS), the intermittent and constant osteoarthritis pain questionnaire (ICOAP) for hip or knee and a multidimensional satisfaction questionnaire (23 items; 4 point scale). Eighty-seven patients (57 female), mean age 68 years (SD 10.9) were included, with follow-up data available in 63 patients (72 %). Statistically significant improvements were seen regarding the SF-36 physical summary component score, the EQ-5D, the ICOAP scores for hip and knee, the HOOS subscale sports and the KOOS subscales pain, symptoms and activities of daily living. The proportions of patients reporting to be satisfied ranged from 79 to 98 % per item. In patients with hip and knee OA pain, function and HRQoL improved significantly after a single-visit multidisciplinary OA management intervention in specialist care, with high patient satisfaction. PMID:23325095

  11. 24/7 Neurocritical Care Nurse Practitioner Coverage Reduced Door-to-Needle Time in Stroke Patients Treated with Tissue Plasminogen Activator

    PubMed Central

    Moran, Jennifer L.; Nakagawa, Kazuma; Asai, Susan M.; Koenig, Matthew A.

    2016-01-01

    Background Stroke centers with limited on-site neurovascular physician coverage may experience delays in acute stroke treatment. We sought to assess the impact of providing 24/7 neurocritical care acute care nurse practitioner (ACNP) “stroke code” first responder coverage on treatment delays in acute stroke patients who received tissue plasminogen activator (tPA). Methods Consecutive acute ischemic stroke patients treated with intravenous tPA at a primary stroke center on Oahu between 2009 and 2014 were retrospectively studied. 24/7 ACNP stroke code coverage (intervention) was introduced on July 1, 2011. The tPA utilization, door-to-needle (DTN) time, imaging-to-needle (ITN) time, and independent ambulation at hospital discharge were compared between the preintervention period (24 months) and the postintervention period (33 months). Results We studied 166 stroke code patients who were treated with intravenous tPA, 44 of whom were treated during the preintervention period and 122 of whom were treated during the postintervention period. After the intervention, the median DTN time was reduced from 53 minutes (interquartile range [IQR] 45–73) to 45 minutes (IQR 35–58) (P = .001), and the median ITN time was reduced from 36 minutes (IQR 28–64) to 21 minutes (IQR 16–31) (P < .0001). Compliance with the 60-minute target DTN improved from 61.4% (27 of 44 patients) in the preintervention period to 81.2% (99 of 122 patients) in the postintervention period (P = .004). The tPA treatment rates were similar between the preintervention and postintervention periods (P = .60). Conclusions Addition of 24/7 on-site neurocritical care ACNP first responder coverage for acute stroke code significantly reduced the DTN time among acute stroke patients treated with tPA. PMID:26907680

  12. Advancing Genomic Research and Reducing Health Disparities: What Can Nurse Scholars Do?

    PubMed Central

    Jaja, Cheedy; Gibson, Robert; Quarles, Shirley

    2012-01-01

    Purpose Advances in genomic research are improving our understanding of human diseases and evoking promise of an era of genomic medicine. It is unclear whether genomic medicine may exacerbate or attenuate extant racial group health disparities. We delineate how nurse scholars could engage in the configuration of an equitable genomic medicine paradigm. Organizing Construct We identify as legitimate subjects for nursing scholarship the scientific relevance, ethical, and public policy implications for employing racial categories in genomic research in the context of reducing extant health disparities. Findings Since genomic research is largely population specific, current classification of genomic data will center on racial and ethnic groups. Nurse scholars should be involved in clarifying how putative racial group differences should be elucidated in light of the current orthodoxy that genomic solutions may alleviate racial health disparities. Conclusions Nurse scholars are capable of employing their expertise in concept analysis to elucidate how race is used as a variable in scientific research, and to use knowledge brokering to delineate how race variables that imply human ancestry could be utilized in genomic research pragmatically in the context of health disparities. Clinical Relevance In an era of genomic medicine, nurse scholars should recognize and understand the challenges and complexities of genomics and race and their relevance to health care and health disparities. PMID:23452096

  13. Improving Transitions of Care With an Advanced Practice Nurse: A Pilot Study.

    PubMed

    Hsueh, Martha; Dorcy, Kathleen

    2016-06-01

    Gaps in complex oncology care coordination between inpatient and outpatient settings can result in treatment and monitoring delays and omissions, which can negatively affect patient outcomes. Gaps also exist for patients facing complex treatment modalities and collaborations between multiple care teams working at geographically distant sites. A pilot advanced practice nurse care coordinator 
(APNCC) role to coordinate these complex care transitions and implement processes for safer and more efficient care has shown promise.
. PMID:27206289

  14. Can the Institute of Medicine trump the dominant logic of nursing? Leading change in advanced practice education.

    PubMed

    Dreher, Melanie C; Clinton, Patricia; Sperhac, Arlene

    2014-01-01

    The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate. PMID:24720938

  15. Advanced practice nursing for enduring health needs management: a global perspective.

    PubMed

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. PMID:21839552

  16. Description of the clinical practice of advanced practice nurses in family-centered early intervention in two rural settings.

    PubMed

    Kang, R; Barnard, K; Oshio, S

    1994-12-01

    The purpose of this study was to describe the scope of clinical practice of advanced practice nurses who were involved in a project designed to increase access of families with at-risk and disabled young children, newborn to 3 years of age, to early intervention services in rural Washington State. The findings from this study are based on the retrospective review of records of clients seen by the advanced practice nurses. Nursing diagnoses and nursing interventions were assigned to chart recordings. The most frequently occurring nursing diagnoses assigned to parents were Altered Parenting, Altered Family Processes, Fear, Noncompliance, and Knowledge Deficit. The most frequently occurring nursing diagnoses assigned to children were Impaired Physical Mobility, Impaired Verban Communication, Altered Nutrition: Less than Body Requirements, Sensory-Perceptual Alteration, and Altered Thought Processes. Categories of nursing intervention recorded most frequently were Monitoring, Planning and Information. Discussion of findings addresses the roles and reimbursement of advanced practice nurses who provide family-centered early intervention services in rural communities. PMID:7870654

  17. Surgeon-nurse anesthetist collaboration advanced surgery between 1889 and 1950.

    PubMed

    Koch, Bruce Evan

    2015-03-01

    To meet the need for qualified anesthetists, American surgeons recruited nurses to practice anesthesia during the Civil War and in the latter half of the 19th century. The success of this decision led them to collaborate with nurses more formally at the Mayo Clinic in Minnesota. During the 1890s, Alice Magaw refined the safe administration of ether. Florence Henderson continued her work improving the safety of ether administration during the first decade of the 20th century. Safe anesthesia enabled the Mayo surgeons to turn the St. Mary's Hospital into a surgical powerhouse. The prominent surgeon George Crile collaborated with Agatha Hodgins at the Lakeside Hospital in Cleveland to introduce nitrous oxide/oxygen anesthesia. Nitrous oxide/oxygen caused less cardiovascular depression than ether and thus saved the lives of countless trauma victims during World War I. Crile devised "anoci-association," an outgrowth of nitrous oxide/oxygen anesthesia. Hodgins' use of anoci-association made Crile's thyroid operations safer. Pioneering East Coast surgeons followed the lead of the surgeons at Mayo. William Halsted worked closely with Margaret Boise, and Harvey Cushing worked closely with Gertrude Gerard. As medicine became more complex, collaboration between surgeons and nurse anesthetists became routine and necessary. Teams of surgeons and nurse anesthetists advanced thoracic, cardiovascular, and pediatric surgery. The team of Evarts Graham and Helen Lamb performed the world's first pneumonectomy. Surgeon-nurse anesthetist collaboration seems to have been a uniquely American phenomenon. This collaboration facilitated both the "Golden Age of Surgery" and the profession we know today as nurse anesthesia. PMID:25695581

  18. Exploring the use of standardized patients for simulation-based learning in preparing advanced practice nurses.

    PubMed

    Kowitlawakul, Yanika; Chow, Yeow Leng; Salam, Zakir Hussian Abdul; Ignacio, Jeanette

    2015-07-01

    The use of standardized patients for simulation-based learning was integrated into the Master of Nursing curriculum in the 2012-2013 academic year. The study aimed to explore the Master of Nursing students' experiences with and perceptions of using standardized patients in simulations, and to identify the students' learning needs in preparing to become advanced practice nurses. The study adopted an exploratory descriptive qualitative design, using a focus group interview. The study was conducted at a university in Singapore. Seven Master of Nursing students who were enrolled in the Acute Care Track of Master of Nursing program in the 2012-2013 academic year participated in the study. The data were gathered at the end of the first semester. Content analysis was used to analyze the data. Three main categories - usefulness, clinical limitations, and realism - were identified in the study. The results revealed that the students felt using standardized patients was useful and realistic for developing skills in history taking, communication, and responding to an emergency situation. On the other hand, they found that the standardized patients were limited in providing critical signs and symptoms of case scenarios. To meet the learning objectives, future development and integration of standardized patients in the Master of Nursing curriculum might need to be considered along with the use of a high-fidelity simulator. This can be an alternative strategy to fill the gaps in each method. Obviously, using standardized patients for simulation-based learning has added value to the students' learning experiences. It is highly recommended that future studies explore the impact of using standardized patients on students' performance in clinical settings. PMID:25819268

  19. Supporting assistant practitioners during their training.

    PubMed

    Ripley, Kenneth; Hoad, Bridget

    2016-07-27

    Assistant practitioners, also known as associate practitioners, provide support to the registered healthcare workforce, practising with advanced knowledge and skills. Assistant practitioners require substantial training to obtain the skills and knowledge required for the role. This article identifies the challenges trainee assistant practitioners may encounter, and makes recommendations for how they can be best supported. The core areas where trainee assistant practitioners require support from their colleagues and mentors are workload, role clarity, mentoring, academic challenge and recognition as learners. PMID:27461328

  20. A consensus statement on critical thinking in nursing.

    PubMed

    Scheffer, B K; Rubenfeld, M G

    2000-11-01

    The purpose of this study was to define critical thinking in nursing. A Delphi technique with 5 rounds of input was used to achieve this purpose. An international panel of expert nurses from nine countries: Brazil, Canada, England, Iceland, Japan, Korea, Netherlands, Thailand, and 23 states in the U.S. participated in this study between 1995 and 1998. A consensus definition (statement) of critical thinking in nursing was achieved. The panel also identified and defined 10 habits of the mind (affective components) and 7 skills (cognitive components) of critical thinking in nursing. The habits of the mind of critical thinking in nursing included: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open-mindedness, perseverance, and reflection. Skills of critical thinking in nursing included: analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting and transforming knowledge. These findings can be used by practitioners, educators and researchers to advance understanding of the essential role of critical thinking in nursing. PMID:11103973

  1. What is Family-Centered Care for Nursing Home Residents With Advanced Dementia?

    PubMed Central

    Lopez, Ruth Palan; Mazor, Kathleen M.; Mitchell, Susan L.; Givens, Jane L.

    2014-01-01

    To understand family members’ perspectives on person- and family-centered end-of-life care provided to nursing home (NH) residents with advanced dementia, we conducted a qualitative follow-up interview with 16 respondents who had participated in an earlier prospective study, Choices, Attitudes, and Strategies for Care of Advance Dementia at End of Life (CASCADE). Family members of NH residents (N = 16) with advanced dementia participated in semistructured qualitative interviews that inquired about overall NH experience, communication, surrogate decision making, emotional reaction, and recommendations for improvement. Analysis identified 5 areas considered important by family members: (1) providing basic care; (2) ensuring safety and security; (3) creating a sense of belonging and attachment; (4) fostering self-esteem and self-efficacy; and (5) coming to terms with the experience. These themes can provide a framework for creating and testing strategies to meet the goal of person- and family-centered care. PMID:24085250

  2. Providing a navigable route for acute medicine nurses to advance their practice: a framework of ascending levels of practice.

    PubMed

    Lees-Deutsch, Liz; Christian, Jan; Setchfield, Ian

    2016-01-01

    This article conveys concerns raised by delegates at the International SAM Conference (Manchester, 2015) regarding how to advance nursing practice in acute medicine. It endeavors to capture the essence of 'how to advance practice' and 'how to integrate advanced practice' within the workforce structures of an acute medicine unit (AMU). It addresses the production of tacit knowledge and the recognition and integration of this to developing the nursing workforce. The current context of NHS efficiencies and recruitment issues emphasize the value of retaining tacit knowledge. Uniquely, this article offers an early conceptual framework through which levels of advancement and potential transition points to advance nursing practice in acute medicine are articulated. Determining how to advance requires identification of prior accomplishments such as, tacit knowledge, experiential learning, CPD, specialist courses and management experience. This requires nurses to make judicious decisions to advance their practice and the distinction between 'amassing experience' and 'career progression'. It aims to stimulate thinking around the practicalities of advancement, the value of tacit knowledge and potential realization through the framework trajectory. PMID:27441313

  3. Advance directives: the New Zealand context.

    PubMed

    Wareham, Pauline; McCallin, Antoinette; Diesfeld, Kate

    2005-07-01

    Advance directives convey consumers' wishes about accepting or refusing future treatment if they become incompetent. They are designed to communicate a competent consumer's perspective regarding the preferred treatment, should the consumer later become incompetent. There are associated ethical issues for health practitioners and this article considers the features that are relevant to nurses. In New Zealand, consumers have a legal right to use an advance directive that is not limited to life-prolonging care and includes general health procedures. Concerns may arise regarding a consumer's competence and the document's validity. Nurses need to understand their legal and professional obligations to comply with an advance directive. What role does a nurse play and what questions arise for a nurse when advance directives are discussed with consumers? This article considers the cultural dimensions, legal boundaries, consumers' and providers' perspectives, and the medical and nursing positions in New Zealand. PMID:16045243

  4. [Challenges and opportunities: contributions of the Advanced Practice Nurse in the chronicity. Learning from experiences].

    PubMed

    Appleby, Christine; Camacho-Bejarano, Rafaela

    2014-01-01

    Undoubtedly, our society is facing new economic, political, demographic, social and cultural challenges that require healthcare services able to meet the growing health needs of the population, especially in dealing with chronic conditions. In this new context, some countries such as the United Kingdom have made a firm commitment to develop new models for chronic patients care based on the introduction of new figures of Advanced Practice Nurses, which includes 4 cornerstones of professional practice: advanced clinical skills, clinical management, teaching and research. The implementation of this new figures implies a redefinition of professional competencies and has its own accreditation system and a specific catalogue of services adapted to the population requirements, in order to provide chronic care support from Primary Care settings. This trajectory allows us analysing the process of design and implementation of these new models and the organizational structure where it is integrated. In Spain, there are already experiences in some regions such as Andalucia and the Basque Country, focused on the creation of new advanced nursing roles. At present, it is necessary to consider suitable strategic proposals for the complete development of these models and to achieve the best results in terms of overall health and quality of life of patients with chronic conditions, improving the quality of services and cost-effectiveness through a greater cohesion and performance of healthcare teams towards the sustainability of healthcare services and patient satisfaction. PMID:24468497

  5. An Incentive Pay Plan for Advanced Practice Registered Nurses: Impact On Provider and Organizational Outcomes.

    PubMed

    Rhodes, Catherine A; Bechtle, Mavis; McNett, Molly

    2015-01-01

    Advanced practice registered nurses (APRNs) are integral to the provision of quality, cost-effective health care throughout the continuum of care. To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated. Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers. After the first year of implementation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges. The incentive plan is a win-win for hospitals that employ APRNs. PMID:26259336

  6. Interprofessional Obstetric Ultrasound Education: Successful Development of Online Learning Modules; Case-Based Seminars; and Skills Labs for Registered and Advanced Practice Nurses, Midwives, Physicians, and Trainees.

    PubMed

    Shaw-Battista, Jenna; Young-Lin, Nichole; Bearman, Sage; Dau, Kim; Vargas, Juan

    2015-01-01

    Ultrasound is an important aid in the clinical diagnosis and management of normal and complicated pregnancy and childbirth. The technology is widely applied to maternity care in the United States, where comprehensive standard ultrasound examinations are routine. Targeted scans are common and used for an increasing number of clinical indications due to emerging research and a greater availability of equipment with better image resolution at lower cost. These factors contribute to an increased demand for obstetric ultrasound education among students and providers of maternity care, despite a paucity of data to inform education program design and evaluation. To meet this demand, from 2012 to 2015 the University of California, San Francisco nurse-midwifery education program developed and implemented an interprofessional obstetric ultrasound course focused on clinical applications commonly managed by maternity care providers from different professions and disciplines. The course included matriculating students in nursing and medicine, as well as licensed practitioners such as registered and advanced practice nurses, midwives, and physicians and residents in obstetrics and gynecology and family medicine. After completing 10 online modules with a pre- and posttest of knowledge and interprofessional competencies related to teamwork and communication, trainees attended a case-based seminar and hands-on skills practicum with pregnant volunteers. The course aimed to establish a foundation for further supervised clinical training prior to independent practice of obstetric ultrasound. Course development was informed by professional guidelines and clinical and education research literature. This article describes the foundations, with a review of the challenges and solutions encountered in obstetric ultrasound education development and implementation. Our experience will inform educators who wish to facilitate obstetric ultrasound competency development among new and experienced

  7. Positioning advanced practice registered nurses for health care reform: consensus on APRN regulation.

    PubMed

    Stanley, Joan M; Werner, Kathryn E; Apple, Kathy

    2009-01-01

    Advanced practice registered nurses (APRNs) have positioned themselves to serve an integral role in national health care reform. This article addresses both the policy and the process to develop this policy that has placed them in a strategic position. A successful transformation of the nation's health system will require utilization of all clinicians, particularly primary care providers, to the full extent of their education and scope of practice. APRNs are highly qualified clinicians who provide cost-effective, accessible, patient-centered care and have the education to provide the range of services at the heart of the reform movement, including care coordination, chronic care management, and wellness and preventive care. The APRN community faces many challenges amidst the opportunities of health reform. However, the APRN community's triumph in reaching consensus on APRN regulation signifies a cohesive approach to overcoming the obstacles. The consensus model for APRN regulation, endorsed by 44 national nursing organizations, will serve as a beacon for nursing, as well as a guidepost for consumers and policymakers, on titling, education, certification, accreditation, and licensing for all four APRN roles. PMID:19942200

  8. To lead or not to lead? Prospective controlled study of emergency nurses' provision of advanced life support team leadership

    PubMed Central

    Gilligan, P; Bhatarcharjee, C; Knight, G; Smith, M; Hegarty, D; Shenton, A; Todd, F; Bradley, P

    2005-01-01

    Background and objectives: In many emergency departments advanced life support (ALS) trained nurses do not assume a lead role in advanced resuscitation. This study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation. Methods: A prospective study was conducted at five emergency departments and one nurses' association meeting. All participants went through the same scenario. Details recorded included baseline blood pressure and pulse rate, time in post, time of ALS training, and subjective stress score (1 = hardly stressed; 10 = extremely stressed). Scoring took into account scenario understanding, rhythm recognition, time to defibrillation, appropriateness of interventions, and theoretical knowledge. Results: Of 57 participants, 20 were ALS trained nurses, 19 were ALS trained emergency senior house officers (SHOs), and 18 were emergency SHOs without formal ALS training. The overall mean score for doctors without ALS training was 69.5%, compared with 72.3% for ALS trained doctors and 73.7% for ALS trained nurses. Nurses found the experience less stressful (subjective stress score 5.78/10) compared with doctors without ALS training (6.5/10). The mean time taken to defibrillate from the appearance of a shockable rhythm on the monitor by the nurses and those SHOs without ALS training was 42 and 40.8 seconds, respectively. Conclusion: ALS trained nurses performed as well as ALS trained and non ALS trained emergency SHOs in a simulated cardiac arrest situation and had greater awareness of the potentially reversible causes of cardiac arrest. Thus if a senior or middle grade doctor is not available to lead the resuscitation team, it may be appropriate for experienced nursing staff with ALS training to act as ALS team leaders rather than SHOs. PMID:16113181

  9. Advanced Practice Nursing: Meeting the Caregiving Challenges for Families of Persons with Frontotemporal Dementia

    PubMed Central

    Merrilees, Jennifer; Ketelle, Robin

    2010-01-01

    Frontotemporal dementia (FTD), once thought to be a rare cause for dementia, is now acknowledged to be the most common presenile (before age 65) cause of dementia (1). FTD is associated with profound changes in behavior, personality, emotions, and cognition. The purpose of this paper is to describe two cases of patients with FTD in order to illustrate salient aspects of the caregiving experience. Issues faced by caregivers are organized into 6 categories: diagnosis, behavioral symptoms, function, communication, long term management and care, and maintenance of the caregiver’s emotional and physical health. Examples of interventions directed by advanced practice nurses are described. We suggest that management of FTD requires expertise as scientific advances and discoveries about FTD continually change the landscape of care. PMID:20716977

  10. Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.

    PubMed

    Farrell, Kathleen; Payne, Camille; Heye, Mary

    2015-01-01

    The emergence of interprofessional collaboration and practice as a means to provide patient-centered care and to decrease the current fragmentation of health care services in the 21st century provides a clear and unique opportunity for the advanced practice registered nurse (APRN) to assume a key role. For APRNs and other health care providers, to participate effectively as team members requires an interprofessional mindset. Development of interprofessional skills and knowledge for the APRN has been hindered by a silo approach to APRN role socialization. The Institute of Medicine Report (IOM; 2010) states that current health care systems should focus on team collaboration to deliver accessible, high-quality, patient-centered health care that addresses wellness and prevention of illness and adverse events, management of chronic illness, and increased capacity of all providers on the team. The purpose of this article is to demonstrate the need to incorporate interprofessional education (IPE) into the socialization models used in advanced practice nursing programs. IPE requires moving beyond profession-specific educational efforts to engage students of different health care professions in interactive learning. Being able to work effectively as member of a clinical team while a student is a fundamental part of that learning (Interprofessional Education Collaborative Expert Panel, 2011). The objective of IPE curriculum models in graduate nursing programs is to educate APRNs in the development of an interprofessional mindset. Interprofessional collaboration and coordination are needed to achieve seamless transitions for patients between providers, specialties, and health care settings (IOM, 2010). Achieving the vision requires the continuous development of interprofessional competencies by APRNs as part of the learning process, so that upon entering the workforce, APRNs are ready to practice effective teamwork and team-based care. Socialization of the professional APRN

  11. Developing a professional poster: four "ps" for advanced practice nurses to consider.

    PubMed

    Bindon, Susan L; Davenport, Joan M

    2013-01-01

    Professional posters play an important role in the dissemination of knowledge and the professional development of advanced practice nurses, graduate students, and clinical faculty. Posters should be considered an integral component in communication of professional work in practice, research, and education. The invitation to submit a poster abstract is an important opportunity for clinicians and faculty alike to consider. Though sometimes misperceived as less prestigious than a podium presentation, posters add a unique element to professional and academic events. The argument is made for posters as an equal among scholarly presentation formats. The poster serves as a tremendous opportunity for collaboration between partners and a way to communicate important findings and advertise the presenters' work. For the advanced practice nurse who is a novice in presenting best practice or evidence from research trials, the poster format may be less intimidating while allowing the invaluable sharing of results. Four critical elements of professional poster development are deciding on a clear Purpose, targeting the right People, outlining key steps in the Process, and delivering a memorable Presentation. Using the "4 Ps" as cornerstones for the work of developing, preparing, and delivering the poster to an audience, the authors aim to help organize the entire process into these essential considerations. The poster, as a means of scholarly work, is a viable and essential activity, as interdisciplinary collaboration and sharing of best practice becomes the expectation for all professional development. PMID:23615014

  12. Planning training seminars in palliative care: a cross-sectional survey on the preferences of general practitioners and nurses in Austria

    PubMed Central

    2010-01-01

    Background Training in palliative care is frequently requested by health care professionals. However, little is known in detail about the subject matters and the educational preferences of physicians and staff or assistant nurses in this field. Methods All 897 registered GPs and all 933 registered home care nurses in the district of Steiermark/Austria were sent postal questionnaires. Results Results from 546 (30%) respondents revealed that GPs prefer evening courses and weekend seminars, whereas staff and assistant nurses prefer one-day courses. Multidisciplinary sessions are preferred by almost 80% of all professional groups. GPs preferred multi disciplinary groups most frequently when addressing psychosocial needs (88.8%) and ethical questions (85.8%). Staff and assistant nurses preferred multidisciplinary groups most frequently in the area of pain management (88%) and opted for multi disciplinary learning to a significantly higher extent than GPs (69%; p < 0.01). Those topics were ranked first which are not only deepening, but supplementing the professional training. On average, GPs were willing to spend a maximum amount of € 400 per year for training seminars in palliative care, whereas nurses would spend approximately € 190 for such classes. The results provide a detailed analysis of the preferences of GPs and nurses and offer guidance for the organisation of training seminars in palliative care. Conclusions Medical and nursing education programs often pursue separate paths. Yet our findings indicate that in palliative care multidisciplinary training seminars are favoured by both, doctors and nurses. Also, both groups prefer topics that are not only deepening, but supplementing their professional knowledge. PMID:20540757

  13. Evaluation of an Individualized Continuing Education Program for Physicians and Nurse Practitioners: An Example of the Situational Nature of Program Evaluation.

    ERIC Educational Resources Information Center

    Tresolini, Carol P.; Savage, Katherine D.; Hedgpeth, Marian Wells; Curtis, Peter

    The Visiting Clinician Program (VCP) was established in 1996 at a public medical school to provide individualized continuing education to participants and to foster closer ties between academic health center faculty and community practitioners who serve as preceptors for health professions students. Various methods have been used to evaluate the…

  14. The scientist-practitioner model: how do advances in clinical and cognitive neuroscience affect neuropsychology in the courtroom?

    PubMed

    Wood, Rodger Ll

    2009-01-01

    One of the core tenets of the scientist-practitioner model, slightly modified to make it applicable to modern neuropsychology, is that assessment procedures should be developed, applied, and interpreted in a relevant scientific framework. However, over the last 30 years, the general structure of a neuropsychological assessment has changed little, if at all. It has continued to focus mainly on the assessment of cognitive constructs such as intelligence, memory, attention, and perception. During the same time period, cognitive neuroscience has focused on integrative systems, largely controlled by frontal mechanisms, that allow individuals to utilize cognitive functions in an adaptive way, especially in the context of novel situations or when social stimuli are ambiguous. Consequently, the gulf between cognitive neuroscience and the practice of clinical neuropsychology has grown uncomfortably large. This article attempts to review some of the developments in cognitive and affective neuroscience that are relevant to an evaluation of neuropsychological abilities, especially in a medicolegal context, to determine whether conventional neuropsychological methods can be considered fit for purpose. PMID:19333064

  15. Clinical Specialists and Advanced Practitioners in Physical Therapy: A Survey of Physical Therapists and Employers of Physical Therapists in Ontario, Canada

    PubMed Central

    Gordon, Robert; Freeburn, Ryan; So, Colleen; Beauchamp, David; Landry, Michel D.; Switzer-McIntyre, Sharon; Evans, Cathy; Brooks, Dina

    2008-01-01

    Purpose: Opportunities to expand the role of physical therapists (PTs) have evolved to include clinical specialists and advanced practitioners, although the literature on these roles is limited. We examined perceptions of PTs and PT employers in Ontario regarding clinical specialization and advanced practice. Methods: Using a modified Dillman approach, a cross-sectional survey was conducted with 500 PTs and 500 PT employers in Ontario. Questionnaires were tailored to address specific issues related to each cohort. Results: Sixty percent of PTs and 53% of PT employers responded to the survey. Thirty-three percent of PT respondents already considered themselves “clinical specialists” (CS), and 8% considered themselves “advanced practitioners” (AP), although neither role is yet formally recognized in Canada. Both groups had substantial interest in pursuing formal recognition of CS and AP status. Respondents indicated that their primary motivation to pursue such roles was to enhance clinical reasoning skills with the goal of improving client outcomes (82% for the role of CS, 71% for the role of AP). Respondents supported the involvement of academic institutions in the process (60% for CS, 70% for AP). Conclusion: PTs and PT employers are supportive of the roles of the CS and AP within the profession, even though there is currently no formal recognition of either role in Canada. PMID:20145755

  16. Preparing culturally competent practitioners.

    PubMed

    St Clair, A; McKenry, L

    1999-05-01

    Preparing culturally competent practitioners is critical, and evaluating the effect of experiences intended to move students toward cultural competence is important. This research study explored the relationship among short-term international nursing clinical immersion experiences, cultural self-efficacy, and cultural competence. A triangulated research design was used to explore the relationship among the variables with 200 senior undergraduate and graduate nursing students from a university in New England. Quantitative analysis found statistically significant differences in the achievement of cultural self-efficacy for the participants who completed the international clinical experiences versus those who remained in the United States. Qualitative analysis, used to further explain the quantitative results, found that the differences were related to international students' ability to overcome their ethnocentrism, experience a transformative perspective about being culturally aware and sensitive, as well as understand and integrate the patients' cultural practices and beliefs into the students' Western health care practices. It became apparent that something other than cultural self-efficacy had occurred for participants in the international immersion experiences. The students believed they had entered the arena of cultural competence. Short-term clinical cultural immersion experiences have relevance for assisting faculty to move nursing students toward an understanding and achievement of cultural competence in ways currently not possible with nonimmersion community cultural experiences. PMID:10438097

  17. A conceptual framework for advanced practice nursing in a pediatric tertiary care setting: the SickKids' experience.

    PubMed

    LeGrow, Karen; Hubley, Pam; McAllister, Mary

    2010-05-01

    Advanced practice nurses (APNs) at The Hospital for Sick Children (SickKids) are pediatric healthcare providers who integrate principles and theories of advanced nursing with specialty knowledge to provide autonomous, independent, accountable, ethical and developmentally appropriate care in complex, often ambiguous and rapidly changing healthcare environments. Caring for children and adolescents requires culturally sensitive and family-centred approaches to care that incorporate a unique body of knowledge. Family-centred care is an approach to planning, delivery and evaluation of healthcare that is governed by the establishment of mutually beneficial partnerships among APNs, health professionals and children/families. The cornerstone of APN practice at SickKids is the recognition of "family" as the recipients of care. By valuing and developing relationships with families, APNs promote excellence in healthcare across the care continuum to optimize the child's and family's physical, emotional, social, psychological and spiritual well-being. This paper outlines the evolution of advanced practice nursing at SickKids, beginning with the introduction of APN roles in the 1970s and culminating in the current critical mass of APNs who have been integrated throughout the hospital's infrastructure. We describe the process used to create a common vision and a framework to guide pediatric advanced nursing practice. PMID:20530994

  18. From scientific discovery to health outcomes: A synergistic model of doctoral nursing education.

    PubMed

    Michael, Melanie J; Clochesy, John M

    2016-05-01

    Across the globe, health system leaders and stakeholder are calling for system-level reforms in education, research, and practice to accelerate the uptake and application of new knowledge in practice and to improve health care delivery and health outcomes. An evolving bi-dimensional research-practice focused model of doctoral nursing education in the U.S. is creating unprecedented opportunities for collaborative translational and investigative efforts for nurse researchers and practitioners. The nursing academy must commit to a shared goal of preparing future generations of nurse scientists and practitioners with the capacity and motivation to work together to accelerate the translation of evidence into practice in order to place nursing at the forefront of health system improvement efforts and advance the profession. PMID:27125154

  19. Opioid therapy for chronic low back pain: prescribing considerations for advanced practice registered nurses.

    PubMed

    Lall, Maureen Patricia

    2014-12-01

    Chronic low back pain is a common, disabling, and costly condition, and advanced practice registered nurses (APRNs) must carefully evaluate patients before considering long-term opioid therapy as a management strategy. APRNs should refer patients suspected of having a serious condition, or identifiable etiology, for specialist evaluation, as many patients improve with physical therapy, interventional pain management procedures, or surgical intervention. For patients unresponsive to nonopioid treatment, APRNs with an understanding of opioids, and the experience to assess and manage the risks of opioid misuse, abuse, and diversion, may consider long-term opioid therapy as part of a multimodal management plan. Such prescribing necessitates careful patient selection; informed consent; prudent opioid dosing and titration; and monitoring for response to treatment, adverse effects, and aberrant drug-taking behavior. Treatment and regulatory guidelines can assist APRNs in providing safe and effective care to patients with chronic low back pain. PMID:25365050

  20. Portfolio use as a tool to demonstrate professional development in advanced nursing practice.

    PubMed

    Hespenheide, Molly; Cottingham, Talisha; Mueller, Gail

    2011-01-01

    A concrete way of recognizing and rewarding clinical leadership, excellence in practice, and personal and professional development of the advanced practice registered nurse (APRN) is lacking in the literature and healthcare institutions in the United States. This article presents the process of developing and evaluating a professional development program designed to address this gap. The program uses APRN Professional Performance Standards, Relationship-Based Care, and the Magnet Forces as a guide and theoretical base. A key tenet of the program is the creation of a professional portfolio. Narrative reflections are included that illustrate the convergence of theories. A crosswalk supports this structure, guides portfolio development, and operationalizes the convergence of theories as they specifically relate to professional development in advanced practice. Implementation of the program has proven to be challenging and rewarding. Feedback from APRNs involved in the program supports program participation as a meaningful method to recognize excellence in advanced practice and a clear means to foster ongoing professional growth and development. PMID:22016019

  1. Knowledge of and Attitudes toward Nonpharmacological Interventions for Treatment of Behavior Symptoms Associated with Dementia: A Comparison of Physicians, Psychologists, and Nurse Practitioners

    ERIC Educational Resources Information Center

    Cohen-Mansfield, Jiska; Jensen, Barbara; Resnick, Barbara; Norris, Margaret

    2012-01-01

    Purpose of the Study: Behavior problems are common in nursing homes. Current guidelines recommend nonpharmacological interventions (NPHIs) as first-line treatment, but pharmacological regimens (PIs) continue to be used. Given differences in background and training of those who treat behavior problems in residents, we compared attitudes of…

  2. The Role of Nurse Educators in the Development of Reflective Practitioners: A Selective Case Study of the Australian and UK Experience.

    ERIC Educational Resources Information Center

    Mallik, Maggie

    1998-01-01

    A study tour of two British and eight Australian nursing schools found reflective practice fully endorsed in Australia, but the movement is threatened by concern with cost effectiveness. Issues to be resolved include ethical use of student journals and process and outcome evaluation of the effectiveness of reflection. (SK)

  3. Child Psychiatric Nursing Option.

    ERIC Educational Resources Information Center

    Koehler, Mary Frances

    1981-01-01

    Describes a course at the Indiana University School of Nursing which allows senior students in a baccalaureate nursing program to concentrate on emotionally disturbed children in an advanced nursing course. Discusses course philosophy, clinical experiences, and program results. (CT)

  4. Advocacy and leadership when parental rights and child welfare collide: the role of the advanced practice nurse.

    PubMed

    Walton, Mary K

    2002-02-01

    This article describes the experience of an advanced practice nurse in a challenging clinical situation. A mother with mental illness and mental retardation seeks to retain parental rights and care for her newborn with cystic fibrosis. The nurse provides leadership to the hospital team and serves as an advocate throughout legal proceedings. A systematic, nonjudgmental, and empathic approach to gathering information, working with the family, welfare, and legal representatives is described. Enacting a complex and court-mandated homecare education regimen to the disabled mother is discussed. Preparation to testify in a termination of parental rights proceeding is outlined and a summary description of the testimony provided. PMID:11891494

  5. Partnership for the Advancement of Information Literacy in a Nursing Program

    ERIC Educational Resources Information Center

    Beck, Sheila; Blake-Campbell, Barbara; McKay, Devin

    2012-01-01

    Nursing educators know that healthcare stakeholders expect nursing graduates to be able to manage information. Consequently, many nursing education programs are exploring ways of integrating information literacy across the curriculum not only to bolster evidence-based practice, but also to enhance professional development and encourage lifelong…

  6. Advanced Practice Nursing: Is the Physician's Assistant an Accident of History or a Failure to Act?

    ERIC Educational Resources Information Center

    Christman, Luther

    1998-01-01

    The responses of some nursing organizations regarding the establishment of collaborative relationships in the nursing profession may be responsible for the development of the physician assistant profession. The nursing profession should examine these responses while planning strategies to cope with the current chaos in health care. (JOW)

  7. Mini Review of Integrated Care and Implications for Advanced Practice Nurse Role

    PubMed Central

    McIntosh, Diana; Startsman, Laura F.; Perraud, Suzanne

    2016-01-01

    Literature related to primary care and behavioral health integration initiatives is becoming abundant. The United States’ 2010 Patient Protection and Affordable Care Act included provisions encouraging increased collaboration of care for individuals with behavioral and physical health service needs in the public sector. There is relatively little known of Advanced Practice Registered Nurses’ (APRNs) roles with integrating primary and behavioral healthcare. The goal of this review article is to: (a) define integration of physical and behavioral healthcare and potential models; (b) answer the question as to what are effective evidence based models/strategies for integrating behavioral health and primary care; (c) explore the future role and innovations of APRNs in the integration of physical and behavioral healthcare. Results: The evidence- based literature is limited to three systematic reviews and six randomized controlled trials. It was difficult to generalize the data and the effective integration strategies varied from such interventions as care management to use of sertraline to depression management and to access. There were, though, implications for the integrated care advanced practice nurse to have roles inclusive of competencies, leadership, engagement, collaboration and advocacy. PMID:27347258

  8. Enhancing presentation skills for the advanced practice nurse: strategies for success.

    PubMed

    Vollman, Kathleen M

    2005-01-01

    Professional speaking is a component of the professional practice role of the advanced practice nurse (APN). The skills to communicate effectively to one person or an audience of 100 provide the APN with the essential tools for implementing change, collaborating effectively, presenting information at professional meetings, or communicating the impact of clinical outcomes in the boardroom. Public speaking skills, a professional image, and improved communication can facilitate advancement along any career ladder. The greater your fear, the more self-confidence you will gain by stepping up to a challenge and conquering it. This article describes strategies for organizing and presenting your message in a clear and concise format. Techniques to manage the anxiety produced when attempting to articulate your thoughts is essential for effective communication. Skills for enhancing the delivery of your message through effective body language, professional image, voice modulation, and use of audiovisual aids are addressed. Creative techniques for fielding questions are key in promoting a dynamic closure and provide consistent reinforcement of the key message content. PMID:15714019

  9. The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students.

    PubMed

    Defenbaugh, Nicole; Chikotas, Noreen E

    2016-01-01

    The purpose of this qualitative study was to examine the impact of standardized patient experiences (SPE) in the education of the Advanced Practice Nurse (APN). The education of the APN requires educators to make every attempt to promote competency in the areas of communication and clinical-decision making. SPE programs have been found to improve the interpersonal, problem solving, and critical thinking skills of nursing students. For this research twenty-nine APN students participated in SPEs over the course of two semesters. Fifteen student volunteers of those 29 participants were then interviewed three months after the experience. Results revealed that having an expert in the field of communication studies increased awareness of communication skills and how to improve nurse-patient encounters in the clinical setting. The interprofessional collaboration during the SPEs assisted in facilitating the application of learned communication skills into patient-centered care of the APN student. PMID:26122938

  10. Measuring the Contribution and Complexity of Nurse and Physiotherapy Consultants: A Feasibility Study

    PubMed Central

    Richardson, Janet; Ainsworth, Roberta; Humphreys, Ann; Stenhouse, Elizabeth; Watkins, Mary

    2008-01-01

    Advanced practice roles in nursing and other health professions have become integral to a range of healthcare services world-wide providing experienced practitioners with the opportunity to extend their roles and influence decision making whilst maintaining patient contact. However, there has been limited research to evaluate the impact on health services of these advanced practice roles. The aim of this feasibility study was to analyse Nurse and Allied Health Professionals (AHP) Consultant activity in the four functions of the role (education, expert practice, leadership, research). A structured diary assessed the activity of five Consultant Nurses and one Consultant Physiotherapist over a one week period. Detailed analysis of a clinic carried out by one of the Consultants was undertaken using a mapping procedure. Results suggest that the activity diary, combined with mapping of activities, illustrate the complexity and variety of the role and facilitate meaningful reflection on what advanced practitioners do. PMID:19319215

  11. Oncology nursing support for safe and effective use of eribulin in metastatic breast cancer.

    PubMed

    Donovan, Diana; Urquhart, Laura; Hopkins, Una; Knight, Sandra; Moore, Laura

    2014-01-01

    Nurse practitioners play important roles in breast cancer prevention, early detection, therapeutic efficacy, and surveillance. Assessment of a patient's health status is part of the nine nurse practitioner core competencies updated in 2012 by the National Organization of Nurse Practitioner Faculties. Although adverse events are common in treatment for metastatic breast cancer (MBC), proactive management strategies can limit the number and/or severity of adverse events. Additionally, knowledge of common metastatic sites and clinical signs/symptoms of recurrence provides one of the first-line strategies for successful treatment. We review five case studies of women with MBC who were managed successfully with eribulin mesylate in late lines of therapy after at least two chemotherapeutic regimens for advanced breast cancer that included both an anthracycline and a taxane in either the adjuvant or metastatic setting. PMID:24855406

  12. Advancing HIV Nursing Practice: The Doctor of Nursing Practice HIV Specialty at Rutgers, the State University of New Jersey.

    PubMed

    Willard, Suzanne; Nelson, John; Reyes, Darcel; Linn, Annē

    2016-01-01

    The move to integrate HIV treatment and care into primary care is a major obstacle for the current U.S. health care workforce. Many HIV specialty providers will soon retire, while few primary care clinicians have been adequately trained in the diagnosis, care, and treatment of people living with HIV. The Health Resources and Services Administration (HRSA) has supported the development of a Doctor of Nursing Practice (DNP) program with an HIV specialty at Rutgers, the State University of New Jersey, to assure successful transition to an HIV primary care workforce. The Rutgers School of Nursing has been at the forefront of the DNP education movement and is among the first to develop an HIV-focused DNP program. Thirty-seven students have enrolled in the 3-year program, and two have graduated from the first cohort. Here we discuss the planning, implementation, successes, and recommendations of the new program. PMID:27086187

  13. From Nurse to Nurse Anesthetist: The Influence of Age and Gender on Professional Socialization and Career Commitment of Advanced Practice Nurses.

    ERIC Educational Resources Information Center

    Waugaman, Wynne R.; Lohrer, Donna J.

    2000-01-01

    A survey of 1,106 student nurse anesthetists (40% male) showed that increasing age was negatively correlated with socioeconomic rewards. Male gender was positively correlated with administrative/supervisory roles, female gender with holistic patient care. Men achieved socialization more readily in occupational orientation. (SK)

  14. Still spending dollars, still searching for sense: advanced practice nursing in an era of regulatory and economic turmoil.

    PubMed

    Safriet, B J

    1998-01-01

    Regulatory and market forces are dramatically affecting the practice prospects for advanced practice nurses (APNs). Examples include the designation of APNs as primary care providers by for-profit capitated systems, the elimination of "geographic" practice boundaries by the advent of telepractice, and the revision of governmental reimbursement provisions for entire categories of APNs. Educational, political, and economic challenges necessitate an increased APN leadership role in national and state policy reform efforts. PMID:9874960

  15. Computer Literacy Needs of Nurse Educators and Nurse Managers

    PubMed Central

    Arnold, Jean M.; Bauer, Carol A.

    1985-01-01

    A questionnaire was used to survey the computer literacy needs of 445 nurse educators and nurse managers within a northeastern metropolitan area. There are commonalities and differences between nurse educators and nurse managers regarding advanced computer applications; but both groups expressed an urgent need for continuing nursing education courses at the advanced level.

  16. The Institute for Johns Hopkins Nursing: A Collaborative Model for Nursing Practice and Education.

    ERIC Educational Resources Information Center

    Sabatier, Kathleen Hartman

    2002-01-01

    The Institute for Johns Hopkins Nursing was developed collaboratively by the Johns Hopkins University School of Nursing and the Johns Hopkins Hospital Department of Nursing. The institute prepares nurses for practice, keeps practitioners current, and provides nursing staff development programs. (Contains 11 references.) (JOW)

  17. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:25397338

  18. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2011-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:21808173

  19. A complex regional intervention to implement advance care planning in one town's nursing homes: Protocol of a controlled inter-regional study

    PubMed Central

    2011-01-01

    Background Advance Care Planning (ACP) is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent. In Germany, recent legislation confirms that advance directives (AD) have to be followed if they apply to the medical situation, but implementation of ACP has not yet been described. Methods/Design In a longitudinal controlled study, we compare 1 intervention region (4 nursing homes [n/hs], altogether 421 residents) with 2 control regions (10 n/hs, altogether 985 residents). Inclusion went from 01.02.09 to 30.06.09, observation lasted until 30.06.10. Primary endpoint is the prevalence of ADs at follow-up, 17 (12) months after the first (last) possible inclusion. Secondary endpoints compare relevance and validity of ADs, process quality, the rate of life-sustaining interventions and, in deceased residents, location of death and intensity of treatment before death. The regional multifaceted intervention on the basis of the US program Respecting Choices® comprises training of n/h staff as facilitators, training of General Practitioners, education of hospital and ambulance staff, and development of eligible tools, including Physician Orders for Life-Sustaining Treatment in case of Emergency (POLST-E). Participation data: Of 1406 residents reported to live in the 14 n/hs plus an estimated turnover of 176 residents until the last possible inclusion date, 645 (41%) were willing to participate. Response rates were 38% in the intervention region and 42% in the control region. Non-responder analysis shows an equal distribution of sex and age but a bias towards dependency on nursing care in the responder group. Outcome analysis of this study will become available in the course of 2011. Discussion Implementing an ACP program for the n/hs and related health care providers of a region requires a

  20. Neonatal nursing: an unmet challenge in India.

    PubMed

    Kalyan, Geetanjli; Vatsa, Manju

    2014-11-01

    Nurses comprise a key component to maternal and newborn health care delivery, including the care of 'at-risk' or sick newborns. However, the efficiency and effectiveness of services rely heavily on adequate numbers of highly skilled neonatal nurses. Currently, in India, a significant shortage of trained nurses in the field of newborn care is contributing to poor neonatal outcomes. Specifically, nurses caring for newborns lack the competency and experience needed to ensure optimal care. This deficiency has been linked to a lack of expert faculty, standardized training and minimal or no exposures to newborn clinical care areas during pre service education. Moreover, in addition to a lack of operational research in the area, nurses who provide care for newborns are often faced with numerous system related issues that impede their ability to provide optimal care. Most notably, frequent changes of work place, poor wages, and lack of continuing education, skill maintenance, recognition, and collaborative team culture further compromise the nursing care. All these lead to poor motivation and competency. To meet this challenge, it is essential that emphasis be placed on the identification and support of nursing faculty with expertise in newborn and neonatal care who are able to ensure that nurses receive standardized education for pre-service, in-service and ongoing care. In addition, importance should be placed on encouraging newborn nursing research as well as on governmental increases in salary compensation. Lastly, given the shortage of physicians to take care of sick neonates in remote areas, the creation of a cadre of Neonatal nurse practitioner/ advanced practice nurses would be an invaluable solution in developing countries. Furthermore, centralized oversight of newborn education and training would be best served, if responsibility was placed with Reproductive maternal newborn child health (RMNCH) workers and district level officers. PMID:25278279

  1. Barriers to Advance Care Planning in Cancer, Heart Failure and Dementia Patients: A Focus Group Study on General Practitioners' Views and Experiences

    PubMed Central

    De Vleminck, Aline; Pardon, Koen; Beernaert, Kim; Deschepper, Reginald; Houttekier, Dirk; Van Audenhove, Chantal; Deliens, Luc; Vander Stichele, Robert

    2014-01-01

    Background The long-term and often lifelong relationship of general practitioners (GPs) with their patients is considered to make them the ideal initiators of advance care planning (ACP). However, in general the incidence of ACP discussions is low and ACP seems to occur more often for cancer patients than for those with dementia or heart failure. Objective To identify the barriers, from GPs' perspective, to initiating ACP and to gain insight into any differences in barriers between the trajectories of patients with cancer, heart failure and dementia. Method Five focus groups were held with GPs (n = 36) in Flanders, Belgium. The focus group discussions were transcribed verbatim and analyzed using the method of constant comparative analysis. Results Three types of barriers were distinguished: barriers relating to the GP, to the patient and family and to the health care system. In cancer patients, a GP's lack of knowledge about treatment options and the lack of structural collaboration between the GP and specialist were expressed as barriers. Barriers that occured more often with heart failure and dementia were the lack of GP familiarity with the terminal phase, the lack of key moments to initiate ACP, the patient's lack of awareness of their diagnosis and prognosis and the fact that patients did not often initiate such discussions themselves. The future lack of decision-making capacity of dementia patients was reported by the GPs as a specific barrier for the initiation of ACP. Conclusion The results of our study contribute to a better understanding of the factors hindering GPs in initiating ACP. Multiple barriers need to be overcome, of which many can be addressed through the development of practical guidelines and educational interventions. PMID:24465450

  2. Updating the definition and role of public health nursing to advance and guide the specialty.

    PubMed

    Bekemeier, Betty; Walker Linderman, Tessa; Kneipp, Shawn; Zahner, Susan J

    2015-01-01

    National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty--The Definition and Role of Public Health Nursing--has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings. PMID:25284433

  3. Conceptualizing Telehealth in Nursing Practice: Advancing a Conceptual Model to Fill a Virtual Gap.

    PubMed

    Nagel, Daniel A; Penner, Jamie L

    2016-03-01

    Increasingly nurses use various telehealth technologies to deliver health care services; however, there has been a lag in research and generation of empirical knowledge to support nursing practice in this expanding field. One challenge to generating knowledge is a gap in development of a comprehensive conceptual model or theoretical framework to illustrate relationships of concepts and phenomena inherent to adoption of a broad range of telehealth technologies to holistic nursing practice. A review of the literature revealed eight published conceptual models, theoretical frameworks, or similar entities applicable to nursing practice. Many of these models focus exclusively on use of telephones and four were generated from qualitative studies, but none comprehensively reflect complexities of bridging nursing process and elements of nursing practice into use of telehealth. The purpose of this article is to present a review of existing conceptual models and frameworks, discuss predominant themes and features of these models, and present a comprehensive conceptual model for telehealth nursing practice synthesized from this literature for consideration and further development. This conceptual model illustrates characteristics of, and relationships between, dimensions of telehealth practice to guide research and knowledge development in provision of holistic person-centered care delivery to individuals by nurses through telehealth technologies. PMID:25858897

  4. Learning Style of Students and Practitioners in Five Health Professions.

    ERIC Educational Resources Information Center

    Katz, Noomi; Heimann, Nanci

    1991-01-01

    An Israeli sample of 378 students and 251 practitioners in occupational therapy (OT), social work, nursing, physical therapy, and clinical psychology completed Kolb's Learning Style Inventory. Findings suggest greater variance in learning style among students. OT students were least abstract. Both OT students and practitioners were predominantly…

  5. Healthcare Proxy Awareness of Suspected Infections Among Nursing Home Residents with Advanced Dementia

    PubMed Central

    Givens, Jane L.; Spinella, Sara; Ankuda, Claire K.; D’Agata, Erika; Shaffer, Michele L.; Habtemariam, Daniel; Mitchell, Susan L.

    2015-01-01

    Background Infections are common in advanced dementia. Little is known about healthcare proxy involvement in decision making regarding infections. Design Prospective cohort study Setting/Participants 362 nursing home (NH) residents with advanced dementia and their proxies in 35 Boston-area facilities. Measurements Charts were abstracted monthly (up to 12 months) for documentation of suspected infections and provider/proxy discussions for each episode. Proxies were interviewed within 8 weeks of the infection to determine their awareness and decision-making involvement. Factors associated with proxy awareness and discussion documentation were identified. Results There were 496 suspected infections; proxies were reached for interview for 395 (80%). Proxy/provider discussions were documented for 207/395 episodes (52%), yet proxies were aware of only 156/395 (39%). Proxies participated in decision-making for 89/156 (57%) episodes of which they were aware. Proxy awareness was associated with antimicrobial use (adjusted odds ratio (AOR) 3.43, 95% confidence interval (CI) 1.94–6.05), hospital transfer (AOR 3.00, 95% CI 1.19–7.53), infection occurrence within 30 days of death (AOR 3.32, 95% CI 1.54–7.18) and fewer days between infection and study interview (AOR 2.71, 95% CI 1.63–4.51). Discussion documentation was associated with the resident residing in a dementia special care unit (AOR 1.71, 95% CI 1.04–2.80), not on hospice (AOR 3.25, 95% CI 1.31–8.02), more provider visits (AOR 1.71, 95% CI 1.07–2.75), proxy visits > 7 hours/week (AOR 1.93, 95% CI 1.02–3.67), and episode within 30 days of death (AOR 3.99, 95% CI 1.98–8.02). Conclusion Proxies are unaware of and do not participate in decision-making for most suspected infections experienced by NH residents with advanced dementia. Proxy awareness of episodes and documentation of provider/proxy discussions are not congruent. PMID:26031905

  6. Nursing informatics: the future now.

    PubMed

    Mamta

    2014-01-01

    Technological advancements in the health care field have always impacted the health care practices. Nursing practice has also been greatly influenced by the technology. In the recent years, use of information technology including computers, handheld digital devices, internet has advanced the nursing by bridging the gap from nursing as an art to nursing as science. In every sphere of nursing practice, nursing research, nursing education and nursing informatics play a very important role. If used properly it is a way to save time, helping to provide quality nursing care and increases the proficiency of nursing personnel. PMID:25924417

  7. Now We Know: Assessing Sexual Assault Criminal Justice Case Processing in an Urban Community Using the Sexual Assault Nurse Practitioner Evaluation Toolkit.

    PubMed

    Valentine, Julie L; Shaw, Jessica; Lark, Alyssa; Campbell, Rebecca

    2016-01-01

    Campbell and colleagues developed an evaluation Toolkit for use by sexual assault nurse examiners (SANEs) to assess criminal case outcomes in adult sexual assault cases seen by SANE programs (Campbell, Townsend, Shaw, Karim, & Markowitz, 2014; Campbell, Bybee, et al., 2014). The Toolkit provides step-by-step directions and an easy-to-use statistical program. This study describes implementation of the Toolkit in Salt Lake County, the first site outside the pilot sites to utilize the program. The Toolkit revealed that, in Salt Lake County from 2003 to 2011, only 6% of adult sexual assault cases were successfully prosecuted. These findings prompted multiple community discussions, media attention, and a call to action to improve the investigation and prosecution of adult sexual assault cases. The primary purpose of this case report is to encourage other SANE teams and communities to use the Toolkit by sharing the successful experience of Salt Lake County in implementing the Toolkit.Video Abstract available for additional insights from Dr. Valentine (see Supplemental Digital Content 1, http://links.lww.com/JFN/A19). PMID:27496646

  8. Legal, professional and ethical considerations of advanced perioperative practice.

    PubMed

    Quick, Julie

    2010-05-01

    Advances within the NHS have recognised nurses in roles that go beyond the historical parameters of their initial training and role characteristics (DH 1999, DH 2000). Working within such a role creates added responsibilities of advancing practice and the continuing development of knowledge and skills. Nurses working at a higher level of practice will require an understanding of not only the professional and legal implications that new roles create, but also an awareness of the ethical dilemmas that will undoubtedly become increasingly complex (Bartter 2002). This article examines the professional, legal and ethical implications of advanced perioperative practice through the author's role as a surgical care practitioner (SCP). PMID:20521577

  9. Advance directives and nursing home stays associated with less aggressive end-of-life care for patients with severe dementia.

    PubMed

    Nicholas, Lauren H; Bynum, Julie P W; Iwashyna, Theodore J; Weir, David R; Langa, Kenneth M

    2014-04-01

    The number of older adults with cognitive impairment is increasing, and such adults often require a surrogate to make decisions about health care. However, little is known about the aggressiveness of end-of-life care for these people, especially those who reside in the community. We found that cognitive impairment is common among older adults approaching the end of life, whether they live in the community or in a nursing home, and that nearly 30 percent of patients with severe dementia remained in the community until death. Among those patients, having an advance directive in the form of a living will was associated with significantly less aggressive care at the end of life, compared to similar patients without an advance directive-as measured by Medicare spending ($11,461 less per patient), likelihood of in-hospital death (17.9 percentage points lower), and use of the intensive care unit (9.4 percentage points lower). In contrast, advance directives were not associated with differences in care for people with normal cognition or mild dementia, whether they resided in the community or in a nursing home. Timely advance care planning after a diagnosis of cognitive impairment may be particularly important for older adults who reside in the community. PMID:24711329

  10. Nursing education in Iran: past, present, and future.

    PubMed

    Tabari Khomeiran, Rasoul; Deans, Cecil

    2007-10-01

    Nursing education in Iran has undergone significant change since its genesis with foreign missionaries over one hundred years ago. More recently, following the 1979 Islamic revolution, nurse education has followed the direction taken by most other countries in moving from an apprenticeship model of training to an academic model. A series of transformative changes to nursing education specifically-and across the higher education system generally-has resulted in nurses now being able to undertake study across all university-based programs up to and including doctoral level. Contemporary nursing students have access to full-text professional journals through the internet, and they may pursue their doctoral studies in other countries. Although these improvements in nursing education in Iran are to be applauded, much more needs to be accomplished to ensure that highly competent nurse practitioners continue to be produced in this country. This article presents an historical overview of the development of nursing education in Iran, within its economic and sociopolitical contexts. Recommendations based upon lessons learned from historical and contemporary realities are presented in order to advance nursing education in this part of world. PMID:17125890

  11. The role of the surgical care practitioner within the surgical team.

    PubMed

    Quick, Julie

    Changes to the surgical workforce and the continued development of health policy have perpetuated the requirement for innovative perioperative roles. The surgical care practitioner is a nurse or allied health professional who works within a surgical team and has advanced perioperative skills, including the ability to undertake surgical interventions.With only limited literature evaluating this role, any benefits of their inclusion to a surgical team are largely anecdotal. This article presents the findings of an autoethnographic inquiry that explored the experiences of surgical team members who worked with the nurse researcher in her role as surgical care practitioner. Surgeons identified the provision of a knowledgeable, competent assistant and operator who enhanced patient care, helped maintain surgical services and supported the training of junior doctors. The professional, ethical and legal obligations of advanced perioperative practice were upheld. Interprofessional collaboration was improved, as was service provision. This further enhanced the patient experience. The traditional viewpoint that nurses who undertake tasks previously associated with medicine should be working to the standard of a doctor is challenged but requires further examination. PMID:24261091

  12. Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries.

    PubMed

    Coffey, Alice; McCarthy, Geraldine; Weathers, Elizabeth; Friedman, M Isabel; Gallo, Katherine; Ehrenfeld, Mally; Chan, Sophia; Li, William H C; Poletti, Piera; Zanotti, Renzo; Molloy, D William; McGlade, Ciara; Fitzpatrick, Joyce J; Itzhaki, Michal

    2016-06-01

    Nurses' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care. PMID:26823112

  13. The Integration of Research by Nurse Educators: Advancing Practice through Professional Development Programs.

    ERIC Educational Resources Information Center

    Waddell, Janice; Durrant, Michele; Avery, Shirley

    1999-01-01

    A nurse preceptorship program used narrative to help participants explore the complexity of pediatric clinical practice. Through narratives they shared clinical decision making, knowledge, and skills, transforming knowing into story telling into learning. (SK)

  14. Nursing and philanthropy: a partnership to advance professional excellence and exceptional care.

    PubMed

    Janney, Michelle A

    2014-01-01

    Michelle A. Janney, PhD, RN, NEA-BC, 2013 AONE President, Senior Vice President, and Wood-Prince Family Chief Nurse Executive at Northwestern Memorial Hospital, discusses the impact of engaging institutional leadership in nursing philanthropic and strategic priorities and the importance of developing a culture of philanthropy that permeates the organization and encourages participation from all levels. The article highlights key outcomes of Northwestern Memorial Hospital's collective efforts to build a culture of philanthropy that prioritizes nursing as consequential to the mission of the organization. The outcomes demonstrate how such a culture provides a critical platform for creating opportunities that enable nurses to be indispensable partners in a shared commitment to the highest-quality, scientifically driven, personalized care. PMID:25208145

  15. Advancing medical-surgical nursing practice: improving management of the changing patient condition.

    PubMed

    Monroe, Heidi; Plylar, Peggy; Krugman, Mary

    2014-01-01

    Higher patient acuities and more novice nurses on medical-surgical units have Educators focused on achieving positive outcomes with changes in patient condition. An educational program was developed to enhance nurses' knowledge, skill, and confidence in assessing hemodynamics, recognizing early signs of instability, and administering vasoactive medications. The program was successful with significant knowledge improvement as well as an increased use of the Medical Emergency Team while maintaining a low number of code calls. PMID:25407973

  16. Advance care planning for nursing home residents with dementia: policy vs. practice.

    PubMed

    2016-05-27

    Despite the potential benefits of ACP for nursing home residents with dementia, the authors of this study highlight that hardly any research has focused on the involvement of residents/families in ACP and that ACP is rarely realised for these people. Their research aimed to evaluate the ACP policy for people with dementia in nursing homes and to gain insight into the involvement of residents with dementia and their families in ACP. PMID:27231078

  17. Implementing computer-based testing in distance education for advanced practice nurses: lessons learned.

    PubMed

    Caudle, Patricia; Bigness, Joanne; Daniels, Judi; Gillmor-Kahn, Mickey; Knestrick, Joyce

    2011-01-01

    A distance education program utilized by graduate nursing students worldwide faces unique problems with testing. This article presents the results of a pilot study on the implementation of computer-based testing at the Frontier Nursing University. A detailed analysis of the evaluative survey completed by students in the pilot study revealed issues of hi-directional respect and trust between faculty and students and technological anxiety among students using computer-based testing. PMID:22029246

  18. A model of consensus formation for reconciling nursing's disciplinary matrix.

    PubMed

    Dobratz, Marjorie C

    2010-01-01

    With questions raised as to whether or not nursing knowledge should be developed from extant conceptual/theoretical models or from practice-based environments, this paper utilizes Kuhn's disciplinary matrix and Laudan's model of consensus formation to explore the changing nature of the discipline's structural matrix. Kuhn's notion that a discipline's structural matrix includes symbolic generalizations, models and exemplars, and Laudan's view that a maturing discipline embraces factual, methodological, and axiological (goals and aims) knowledge, and that context and discourse are also involved in advancing a discipline is described as a means for reconciling the source of nursing knowledge. This paper posits that shared axiological goals connect both theorists and practitioners, and resolve potential conflicts as to viable sources of nursing knowledge. Through shared goals that include humanization, meaning, quality of life, caring, consciousness, transcendence, and presence, which bridge both theoretical and practice approaches, nursing's charge to contribute to the good of society is fulfilled. PMID:20017883

  19. Incorporating Storytelling into Practice: How HRD Practitioners Foster Strategic Storytelling

    ERIC Educational Resources Information Center

    Tyler, Jo A.

    2007-01-01

    Human resource development (HRD) practitioners are adding storytelling to their box of tactical and strategic tools. This qualitative research study investigates how HRD practitioners in for-profit settings apply storytelling as a means of advancing organizational goals. The primary focus of practitioners is on instrumental application of stories…

  20. Adolescent Literacy Development in Out-of-School Time: A Practitioner's Guide. Final Report from Carnegie Corporation of New York's Council on Advancing Adolescent Literacy

    ERIC Educational Resources Information Center

    Moje, Elizabeth Birr; Tysvaer, Nicole

    2010-01-01

    In response to requests from out-of-school time (OST) providers, the authors have created this practitioner's guidebook for integrating adolescent literacy development initiatives into a wide variety of OST programs. As readers will discover in subsequent chapters, the authors' definition of adolescent literacy development represents a…

  1. Critique of the Graduate Nurse: An International Perspective.

    ERIC Educational Resources Information Center

    Greenwood, Jennifer

    2000-01-01

    Nurses in service fault beginning nurses' insufficient clinical and patient management skills. Nurse educators maintain that practicing nurses do not facilitate the transition of entry-level nurses. More collaboration between teachers and practitioners is needed. (Commentaries by Sally Glen, Patrick Crookes, and Pam Walter follow.) (SK)

  2. Promoting Excellence in End-of-Life Care: lessons learned from a cohort of nursing home residents with advanced Huntington disease.

    PubMed

    Dellefield, Mary E; Ferrini, Rebecca

    2011-08-01

    Huntington disease (HD) is a genetic neurodegenerative disorder that progresses over decades and is ultimately terminal. As HD advances, patients are frequently placed in institutional care settings, including nursing homes and hospices where family, nursing staff, and interdisciplinary team members are challenged to help patients live to their highest potential and die with dignity. Edgemoor, a distinct part of the San Diego County Psychiatric Hospital, is a regional referral facility for patients with HD. Over the past 8 years, we have cared for 53 patients with advanced HD and describe our experiences by presenting their demographic characteristics and the lessons we have learned in caring for them. Ultimately, we found that the Robert Wood Johnson Foundation's Promoting Excellence in End-of-Life Care Initiative provided a meaningful framework for setting clinical priorities. This framework is used to summarize the clinical lessons that nursing staff and interdisciplinary team members learned about caring well for institutionalized individuals with advanced HD. PMID:21796039

  3. Patient safety culture assessment in the nursing home

    PubMed Central

    Handler, S M; Castle, N G; Studenski, S A; Perera, S; Fridsma, D B; Nace, D A; Hanlon, J T

    2006-01-01

    Objective To assess patient safety culture (PSC) in the nursing home setting, to determine whether nursing home professionals differ in their PSC ratings, and to compare PSC scores of nursing homes with those of hospitals. Methods The Hospital Survey on Patient Safety Culture was modified for use in nursing homes (PSC‐NH) and distributed to 151 professionals in four non‐profit nursing homes. Mean scores on each PSC‐NH dimension were compared across professions (doctors, pharmacists, advanced practitioners and nurses) and with published benchmark scores from 21 hospitals. Results Response rates were 68.9% overall and 52–100% for different professions. Most respondents (76%) were women and had worked in nursing homes for an average of 9.8 years, and at their current facility for 5.4 years. Professions agreed on 11 of 12 dimensions of the survey and differed significantly (p<0.05) only in ratings for one PSC dimension (attitudes about staffing issues), where nurses and pharmacists believed that they had enough employees to handle the workload. Nursing homes scored significantly lower (ie, worse) than hospitals (p<0.05) in five PSC dimensions (non‐punitive response to error, teamwork within units, communication openness, feedback and communication about error, and organisational learning). Conclusions Professionals in nursing homes generally agree about safety characteristics of their facilities, and the PSC in nursing homes is significantly lower than that in hospitals. PSC assessment may be helpful in fostering comparisons across nursing home settings and professions, and identifying targets for interventions to improve patient safety. PMID:17142586

  4. Multi-center development and testing of a simulation-based cardiovascular assessment curriculum for advanced practice nurses.

    PubMed

    Jeffries, Pamela R; Beach, Michael; Decker, Sharon I; Dlugasch, Lucie; Groom, Jeffrey; Settles, Julie; O'Donnell, John M

    2011-01-01

    Cardiovascular assessment skills are deficient among advanced practice nursing students, and effective instructional methods to improve assessment skills are needed. The purpose of this study was to develop, implement, and evaluate outcomes of a cardiovascular assessment curriculum for advanced practice nurses at four institutions. Each institution used a one-group pre-to-post-intervention design. Educational interventions included faculty-led, simulation-based case presentations using the Harvey cardiopulmonary patient simulator (CPS), and independent learning sessions using the CPS and a multimedia, computer-based CD-ROM program. Outcome measures included a 31-item cognitive written exam, a 13-item skills checklist used in each of a three-station objective structured clinical exam, learner self-efficacy and satisfaction survey, instructor satisfaction and self-efficacy survey, and a participant logbook to record practice time using the self-learning materials. Thirty-six students who received the simulation-based training showed statistically significant pre-to-post-test improvement in cognitive knowledge and cardiovascular assessment skills. PMID:22029244

  5. Evaluation of the Penn Macy Initiative To Advance Academic Nursing Practice.

    ERIC Educational Resources Information Center

    Evans, Lois K.; Swan, Beth Ann; Lang, Norma E.

    2003-01-01

    In the Penn Macy Initiative, 21 nursing schools participated in summer institutes and follow-up consultations to refine practice. Evaluation data from participants' daily and postinstitute feedback, institutional self-evaluations, and comparison of school accomplishments identified critical indicators of progress in academic practice. A key…

  6. Pediatric Endocrinology Nurses Society

    MedlinePlus

    ... International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement ... PENS@kellencompany.com • Copyright © 2016 Pediatric Endocrinology Nursing Society • ALL RIGHTS RESERVED • Privacy Policy • Admin

  7. Certified nurse-midwife

    MedlinePlus

    ... laws. As with other advanced practice nurses, license requirements for CNMs can vary from state to state. ... national organization and all states have the same requirements for professional practice standards. Only graduates of nurse- ...

  8. Professional Behavior in Nursing.

    PubMed

    Kowalski, Karren

    2016-04-01

    Being clear about what constitutes professional behavior is a pathway to effective leadership. Not all nurses come out of educational programs with an understanding about what aspects of behavior signal true professionalism. This article uses the American Organization of Nurse Executives' Nurse Executive Competency for Processional Behavior to help professional development nurse faculty identify role modeling behavior and other aspects that new nurses can use to help them advance in their careers, while improving care to patients and families. PMID:27031029

  9. General practitioners and the independent contractor status

    PubMed Central

    Gray, D. J. Pereira

    1977-01-01

    Primary medical care can be provided either by a bureaucratic hierarchical organization or alternatively by independent contractors. Most members of the caring professions in medicine, nursing, and social work are employed in bureaucracies, whereas general medical practitioners, general dental practitioners, opticians, and pharmacists are independent contractors. The independent contractor status has recently been heavily attacked from within the medical and nursing professions, and also from outside. It has been suggested that contracting for services is an inappropriate and anomalous way of arranging medical care, which should now be stopped. However, this process of contracting for services can be analysed, using perspectives from some of the behavioural sciences, to reveal hidden depths in the independent contractor status which suggest that the provision of primary medical care is best carried out by independent contractors. PMID:616865

  10. National Association of Pediatric Nurse Practitioners

    MedlinePlus

    ... News Newsflash Events Twitter Babies With Zika-Related Microcephaly Fall Further Behind Average Milestones As They Grow ... 49 min ago STUDY: Babies with #Zika related microcephaly fall behind average milestones as they grow older. ...

  11. Online nurse practitioner education: Achieving student competencies.

    PubMed

    Distler, John W

    2015-11-15

    This review article will describe the methods used in a fully online NP program with curricular framework based on experiential and adult learning theories using problem-based learning. The focus is on faculty facilitation, preceptor preparation, student evaluation, and the development of engaging clinical partnerships. PMID:26474204

  12. The role of the nurse in advanced practice in bereavement care.

    PubMed

    Glass, B C

    1993-03-01

    The CNS may be instrumental in assisting patients, families, and staff in dealing effectively with loss and grief. This paper presents a review of theoretical and research literature examining theories and current research on grief. Physical and emotional responses to loss are discussed, and factors that influence the bereavement process are presented. The role of the CNS in facilitating grief resolution and in assisting the staff nurse to intervene appropriately with the bereaved is examined. PMID:8364832

  13. Using an academic-community partnership model and blended learning to advance community health nursing pedagogy.

    PubMed

    Ezeonwu, Mabel; Berkowitz, Bobbie; Vlasses, Frances R

    2014-01-01

    This article describes a model of teaching community health nursing that evolved from a long-term partnership with a community with limited existing health programs. The partnership supported RN-BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face-to-face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community-based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery. PMID:24720659

  14. Cardiovascular nursing in Israel.

    PubMed

    Blaer, Yosef; Rosenberg, Orit; Reisin, Leonardo

    2003-01-01

    Cardiovascular (CV) nursing as an entity in Israel dates back to 1952, when the nurses in Tel-Hashomer hospital took care of postoperative heart surgery patients. The first intensive cardiac care units (ICCUs) were established in 1971. In 1982, the first ICCU course was established in Tel-Hashomer hospital nursing school. Today, most of the nursing staff in Israels ICCUs are graduates of ICCU courses. The nurses professional society, the Society for Nursing of Israel, was established in 1947. In 1989 the Society for Advancement of Cardiac Nursing in Israel (SACN) was established. The main goals of the society were: the exchange of CV nursing knowledge, CV nursing research, CV nursing education in nursing schools, education of nurses in other departments in the care of the cardiac patient, and CV nursing education in the community. The CV nurse takes a large role in the total care of the cardiac patient, which includes rehabilitation within the hospital and in the ambulatory setting and coordination of nursing in national and international multicenter clinical trials. In collaboration with the Ministry of Health Nursing Division, Israeli CV nurses participate in national and international projects to: develop and upgrade nursing education; train new CV nurses; develop, review, and revise nursing protocols and guidelines; and establish new, more advanced ICCUs in underdeveloped areas within Israel and around the world. Our vision for the future development of CV nursing in Israel includes coordination and management roles in the hospital setting, and the establishment and management of home-care programs. PMID:12624572

  15. The intention of advanced practice registered nurses to remain in positions at family planning clinics serving low-income women.

    PubMed

    Cheng, An-Lin; Kelly, Patricia J; Carlson, Kimberly; Witt, Jacki

    2014-01-01

    Federally funded Title X Family Planning Clinics are critical safety nets for reproductive health services in which advanced practice nurses (APRNs) provide the majority of care. The goal of this study was to identify factors affecting APRN's intention to remain in positions at these clinics. An Internet-administered survey was completed by 406 APRNs working in Title X clinics. The survey, based on a causal model of retention adapted for APRN practice, included 10 factors. Factor significance and model selection criteria were used to determine model fit. Intention to remain in current positions was associated with greater family responsibilities and lower levels of involvement in professional associations. Less routinization, more integration, and a greater sense of distributive justice were significant causal paths to job satisfaction (a significant mediator for intention to remain). Results provide Title X administrators information that can guide them in policy development to maximize APRN retention. PMID:24503318

  16. A phenomenological investigation into the role of the clinical nurse specialist.

    PubMed

    Bousfield, C

    1997-02-01

    This research study adopts a phenomenological approach to investigate how a group of clinical nurse specialists think and experience their role. It reviews the literature on the clinical nurse specialist from 1943, when Frances Reiter first coined the phrase "nurse clinician', to the present time, when individuals are committed to a range of initiatives aimed at improving the quality of the British National Health Service and patient care. The study investigates and analyses their views and conveys the personal meaning of clinical nurse specialists' "lived experience' in the role. Findings of the study suggest that clinical nurse specialists are experienced practitioners who strive to be in positions in which they influence patient care and utilize advanced knowledge, expertise and leadership skills in a multidisciplinary environment. The literature proposes that for the role to be recognized and accepted individuals need to be educated at an advanced level, demonstrate practice based in research and have a firm base as a specialist in nursing. The findings clearly suggest that while the role of the clinical nurse specialist can be influenced in a positive manner by the organization and guided by the individual, it is important to acknowledge that the role is in a transitional phase. Finally, the research suggests the importance of establishing a clear role definition in a creative and supportive environment allowing for autonomy, professional growth and the development of individuals as clinically competent nurse specialists. PMID:9043997

  17. Constructing Practitioner Research

    ERIC Educational Resources Information Center

    Shaw, Ian; Lunt, Neil

    2012-01-01

    The authors draw on a case study evaluation of two networked cohorts of practitioner-researchers in a children's services national social work agency in one of the home countries of the United Kingdom. The aim of the present study was to understand the meaning of practitioner research for social work professionals through an exploration of how…

  18. An Analysis of Canadian Psychiatric Mental Health Nursing through the Junctures of History, Gender, Nursing Education, and Quality of Work Life in Ontario, Manitoba, Alberta, and Saskatchewan

    PubMed Central

    2013-01-01

    A society that values mental health and helps people live enjoyable and meaningful lives is a clear aspiration echoed throughout our Canadian health care system. The Mental Health Commission of Canada has put forth a framework for a mental health strategy with goals that reflect the virtue of optimal mental health for all Canadians (Mental Health Commission Canada, 2009). Canadian nurses, the largest group of health care workers, have a vital role in achieving these goals. In Canada, two-thirds of those who experience mental health problems do not receive mental health services (Statistics Canada, 2003). Through a gendered, critical, and sociological perspective the goal of this paper is to further understand how the past has shaped the present state of psychiatric mental health nursing (PMHN). This integrative literature review offers a depiction of Canadian PMHN in light of the intersections of history, gender, education, and quality of nursing work life. Fourteen articles were selected, which provide a partial reflection of contemporary Canadian PMHN. Findings include the association between gender and professional status, inconsistencies in psychiatric nursing education, and the limitations for Canadian nurse practitioners to advance the role of the psychiatric mental health nurse practitioner. PMID:23710367

  19. Different Voices in Nurse Education

    ERIC Educational Resources Information Center

    Stokes, Gilian

    2007-01-01

    Nurse educators, like many of their health care professional colleagues, frequently face moral dilemmas when they identify a student as presenting an unacceptable risk to public safety. In this situation, the statutory requirement of nurse educators to protect the public, under the Health Practitioners Competence Assurance Act (2003), competes…

  20. The Senior Living Lab: an example of nursing leadership.

    PubMed

    Riva-Mossman, Susie; Kampel, Thomas; Cohen, Christine; Verloo, Henk

    2016-01-01

    The Senior Living Lab (SLL) is dedicated to the care of older adults and exemplifies how nursing leadership can influence clinical practice by designing research models capable of configuring interdisciplinary partnerships with the potential of generating innovative practices and better older patient outcomes. Demographic change resulting in growing numbers of older adults requires a societal approach, uniting stakeholders in social innovation processes. The LL approach is an innovative research method that values user perceptions and participation in the cocreation of new products and services. The SLL is crafting a platform responsive to change. It is a learning organization facilitating community-based participatory research methods in the field. Advanced nurse practitioners are well positioned to lead the way forward, fostering interdisciplinary academic collaborations dedicated to healthy aging at home. The SLL demonstrates how nursing science is taking the lead in the field of social innovation. PMID:27013869

  1. The Senior Living Lab: an example of nursing leadership

    PubMed Central

    Riva-Mossman, Susie; Kampel, Thomas; Cohen, Christine; Verloo, Henk

    2016-01-01

    The Senior Living Lab (SLL) is dedicated to the care of older adults and exemplifies how nursing leadership can influence clinical practice by designing research models capable of configuring interdisciplinary partnerships with the potential of generating innovative practices and better older patient outcomes. Demographic change resulting in growing numbers of older adults requires a societal approach, uniting stakeholders in social innovation processes. The LL approach is an innovative research method that values user perceptions and participation in the cocreation of new products and services. The SLL is crafting a platform responsive to change. It is a learning organization facilitating community-based participatory research methods in the field. Advanced nurse practitioners are well positioned to lead the way forward, fostering interdisciplinary academic collaborations dedicated to healthy aging at home. The SLL demonstrates how nursing science is taking the lead in the field of social innovation. PMID:27013869

  2. The Doctor of Nursing Practice: defining the next steps.

    PubMed

    Grey, Margaret

    2013-08-01

    The purpose of this article is to summarize the previous articles in this special issue of the Journal of Nursing Education that are based on the Committee on Institutional Cooperation's Dean's Conference on the Doctor of Nursing Practice (DNP) and to identify areas of consensus, as well as areas of controversy. Areas of consensus include the high level of interest in DNP programs and the intent to expand the role of the advanced practice nurse to population health, policy, and leadership. Areas of controversy include the nature of the DNP product, the definition of clinical experiences, the nature of the capstone project, the outcomes of these new practitioners, and the impact on schools. Suggestions for achieving higher levels of consensus, including the need for respective, inclusive dialogue, are provided. PMID:23875725

  3. Healthcare practitioners' personal and professional values.

    PubMed

    Moyo, Mpatisi; Goodyear-Smith, Felicity A; Weller, Jennifer; Robb, Gillian; Shulruf, Boaz

    2016-05-01

    Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them into a single framework using Schwartz's values model. We searched Medline, Embase, PsycINFO, CINAHL and ERIC databases for articles on personal and professional values of healthcare practitioners and students. We extracted values from included papers and synthesized them into a single framework using Schwartz's values model. We summarised the framework within the context of healthcare practice. We identified 128 values from 50 included articles from doctors, nurses and allied health professionals. A new framework for the identified values established the following broad healthcare practitioner values, corresponding to Schwartz values (in parentheses): authority (power); capability (achievement); pleasure (hedonism); intellectual stimulation (stimulation); critical-thinking (self-direction); equality (universalism); altruism (benevolence); morality (tradition); professionalism (conformity); safety (security) and spirituality (spirituality). The most prominent values identified were altruism, equality and capability. This review identified a comprehensive set of personal and professional values of healthcare practitioners. We integrated these into a single framework derived from Schwartz's values model. This framework can be used to assess personal and professional values of healthcare practitioners across professional groups, and can help improve practitioners' awareness of their values so they can negotiate more patient-centred decisions. A common values framework across professional groups can support shared education strategies on values and help improve interprofessional teamwork and decision-making. PMID:26215664

  4. Practitioner and student latex exposure and allergy.

    PubMed

    Amin, A; Palenick, C J; Burke, F J

    1996-01-01

    Greater application of universal precautions has increased practitioner exposure to chemicals present in personal protective equipment. Of prime concern is the latex present in examination and surgical gloves. A survey concerning latex exposure, allergies, and handwashing was administered to three advanced classes of dental students and was sent to 300 private practitioners in Central Indiana. Results indicate that adverse skin reactions to latex start while in dental school. Problems due to latex gloves were reported by 18.6 percent of the students. Student handwashing materials and methods were adequate, except for inadequate washing time. Adverse skin reactions were reported by 24.1 percent of practitioners wearing latex gloves. Two handwashing problems were noted--inadequate washing time and the common use of water instead of an antimicrobial soap after glove removal. Both students and practitioners reported relatively high levels of personal and family histories of allergy to a variety of sources. PMID:9517336

  5. Physician Assistant and Advance Practice Nurse Care in Hospital Outpatient Departments: United States, 2008-2009

    MedlinePlus

    ... Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard Technical Notes Other Publications Advance Data From Vital and ... Vital Statistics of the United States: 1890-1938 Technical Appendices Miscellaneous Publications National Conference on Health Statistics ...

  6. Nursing and Professionalization: On the Road to Recovery.

    ERIC Educational Resources Information Center

    Rosenfeld, Peri

    1986-01-01

    The author discusses features that define a profession, barriers to high status for nurses, nursing as a traditionally female occupation, and nurses' responsibility to advance nursing as a profession. (CT)

  7. “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area

    PubMed Central

    Devik, Siri Andreassen; Hellzen, Ove; Enmarker, Ingela

    2015-01-01

    Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients’ strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context. PMID:26362533

  8. "Picking up the pieces" - Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area.

    PubMed

    Devik, Siri Andreassen; Hellzen, Ove; Enmarker, Ingela

    2015-01-01

    Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients' strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context. PMID:26362533

  9. Meeting the learning needs of AMU nurses through collaborative working.

    PubMed

    Mitchell, Laura; Bury, Emily; Leonard, Orla

    The 'Nursing the Acute Medical Patient' level 8 continuing professional development (CPD) programme was developed to support the learning needs of staff nurses within an acute medical unit (AMU) in an Irish academic teaching hospital. Within this recently-established AMU, the nursing team was challenged by the complexity of clinical presentations. At the outset of the programme, over half of nurses employed in the AMU had less than 5 years' clinical experience. The 6-month CPD programme was developed collaboratively by the registered nurse tutor, advanced nurse practitioner candidate (trainee) in acute medicine and the clinical facilitator. The programme was accredited by University College Dublin, and awarded 10 European Credit Transfer System credits. Clinical competency assessment had to be completed in order to pass the programme and was facilitated by the development of the Comprehensive Clinical Learning Objective Performance Evaluation (CLOPE) document. The programme was positively evaluated by students and the wider multidisciplinary team. It has made a significant contribution to both staff development and the delivery of evidence-based care in the AMU. PMID:27019168

  10. Development and evaluation of a psychoeducation practitioner training program (PPTP).

    PubMed

    Matsuda, Mitsunobu; Kono, Ayumi

    2015-08-01

    The objective of this study was to develop a psychoeducation practitioner training program (PPTP) and to evaluate its usefulness with regard to nursing competencies (knowledge, self-efficacy, attitude, motivation, skills). A mixed-method research design was applied in this study. Some of the quantitative data were a one-group pretest-posttest study. Forty nurses participated in the PPTP, of whom 38 (17 men and 21 women) completed a 2-consecutive-day curriculum (dropout rate: 5%). The PPTP significantly improved nurses' knowledge of, self-efficacy for, and attitude toward psychoeducation. However, the program did not lead to the acquisition of psychoeducational skills. PMID:26165976

  11. Regulatory Advances in 11 Sub-Saharan Countries in Year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC).

    PubMed

    Dynes, Michelle; Tison, Laura; Johnson, Carla; Verani, Andre; Zuber, Alexandra; Riley, Patricia L

    2016-01-01

    Sub-Saharan Africa carries the greatest burden of the HIV pandemic. Enhancing the supply and use of human resources through policy and regulatory reform is a key action needed to improve the quality of HIV services in this region. In year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC), a President's Emergency Plan for AIDS Relief initiative, 11 country teams of nursing and midwifery leaders ("Quads") received small grants to carry out regulatory improvement projects. Four countries advanced a full stage on the Regulatory Function Framework (RFF), a staged capability maturity model used to evaluate progress in key regulatory functions. While the remaining countries did not advance a full stage on the RFF, important gains were noted. The year-3 evaluation highlighted limitations of the ARC evaluation strategy to capture nuanced progress and provided insight into how the RFF might be adapted for future use. PMID:27086189

  12. Regulatory Advances in 11 Sub-Saharan Countries in Year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC)

    PubMed Central

    Dynes, Michelle; Tison, Laura; Johnson, Carla; Verani, Andre; Zuber, Alexandra; Riley, Patricia L.

    2016-01-01

    Sub-Saharan Africa carries the greatest burden of the HIV pandemic. Enhancing the supply and use of human resources through policy and regulatory reform is a key action needed to improve the quality of HIV services in this region. In year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC), a President’s Emergency Plan for AIDS Relief initiative, 11 country teams of nursing and midwifery leaders (“Quads”) received small grants to carry out regulatory improvement projects. Four countries advanced a full stage on the Regulatory Function Framework (RFF), a staged capability maturity model used to evaluate progress in key regulatory functions. While the remaining countries did not advance a full stage on the RFF, important gains were noted. The year-3 evaluation highlighted limitations of the ARC evaluation strategy to capture nuanced progress and provided insight into how the RFF might be adapted for future use. PMID:27086189

  13. Information-Seeking Activity of Rural Health Practitioners.

    ERIC Educational Resources Information Center

    Matsuda, Sandra; Donaldson, Joe F.

    The information-seeking activity (ISA) of 16 rural health practitioners (occupational, physical, and respiratory therapists; radiological technologists; speech/language pathologists; and nurses) was explored using qualitative methods of participant observation, document collection, and in-depth interviews. Field notes and documents were collected…

  14. Scheme aims to ensure students become competent practitioners.

    PubMed

    Walsh, Kirsty

    2015-08-26

    Thank you for publishing my article on the programme that Central Manchester NHS Foundation Trust has developed to provide additional preparatory support to enable third-year nursing and midwifery students to become competent practitioners, at the point of registration (careers, August 19). However, there were some changes made during editing that I would like to correct. PMID:26307314

  15. NURSE-LED INTERVENTION TO IMPROVE SURROGATE DECISION MAKING FOR PATIENTS WITH ADVANCED CRITICAL ILLNESS

    PubMed Central

    White, Douglas B.; Cua, Sarah Martin; Walk, Roberta; Pollice, Laura; Weissfeld, Lisa; Hong, Seoyeon; Landefeld, C. Seth; Arnold, Robert M.

    2013-01-01

    Background Problems persist with surrogate decision making in intensive care units, leading to distress for surrogates and treatment that may not reflect patients’ values. Objectives To assess the feasibility, acceptability, and perceived effectiveness of a multifaceted, nurse-led intervention to improve surrogate decision making in intensive care units. Study Design A single-center, single-arm, interventional study in which 35 surrogates and 15 physicians received the Four Supports Intervention, which involved incorporating a family support specialist into the intensive care team. That specialist maintained a longitudinal relationship with surrogates and provided emotional support, communication support, decision support, and anticipatory grief support. A mixed-methods approach was used to evaluate the intervention. Results The intervention was implemented successfully in all 15 patients, with a high level of completion of each component of the intervention. The family support specialist devoted a mean of 48 (SD 36) minutes per day to each clinician-patient-family triad. All participants reported that they would recommend the intervention to others. At least 90% of physicians and surrogates reported that the intervention (1) improved the quality and timeliness of communication, (2) facilitated discussion of the patient’s values and treatment preferences, and (3) improved the patient-centeredness of care. Conclusions The Four Supports Intervention is feasible, acceptable, and was perceived by physicians and surrogates to improve the quality of decision making and the patient-centeredness of care. A randomized trial is warranted to determine whether the intervention improves patient, family, and health system outcomes. PMID:23117903

  16. Incorporating Peplau's Theory of Interpersonal Relations to Promote Holistic Communication Between Older Adults and Nursing Students.

    PubMed

    Deane, William H; Fain, James A

    2016-03-01

    With the increased life expectancy, older adults will interact with multiple health care providers to manage acute and chronic conditions. These interactions include nursing students who use various health care settings to meet the clinical practicum requirements of their programs. Nursing faculty are charged with facilitating students' learning throughout the program from basic human needs, to holistic communication, to advanced medical surgical concepts. Despite educating students on holistic communication, there remains a lack of a reliable framework to undertake the task of teaching holistic communication skills. Nursing students preparing to function as licensed practitioners need to develop appropriate knowledge to holistically care for older adults. The purpose of this article is to examine Hildegard Peplau's interpersonal relations theory as a framework to assist nursing students to understand holistic communication skills during their encounters with older adults. Peplau's theory provides nursing a useful set of three interlocking and oftentimes overlapping working phases for nurses' interaction with patients in the form of the nurse-patient relationship. Nursing education could adopt the three phases of Peplau's interpersonal relations theory to educate students on holistically communicating with older adults. PMID:25854267

  17. School Nurse Intention to Pursue Higher Education

    ERIC Educational Resources Information Center

    Broussard, Lisa; White, Debra

    2014-01-01

    In 2011, the Institute of Medicine recommended that 80% of the nurses possess a minimum of a bachelor of science in nursing by 2020 and double the number of doctorally prepared nurses. This has prompted a significant number of registered nurses to advance their educational level. School nurses in Louisiana are not required to have a…

  18. Nursing Training Act of 1975. Fact Sheets.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Div. of Nursing.

    The Nursing training Act of 1975 revises and extends the nursing training authorities provided under Title VIII of the Public Health Service Act for a three-year period, thus providing aid to nursing training through September 30, 1978. It provides two new, separate authorities for the support of Advanced Nursing Training and Nursing Practitioner…

  19. Expanding clinical roles for nurses to realign the global health workforce with population needs: a commentary.

    PubMed

    Maier, Claudia B; Aiken, Linda H

    2016-01-01

    Many countries, including Israel, face health workforce challenges to meet the needs of their citizens, as chronic conditions increase. Provider shortages and geographical maldistribution are common. Increasing the contribution of nurse practitioners and other advanced practice nursing roles through task-shifting and expansion of scope-of-practice can improve access to care and result in greater workforce efficiency. Israel and many other countries are introducing reforms to expand nurses' scope-of-practice. Recent international research offers three policy lessons for how countries just beginning to implement reforms could bypass policy barriers to implementation. First, there is substantial evidence on the equivalence in quality of care, patient safety and high consumer acceptance which should move policy debates from if to how to effectively implement new roles in practice. Second, regulatory and finance policies as well as accessible advanced education are essential to facilitate realignment of roles. Third, country experience suggests that advanced practice roles for nurses improve the attractiveness of nursing as a career thus contributing to solving nursing shortages rather than exacerbating them. Designing enabling policy environments and removing barriers will gain in relevance in the future as the demand for high-quality, patient-centered care is increasing. PMID:27280014

  20. Impact of Video Laryngoscopy on Advanced Airway Management by Critical Care Transport Paramedics and Nurses Using the CMAC Pocket Monitor

    PubMed Central

    Boehringer, Bradley; Choate, Michael; Hurwitz, Shelley; Tilney, Peter V. R.; Judge, Thomas

    2015-01-01

    Accurate endotracheal intubation for patients in extremis or at risk of physiologic decompensation is the gold standard for emergency medicine. Field intubation is a complex process and time to intubation, number of attempts, and hypoxia have all been shown to correlate with increases in morbidity and mortality. Expanding laryngoscope technology which incorporates active video, in addition to direct laryngoscopy, offers providers improved and varied tools to employ in management of the advanced airway. Over a nine-year period a helicopter emergency medical services team, comprised of a flight paramedic and flight nurse, intended to intubate 790 patients. Comparative data analysis was performed and demonstrated that the introduction of the CMAC video laryngoscope improved nearly every measure of success in airway management. Overall intubation success increased from 94.9% to 99.0%, first pass success rates increased from 75.4% to 94.9%, combined first and second pass success rates increased from 89.2% to 97.4%, and mean number of intubation attempts decreased from 1.33 to 1.08. PMID:26167501

  1. Addressing Spirituality Within the Care of Patients at the End of Life: Perspectives of Patients With Advanced Cancer, Oncologists, and Oncology Nurses

    PubMed Central

    Phelps, Andrea C.; Lauderdale, Katharine E.; Alcorn, Sara; Dillinger, Jennifer; Balboni, Michael T.; Van Wert, Michael; VanderWeele, Tyler J.; Balboni, Tracy A.

    2012-01-01

    Purpose Attention to patients' religious and spiritual needs is included in national guidelines for quality end-of-life care, but little data exist to guide spiritual care. Patients and Methods The Religion and Spirituality in Cancer Care Study is a multi-institution, quantitative-qualitative study of 75 patients with advanced cancer and 339 cancer physicians and nurses. Patients underwent semistructured interviews, and care providers completed a Web-based survey exploring their perspectives on the routine provision of spiritual care by physicians and nurses. Theme extraction was performed following triangulated procedures of interdisciplinary analysis. Multivariable ordinal logistic regression models assessed relationships between participants' characteristics and attitudes toward spiritual care. Results The majority of patients (77.9%), physicians (71.6%), and nurses (85.1%) believed that routine spiritual care would have a positive impact on patients. Only 25% of patients had previously received spiritual care. Among patients, prior spiritual care (adjusted odds ratio [AOR], 14.65; 95% CI, 1.51 to 142.23), increasing education (AOR, 1.26; 95% CI, 1.06 to 1.49), and religious coping (AOR, 4.79; 95% CI, 1.40 to 16.42) were associated with favorable perceptions of spiritual care. Physicians held more negative perceptions of spiritual care than patients (P < .001) and nurses (P = .008). Qualitative analysis identified benefits of spiritual care, including supporting patients' emotional well-being and strengthening patient-provider relationships. Objections to spiritual care frequently related to professional role conflicts. Participants described ideal spiritual care to be individualized, voluntary, inclusive of chaplains/clergy, and based on assessing and supporting patient spirituality. Conclusion Most patients with advanced cancer, oncologists, and oncology nurses value spiritual care. Themes described provide an empirical basis for engaging spiritual issues

  2. Federal government initiates National Practitioner Data Bank.

    PubMed

    Bodenhorn, K; Hardy-Havens, D

    1989-01-01

    The formulation of the data bank will require the exchange of data and merging of information from a number of sources. The development and the implementation of this computerized system will be the work of the UNISYS Corporation in concert with the Bureau of Health Professions' Office of Quality Assurance, a part of the Health Resources and Services Administration, HHS. The assurance of the quality of the data on each nurse--correct, up-to-date, etc.--is the responsibility of the parties reporting to the data bank. In addition, each and every pediatric nurse practitioner will need to become knowledgeable regarding the data base and periodically ascertain that the information regarding himself or herself is correct. As additional information is received on the process by which you can monitor the bank's data on you, it will be published. PMID:2724023

  3. Value of intensified nursing

    PubMed Central

    Frank, Wilhelm; Konta, Brigitte; Prusa, Nina; Raymann, Cornelia

    2006-01-01

    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. From the thin literature to this topic a selection of predetermined topics was analysed where at least two articles with a sufficient high methodical quality were available. The selected topic groups were: „Infant and paediatric nursing", "gerontology" and "oncology". Generally the five publications concerning infant and paediatric nursing could conclusive show a benefit of intensified nursing. Further research is still needed to prove intensified nursing care. Two publications could be found to the gerontological intensified nursing; both used an extended nursing model and an enlarged use of resources. Both studies demonstrated a measurable success in the applied parameters. Two studies also could be analysed in the oncological field in which successes were also provable by the applied parameters. The success was given especially in a higher patient satisfaction, one study showed an improved scheduling (time planning) of nurses. There was not one article concerning economic questions of intensified nursing care. It has to be taken into account that the financial resources have to be used effectively also in nursing nowadays. It has to be assumed that the costs are driven by increased use of resources. Savings can be achieved, however, in the form of avoided therapies and days in hospital by intensified nursing. The intensified nursing can be considered as similar cost-effective as conventional models of nursing. Ethically it is necessary to consider that the possibilities of

  4. Nursing in Malawi: nursing theory in the movement to professionalize nursing.

    PubMed

    Bultemeier, Kaye I

    2012-04-01

    Nursing in Malawi has been predominately a technical trade and only recently has begun the transition to a profession with autonomy and advanced degree preparation. Nursing theories provide a framework for the evolution of nursing to an independent profession. Theories provide a means for the articulation of the nursing role to other members of the healthcare team including consumers. Healthcare and human needs are basic and the guidance provided by nursing theories, including Nightingale's, gives language and structure to the education of nurses as the profession moves into advanced practice in a developing country. PMID:22451639

  5. Training Career Practitioners

    ERIC Educational Resources Information Center

    Niles, Spencer G.; Engels, Dennis; Lenz, Janet

    2009-01-01

    This article summarizes 8 presentations from Group 8 on the theme "Training of Researchers and Practitioners," which were part of the 2007 joint symposium of the International Association for Educational and Vocational Guidance, Society for Vocational Psychology, and National Career Development Association held in Padua, Italy. Three themes…

  6. Resources for the Practitioner.

    ERIC Educational Resources Information Center

    Hackeling, Joan, Comp.

    2003-01-01

    This list of print and electronic resources is designed to act as a springboard to assist practitioners in finding information to start implementing sustainability efforts on their campuses. The resources are listed in the following categories: general, international, K-12, policy/partnerships, campus environmental assessments, green building,…

  7. A Practitioner's Commentary

    ERIC Educational Resources Information Center

    McVey, Richard

    2010-01-01

    I have been delivering the flexible family work approaches outlined in this supplement at Aquarius for the past 8 years. Aquarius is an English Midlands-based addictions charity working with people who have problems with alcohol, drugs, or gambling and supporting their family members/concerned others. I have been a practitioner participating in…

  8. Practitioner Evaluation at Work

    ERIC Educational Resources Information Center

    Shaw, Ian; Faulkner, Alex

    2006-01-01

    Practitioner involvement in evaluation, research, development, and other forms of disciplined inquiry that are small scale, local, grounded, and carried out by professionals who directly deliver those services is embraced across a wide range of professions as essential to good professional practice. However, little is known about the character,…

  9. Conceptualizing the Practitioner Doctorate

    ERIC Educational Resources Information Center

    Lester, Stan

    2004-01-01

    Professional doctorates now form an established alternative to the PhD, both in the UK and Australia. Recent developments have seen the emergence of what some commentators call second-generation doctorates, more closely geared to the needs of professional practitioners. The current culmination of this development is represented by what might be…

  10. Advanced Practice Registered Nurses: Gateway to Screening for Bipolar Disorder in Primary Care

    PubMed Central

    Kriebel-Gasparro, Ann Marie

    2016-01-01

    Objective: The goal of this mixed methods descriptive study was to explore Advanced Practice Registered Nurses’ (APRNs’) knowledge of bipolar disorder (BPD) and their perceptions of facilitators and barriers to screening patients with known depression for BPD. Methods: A mixed method study design using surveys on BPD knowledge and screening practices as well as focus group data collection method for facilitators and barriers to screening. Results: 89 APRNs completed the survey and 12 APRNs participated in the focus groups. APRNs in any practice setting had low knowledge scores of BPD. No significant differences in screening for BPD for primary and non primary care APRNs. Qualitative findings revealed screening relates to tool availability; time, unsure of when to screen, fear of sigma, symptoms knowledge of BPD, accessible referral system, personal experiences with BPD, and therapeutic relationships with patients. Conclusion: Misdiagnosis of BPD as unipolar depression is common in primary care settings, leading to a long lag time to optimal diagnosis and treatment. The wait time to diagnosis and treatment could be reduced if APRNs in primary care settings screen patients with a diagnosis of depression by using validated screening tools. These results can inform APRN practice and further research on the effectiveness of screening for reducing the morbidity and mortality of BPDs in primary care settings; underscores the need for integration of mental health care into primary care as well as the need for more APRN education on the diagnosis and management of bipolar disorders. PMID:27347256

  11. AACN White Paper: Distance Technology in Nursing Education.

    ERIC Educational Resources Information Center

    American Association of Colleges of Nursing, Washington, DC.

    Technological advances have increased opportunities for nursing education, affording increased collaboration among nursing faculties in teaching, practice, and research. In an era when nurses are in demand, technology may help the profession educate nurses, prepare future educators, and advance the science of nursing. Several factors should be…

  12. Is provider type associated with cancer screening and prevention: advanced practice registered nurses, physician assistants, and physicians

    PubMed Central

    2014-01-01

    Background Physician recommendations for cancer screening and prevention are associated with patient compliance. However, time constraints may limit physicians’ ability to provide all recommended preventive services, especially with increasing demand from the Affordable Care Act in the United States. Team-based practice that includes advanced practice registered nurses and physician assistants (APRN/PA) may help meet this demand. This study investigates the relationship between an APRN/PA visit and receipt of guideline-consistent cancer screening and prevention recommendations. Methods Data from the 2010 National Health Interview Survey were analyzed with multivariate logistic regression to assess provider type seen and receipt of guideline-consistent cancer screening and prevention recommendations (n = 26,716). Results In adjusted analyses, women who saw a primary care physician (PCP) and an APRN/PA or a PCP without an APRN/PA in the past 12 months were more likely to be compliant with cervical and breast cancer screening guidelines than women who did not see a PCP or APRN/PA (all p < 0.0001 for provider type). Women and men who saw a PCP and an APRN/PA or a PCP without an APRN/PA were also more likely to receive guideline consistent colorectal cancer screening and advice to quit smoking and participate in physical activity than women and men who did not see a PCP or APRN/PA (all p < 0.01 for provider type). Conclusions Seeing a PCP alone, or in conjunction with an APRN/PA is associated with patient receipt of guideline-consistent cancer prevention and screening recommendations. Integrating APRN/PA into primary care may assist with the delivery of cancer prevention and screening services. More intervention research efforts are needed to explore how APRN/PA will be best able to increase cancer screening, HPV vaccination, and receipt of behavioral counseling, especially during this era of healthcare reform. PMID:24685149

  13. Nursing informatics competences still challenging nurse educators.

    PubMed

    Rajalahti, Elina; Saranto, Kaija

    2012-01-01

    In recent years nursing documentation has been one of the most important development areas of nursing informatics (NI) in Finland. The purpose of this study is to describe the development of the nurse educators' competences in nursing documentation during a project called eNNI. The eNNI project (2008-2010) was a cooperative project by nurse educators and working life experts. The goal of the project was to implement the national documentation model and thereby improve operational processes at workplaces. The study includes pre- and post-test questioning of NI applications with a web-based questionnaire (n=136). The data were analyzed with distribution, cross-tabulations and average tests and descriptive statistic multivariate method. According to the results, the ICT skills of the nurse educators were good at the end of the project, and they had good information literacy competence. On the other hand, their advanced NI skills left room for improvement. PMID:22874332

  14. Brexit: what does it mean for the future of UK nursing?

    PubMed

    Hurlow, Jennifer

    2016-07-28

    Following the result of the UK referendum on membership of the European Union, Jennifer Hurlow, a Nurse Practitioner from the USA, considers how this may shape nursing in the coming years. PMID:27467649

  15. An outcome-based evaluation of nursing competency of baccalaureate senior nursing students in Taiwan.

    PubMed

    Hsieh, Suh-Ing; Hsu, Li-Ling

    2013-12-01

    Limited literature is available for demographic and learning factors related to performance of baccalaureate nursing students. The study aimed at examining mean differences in nursing competency between the first week and the sixth week of a nursing clinical practicum as well as evaluating mean differences in nursing competency by demographic and learning factors at the sixth week of a nursing clinical practicum controlling for baseline scores of nursing competency. A comparative study design was conducted using the competency inventory for baccalaureate senior nursing students based on learning outcomes. Participants were surveyed at the first week and the sixth week of a nursing practicum with 95% mean response rate. Paired t test was used to compare within-subjects differences in mean nursing competency. ANCOVA and Kruskal-Wallis test, and Mann-Whitney U test were conducted to compare between-subjects differences in mean nursing competency. There are significant mean differences in nursing competency in general clinical skills, lifelong learning, clinical biomedical science, caring, and critical thinking and reasoning between the 1st week and the 6th week of nursing practicum. Likewise, type of nursing program, prior schooling, type of nursing license, interest in nursing, and extracurricular activity experience were significantly related to mean total nursing competency. Similarly, demographic attributes (location of school, type of nursing program, prior schooling, type of nursing license, a family member working as a medical practitioner or a nurse, interest in nursing, attributes of preferred workplace after college) and learning factors (extracurricular activity experience, played an active role in classroom discussions and asked questions, academic class rank, and English grade, clinical biomedical science, nursing science, and nursing practicum) were significantly related to six-subscale scores of nursing competency. There are mean differences in nursing

  16. [Mental health support for nurses].

    PubMed

    Fukushima, Yoshie

    2012-01-01

    Burnout specific to human service workers has been reported in the U.S. in the 1970s. Since then, such burnout has become widely known and the mental health of nurses has attracted attention. Stressors in the work environment and complexity have increased with advancement in increasingly complicated medical care. One of the major roles of a psychiatric liaison nurse is to provide support to improve the mental health of nurses. In our hospital, a psychiatric liaison nurse has a staff position under the direct supervision of the director of the nursing department but operates outside the chain of command. A psychiatric liaison nurse is not involved in the performance review of nurses. Thus, the nursing staff and the nursing manager can discuss their problems with the psychiatric liaison nurse without risks. Psychiatric liaison nurses provide support as counselors through individual and group interviews so that nurses can become re-energized about their work. In addition, psychiatric liaison nurses provide consultations and education. They perform coordination function to organize an environment to promote consultations regarding nurse support to the staff nurses and the nursing manager and to promote support by supervisors. For support after reinstatement of a nurse following a medical leave, it is particularly important to work with not only the individual nurse but also the entire nursing team. In our hospital, newly graduated nurses are given the GHQ-28 after one month of employment to assess the support they might need. In our study, nurses with high risks were divided into a group with a score of at least 6 points but less than 10 points and a group with a score of at least 10 points. The group with at least 10 points had significantly higher rates of leave of absence and resignation. Thus, early intervention was thought to be necessary in newly graduated nurses with a score of at least 10 points in the GHQ. PMID:22712205

  17. Preparing Culturally Competent Practitioners.

    ERIC Educational Resources Information Center

    St. Clair, Anita; McKenry, Leda

    1999-01-01

    Compared to 120 controls, 80 nursing students participating in international clinical-immersion experiences showed a significant increase in cultural self-efficacy and awareness, ability to overcome ethnocentrism, and ability to integrate patients' cultural beliefs into health-care practices. (SK)

  18. Consistencies and Inconsistencies in Nurses' Ethical Reasoning.

    ERIC Educational Resources Information Center

    Lawrence, Jeanette A.; Helm, Ann

    1987-01-01

    Examines inconsistencies in individual nurses' decisions about ethical situations and their justifications in the light of changes due to contemporary feminism and professionalization of the nursing role. Suggests empirical identification of ambiguities identified by practitioners be added as a component of professional education. (Author/DH)

  19. Framework for analyzing supply and demand for specialist and advanced practice registered dietitians.

    PubMed

    O'Sullivan Maillet, Julie; Brody, Rebecca A; Skipper, Annalynn; Pavlinac, Jessie M

    2012-03-01

    The number of credentialed dietetics specialists--approximately 15% of the profession--is proportionately higher than those in other allied health and nursing professions. Credentialed specialists seem to receive greater compensation earlier in their career, but this advantage neutralizes as length of time in the profession increases. A larger proportion of younger registered dietitians (RDs) are specialists, which may mean an increase in supply of specialists in the future. There is considerable interest in creation of health promotion and foodservice management credentials. Consideration should be given to collaborating with other organizations to explore new models of recognition or credentialing for narrow areas of focus. Creating a methodology that can differentiate the tasks and approaches to practice that are unique to advanced practitioners compared with specialists has been a challenge. Prior research has not succeeded in identifying the differences in what advanced practitioners do. Future research to isolate advanced practice must take practice approach into account. A new, research-based, credential for advanced practitioners is possible, or a recognition program for advanced practice RDs could be considered. Precise supply and demand for specialty and advanced practice RDs cannot be measured. Thus, in this technical article, the authors share the available information regarding supply and demand with regard to dietetics specialists and advanced practitioners. It seems there are distinctions among the various levels of practice and recognition of their value to the profession and to the health of the public. PMID:22709861

  20. Child health nurses in the Solomon Islands: lessons for the Pacific and other developing countries

    PubMed Central

    2012-01-01

    Objectives To understand the roles of nurses with advanced training in paediatrics in the Solomon Islands, and the importance of these roles to child health. To understand how adequately equipped child health nurses feel for these roles, to identify the training needs, difficulties and future opportunities. Design Semi-structured interviews. Settings Tertiary hospital, district hospitals and health clinics in the Solomon Islands. Participants Twenty-one paediatric nurses were interviewed out of a total of 27 in the country. Results All nurses were currently employed in teaching, clinical or management areas. At least one or two nurses were working in each of 7 of the 9 provinces; in the two smaller provinces there were none. Many nurses were sole practitioners in remote locations without back-up from doctors or other experienced nurses; all had additional administrative or public health duties. Different types of courses were identified: a residential diploma through the University of Papua New Guinea or New Zealand and a diploma by correspondence through the University of Sydney. Conclusions Child health nurses in the Solomon Islands fulfill vital clinical, public health, teaching and administrative roles. Currently they are too few in number, and this is a limiting factor for improving the quality of child health services in that country. Current methods of training require overseas travel, or are expensive, or lack relevance, or remove nurses from their work-places and families for prolonged periods of time. A local post-basic child health nursing course is urgently needed, and models exist to achieve this. PMID:23171144