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Sample records for nurse practitioner workforce

  1. The acute care nurse practitioner in Ontario: a workforce study.

    PubMed

    Hurlock-Chorostecki, Christina; van Soeren, Mary; Goodwin, Sharon

    2008-01-01

    In spite of the long history of nurse practitioner practice in primary healthcare, less is known about nurse practitioners in hospital-based environments because until very recently, they have not been included in the extended class registration (nurse practitioner equivalent) with the College of Nurses of Ontario. Recent changes in the regulation of nurse practitioners in Ontario to include adult, paediatric and anaesthesia, indicates that a workforce review of practice profiles is needed to fully understand the depth and breadth of the role within hospital settings. Here, we present information obtained through a descriptive, self-reported survey of all nurse practitioners working in acute care settings who are not currently regulated in the extended class in Ontario. Results suggest wide acceptance of the role is concentrated around academic teaching hospitals. Continued barriers exist related to legislation and regulation as well as understanding and support for the multiple aspects of this role beyond clinical practice. This information may be used by nurse practitioners, nursing leaders and other administrators to position the role in hospital settings for greater impact on patient care. As well, understanding the need for regulatory and legislative changes to support the hospital-based Nurse Practitioner role will enable greater impact on health human resources and healthcare transformation. PMID:19029848

  2. 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

  3. 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.

  4. 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…

  5. Descriptive, cross-country analysis of the nurse practitioner workforce in six countries: size, growth, physician substitution potential

    PubMed Central

    Maier, Claudia B; Barnes, Hilary; Aiken, Linda H; Busse, Reinhard

    2016-01-01

    Objectives Many countries are facing provider shortages and imbalances in primary care or are projecting shortfalls for the future, triggered by the rise in chronic diseases and multimorbidity. In order to assess the potential of nurse practitioners (NPs) in expanding access, we analysed the size, annual growth (2005–2015) and the extent of advanced practice of NPs in 6 Organisation for Economic Cooperation and Development (OECD) countries. Design Cross-country data analysis of national nursing registries, regulatory bodies, statistical offices data as well as OECD health workforce and population data, plus literature scoping review. Setting/participants NP and physician workforces in 6 OECD countries (Australia, Canada, Ireland, the Netherlands, New Zealand and USA). Primary and secondary outcome measures The main outcomes were the absolute and relative number of NPs per 100 000 population compared with the nursing and physician workforces, the compound annual growth rates, annual and median percentage changes from 2005 to 2015 and a synthesis of the literature on the extent of advanced clinical practice measured by physician substitution effect. Results The USA showed the highest absolute number of NPs and rate per population (40.5 per 100 000 population), followed by the Netherlands (12.6), Canada (9.8), Australia (4.4), and Ireland and New Zealand (3.1, respectively). Annual growth rates were high in all countries, ranging from annual compound rates of 6.1% in the USA to 27.8% in the Netherlands. Growth rates were between three and nine times higher compared with physicians. Finally, the empirical studies emanating from the literature scoping review suggested that NPs are able to provide 67–93% of all primary care services, yet, based on limited evidence. Conclusions NPs are a rapidly growing workforce with high levels of advanced practice potential in primary care. Workforce monitoring based on accurate data is critical to inform educational capacity

  6. 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 ...

  7. 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…

  8. 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,…

  9. Find a Nurse Practitioner

    MedlinePlus

    Find a Nurse Practitioner AANP Home MyAANP Contact Us Find an NP near me or near Search Reset I accept AANP's Terms of Use Overall Focus All Primary ... practice site(s) to NP Finder, and enjoy many more member benefits.

  10. Development of the nurse practitioner.

    PubMed

    Howie, P

    1992-03-25

    In the first of two articles on the development of the emergency nurse practitioner, Peter Howie reports on a new scheme in Lincoln where all first-level nurses have been trained as nurse practitioners. The initiative was introduced following a study in the theoretical management of patients by experienced accident and emergency sisters. The author outlines the training course provided and the protocols within which nurse practitioners work. PMID:27236949

  11. Development of the nurse practitioner.

    PubMed

    Howie, P

    1992-03-25

    In the first of two articles on the development of the emergency nurse practitioner, Peter Howie reports on a new scheme in Lincoln where all first-level nurses have been trained as nurse practitioners. The initiative was introduced following a study in the theoretical management of patients by experienced accident and emergency sisters. The author outlines the training course provided and the protocols within which nurse practitioners work. PMID:1392461

  12. 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

  13. 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…

  14. Maximizing nurse practitioners' contributions to primary care through organizational changes.

    PubMed

    Poghosyan, Lusine; Aiken, Linda H

    2015-01-01

    The nurse practitioner (NP) workforce represents a considerable supply of primary care providers able to contribute to meeting a growing demand for care. However, organizational barriers hinder their optimal use. This article presents reports from 592 NPs on their roles, organizational support available to them, relationships between NPs and administration, their job satisfaction, and intentions of leaving their jobs. Nurse practitioners reported deficits in organizational context of care, problematic deployment of resources, and unfavorable working relationships with administrators. Addressing these challenges and creating work environments conducive to NP practice are necessary to fully exploit the capacity of the NP workforce. PMID:25748259

  15. 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)

  16. Development of a Family Nurse Practitioner Curriculum

    ERIC Educational Resources Information Center

    Januska, Charlotte; And Others

    1973-01-01

    The family nurse practitioner is a generalist who combines the basic skills of the pediatric and medical nurse practitioner with the orientation and approach of the public health nurse. This article outlines the task of preparing the family nurse practitioner. (Author)

  17. Nursing workforce retention: challenging a bullying culture.

    PubMed

    Stevens, Stella

    2002-01-01

    Discussions surrounding nursing shortages typically focus on recruitment, but retention is also a problem. Emerging research suggests that intimidation in the nursing workforce is a problem that planners need to deal with as part of an overall strategy aimed at maintaining a balance between supply and demand. This paper explores issues surrounding intimidation in the nursing workforce and looks at how one major teaching hospital in Australia attempted to address the problem. PMID:12224882

  18. Missing Links in Nurse Practitioner Education.

    ERIC Educational Resources Information Center

    Brower, H. Terri; And Others

    1988-01-01

    A survey of 136 nurse practitioners in southeastern Florida assessed the learning needs of that group. Results indicate that most of southeastern Florida's nurse practitioners are practice-oriented. Results are broken down into six groups of nurse practitioners and 11 educational content areas. (CH)

  19. 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)

  20. 77 FR 36549 - Nursing Workforce Diversity Invitational Summit-“Nursing in 3D: Workforce Diversity, Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... HUMAN SERVICES Health Resources and Services Administration Nursing Workforce Diversity Invitational Summit--``Nursing in 3D: Workforce Diversity, Health Disparities, and Social Determinants of Health...). ACTION: Notice of meeting. SUMMARY: HRSA's Bureau of Health Professions, Division of Nursing, will...

  1. The nurse practitioner in Planned Parenthood clinics.

    PubMed

    Manisoff, M

    1981-01-01

    Nurse practitioners have become a major and virtually indispensable resource for women coming to clinics for family planning services. This new study of Planned Parenthood clinics shows that nurse practitioners serve more than 3/5 of all patients, at a cost considerably below that of physician care. (An estimated 3 million dollars a year is saved by using nurse practitioners.) These health workers insert IUDs and prescribe oral contraceptives and various other medications. Most have had between 12 and 18 weeks of formal training in family planning in addition to their nursing education. Salaries of nurse practitioners are only about 1/2 those of physicians in Planned Parenthood clinics.

  2. 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…

  3. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who is... assistant, nurse midwife or specialized nurse practitioner who furnished the service is legally permitted to... practitioners, physician assistants, nurse midwives or specialized nurse practitioners are not covered if...

  4. 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.

  5. The aging nursing workforce: How to retain experienced nurses.

    PubMed

    Cohen, Jeremye D

    2006-01-01

    In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce. PMID:16916117

  6. The aging nursing workforce: How to retain experienced nurses.

    PubMed

    Cohen, Jeremye D

    2006-01-01

    In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.

  7. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... practitioner's, and clinical nurse specialists' services and services furnished incident to their professional... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse...

  8. 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 social worker services. (a) Services and supplies incident to a nurse practitioner, physician...

  9. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... practitioner's, and clinical nurse specialists' services and services furnished incident to their professional... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse...

  10. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... practitioner's, and clinical nurse specialists' services and services furnished incident to their professional... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse...

  11. 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

    ... practitioner's, and clinical nurse specialists' services and services furnished incident to their professional... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse...

  12. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... practitioner's, and clinical nurse specialists' services and services furnished incident to their professional... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse practitioner's... services. (a) General rule. A physician assistant's, nurse practitioner's, and clinical nurse...

  13. 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...

  14. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Nurse practitioner services. 440.166 Section 440... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services...

  15. 42 CFR 441.22 - Nurse practitioner services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 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...

  16. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Nurse practitioner services. 440.166 Section 440... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services...

  17. 42 CFR 440.166 - 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. 440.166 Section 440... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services...

  18. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Nurse practitioner services. 440.166 Section 440... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services...

  19. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Nurse practitioner services. 440.166 Section 440... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services...

  20. 42 CFR 441.22 - Nurse practitioner services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 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...

  1. 42 CFR 441.22 - Nurse practitioner services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 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...

  2. 42 CFR 441.22 - Nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 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. Developing family planning nurse practitioner protocols.

    PubMed

    Hawkins, J W; Roberto, D

    1984-01-01

    This article focuses on the process of development of protocols for family planning nurse practitioners. A rationale for the use of protocols, a definition of the types and examples, and the pros and cons of practice with protocols are presented. A how-to description for the development process follows, including methods and a suggested tool for critique and evaluation. The aim of the article is to assist nurse practitioners in developing protocols for their practice.

  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. Advanced Health Assessment in Nurse Practitioner Programs.

    ERIC Educational Resources Information Center

    Kelley, Frances J.; Kopac, Catharine

    2001-01-01

    Responses from 140 nursing schools indicated that most taught health assessment to nurse practitioners as a separate course; public institutions were more involved in computer-assisted instruction. Faculty cited scarce resources and limited time to develop new teaching strategies. Most agreed that graduate courses should focus on differential…

  7. Does State Legislation Improve Nursing Workforce Diversity?

    PubMed

    Travers, Jasmine; Smaldone, Arlene; Cohn, Elizabeth Gross

    2015-08-01

    A health-care workforce representative of our nation's diversity is a health and research priority. Although racial and ethnic minorities represent 37% of Americans, they comprise only 16% of the nursing workforce. The purpose of this study was to examine the effect of state legislation on minority recruitment to nursing. Using data from the National Conference of State Legislatures, American Association of Colleges of Nursing, and U.S. census, we compared minority enrollment in baccalaureate nursing programs of states (Texas, Virginia, Michigan, California, Florida, Connecticut, and Arkansas) before and 3 years after enacting legislation with geographically adjacent states without legislation. Data were analyzed using descriptive and chi-square statistics. Following legislation, Arkansas (13.8%-24.5%), California (3.3%-5.4%), and Michigan (8.0%-10.0%) significantly increased enrollment of Blacks, and Florida (11.8%-15.4%) and Texas (11.2%-13.9%) significantly increased enrollment of Hispanic baccalaureate nursing students. States that tied legislation to funding, encouragement, and reimbursement had larger enrollment gains and greater minority representation. PMID:26351214

  8. Creating disability inclusive work environments for our aging nursing workforce.

    PubMed

    Matt, Susan B; Fleming, Susan E; Maheady, Donna C

    2015-06-01

    The workforce is aging, and the implications of an older nursing workforce are profound. As nurses age, injuries and disabilities are more prevalent. If disabilities were more commonly recognized and accommodated in the design of our nursing work environments, we could meet future needs. This article explores the literature on accommodations for an aging workforce, reports disabilities commonly seen in this population, and introduces universal design. PMID:26010282

  9. Creating disability inclusive work environments for our aging nursing workforce.

    PubMed

    Matt, Susan B; Fleming, Susan E; Maheady, Donna C

    2015-06-01

    The workforce is aging, and the implications of an older nursing workforce are profound. As nurses age, injuries and disabilities are more prevalent. If disabilities were more commonly recognized and accommodated in the design of our nursing work environments, we could meet future needs. This article explores the literature on accommodations for an aging workforce, reports disabilities commonly seen in this population, and introduces universal design.

  10. A model of succession planning for mental health nurse practitioners.

    PubMed

    Hampel, Sally; Procter, Nicholas; Deuter, Kate

    2010-08-01

    This paper reviews current literature on succession planning for mental health nurse practitioners (NPs) and discusses a model of succession planning that is underpinned by principals of leadership development, workforce participation and client engagement. The paper identifies succession planning as a means of managing a present and future workforce, while simultaneously addressing individual and organizational learning and practice development needs. A discussion of the processes attendant upon sustainable succession planning - collegial support, career planning and development, information exchange, capacity building, and mentoring is framed within the potential interrelationships between existing NP, developing NP and service directors and/or team managers. Done effectively and in partnership with wider clinical services, succession planning has the potential to build NP leadership development and leadership transition more broadly within mental health services.

  11. Magnetism and the nursing workforce.

    PubMed

    Messmer, Patricia R; Turkel, Marian C

    2010-01-01

    The focus of this chapter is to highlight practice exemplars and research findings related to the five components of the new Magnet Model. A brief overview of the historical development and professional evolution of the American Nurses Credentialing Center (ANCC) Magnet Recognition Program is presented followed by a brief overview of the original fourteen forces of magnetism. Content related to empirical practice-based research framed under the components of transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovation, and improvement; and empirical outcomes is presented and discussed. The authors provide key findings from scholarly publications and describe how the findings contribute to the creation of work environments based on the tenets of magnetism. The chapter concludes with a brief over of the ANCC Pathway to Excellence Program.

  12. Nurse practitioners: a contract for change and excellence in nursing.

    PubMed

    Turner, Clare; Keyzer, Dirk

    2002-10-01

    The role of the Nurse Practitioner has been in existence in a variety of contexts and within a broad range of the scope of their practice throughout the world for a number of years. Many nurses work at this advanced level of clinical practice without the acknowledgement f the very important and responsible role that they play within the healthcare setting. Although the United States and United Kingdom have recognised the role of the advanced Nurse Practitioner for a number of years, there still exists confusion and disagreement as to their scope of practice. There is uncertainty and anxiety as to where the role boundaries between nursing and medical and allied health professionals begin and end. The role of the Nurse Practitioner in Australia has not been without its problems in the developmental stage of its creation. New South Wales finally achieved recognition of the role this year after a decade of negotiation. This has culminated in the acceptance for the development of 40 Nurse Practitioner positions across the State. The first of these was accepted in the Far West Area Health Service in May 2001. The Far West Area Health Service created a five-year plan, which addresses the development of nurses preparing for authorisation, the creation of Nurse Practitioner positions in the remote communities, the creation of clinical guidelines to support advanced practice and the evaluation process for both the positions and the nurses. The objective of this approach is to ensure effective implementation of these advanced nursing positions in the remote communities of New South Wales. The Nurse Practitioner role needs to respond to the individual, the family and the community, utilising advanced clinical skills and remaining responsive to the changes in health care within a primary health care framework, which is essential for combating the complex health care issues in remote areas (NSW Health 2000). PMID:12539922

  13. Advance directives: role of nurse practitioners.

    PubMed

    Schlenk, J S

    1997-07-01

    Advance directives are documents that guide end of life decisions. Although advance directives are a fairly recent phenomenon in health care, they are grounded in both legal and ethical principles. Studies show few people have completed advance directives. Persons do not tend to complete advance directives for various reasons. Lack of knowledge has been identified, as well as belief that physicians should initiate the discussion and that the topic is appropriate only for the elderly or those in poor health. Many nurse practitioners practice in primary care settings, which are ideal for discussions about advance directives. Nurse practitioners possess the opportunities and skills to discuss advance directives with their patients.

  14. 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.

  15. 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

  16. Nurse Practitioners, Physician Assistants and Certified Nurse Midwives in California.

    ERIC Educational Resources Information Center

    California Univ., San Francisco. Center for California Health Workforce Studies.

    Surveys were mailed to all nurse practitioners (NPs), physician assistants (PAs) and certified nurse midwives (CNMs) registered in California, asking questions about education, labor force participation, specialty, and location and type of practice site, as well as the demographic characteristics of these professionals and their patients. Response…

  17. Nurse Practitioners: A Decade of Change--Part III.

    ERIC Educational Resources Information Center

    Sultz, Harry A.; And Others

    1983-01-01

    This is the third report of the findings of the longitudinal studies of nurse practitioners in the United States. It compares the characteristics and motivations of students in nurse practitioner programs in 1973 and 1980. (JOW)

  18. A Missed Opportunity: Master's Education for Certified Nurse Practitioners.

    ERIC Educational Resources Information Center

    Vessey, Judith A.; Morrison, Candis

    1997-01-01

    Describes Johns Hopkins's Nurse Practitioner Certificate to Master's Program for certified nurse practitioners who lacked master's-level credentials. the program features challenge mechanisms whereby students can acquire credits by examination or portfolio development. (SK)

  19. Nurse Practitioners: A Decade of Change--Part IV.

    ERIC Educational Resources Information Center

    Sultz, Harry A.; And Others

    1984-01-01

    Highlights trends in nurse practitioner employment from 1974-1982. The data illustrate that the nurse practitioner movement has grown and stablized and is now an integral part of the health care program. (JOW)

  20. Psychological Characteristics of the Nurse Practitioner

    ERIC Educational Resources Information Center

    White, Martha Sturm

    1975-01-01

    A review of research pertaining to the nurse practitioner reveals most research to be of a descriptive nature. More theoretical research is needed--multi-criteria for measuring success and effectiveness, predictions from different personality and developmental theories, and more complex variables. (Author/EA)

  1. Family nurse practitioners: "value add" in outpatient chronic disease management.

    PubMed

    Stephens, Lynn

    2012-12-01

    Nurse practitioners are capable leaders in primary care design as practices nationwide move to consider and adopt the patient-centered medical home. The chronic care model provides a structure to enhance the care of chronic illness. Nurse practitioners are instrumental in many areas of this model as both leaders and caregivers. Safety and quality are basic medical home goals; nurse practitioners enhance both. The addition of a nurse practitioner to a practice is an effective "value add" in every way.

  2. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under this... practitioner, physician assistant, nurse midwife, or specialized nurse practitioner; (4) Furnished under...

  3. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under this... practitioner, physician assistant, nurse midwife, or specialized nurse practitioner; (4) Furnished under...

  4. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Services and supplies incident to nurse practitioner and physician assistant services. (a) Services and supplies incident to a nurse practitioner's or physician assistant's services are reimbursable under this... practitioner, physician assistant, nurse midwife, or specialized nurse practitioner; (4) Furnished under...

  5. Nurse Practitioners in College Health--Where Are They Now?

    ERIC Educational Resources Information Center

    Moore, Donna J.; And Others

    1981-01-01

    A controlled, computerized study of graduates of the Brigham Young University College Health Nurse Practitioner Course was conducted to determine the level of job satisfaction and professional acceptance of nurse practitioners. Findings suggest that nurse practitioners show a high degree of self-acceptance and physician and peer acceptance. (JN)

  6. 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... Nurse practitioners' services. (a) Definition. As used in this section, the term “physician” means a... Medicare Part B coverage of his or her services, a nurse practitioner must be a registered...

  7. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Nurse practitioners' services. 410.75 Section 410... Nurse practitioners' services. (a) Definition. As used in this section, the term “physician” means a... Medicare Part B coverage of his or her services, a nurse practitioner must be a registered...

  8. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Nurse practitioners' services. 410.75 Section 410... Nurse practitioners' services. (a) Definition. As used in this section, the term “physician” means a... Medicare Part B coverage of his or her services, a nurse practitioner must be a registered...

  9. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Nurse practitioners' services. 410.75 Section 410... Nurse practitioners' services. (a) Definition. As used in this section, the term “physician” means a... Medicare Part B coverage of his or her services, a nurse practitioner must be a registered...

  10. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for nurse practitioners' and clinical nurse... AND OTHER HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners..., 1992 and ending December 31, 1997, allowed amounts for the services of a nurse practitioner or...

  11. 42 CFR 414.56 - Payment for nurse practitioners' and clinical nurse specialists' services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Payment for nurse practitioners' and clinical nurse... AND OTHER HEALTH SERVICES Physicians and Other Practitioners § 414.56 Payment for nurse practitioners..., 1992 and ending December 31, 1997, allowed amounts for the services of a nurse practitioner or...

  12. 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...

  13. 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

  14. 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

  15. Neonatal nurse practitioners: past, present, and future.

    PubMed

    Honeyfield, Mary Ellen

    2009-06-01

    The advanced practice nursing role in neonatal intensive care enjoys an almost 40-year history. The 1970s and the 1980s were fraught with growing pains, including what to call these providers, and role clarity that was defined in most settings by community need. With the birth of NANN, 25 years ago, the neonatal nurse practitioner (NNP) role began to receive support and advocacy that led to the development of educational standards and definition of the role. This article reviews the role's history and identifies current and future issues that will require attention by the national NNP leadership. PMID:19542775

  16. The case for renewed investment in the district nursing specialist practitioner qualification.

    PubMed

    Longstaff, Fiona

    2013-09-01

    District nursing as a profession has been under significant threat over the last few years due to a lack of foresight and funding, resulting in an undervalued and underinvested workforce. The once-heralded specialist practitioner programme was slowly decommissioned in all but a handful of universities, leaving no alternative but for community trusts to employ staff nurses in team leader roles without the development the added qualification gave them. In light of the renewed focus on the fundamental advancement of district nurses and recent Government publications clearly reinforcing the district nurse's role, this article argues for the need for educational commissioners and workforce planners to commit to continued investment in this vital profession.

  17. 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).

  18. Bringing magic to the nursing workforce of the future.

    PubMed

    Sorrell, Jeanne M; Cangelosi, Pamela R

    2004-01-01

    How can nursing education respond to the ominous signs of a serious shortage of nurses in the future? One answer to this question is a focus on reclaiming nurses' stories of the "real-world" of nursing practice. In the process of creating a childrens book, The Magic Stethoscope, a group of nurse authors found a new appreciation for the stories of their practice and the need to share these stories with children. The authors hope that these stories will inspire children to consider the exciting career opportunities for the nursing workforce of the future. PMID:15495759

  19. 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

  20. Promoting the nurse practitioner by using a marketing approach.

    PubMed

    Gallagher, S M

    1996-03-01

    Being good at what you do is not enough. Despite strong evidence that the nurse practitioner delivers cost-efficient and outcome-based care, few consumers really understand the nurse practitioner's scope of practice. With the current rapidly changing status of health care, the nurse practitioner is presented with many opportunities. Strategies that ensure survival and growth are critical to longevity. Marketing strategies can offer solutions to these challenges. The 4 P's of marketing are discussed as an approach to promote the role of the nurse practitioner.

  1. The Initiative to Move Toward a More Highly Educated Nursing Workforce: Findings from the Kansas Registered Nurse Workforce Survey.

    PubMed

    Shen, Qiuhua; Peltzer, Jill; Teel, Cynthia; Pierce, Janet

    2015-01-01

    The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, recommends increasing the proportion of registered nurses (RNs) with a baccalaureate in nursing (BSN) to 80% by 2020. Kansas lacks a central mechanism to collect current data on the RN workforce; therefore, detailed information about the RN workforce, including current educational level, is unknown. The purposes of the survey were to (a) describe the Kansas RN workforce, (b) examine the relationship between nursing education and employment, (c) compare and contrast the workforce to other states and national data and (d) discuss implications of strategic planning and policy making for nursing education. The on-line Kansas RN Workforce Survey link was sent to 44,568 RNs by e-mail, and the response rate was 15.6% (n = 6,948). The survey consisted of 34 questions on demographics, education, licensing, and employment. Kansas RNs were predominately women (92%) and Caucasian with an average age of 47.7 years. Approximately 46.3% of RNs obtained a BSN as their initial education. Analysis of highest level of nursing education showed that 60.5% of Kansas RNs were at least baccalaureate prepared, with 14.9% obtaining a master's degree or higher. More than 50% of RNs worked in hospitals as staff nurses. RNs with advanced education were more likely to be employed, tended to work in academic settings or ambulatory clinics, and were more likely to be faculty or in management/leadership positions. Overall, the Kansas RN workforce is closer to reaching the 80% baccalaureate-prepared goal recommended by the Future of Nursing report than has been reported. Educational level was closely related to RNs' choices of work settings and positions. Additional work such as promoting academic progression needs to continue to build a more highly educated RN workforce. PMID:26653039

  2. 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.

  3. Challenges facing internationalisation of nursing practice, nurse education and nursing workforce in Australia.

    PubMed

    Parker, Vicki; McMillan, Margaret

    2007-04-01

    This paper examines factors that have lead to increasing internationalisation in nursing workforce and nursing education and contends that education and support for nurse managers and nurse academics is required in order to better prepare them for the challenges they will face. There are many benefits to be gained from internationalisation of nursing, the most significant being greater cross-cultural understanding and improved practices in workplaces across countries. However, the way in which nursing and nurses contribute to the international agenda is crucial to maintaining standards of education and nursing care in Australia and in countries with whom Australians collaborate. Internationalisation poses numerous challenges that need to be carefully thought through. This paper seeks to unravel and scrutinize some of the issues central to internationalisation in nursing, particularly in the Australian context.

  4. 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)

  5. A nurse practitioner patient care team: implications for pediatric oncology.

    PubMed

    Golden, Julia Rose

    2014-01-01

    The role of the pediatric advanced practice registered nurse continues to evolve within the ever-changing field of health care. In response to increased demand for health care services and because of a variety of changes in the health care delivery system, nurse practitioner patient care teams are an emerging trend in acute care settings. Care provided by nurse practitioner teams has been shown to be effective, efficient, and comprehensive. In addition to shorter hospital stays and reduced costs, nurse practitioner teams offer increased quality and continuity of care, and improved patient satisfaction. Nurse practitioner patient care teams are well suited to the field of pediatric oncology, as patients would benefit from care provided by specialized clinicians with a holistic focus. This article provides health care professionals with information about the use of nurse practitioner patient care teams and implications for use in pediatric oncology.

  6. The business management preceptorship within the nurse practitioner program.

    PubMed

    Wing, D M

    1998-01-01

    Changes in health care reimbursement practices have affected the way in which primary health care is provided. To be successful, nurse practitioners must have a proficient understanding of basic business functions, including accounting, finance, economics, marketing, and reimbursement practices. Yet, many graduates of nurse practitioner programs are not adequately prepared to make fundamental business decisions. Therefore, it is essential that nurse practitioner faculty provide learning experiences on primary practice business. Because the preceptor experience is an integral aspect of nurse practitioner education, a business preceptorship provides students with pragmatic knowledge of the clinical practice within a business framework. The University of Indianapolis School of Nursing offers a nurse practitioner business preceptorship. The implementation, challenges, and positive outcomes of the course are discussed in this article.

  7. Workforce planning and community children's nurses: it's all in the advertisements.

    PubMed

    Winter, Ann Marie; Teare, Jean

    2002-06-01

    This paper outlines a study exploring job advertisements for community children's nurses (CCNs). A post-structural approach was taken to illuminate the development of community children's nursing services (CCNS) and the profile of characteristics, skills and caseload within a workforce-planning context. An analysis of 100 advertisements looked at title, skills, caseload, qualifications and evolving roles. The analysis comprised an initial quantitative descriptive account of data, followed by further analysis of the text using thematic analysis and coding. The skills identified were compared to those identified by Proctor et al. (1999). The most commonly occurring skills were interpersonal (35%), multi-professional team working (33%), clinical (28%), management (18%) and leadership (16%). The analysis was limited, but provides a unique insight into employers' perceived needs in providing CCN services, evolving titles and roles and could inform practitioners, contribute to service evaluation, future service provision and workforce planning. PMID:12136819

  8. 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.

  9. 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…

  10. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....75 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Medicare Part B coverage of his or her services, a nurse practitioner must be a registered professional... requirements: (i) Be certified as a nurse practitioner by a recognized national certifying body that...

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. Disrupting Communities of Practice? How "Reluctant" Practitioners View Early Years Workforce Reform in England

    ERIC Educational Resources Information Center

    Payler, Jane K.; Locke, Rachel

    2013-01-01

    This article reports on the views of early years practitioners in England from settings that were identified as "reluctant to engage" with one of the government's key policies, the introduction of Early Years Professional Status (EYPS), to drive forwards workforce reform. Focus groups, interviews and a survey were undertaken in 2009 with 35…

  17. Exploring the transition from registered nurse to family nurse practitioner.

    PubMed

    Poronsky, Cathlin Buckingham

    2013-01-01

    There is limited information available regarding the transition from registered nurse (RN) to family nurse practitioner (FNP). Several authors described this transition as taking place in 4 stages, and others described it as a 2-phase process. However, there is a lack of consensus about the definition of these stages and phases and at what point they occur for nurses who are making the transition from an RN to an FNP. From what is known, this multistage/2-phase transition is accompanied by feelings of anxiety, stress, role confusion, and emotional turmoil. As a nurse faculty member, the author theorized that nurse faculty might be in a position to provide support for graduate students making this transition in role. However, there was little information available about the transition phases, stages, and needs of students during graduate school. The search for a framework to explore transition yielded transition theory, which is described and applied to FNP transition in this article. Transition theory may be useful for examining more fully the phases and stages of RN-to-FNP transition. In this time of increased need for qualified primary care providers, it is essential that graduates of FNP programs transition into practice following graduation.

  18. The globalization of the nursing workforce: Pulling the pieces together.

    PubMed

    Jones, Cheryl B; Sherwood, Gwen D

    2014-01-01

    The "globalization" of health care creates an increasingly interconnected workforce spanning international boundaries, systems, structures, and processes to provide care to and improve the health of peoples around the world. Because nurses comprise a large sector of the global health workforce, they are called upon to provide a significant portion of nursing and health care and thus play an integral role in the global health care economy. To meet global health care needs, nurses often move within and among countries, creating challenges and opportunities for the profession, health care organizations, communities, and nations. Researchers, policy makers, and industry and academic leaders must, in turn, grapple with the impacts of globalization on the nursing and health care workforce. Through this special issue, several key areas for discussion are raised. Although far from exhaustive, our intent is to expand and stimulate intra- and interprofessional conversations raising awareness of the issues, uncover unanticipated consequences, and offer solutions for shaping the nursing and health care workforce of the future.

  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. A Pilot Study to Explore Nurse Educator Workforce Issues.

    PubMed

    Westphal, Judith; Marnocha, Suzanne; Chapin, Tammy

    2016-01-01

    As the demand for nurses continues to rise, the recruitment and retention of qualified nurse educators (NEs) is essential. The purpose of this descriptive study was to explore NE workforce issues using the Faculty Satisfaction Survey at a single nursing program. Respondents were somewhat to very satisfied with their job; however, they were less satisfied with salary/compensation and stated they would leave academia for higher wages. Satisfaction differences were noted between full-time and part-time NEs. Job motivators may be the key to recruitment and retention of NEs and a way to avoid a nursing shortage crisis. PMID:27405201

  1. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Nurse practitioner and physician assistant services... Clinic and Federally Qualified Health Center Services § 405.2414 Nurse practitioner and physician... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who...

  2. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Nurse practitioner and physician assistant services... Clinic and Federally Qualified Health Center Services § 405.2414 Nurse practitioner and physician... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who...

  3. 42 CFR 405.2414 - Nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Nurse practitioner and physician assistant services... Clinic and Federally Qualified Health Center Services § 405.2414 Nurse practitioner and physician... nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner who...

  4. 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.

  5. Marketing strategies of nurse practitioners in New York State.

    PubMed

    Nolan, C M; Conway, L G; Litteer, T B; Peterson-Sweeney, K; Richardson, K; Smith, S W; Stoler, P M

    1988-08-01

    As competition within the health care field increases, marketing strategies are becoming more important for all members of the health care team, including nurse practitioners. The purpose of this research was to identify marketing strategies being used by nurse practitioners in New York state. A total of 285 practitioners responded to a survey containing questions related to marketing techniques traditionally used in the business world: service differentiation, market segmentation and practice promotion. A majority of respondents did not report using many of the marketing strategies contained in the survey, although most nurse practitioners did report identifying themselves as primary care providers in one-on-one interactions with clients. Significantly higher marketing scores were found for nurse practitioners who attended a workshop or seminar on marketing strategies, had three or more years of experience, or who practiced in private outpatient settings.

  6. Sustaining the Rural Workforce: Nursing Perspectives on Worklife Challenges

    ERIC Educational Resources Information Center

    Hunsberger, Mabel; Baumann, Andrea; Blythe, Jennifer; Crea, Mary

    2009-01-01

    Context: Concerns have been raised about the sustainability of health care workforces in rural settings. According to the literature, rural nurses' work satisfaction varies with the resources and supports available to respond to specific challenges. Given the probable effects of stressors on retention, it is essential to understand the unique…

  7. Competencies for the Nurse Practitioner Working with Adult Urology Patients.

    PubMed

    Quallich, Susanne A; Bumpus, Sherry M; Lajiness, Shelley

    2015-01-01

    The role of the nurse practitioner (NP) has expanded into specialty domains. This document proposes 24 competencies specific to the urology NP, which are also consistent with the recommendations of National Organization of Nurse Practitioner Faculties (NONPF) and compliment the American Urologic Association (AUA) 2014 white paper on the incorporation of advanced practice providers in urology practices. It describes three levels of practice and experience progression for the urology NP working with adult patients, independent of specific clinical setting. These urology-specific competencies supplement and complement the core competencies and population-focused competencies of generalist nurse practitioners.

  8. 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.

  9. [An alternative proposal for the scientific productivity of nurse practitioners].

    PubMed

    Boemer, M R; Santos, B M; Aguillar, O M; Stopa, M J

    1990-08-01

    We report our experience with University extension courses on research methodology offered to nurse practitioners in order to provide them with some fundaments about the topic. These courses, which were given in 1984, 1986 and 1988 by the Nursing School of Ribeirão Preto-USP, were proposed by the coordinators who felt it is necessary to stimulate the scientific production of nurse practitioners; thus, the basic proposal of the courses was to promote this stimulation, thus, in addition to presenting the content of different research methodologies, the courses discussed nursing research that appeared to be relevant for practice. Some time after the courses were given, the nurses who had taken them were approached in order to obtain information to be used for the elaboration of future courses and to evaluate the contribution made by the initial courses in terms of stimulation of research by nurse practitioners.

  10. Nurse practitioners in general practice: an expanding role.

    PubMed

    Kaufman, G

    1996-11-13

    At a time when the government is proposing to allow nurses to become equal partners with GPs and a consultative report commissioned by the NHSE found that nurse practitioners provide cheaper and better services for patients (NHSE 1996), this article describes the role of a nurse practitioner working in a GP fundholding practice in the UK. The author considers issues of autonomy and accountability surrounding the development of the role. Its relationship to the development of nursing and caring is examined in the light of some doctors' and nurses' scepticism and ambivalence. The benefits to patients are presented to highlight the value of a properly structured nurse practitioner role integrated into primary care provision.

  11. 42 CFR 405.2414 - Nurse practitioner, physician assistant, and certified nurse midwife services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Nurse practitioner, physician assistant, and... practitioner, physician assistant, and certified nurse midwife services. (a) Professional services are payable under this subpart if the services meet all of the following: (1) Furnished by a nurse...

  12. 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.

  13. Deployment experiences of Army nurse practitioners.

    PubMed

    Lewis, Paul C; Stewart, Della; Brown, William

    2012-08-01

    Army Nurse Practitioners (NPs) provide immediate and lifesaving care during combat operations. The most recent conflicts of Operation Iraqi Freedom and Operation Enduring Freedom have seen an increasing number of NP deployments. The uniqueness of these conflicts has also seen NPs being used in nontraditional roles. This study surveyed 50 Army NPs with deployment experience to explore and elucidate their clinical practices in a combat environment. Over 70% reported seeing greater than 11 patients a day with the top three diagnoses of musculoskeletal/soft tissue (noncombat), spinal pain (mechanical, sciatica), and gastrointestinal complaints. Over 74% reported having a physician available for collaboration, but 50% reported providing independent emergency care and 58% treating life-threatening injuries. The NPs in this study report standard credentialing privileges with most care falling within this realm. However, a few report nontraditional roles such as hospital admitting privileges. This study adds to the growing body of knowledge on NP practice in a combat environment, which shows increased decision making and advanced clinical skills. NPs are battlefield multipliers who bring additional skills and abilities to the combat environment. PMID:22934365

  14. Nurse practitioner work: A case study.

    PubMed

    Bourgeois, Sharon; Blanchard, Denise; Doldissen, Rebecca; Maher, Laura; Stoddart, Kiea; Johnston, Nicole; Hungerford, Catherine

    2014-01-01

    Abstract Within any professional practice, knowledge developments to support service delivery and to understand roles inherent within that practice context are critical. The purpose of this article is to present findings from case study research that used the AUSPRAC Research Toolkit Interview Schedule and to propose an additional theme to the Interview Schedule. Case Study method was used to explore the role of a nurse practitioner (NP) within a specific context of practice in an Australian Healthcare institution. Three semi-structured interviews with a NP using the AUSPRAC Research Toolkit Interview Schedule and one additional interview were employed. Data was analysed where initial free coding, then theme generation contributed to knowledge development. The AUSPRAC Research Toolkit Interview Schedule generated knowledge about the NP role. Themes identified for interviews in the Schedule were: the organisation of care, team functioning and patient service. Analysis of data from these themes identified that information related to ongoing development of professional practice was not forthcoming from the participant. The authors recommend adding a fourth theme to the Interview Schedule to enable exploration of the professional elements of the NP role.

  15. Diffusion of a nursing education innovation: nursing workforce development through promotion of RN/BSN education.

    PubMed

    Diaz Swearingen, Connie; Clarke, Pamela N; Gatua, Mary Wairimu; Sumner, Christa Cooper

    2013-01-01

    Despite state, national, and organizational objectives to increase the proportion of nurses with a bachelor's degree or higher, a majority of nurses hold an associate's degree in nursing. To address the need for a better-prepared nursing workforce in this rural state, an RN/BSN recruitment and retention project was implemented. The authors discuss the Leadership Education to Advance Practice project and its outcomes.

  16. 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)

  17. Toward a Narrative-Centered Curriculum for Nurse Practitioners.

    ERIC Educational Resources Information Center

    Swenson, Melinda M.; Sims, Sharon L.

    2000-01-01

    A narrative-centered nurse practitioner curriculum combines case study analysis, problem-based learning, and a teaching philosophy focused on narrative pedagogy and interpretive research. The curriculum challenges the medical model and develops clinical reasoning skills as well as skills for individualized nursing care. (SK)

  18. A joint course for general practitioner and practice nurse trainers.

    PubMed Central

    Bolden, K J; Lewis, A P

    1990-01-01

    An experimental multidisciplinary course for prospective general practitioner and practice nurse trainers is described. Factual knowledge and attitudes were measured before and after the course and some of the changes measured emphasized the importance of multidisciplinary training. The ideas generated by the group of nurse trainers in terms of their future professional development were identified. PMID:2265007

  19. Developing ambulatory care clinics: nurse practitioners as primary providers.

    PubMed

    Lamper-Linden, C; Goetz-Kulas, J; Lake, R

    1983-12-01

    While hospitals evaluate ambulatory clinics as a revenue-generating service alternative, nursing executives develop new areas for nursing practice in nurse-managed clinics. The authors describe the five-year growth of a nurse-managed ambulatory clinic providing primary health care to those aged 55 and older. The discussion explains nurse practitioner leadership and practice, and accountability between professions. The concept and structure of services and marketing strategies are elated to the people served. Financial feasibility, cost containment, and other factors demonstrate the clinic's contribution to its sponsoring hospital.

  20. Remote nursing certified practice: viewing nursing and nurse practitioner practice through a social justice lens.

    PubMed

    Tarlier, Denise S; Browne, Annette J

    2011-06-01

    Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.

  1. Engaging a wider public health workforce for the future: a public health practitioner in residence approach.

    PubMed

    Pilkington, P; Marco, E; Grant, M; Orme, J

    2013-05-01

    This paper outlines and assesses a project that sought to use a studio residency (a public health practitioner in residence) as a vehicle to introduce public health issues and concepts into the curricula of a studio cohort of fifth and sixth year architecture students. The practitioner delivered workshops, group tutorials and one-to-one guidance on individual design projects whose aim was to improve the health and well-being of the local population. Students reported being enthused by the practitioner and developed a broader understanding of their role as future architects in the promotion and protection of the health of the public. The public health practitioner in residence model may offer an exciting way of educating and inspiring the future wider public health workforce in the built environment design focused professions. Such an approach could transform the way in which such professionals construct their societal role in terms of their future impact on population health and their contribution as members of the wider public health workforce.

  2. Nurse Practitioners and the Expanded Role of the Nurse: A Bibliography. Nurse Planning Information Series No. 5.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Hyattsville, MD. Div. of Nursing.

    This bibliography brings together much of the literature prepared by individuals, organizations, and agencies on nurse practitioners and the expanded role of the nurse. Section I on expanded role includes citations and abstracts to documents that provide general information about the nurse practitioner's role and specific information on the…

  3. Five generations in the nursing workforce: implications for nursing professional development.

    PubMed

    Bell, Julie A

    2013-01-01

    Positive patient outcomes require effective teamwork, communication, and technological literacy. These skills vary among the unprecedented five generations in the nursing workforce, spanning the "Silent Generation" nurses deferring retirement to the newest "iGeneration." Nursing professional development educators must understand generational differences; address communication, information technology, and team-building competencies across generations; and promote integration of learner-centered strategies into professional development activities. PMID:23877293

  4. 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.

  5. Bloodroot: life stories of nurse practitioners in rural Appalachia.

    PubMed

    Caldwell, Debbie Rife

    2007-06-01

    This nursing research study was designed to reveal the life stories of nurse practitioners in rural Appalachia using storytelling and ballad elements of the culture. The researcher was born in a rural Appalachian community in Virginia and was summoned to return to the place of her birth, feeling an invisible kinship to land, blood ties to family, and a longing to honor rural nursing. Seven nurse practitioners from the same community shared their life stories. Using the heuristic phenomenological research method of Moustakas, the researcher became storyteller. The metaphor of bloodroot emerged as the unity of meaning for the life stories. The theme essences were revealed as interconnection: intricate patterns of rural Appalachian culture, intertwining relationships, interrelationships, and inner journey. "Brand New Home," an Appalachian bluegrass ballad, along with pictures of Appalachia, underpins and culminates this study as a creative synthesis. Implications for nursing practice, education, and research are included.

  6. Analysis of the nursing workforce crisis: a call to action.

    PubMed

    Bleich, Michael R; Hewlett, Peggy O; Santos, Susan R; Rice, Rebecca B; Cox, Karen S; Richmeier, Sheila

    2003-04-01

    In our integrative review of reports on the health care workforce shortage, we examined 15 reports that focused primarily on nursing and were conducted by various stakeholders. We studied these reports objectively, identifying problems and solutions as described by the authors, which we then categorized by theme. We found problems at both the national and institutional levels and noted that the reports contained similar problem and solution "themes." Yet we also found gaps between these-some problems had no solutions and some solutions didn't address any of the suggested problems. Gaps occurred among problems and solutions listed in the following theme categories: demand, health care economics, workforce planning, research and data support, and technology. Despite the urgent need, we still lack a national strategy designed to avert the nursing shortage. This review may provide a foundation for such a plan.We present the results of our analysis and our recommendations to the federal government and national organizations, to institutions, and to nurses. These recommendations don't provide a comprehensive strategy for averting the nursing shortage, but they do offer a basis upon which one may be created.

  7. Leadership development: educating nurse practitioners for the future.

    PubMed

    Busen, N H; Jones, M E

    1995-03-01

    The development of leadership potential is recognized to be an essential component of nurse practitioner education to prepare graduates for a dynamic health care system. Leadership potential refers to those skills that enable a nurse practitioner to function as a change agent and to effectively resolve conflict. The purpose of the study was to examine personal variables (personality type, self-esteem, and learning style) with respect to the leadership potential of pediatric nurse practitioner graduates over a 3-year period. The research study was descriptive, and data were analyzed using descriptive statistics. The subjects consisted of 21 female students who completed five instruments used to measure the relationships between variables and leadership potential. Significant results were found between those students who learned abstractly and the ability to function effectively as a change agent post-program.

  8. Twelve Paradoxes: A Message for Nurse Practitioners

    ERIC Educational Resources Information Center

    Bates, Barbara

    1974-01-01

    "The values of nursing must not get lost in the dominant medical culture. If they do, you justly risk the epithet of junior doctor. Our patients do not need junior doctors. They need the knowledge and skills of both medicine and nursing." (Author)

  9. Profiling emergency nurse practitioner service: an interpretive study.

    PubMed

    OʼConnell, Jane; Gardner, Glenn; Coyer, Fiona

    2014-01-01

    The aim of this study was to investigate the practice profile of emergency nurse practitioners across Australia. Nurse practitioners have been providing health service in the emergency setting internationally for more than 30 years, and evidence supports the value of this role in terms of patient satisfaction, effectiveness in improving service indicators, and acceptability of the role. The introduction of this service model has been instrumental in reducing waiting times for low-acuity patients and impacting positively on emergency department service delivery. Recent rapid uptake of this role internationally has outpaced development of the service model to inform education and ongoing service development. This was a national study that used interpretive research methods to identify the practice profile of emergency nurse practitioners. Data were collected from December 2012 to February 2013 through in-depth interviews. An inductive approach was used in data analysis to identify conceptual themes and develop an analysis framework. The study participants worked in a range of service models and managed patient presentations across all levels of acuity and complexity. The findings show that although there is no single definable model of the emergency nurse practitioner role in Australia, there are practice features that are common across all service models; these have been conceptualized as "modes of practice." This study has produced new knowledge about the practice profile of emergency nurse practitioners. The findings will inform development of practice standards for education and continuing professional development for emergency nurse practitioners and facilitate standardized operational definitions for ongoing research into this growing service model.

  10. DEVELOPING AND IMPLEMENTING A CULTURAL AWARENESS WORKSHOP FOR NURSE PRACTITIONERS.

    PubMed

    Elminowski, Nerfis Sanchez

    2015-01-01

    The results of a needs assessment showed that nurse practitioners want additional education on culture and related concepts. Subsequently, a 3-hour cultural education workshop was developed to address this need. The purpose of this study is to determine the impact and effectiveness of a cultural education workshop on the participant's cultural knowledge and cultural competency resulting from the application of that knowledge. Eighteen nurse practitioners and 45 graduate students participated in the study. The results of the study revealed that the cultural awareness workshop had a positive effect on the participants' cultural knowledge and cultural competence. PMID:26647489

  11. A statewide strategy for nursing workforce development through partnerships in Texas.

    PubMed

    Kishi, Aileen; Green, Alexia

    2008-08-01

    Statewide efforts and partnerships were used for nursing workforce development to address the nursing shortage in Texas. A statewide strategic action plan was developed where partnerships and collaboration were the key components. One of the most important outcomes of these statewide partnerships was the passage of the Nursing Shortage Reduction Act 2001. Through this legislation, the Texas Center for Nursing Workforce Studies and its advisory committee were established. This article describes how a statewide infrastructure for nursing workforce policy and legislative and regulatory processes were further developed. An overview is provided on the contributions made by the organizations involved with these strategic partnerships. The ingredients for establishing successful, strategic partnerships are also identified. It is hoped that nursing and health care leaders striving to address the nursing shortage could consider statewide efforts such as those used in Texas to develop nursing workforce policy and legislation.

  12. Visualizing nursing workforce distribution: policy evaluation using geographic information systems.

    PubMed

    Courtney, Karen L

    2005-12-01

    Health services literature suggests that geographic information systems (GIS) are useful policy evaluation tools when policy success is dependent on location. Nursing workforce distribution is an inherently local issue and nursing shortages present serious concerns for local, state and national governments. In 1991, Missouri enacted a nurse recruitment and retention policy targeting underserved (HPSA-designated) counties. Following Institutional Review Board approval, policy effectiveness was explored using a combination of GIS data visualization, spatial and classic statistics. Results of both data visualization and statistical methods do not demonstrate an expected trend of decreasing group differences between HPSA and non-HPSA-designated counties over time. Only two of the five time periods studied had significant group differences. Between 1993 and 1995, the loss in nurse to population ratios in HPSA counties was significant (U=1020, p<0.001); however, between 1999 and 2001, the growth in nurse to population ratio changes in HPSA counties was significant (U=1032, p=0.001). The GIS data visualization and statistical techniques performed suggest that current policy definitions of underserved areas may not be effective in defining areas of nursing shortages and the existing policy implementation may not be achieving the stated goals.

  13. 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…

  14. California Collaborative Model For Nursing Education: Building A Higher-Educated Nursing Workforce.

    PubMed

    Jones, Deloras; Close, Liz

    2015-01-01

    The California Collaborative Model for Nursing Education (CCMNE) promotes seamless ADN-BSN academic progression as the most effective means by which the state can educate the numbers of BSN-prepared nurses needed in the future. Accelerated by state legislation and a national commitment to a higher-educated nursing workforce, the framework is sufficiently flexible to accommodate a variety of strategies that meet the intent of each Core Component, and can be implemented at local, regional, or state levels. Six percent of all current ADN students in California are dual enrolled in CCMNE BSN programs. CCMNE has a positive effect on ADN-BSN completions and will support increasing nursing workforce diversity in California.

  15. The transition to first position as nurse practitioner.

    PubMed

    Kelly, N R; Mathews, M

    2001-04-01

    The nurse who graduates from a nurse practitioner program leaves a comfort zone of nursing practice to enter a new position where feelings of insecurity and stress are common. Because the role of the nurse practitioner (NP) continues to evolve and is influenced by many environmental issues, the preparation of the NP by the academic institution needs to be assessed on a frequent basis. The purpose of this research was to obtain a better understanding of the transitional phase to the first position as NP after graduation. The perceptions of preparation, gains, losses, barriers, facilitators, and strategies for adjustment were explored. A qualitative approach using focus groups was developed in which 21 recent NP graduates from a large university participated in one of four focus groups. Peer debriefing and participant verification were techniques used to ensure credibility and trustworthiness of the data and subsequent analysis. The themes identified were: loss of personal control of time and privacy; changes and losses in relationships; feelings of isolation and uncertainty in establishing the NP role; and a special bonding with clients. Although the participants perceived they were adequately prepared for their role, they also described feelings of guilt and uncertainty from not knowing information they believed they should know. They concluded that they functioned differently than the physician as well as other nurses and found it necessary to distance themselves from the role of other health care providers. This study has implications for colleagues, academic institutions, and the individual nurse practitioner.

  16. Nurses for Wisconsin: A Collaborative Initiative to Enhance the Nurse Educator Workforce.

    PubMed

    Young, Linda K; Adams, Jan L; Lundeen, Sally; May, Katharyn A; Smith, Rosemary; Wendt, L Elaine

    2016-01-01

    Wisconsin, like much of the nation, is currently suffering from a growing nursing shortage. The University of Wisconsin-Eau Claire College of Nursing and Health Sciences, in partnership with the University of Wisconsin-Madison, University of Wisconsin-Milwaukee, and University of Wisconsin Oshkosh nursing programs, took advantage of a University of Wisconsin System Incentive Grant for economic and workforce development to address this problem. With a $3.2 million award, the Nurses for Wisconsin goal is to increase the number of baccalaureate registered nurses by expanding the nursing education capacity within the University of Wisconsin System. Nurses for Wisconsin is accelerating the preparation of nursing faculty by supporting nurses to enroll in doctor of nursing practice or nursing doctor of philosophy programs with pre- and postdoctoral fellowship awards ranging from $21,500 to $90,000 and the recruitment of faculty with a loan repayment program of up to $50,000. In exchange for the financial support, fellows and faculty must make a 3-year commitment to teach in a UW System nursing program. Two conferences for program participants are also funded through the award. The first conference was held in October 2014. The second conference is scheduled for summer 2015. With the first year of the 2-year project completed, this article describes Nurses for Wisconsin from inception to implementation and midterm assessment with a focus on lessons learned. A follow-up article addressing final outcomes and next steps is planned. PMID:27424929

  17. Nurses for Wisconsin: A Collaborative Initiative to Enhance the Nurse Educator Workforce.

    PubMed

    Young, Linda K; Adams, Jan L; Lundeen, Sally; May, Katharyn A; Smith, Rosemary; Wendt, L Elaine

    2016-01-01

    Wisconsin, like much of the nation, is currently suffering from a growing nursing shortage. The University of Wisconsin-Eau Claire College of Nursing and Health Sciences, in partnership with the University of Wisconsin-Madison, University of Wisconsin-Milwaukee, and University of Wisconsin Oshkosh nursing programs, took advantage of a University of Wisconsin System Incentive Grant for economic and workforce development to address this problem. With a $3.2 million award, the Nurses for Wisconsin goal is to increase the number of baccalaureate registered nurses by expanding the nursing education capacity within the University of Wisconsin System. Nurses for Wisconsin is accelerating the preparation of nursing faculty by supporting nurses to enroll in doctor of nursing practice or nursing doctor of philosophy programs with pre- and postdoctoral fellowship awards ranging from $21,500 to $90,000 and the recruitment of faculty with a loan repayment program of up to $50,000. In exchange for the financial support, fellows and faculty must make a 3-year commitment to teach in a UW System nursing program. Two conferences for program participants are also funded through the award. The first conference was held in October 2014. The second conference is scheduled for summer 2015. With the first year of the 2-year project completed, this article describes Nurses for Wisconsin from inception to implementation and midterm assessment with a focus on lessons learned. A follow-up article addressing final outcomes and next steps is planned.

  18. 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…

  19. 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)

  20. Oral health education for pediatric nurse practitioner students.

    PubMed

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

    2013-05-01

    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

  1. 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…

  2. 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)

  3. Faculty Development and Support Needs of Nurse Practitioner Faculty.

    ERIC Educational Resources Information Center

    Jones, Teddy; Norton, Darlene

    1999-01-01

    A nationwide sample of 128 nurse practitioner faculty expressed a significant disparity between ideal and actual faculty support and development structures and processes in their current employment. The greatest hindrance was administrators' lack of knowledge of their clinical practice responsibilities. (JOW)

  4. 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…

  5. Physician Assistant and Nurse Practitioner Prescribing: 1997-2002

    ERIC Educational Resources Information Center

    Hooker, Roderick S.; Cipher, Daisha J.

    2005-01-01

    Context: Physician assistants (PAs) and nurse practitioners (NPs) have licensure to practice in all states and they have prescriptive authority in 47 and 40 states, respectively. However, there have been no published studies from a national standpoint comparing urban and rural settings. Purpose: The objective of this study was to describe the…

  6. 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…

  7. Defining the characteristics of the nurse practitioner role.

    PubMed

    Eve, Lisa

    The role of the nurse practitioner (NP) has recently expanded and is now recognised in a range of health care delivery settings including primary care. In addition, the last few years have seen a proliferation of use of the NP title. This article outlines a set of competencies that aim to bring clarity to the role.

  8. 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.

  9. Telehealth nurse practitioner student clinical experiences: an essential educational component for today's health care setting.

    PubMed

    Hawkins, Shelley Yerger

    2012-11-01

    In order to meet the continuous changes and innovations within the health care system, nurse practitioner faculty must look to the future and prepare nurse practitioner graduates who deliver safe, quality patient care addressing the realities of a global society with a fast-paced expansion of technologies. Preparing nurse practitioner students for practice must include more than information technology knowledge in graduate nursing programs. Formal clinical experiences using various telehealth applications must be integrated into nurse practitioner training. Innovative strategies must be explored by nurse practitioner faculty to assure that graduates can meet the demanding technological demands of our current health care society.

  10. Mobile learning: a workforce development strategy for nurse supervisors.

    PubMed

    Mather, Carey; Cummings, Elizabeth

    2014-01-01

    Digital technology provides opportunities for using mobile learning strategies in healthcare environments. To realise the vision of the National Workforce Development Strategy there needs to be innovation of health professionals to further develop knowledge and skills of clinical supervisors to access and gain an understanding of the value of mobile learning at the workplace. The use of digital technology by clinical supervisors was explored in 2012 as part of a teaching development grant to evaluate the use of Web 2.0 technology to develop a community of practice about clinical supervision. Prior to developing the virtual network of clinical supervisors, feedback about the use of Web 2.0 technology by clinicians was sought via an online survey. Over 90% of respondents used social media, 85% understood what a blog and wiki were and approximately half of the respondents used smart phones. More than one-third indicated they would participate in a virtual community of practice and would like to receive information about clinical facilitation at least once per week. Findings indicate both inhibitors and opportunities for workforce development within healthcare environments that need to be addressed. Support of graduate-ready nurses can be achieved through an integrated outlook that enables health professionals within organisations to undertake mobile learning in situ. A flexible and collaborative approach to continuing professional development within organisations could enhance practice development and could positively impact on workforce development. PMID:25087534

  11. Mobile learning: a workforce development strategy for nurse supervisors.

    PubMed

    Mather, Carey; Cummings, Elizabeth

    2014-01-01

    Digital technology provides opportunities for using mobile learning strategies in healthcare environments. To realise the vision of the National Workforce Development Strategy there needs to be innovation of health professionals to further develop knowledge and skills of clinical supervisors to access and gain an understanding of the value of mobile learning at the workplace. The use of digital technology by clinical supervisors was explored in 2012 as part of a teaching development grant to evaluate the use of Web 2.0 technology to develop a community of practice about clinical supervision. Prior to developing the virtual network of clinical supervisors, feedback about the use of Web 2.0 technology by clinicians was sought via an online survey. Over 90% of respondents used social media, 85% understood what a blog and wiki were and approximately half of the respondents used smart phones. More than one-third indicated they would participate in a virtual community of practice and would like to receive information about clinical facilitation at least once per week. Findings indicate both inhibitors and opportunities for workforce development within healthcare environments that need to be addressed. Support of graduate-ready nurses can be achieved through an integrated outlook that enables health professionals within organisations to undertake mobile learning in situ. A flexible and collaborative approach to continuing professional development within organisations could enhance practice development and could positively impact on workforce development.

  12. Nurse Workforce Challenges in the United States: Implications for Policy. OECD Health Working Papers, No. 35

    ERIC Educational Resources Information Center

    Aiken, Linda H.; Cheung, Robyn

    2008-01-01

    The United States has the largest professional nurse workforce in the world numbering close to 3 million but does not produce enough nurses to meet its growing demand. A shortage of close to a million professional nurses is projected to evolve by 2020. An emerging physician shortage will further exacerbate the nurse shortage as the boundaries in…

  13. 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…

  14. 42 CFR 418.304 - Payment for physician and nurse practitioner services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Payment for physician and nurse practitioner... § 418.304 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)...

  15. 42 CFR 418.304 - Payment for physician and nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 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...

  16. 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...

  17. 42 CFR 418.304 - Payment for physician and nurse practitioner services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for physician and nurse practitioner... § 418.304 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)...

  18. 42 CFR 418.304 - Payment for physician and nurse practitioner services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Payment for physician and nurse practitioner... § 418.304 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)...

  19. 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

  20. 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.

  1. A clinical internship model for the nurse practitioner programme.

    PubMed

    Lee, Geraldine A; Fitzgerald, Les

    2008-11-01

    Nurse practitioners in Victoria, Australia must be prepared to Masters level before seeking nurse practitioner (NP) endorsement. The challenge from a university curriculum development perspective was to develop a programme that prepares the NP theoretically and clinically for their advanced practice role. The aim of this discussion paper is to outline how the internship model was developed and report the students' opinions on the model. The NP students complete the internship with a suitably qualified mentor which requires them to work together to develop and maintain a clinical learning plan, keep a log of the weekly meetings that shows how the objectives have been achieved. The internship includes advanced clinical assessment, prescribing, diagnostic and treatment skills and knowledge related to the nurse's specialty. The clinical assessment tool incorporates the National Competency Standards for the Nurse Practitioner and allows students and mentors to identify the level of practice and set clinical objectives. Students were asked to give feedback on the clinical internship and overall their comments were favourable, reporting benefits of a clinical mentor in their work and the clinical case presentations. The clinical internship allows the acquisition of knowledge and clinical skills in the clinical specialty with an expert clinical mentor in this innovative programme.

  2. State policy and research initiatives focused on improving nursing workforce: an integrative literature review.

    PubMed

    Green, Alexia; Kishi, Aileen; Esperat, M Christina R

    2010-01-01

    The purpose of this chapter is to examine to and synthesize nursing workforce research and policy initiatives at the state level. An integrative literature review was systematically conducted using Ganong's Stages of an Integrative Research Review (1987). Searches were limited to English-language publications in the years from 2000 to 2010 which focused on workforce issues in the United States. A total of 155 published articles were included in this review. Overall, the literature indicated that significant research is examining nursing workforce issues and that states are actively engaged in policy initiatives to address nursing workforce issues, particularly those related to a shortage of nurses and faculty. The findings also indicated a major disconnect between nursing workforce research and patient outcomes research. Recommendations include connecting research and policy links between nursing workforce research and patient outcomes research and creating clear correlations to system-level determinants of quality Additional implications for further research are provided which include the important role of nurse researchers in connecting nursing care and nurse staffing to processes and outcome measures, which demonstrate the financial impact upon health care.

  3. Postgraduate nurse practitioner residency programs: supporting transition to practice.

    PubMed

    Wiltse Nicely, Kelly L; Fairman, Julie

    2015-06-01

    The 2010 Institute of Medicine report The Future of Nursing recommended residency programs for nurses. The number of such postgraduate residencies for nurse practitioners (NPs) is increasing in community settings; still, the Institute of Medicine's recommendation departs from the tradition of direct entry into practice after the completion of a formal nursing program. Research shows that residencies support NPs' transition to practice, but very few data support their impact on patient care. Postgraduate residencies are controversial, and the authors of this Commentary discuss the naming, funding mechanisms, and possible mandating of these programs.The authors believe that residencies should not be mandated but encouraged for new NPs and for those moving to new clinical settings. Team-based residencies provide both an opportunity to improve collaboration and a model of patient-centered care.

  4. A Study of Family Nurse Practitioners: Perceived Competencies and Some of Their Implications for Nursing Education.

    ERIC Educational Resources Information Center

    Ward, Mary Jane Morrow

    This study was designed to determine the most common health needs and problems that family nurse practitioners (FNP) deal with, to determine how competent FNPs judge themselves to be, to determine what sources in nursing education FNPs judge to be most valuable, and to determine whether or not there were significant differences in the level of…

  5. Enhancing computer literacy and information retrieval skills: A rural and remote nursing and midwifery workforce study.

    PubMed

    Mills, Jane; Francis, Karen; McLeod, Margaret; Al-Motlaq, Mohammad

    2015-01-01

    Nurses and midwives collectively, represent the largest workforce category in rural and remote areas of Australia. Maintaining currency of practice and attaining annual licensure with the Australian Health Practitioners Regulatory Authority (AHPRA) present challenges for individual nurses and midwives and for their health service managers. Engagement with information and communication technologies, in order for geographically isolated clinicians to access ongoing education and training, is considered a useful strategy to address such challenges. This paper presents a pre- and post-test study design. It examines the impact of an online continuing professional development (CPD) program on Australian rural nurses and midwives. The aims of the program were to increase basic skill acquisition in the utilisation of common computer software, the use of the Internet and the enhancement of email communication. Findings from the study demonstrate that participants who complete a relevant CPD program gain confidence in the use of information and communication technologies. Further, increased confidence leads to increased access to contemporary, reliable and important health care information on the Internet, in addition to clinicians adopting email as a regular method of communication. Health care employers commonly assume employees are skilled users of information and communication technologies. However, findings from this study contradict such assumptions. It is argued in the recommendations that health care employees should be given regular access to CPD programs designed to introduce them to information and communication technologies. Developing knowledge and skills in this area has the potential to improve staff productivity, raise health care standards and improve patient outcomes. PMID:26552199

  6. Enhancing computer literacy and information retrieval skills: A rural and remote nursing and midwifery workforce study.

    PubMed

    Mills, Jane; Francis, Karen; McLeod, Margaret; Al-Motlaq, Mohammad

    2015-01-01

    Nurses and midwives collectively, represent the largest workforce category in rural and remote areas of Australia. Maintaining currency of practice and attaining annual licensure with the Australian Health Practitioners Regulatory Authority (AHPRA) present challenges for individual nurses and midwives and for their health service managers. Engagement with information and communication technologies, in order for geographically isolated clinicians to access ongoing education and training, is considered a useful strategy to address such challenges. This paper presents a pre- and post-test study design. It examines the impact of an online continuing professional development (CPD) program on Australian rural nurses and midwives. The aims of the program were to increase basic skill acquisition in the utilisation of common computer software, the use of the Internet and the enhancement of email communication. Findings from the study demonstrate that participants who complete a relevant CPD program gain confidence in the use of information and communication technologies. Further, increased confidence leads to increased access to contemporary, reliable and important health care information on the Internet, in addition to clinicians adopting email as a regular method of communication. Health care employers commonly assume employees are skilled users of information and communication technologies. However, findings from this study contradict such assumptions. It is argued in the recommendations that health care employees should be given regular access to CPD programs designed to introduce them to information and communication technologies. Developing knowledge and skills in this area has the potential to improve staff productivity, raise health care standards and improve patient outcomes.

  7. Exploring the Links Between Macro-Level Contextual Factors and Their Influence on Nursing Workforce Composition

    PubMed Central

    Squires, Allison; Beltrán-Sánchez, Hiram

    2012-01-01

    Research that links macro-level socioeconomic development variables to healthcare human resources workforce composition is scarce at best. The purpose of this study was to explore the links between non-nursing factors and nursing workforce composition through a secondary, descriptive analysis of year 2000, publicly available national nursing human resources data from Mexico. Building on previous research, the authors conducted multiple robust regression analysis by federal typing of nursing human resources from 31 Mexican states against macro-level socioeconomic development variables. Average education in a state was significantly associated in predicting all types of formally educated nurses in Mexico. Other results suggest that macro level indicators have a different association with each type of nurse. Context may play a greater role in determining nursing workforce composition than previously thought. Further studies may help to explain differences both within and between countries. PMID:22513839

  8. Best Practice Compass to Workforce Development: A Study. A Toolkit for Policymakers, Donors, Governments, NGOs and Practitioners.

    ERIC Educational Resources Information Center

    Aring, Monika; Corbitt, Cathleen

    This document, which is part of a toolkit for policymakers, donors, governments, nongovernmental organizations, and practitioners, presents the results of case studies of a group of 30 workforce development programs that were selected (during a 2-day workshop by a panel of 14 experts) as representing a balance among geographic regions served and…

  9. [An advanced nurse practitioner in general medicine in the United Kingdom].

    PubMed

    Aston, Jenny

    2015-01-01

    In the United Kingdom, an advanced nurse practitioner can carry out consultations and write prescriptions in the same way as a general practitioner. Jenny Aston, a nurse for more than 30 years, works in a GP surgery in Cambridge. Here, she explains the role of nurses in the organisation of health care in the UK, and talks about her career and her missions as an advanced nurse practitioner.

  10. Clinical mentoring of nurse practitioners: the doctors' experience.

    PubMed

    Barton, Thomas David

    The clinical development of nurse practitioners (NPs) has historically been dependent on mentorship from medical practitioners, yet their experience of this mentorship is generally unexplored. NPs have an ambiguous relationship with medicine as they have been dependent on medical mentorship to develop clinical skills, and they substitute into roles traditionally associated with medical practice. Consequently, NPs challenge professional boundaries and present particular concerns to their medical mentors. Practitioner ethnography examined the experiences of medical mentors, nurse practitioner students and academic staff during a clinical degree programme. This paper reports specifically on the medical mentors, focusing primarily on their professional authority relationship with their students and on their experience of imparting and sharing clinical knowledge. These experiences fell into three perspective stages, the provisional perspective, transitional perspective, and final perspective. Medical mentors were instrumental to the advanced clinical role of the student NP. This resulted in a conflicting experience of promoting a clinical role that challenged traditional medical authority. The effect of this was a cautious re-negotiation of professional boundaries. In future NP students (and their academic teachers) need to acknowledge this if they are to mutually gain the most from their relationship with their medical mentors.

  11. 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

  12. 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.

  13. 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

  14. Globalisation, localisation and implications of a transforming nursing workforce in New Zealand: opportunities and challenges.

    PubMed

    Callister, Paul; Badkar, Juthika; Didham, Robert

    2011-09-01

    Severe staff and skill shortages within the health systems of developed countries have contributed to increased migration by health professionals. New Zealand stands out among countries in the Organisation for Economic Co-operation and Development in terms of the high level of movements in and out of the country of skilled professionals, including nurses. In New Zealand, much attention has been given to increasing the number of Māori and Pacific nurses as one mechanism for improving Māori and Pacific health. Against a backdrop of the changing characteristics of the New Zealand nursing workforce, this study demonstrates that the globalisation of the nursing workforce is increasing at a faster rate than its localisation (as measured by the growth of the Māori and New Zealand-born Pacific workforces in New Zealand). This challenges the implementation of culturally appropriate nursing programmes based on the matching of nurse and client ethnicities. PMID:21790871

  15. Globalisation, localisation and implications of a transforming nursing workforce in New Zealand: opportunities and challenges.

    PubMed

    Callister, Paul; Badkar, Juthika; Didham, Robert

    2011-09-01

    Severe staff and skill shortages within the health systems of developed countries have contributed to increased migration by health professionals. New Zealand stands out among countries in the Organisation for Economic Co-operation and Development in terms of the high level of movements in and out of the country of skilled professionals, including nurses. In New Zealand, much attention has been given to increasing the number of Māori and Pacific nurses as one mechanism for improving Māori and Pacific health. Against a backdrop of the changing characteristics of the New Zealand nursing workforce, this study demonstrates that the globalisation of the nursing workforce is increasing at a faster rate than its localisation (as measured by the growth of the Māori and New Zealand-born Pacific workforces in New Zealand). This challenges the implementation of culturally appropriate nursing programmes based on the matching of nurse and client ethnicities.

  16. 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.

  17. How acceptable are primary health care nurse practitioners to Australian consumers?

    PubMed

    Parker, Rhian; Forrest, Laura; Ward, Nathaniel; McCracken, James; Cox, Darlene; Derrett, Julie

    2013-01-01

    International evidence indicates that nurses working in primary care can provide effective care and achieve positive health outcomes for patients similar to that provided by doctors. Nurse practitioners employed in primary health care perform some tasks previously exclusive to the GP role due to their advanced skills, knowledge and training. In November 2010 Medicare provider rights and Pharmaceutical Benefits Scheme rights were provided for nurse practitioners working in private practice, and in collaboration with a medical practitioner. However, there is limited evidence about how acceptable nurse practitioners are to Australian consumers and what knowledge consumers have of the nurse practitioner role in the delivery of primary health care. The aim of this study was to examine Australian health care consumers' perceptions of nurse practitioners working in primary health care. This paper reports on the results of seven focus groups (n = 77 participants) conducted around Australia. Focus groups participants were asked how acceptable nurse practitioners are as provides of primary health care. Although there was some confusion about the role of nurse practitioners and how this role differed from other primary health care nurses, participants in the focus groups were very positive about nurse practitioners and would find them acceptable in providing primary health care.

  18. Curriculum trends in nurse practitioner programs: current and ideal.

    PubMed

    Bellack, J P; Graber, D R; O'Neil, E H; Musham, C; Lancaster, C

    1999-01-01

    The purpose of this study was to ascertain the extent to which nurse practitioner (NP) education programs are addressing curriculum topics related to practice competencies needed for the next century as recommended by the Pew Health Professions Commission and other professional organizations, including the American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculties. The study was part of a comprehensive survey of 11 health professions education programs. NP program directors indicated greatest dissatisfaction with curriculum coverage of "use of electronic information systems" and "business management of practice." The three most important curriculum topics identified by respondents were "primary care," "health promotion/disease prevention," and "effective patient-provider relationships/communication," identical to the three topics rated most important by all groups combined. The most significant barriers to change identified by the respondents included "an already crowded curriculum" and "limited availability of clinical learning sites." Findings show that NP program directors perceive that they are doing an effective job addressing most of the 33 curriculum topics, but they also recognize a need to continue to improve their curricula in response to the ever-changing health care environment. Barriers to achieving the desired curricular improvements, however, may be significant. Recommendations for overcoming these barriers to change are offered.

  19. 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

  20. Specialist nursing framework for New Zealand: a missing link in workforce planning.

    PubMed

    Holloway, Kathy; Baker, Jacqueline; Lumby, Judy

    2009-11-01

    The current global nursing shortage challenges the provision of a well qualified and sustainable health workforce to meet future population health needs. An identified area of concern for New Zealand reaching health policy targets in chronic conditions management and primary health care is an adequate specialist nurse workforce supply. This article explores the New Zealand context underpinning this concern and contends that effective workforce planning would be supported by the development of a single unified framework for specialist nursing practice in New Zealand. A consistent national framework has the potential to support accurate data collection and enable service providers to identify and plan transparent and transferable pathways for specialist nursing service provision and development. Advanced practice nursing frameworks assist in increasing productivity through building an evidence base about advanced practice, enhancing consistency and equity of expertise; supporting a reduction in role duplication; and enabling succession planning and sustainability.

  1. The evolution of the role of nurses: the history of nurse practitioners in pediatric oncology.

    PubMed

    Wilson, Karla

    2005-01-01

    The role of nursing has been around since the beginning of time as demonstrated historically by caretakers who have attempted to relieve the suffering of children and of the sick within their community. In the late 1940s, the field of pediatric oncology nursing began emerging, and by the early 1970s, there were 2 pediatric nurse practitioner programs specific for pediatric oncology. The practice strategies for this role include not only directing and providing patient care to children with oncologic diseases but also negotiating the healthcare delivery system, monitoring and ensuring the quality of health care practice, offering family-centered care, and demonstrating cultural competency. In essence, the nurse practitioner role is multifaceted, requiring independent and interdependent decision making and direct accountability for clinical judgment in managing the care of children with cancer and their families.

  2. Nurse practitioner organizational climate in primary care settings: implications for professional practice.

    PubMed

    Poghosyan, Lusine; Nannini, Angela; Stone, Patricia W; Smaldone, Arlene

    2013-01-01

    The expansion of the nurse practitioner (NP) workforce in primary care is key to meeting the increased demand for care. Organizational climates in primary care settings affect NP professional practice and the quality of care. This study investigated organizational climate and its domains affecting NP professional practice in primary care settings. A qualitative descriptive design, with purposive sampling, was used to recruit 16 NPs practicing in primary care settings in Massachusetts. An interview guide was developed and pretested with two NPs and in 1 group interview with 7 NPs. Data collection took place in spring of 2011. Individual interviews lasted from 30-70 minutes, were audio recorded, and transcribed. Data were analyzed using Atlas.ti 6.0 software by 3 researchers. Content analysis was applied. Three previously identified themes, NP-physician relations, independent practice and autonomy, and professional visibility, as well as two new themes, organizational support and resources and NP-administration relations emerged from the analyses. NPs reported collegial relations with physicians, challenges in establishing independent practice, suboptimal relationships with administration, and lack of support. NP contributions to patient care were invisible. Favorable organizational climates should be promoted to support the expanding of NP workforce in primary care and to optimize recruitment and retention efforts. PMID:24267928

  3. Nurse practitioner organizational climate in primary care settings: implications for professional practice.

    PubMed

    Poghosyan, Lusine; Nannini, Angela; Stone, Patricia W; Smaldone, Arlene

    2013-01-01

    The expansion of the nurse practitioner (NP) workforce in primary care is key to meeting the increased demand for care. Organizational climates in primary care settings affect NP professional practice and the quality of care. This study investigated organizational climate and its domains affecting NP professional practice in primary care settings. A qualitative descriptive design, with purposive sampling, was used to recruit 16 NPs practicing in primary care settings in Massachusetts. An interview guide was developed and pretested with two NPs and in 1 group interview with 7 NPs. Data collection took place in spring of 2011. Individual interviews lasted from 30-70 minutes, were audio recorded, and transcribed. Data were analyzed using Atlas.ti 6.0 software by 3 researchers. Content analysis was applied. Three previously identified themes, NP-physician relations, independent practice and autonomy, and professional visibility, as well as two new themes, organizational support and resources and NP-administration relations emerged from the analyses. NPs reported collegial relations with physicians, challenges in establishing independent practice, suboptimal relationships with administration, and lack of support. NP contributions to patient care were invisible. Favorable organizational climates should be promoted to support the expanding of NP workforce in primary care and to optimize recruitment and retention efforts.

  4. Vacant hospitals and under-employed nurses: a qualitative study of the nursing workforce management situation in Nepal.

    PubMed

    Adhikari, Radha

    2015-04-01

    It is vital for all healthcare systems to have a sufficient number of suitably trained health professionals including nurses at all levels of health services to deliver effective healthcare. An ethnographic, qualitative method was chosen for this study, which included open-ended, in-depth interviews with a range of stakeholders including student nurses, qualified nurses, nurse managers and lecturers, and the human resource co-ordinator in the Ministry of Health and Population. Available records and policy documents were also analysed. Study findings suggest that there is a severe mal-distribution of the nursing workforce in rural and urban healthcare centres in Nepal. Although there is an oversupply of newly qualified nurses in hospitals in Kathmandu, the staffing situation outside the valley is undesirable. Additionally, the turnover of junior nursing staff remains high in major urban hospitals. Most qualified nurses aspire to work in developed countries, such as the UK, North America, Australia and New Zealand. Between 2000 and 2008, as many as 3000 nurses have left Nepal for jobs in the developed west. There is no effective management strategy in place to retain a nursing workforce, particularly in rural Nepal. This article concludes by proposing some suggestions for a nursing workforce retention policy to address this critical issue.

  5. Integration of spirituality into health care practice by nurse practitioners.

    PubMed

    Treloar, L L

    2000-07-01

    Although conceptualizations of mind, body, and spirit are ancient, spiritual aspects have not been readily integrated into health care. Western medicine's mechanistic model, with its "fix-broken-parts" paradigm, focuses on the physical body, with occasional consideration given to emotional and mental aspects. One's view of self in relation to a Supreme Being, and one's existence and purpose for life is central to health at all levels, e.g., spiritual, physical, emotional, and cognitive. The purpose of this article is to describe the role that nurse practitioners can and should take with patients and their families in integrating spirituality into health care practice.

  6. Thromboelastography: A Practice Summary for Nurse Practitioners Treating Hemorrhage

    PubMed Central

    Hravnak, Marilyn

    2015-01-01

    Nurse practitioners may manage patients with coagulopathic bleeding which can lead to life-threatening hemorrhage. Routine plasma-based tests such as prothrombin time and activated partial thromboplastin time are inadequate in diagnosing hemorrhagic coagulopathy. Indiscriminate administration of fresh frozen plasma, platelets or cryoprecipitate for coagulopathic states can be extremely dangerous. The qualitative analysis that thromboelastography provides can facilitate the administration of the right blood product, at the right time, thereby permitting the application of goal-directed therapy for coagulopathic intervention application and patient survival. PMID:26273234

  7. 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.

  8. 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

  9. The impact of nursing home patients on general practitioners' workload.

    PubMed Central

    Groom, L; Avery, A J; Boot, D; O'Neill, C; Thornhill, K; Brown, K; Jones, R

    2000-01-01

    BACKGROUND: Although the number of people in nursing homes has risen substantially in recent years, the shift of responsibility into general practice has rarely been accompanied by extra resources. These patients may be associated with a higher general practitioner (GP) workload than others of similar age and sex. AIM: To assess the GP workload associated with nursing home residents and its associated costs. METHOD: All nursing home residents aged over 65 years and registered with nine Nottinghamshire practices during one year were matched with patients living in the community for general practice, age, and sex. Data were collected retrospectively for both groups on key workload measures. Costs for the workload measures were calculated using published estimates. RESULTS: Data were collected for 270 pairs of patients. Nursing home patients had more face-to-face contacts in normal surgery hours, telephone calls, and out-of-hours visits. The mean workload cost per month of a nursing home patient (assuming that one patient was seen per visit) was estimated to be 18.21 Pounds (10.49 Pounds higher than the cost of controls). A sensitivity analysis demonstrated that potential savings in visiting costs associated with increasing the numbers of patients seen per visit were 27% for one extra patient seen per visit and 44% for four extra patients. CONCLUSION: Nursing home residents were associated with higher workload for GPs than other patients of the same age and sex living in the community. Our costings provide a basis for negotiating suitable reimbursement of GPs for their additional work. PMID:10962786

  10. Preparing the Workforce for the 21st Century: The Nurse Educator's Challenge.

    ERIC Educational Resources Information Center

    Southern Regional Education Board, Atlanta, GA. Council on Collegiate Education for Nursing.

    This document consists of synopses of selected presentations on the nurse educator's challenge in preparing the workforce for the 21st century that were made during the 1998 meeting of the Council on Collegiate Education for Nursing. In her paper "Redesigning Health Care Delivery," Karlene Kerfoot described changes in health care delivery systems…

  11. Nurse Workforce Characteristics and Infection Risk in VA Community Living Centers: A Longitudinal Analysis

    PubMed Central

    Uchida-Nakakoji, Mayuko; Stone, Patricia W.; Schmitt, Susan K.; Phibbs, Ciaran S.

    2015-01-01

    Objective To examine effects of workforce characteristics on resident infections in Veterans Affairs (VA) Community Living Centers (CLCs). Data Sources A six-year panel of monthly, unit-specific data included workforce characteristics (from the VA Decision Support System and Payroll data) and characteristics of residents and outcome measures (from the Minimum Data Set). Study Design A resident infection composite was the dependent variable. Workforce characteristics of registered nurses (RN), licensed practical nurses (LPN), nurse aides (NA), and contract nurses included: staffing levels, skill mix and tenure. Descriptive statistics and unit-level fixed effects regressions were conducted. Robustness checks varying workforce and outcome parameters were examined. Principal Findings Average nursing hours per resident day was 4.59 hours (sd = 1.21). RN tenure averaged 4.7 years (sd = 1.64) and 4.2 years for both LPN (sd= 1.84) and NA (sd= 1.72). In multivariate analyses RN and LPN tenure were associated with decreased infections by 3.8% (IRR= 0.962 p<0.01) and 2% (IRR=0.98 p<0.01) respectively. Robustness checks consistently found RN and LPN tenure to be associated with decreased infections. Conclusions Increasing RN and LPN tenure are likely to reduce CLC resident infections. Administrators and policymakers need to focus on recruiting and retaining a skilled nursing workforce. PMID:25634087

  12. Touchpoints: changing the face of pediatric nurse practitioner education.

    PubMed

    Percy, Melanie S; Stadtler, Ann; Sands, Dolores

    2002-01-01

    Touchpoints is an interdisciplinary relational model of healthcare primarily used with parents and young children. The underlying premise of the Touchpoints approach is to support the parent/child relationship during the health encounter by enhancing parents' efforts to optimize their child's physical and psychological development. Nurse practitioners who use this approach in practice find they are able to connect quickly to the parents' most urgent concerns for their child. Our experience has been that a pediatric nurse practitioner program that uses Touchpoints as the underlying framework can assist students in achieving a holistic view of families by focusing the curriculum more directly on development and relationships. Students learn that building a relationship with parents, and joining them in the care of their child, produces an atmosphere in the health encounter of mutual respect and trust. Parents leave the encounter feeling satisfied their concern for their child has been heard and questions have been seriously discussed; students leave feeling competent and valued by their patients. Touchpoints provides a model for teaching and demonstrating the development of interpersonal relationships by using the language of the child's behavior.

  13. Prescription omega-3s: an overview for nurse practitioners.

    PubMed

    Mason, Carol M; Long, Janet; Conroy, Cindy

    2011-01-01

    Nurse practitioners (NPs) often take a multidisciplinary approach when treating and educating patients. Collaboration with a registered dietitian is not uncommon when treating patients with severe hypertriglyceridemia (triglycerides [TGs] ≥500 mg/dL). Patients with severe hypertriglyceridemia should be treated and managed to normalize TG levels (TG level <150 mg/dL). Treatment for severe hypertriglyceridemia is often 3-fold, including lifestyle changes, diet modification, and pharmacotherapy. Therapeutic lifestyle changes are generally the first step in lowering TG levels. Registered dietitians promote a heart-healthy diet rich in fruits and vegetables. Evidence has been mounting to support consumption of eicosapentaenoic acid and docosahexaenoic acid to decrease TGs. When lifestyle and diet changes do not effectively decrease TGs, NPs will recommend pharmacological therapy as a next step. A viable pharmacological option includes prescription omega-3 (P-OM3) fatty acid ethyl esters. Each 4-g/d dose of P-OM3 provides 465 mg of eicosapentaenoic acid and 375 mg of docosahexaenoic acid. Clinical trials show that P-OM3 can safely and effectively decrease TGs by 45% in patients with severe hypertriglyceridemia. Nurse practitioners play an important role in the treatment of severe hypertriglyceridemia and in the education of patients about lifestyle and diet changes that can greatly impact patients' health.

  14. The Key Role of Nurse Researchers in the Evaluation of Nurse Practitioner Models of Practice.

    PubMed

    Hungerford, Catherine; Prosser, Brenton; Davey, Rachel

    2015-01-01

    The Nurse Practitioner-Aged Care Models of Practice Program involved diverse models of practice comprising multiple stakeholders located in more than 30 locations across Australia, in remote, rural, urban, and metropolitan settings. Funded by the Australian government, the aims of the program included supporting development of effective, economically viable, and sustainable aged care nurse practitioner models of practice; and enabling improvements in access to primary health care for people aged older than 65 years. This article describes the process by which a framework was developed to support the evaluation of this program. A particular challenge for the nurse researchers involved in the evaluation was to ensure the unique values of the nursing profession were upheld alongside economic, biomedical, and empirical imperatives in the diverse processes involved in collecting and interpreting data. The evaluation framework developed provides an important means of enabling research teams who undertake complex evaluations of diverse nursing models of practice to maintain a common goal--to unify the various stakeholders involved, while at the same time upholding what is most important to the profession of nursing. This article highlights how nurses can play an influential role when involved in the multidisciplinary evaluation of new andinnovative approaches to practice.

  15. 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

  16. Bureau of Health Workforce

    MedlinePlus

    ... Center for Health Workforce Analysis National Practitioner Data Bank Health Workforce Development Health Workforce Training Grant Programs Health Workforce Loan & Scholarship Programs  About HRSA Leadership & Org Chart Budget ...

  17. Transformation by design: nursing workforce innovation and reduction strategies in turbulent times of change.

    PubMed

    Palazzo, Mary O

    2015-01-01

    The evolution of care delivery from an acute care and inpatient standard to the outpatient setting and health promotion model is generating the need for innovative workforce and infrastructure adjustments to meet the new paradigm of population health management. Successful transformation of the nursing workforce necessitates a positive style of thinking that addresses rational concerns during times of difficult transition. Nurse leaders are called to recognize and appreciate the strengths of the nursing workforce by involving them in the course of change through collaboration, planning, and discussion. One unique way to plan and develop new care delivery models is to adopt the framework used in health facility planning and design for new services, units, or hospitals. This framework is flexible and can be adjusted easily to meet the objectives of a small nursing workforce innovation project or expanded to encompass the needs of a large-scale hospital transformation. Structured questioning further helps the team to identify barriers to care and allows for the development of new concepts that are objective and in accord with evidence-based practice and data. This article explores the advantages and disadvantages of implementing innovative workforce redesign and workforce reduction strategies.

  18. Transformation by design: nursing workforce innovation and reduction strategies in turbulent times of change.

    PubMed

    Palazzo, Mary O

    2015-01-01

    The evolution of care delivery from an acute care and inpatient standard to the outpatient setting and health promotion model is generating the need for innovative workforce and infrastructure adjustments to meet the new paradigm of population health management. Successful transformation of the nursing workforce necessitates a positive style of thinking that addresses rational concerns during times of difficult transition. Nurse leaders are called to recognize and appreciate the strengths of the nursing workforce by involving them in the course of change through collaboration, planning, and discussion. One unique way to plan and develop new care delivery models is to adopt the framework used in health facility planning and design for new services, units, or hospitals. This framework is flexible and can be adjusted easily to meet the objectives of a small nursing workforce innovation project or expanded to encompass the needs of a large-scale hospital transformation. Structured questioning further helps the team to identify barriers to care and allows for the development of new concepts that are objective and in accord with evidence-based practice and data. This article explores the advantages and disadvantages of implementing innovative workforce redesign and workforce reduction strategies. PMID:25714955

  19. Developing the children's nursing workforce: profile, first jobs and future plans of newly qualified diplomates.

    PubMed

    Robinson, Sarah; Cox, Susanne; Murrells, Trevor

    2006-03-01

    Concerns regarding the number of children's nurses persist despite initiatives designed to reverse this trend. Recruiting and retaining a diverse nursing workforce is high on the policy agenda, particularly since the publication of the National Service Framework for Children, Young People and Maternity Services. This article reports findings from the first phase of a longitudinal study investigating the careers of child branch diplomates, focusing on the cohort's profile, first jobs and future plans. Findings suggest there is considerable scope to increase diversity in the children's nursing workforce. Child health diplomates indicate little sign of early attrition from nursing at qualification. Continuing professional development is a high priority for many child health nurses at the outset of their careers. These findings provide an important benchmark for later stages of child branch nurses' careers.

  20. The trainee assistant in nursing: a pilot exercise in building and retaining a workforce.

    PubMed

    Deshong, Diane; Henderson, Amanda

    2010-03-01

    With increasing pressures on the skilled nursing workforce, strategies need to be developed to maximise the value of the existing workforce without impacting on the quality of care delivery. This paper reports on the introduction of a Commonwealth and State subsidised program for assistants-in-nursing (AINs) to assist in addressing the global nursing shortage. The program - which has included education sessions with registered nurses about the role of the AIN, delegation and supervision, and has also sustained support to the participants throughout the duration of their employment - has delivered benefits locally to the Princess Alexandra Hospital (PAH) and, broadly, to the nursing profession. Most of the participants completing the program have chosen to continue their employment at PAH or pursue further studies in nursing. PMID:20334755

  1. The public sector nursing workforce in Kenya: a county-level analysis

    PubMed Central

    2014-01-01

    Background Kenya’s human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. Methods National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Results Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value <0.0001). Conclusions An overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved. PMID:24467776

  2. The potential for nurse practitioners in health care reform.

    PubMed

    Archibald, Mandy M; Fraser, Kimberly

    2013-01-01

    In Canada, health care reform is underway to address escalating costs, access and quality of care issues, and existing personnel shortages in various health disciplines. One response of the nursing profession to these stimuli has been the development of the advanced practice nurse, namely, the nurse practitioner (NP). NPs are in an excellent position to address current shortcomings through increasing points of access to the health care system, providing an emphasis on education and disease prevention, and delivering high-quality, cost-effective care in a multitude of practice settings. With an emphasis on the social determinants of health, NPs are in a prime position to provide care to underserved and vulnerable populations across Canada. Despite the potential for NPs to be instrumental in health care reform, there is a lack of support and regulation necessary for their optimal use. Barriers to mobilizing NPs in Canada exist and impede the integration of NPs into the Canadian health care system, which has both quality of care and social justice implications.

  3. 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... 130—Confidential Physician or Nurse Practitioner Affidavit ER31MY00.002 ER31MY00.003...

  4. 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... 130—Confidential Physician or Nurse Practitioner Affidavit ER31MY00.002 ER31MY00.003...

  5. 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... 130—Confidential Physician or Nurse Practitioner Affidavit ER31MY00.002 ER31MY00.003...

  6. 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.

  7. 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

  8. 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.

  9. Primary care nurse practitioners' integrity when faced with moral conflict.

    PubMed

    Laabs, Carolyn Ann

    2007-11-01

    Primary care presents distressful moral problems for nurse practitioners (NPs) who report frustration, powerlessness, changing jobs and leaving advanced practice. The purpose of this grounded theory study was to describe the process NPs use to manage moral problems common to primary care. Twenty-three NPs were interviewed, commenting on hypothetical situations depicting ethical issues common to primary care. Coding was conducted using a constant comparative method. A theory of maintaining moral integrity emerged consisting of the phases of encountering conflict, drawing a line, finding a way without crossing the line, and evaluating actions. The NPs varied in their awareness and the discord encountered in conflict, and in clarity, flexibility and justification of the line drawn. A critical juncture occurred when NPs evaluated how well integrity had been maintained. Some experienced no distress while others experienced self-doubt, regret, outrage and frustration at external constraints, and attempted to reconcile through avoiding, convincing themselves, and compensating.

  10. Patient satisfaction with a new nurse practitioner service.

    PubMed

    Barr, M; Johnston, D; McConnell, D

    2000-07-01

    In the UK the role of the Nurse Practitioner (NP) has been slower to develop than in the USA (Tye 1997). However, since its inception, studies of the role have found positive results in areas of patient satisfaction (Touche Ross 1994). James and Pyrgos (1989) reported 94% of patients suitable to seen by a NP would use a NP if introduced. A study by Freij et al. (1996) concluded that emergency NPs were as competent at interpreting X-rays as casualty officers. Despite such evidence, Meek et al. (1995) noted opposition to this new advanced practice from other disciplines who wished to maintain the 'status quo'. In light of these findings, a study was undertaken to examine the new NP Service at Antrim Hospital, Northern Ireland. A patient satisfaction survey, a retrospective X-ray audit and a subjective assessment by other disciplines, were carried out in order to evaluate the service.

  11. Developing a strategic plan for a neonatal nurse practitioner service.

    PubMed

    Lee, Laurie A; Jones, Luann R

    2004-10-01

    Neonatal nurse practitioners (NNPs) have been in practice for over 3 decades. More recently, NNPs have begun to take ownership for building their group practice models. The purpose of this article is to present a detailed case study demonstrating how one NNP group used a 4-phase strategic planning process to turn a crisis into an opportunity. The article describes data obtained during the strategic planning process from an informal national survey of NNP managers that focused on key benchmarks, such as role definition, responsibilities, protected nonclinical time, NNP salary and benefits, and educational and professional development support. Using the strategic planning process, the group defined mutually agreed upon minimum safe staffing levels for NNPs, interns, residents and neonatologists in their setting. Based on the data generated, the group successfully justified additional NNP positions and organizational support for 10% protected nonclinical time. A sample operational budget, comparison of 3 staffing scenarios, and a timeline are also provided.

  12. Developing a strategic plan for a neonatal nurse practitioner service.

    PubMed

    Lee, Laurie A; Jones, Luann R

    2004-10-01

    Neonatal nurse practitioners (NNPs) have been in practice for over 3 decades. More recently, NNPs have begun to take ownership for building their group practice models. The purpose of this article is to present a detailed case study demonstrating how one NNP group used a 4-phase strategic planning process to turn a crisis into an opportunity. The article describes data obtained during the strategic planning process from an informal national survey of NNP managers that focused on key benchmarks, such as role definition, responsibilities, protected nonclinical time, NNP salary and benefits, and educational and professional development support. Using the strategic planning process, the group defined mutually agreed upon minimum safe staffing levels for NNPs, interns, residents and neonatologists in their setting. Based on the data generated, the group successfully justified additional NNP positions and organizational support for 10% protected nonclinical time. A sample operational budget, comparison of 3 staffing scenarios, and a timeline are also provided. PMID:15517523

  13. Nurse practitioner and physician roles: delineation and complementarity of practice.

    PubMed

    Davidson, R A; Lauver, D

    1984-03-01

    Because of differences in education and role preparation, nurse practitioners (NPs) and physicians (MDs) may assume either complementary or substitutive roles in patient care. To describe role complementarity and similarity, the role perceptions of 15 NPs and 15MDs in joint practice were assessed. Ten NP and MD respondent pairs were selected from a variety of ambulatory primary care settings (urban, rural, public, private, and health maintenance organizations), and five NP-MD pairs were chosen at random. A questionnaire of nine patient vignettes was created; respondents rated the appropriateness of their role in managing the clients described in each vignette using an 8-point scale. Significant differences existed between NP and MD perceived roles for six vignettes, p less than .05. NPs identified as highly role appropriate those vignettes necessitating psychosocial support and health education; MDs identified as highly role appropriate vignettes representing high risk physical conditions. The differences in NP and MD role perception were complementary. PMID:6565298

  14. Scaling up the global nursing health workforce: contributions of an international organization.

    PubMed

    Rukholm, Ellen E; Stamler, Lynnette Leeseberg; Talbot, Lise R; Bednash, Geraldine; Raines, Fay; Potempa, Kathleen; Nugent, Pauline; Clark, Dame Jill Macleod; Bernhauser, Sue; Parfitt, Barbara

    2009-01-01

    In this paper key highlights of the scholarly work presented at the Toronto 2008 Global Alliance for Nursing Education & Scholarship (GANES) conference are summarized, challenges opportunities and issues facing nursing education globally arising from the conference discourse are outlined and initial steps are suggested as a way forward to a shared global view of baccalaureate and graduate nursing education and scholarship. This shared view arises from beginning understandings of the issues and opportunities we face globally starting with and building upon the lessons learned from the literature and from the experiences of nursing educators and nursing education organization locally, regionally, nationally and internationally. The theme of the groundbreaking GANES Toronto conference was "Educating the future nursing and health workforce: A global challenge". One hundred seventy delegates from 17 countries attended the event, with over 80 papers presented. A primary focus of GANES is the contribution of a strategic alliance of national nursing education organizations to contribute to nursing education leading practices and policy that address the scaling up of global nursing and health workforce. The founding members of GANES see a clear link between a strong educational infrastructure and strong scholarship activities in nursing and the ability of a society to be healthy and prosperous. Evidence presented at the recent GANES conference supports that belief. Through the strength of partnerships and other capacity-building efforts, member countries can support each other to address the global nursing education and health challenges while respecting the local issues. PMID:19388426

  15. Scaling up the global nursing health workforce: contributions of an international organization.

    PubMed

    Rukholm, Ellen E; Stamler, Lynnette Leeseberg; Talbot, Lise R; Bednash, Geraldine; Raines, Fay; Potempa, Kathleen; Nugent, Pauline; Clark, Dame Jill Macleod; Bernhauser, Sue; Parfitt, Barbara

    2009-01-01

    In this paper key highlights of the scholarly work presented at the Toronto 2008 Global Alliance for Nursing Education & Scholarship (GANES) conference are summarized, challenges opportunities and issues facing nursing education globally arising from the conference discourse are outlined and initial steps are suggested as a way forward to a shared global view of baccalaureate and graduate nursing education and scholarship. This shared view arises from beginning understandings of the issues and opportunities we face globally starting with and building upon the lessons learned from the literature and from the experiences of nursing educators and nursing education organization locally, regionally, nationally and internationally. The theme of the groundbreaking GANES Toronto conference was "Educating the future nursing and health workforce: A global challenge". One hundred seventy delegates from 17 countries attended the event, with over 80 papers presented. A primary focus of GANES is the contribution of a strategic alliance of national nursing education organizations to contribute to nursing education leading practices and policy that address the scaling up of global nursing and health workforce. The founding members of GANES see a clear link between a strong educational infrastructure and strong scholarship activities in nursing and the ability of a society to be healthy and prosperous. Evidence presented at the recent GANES conference supports that belief. Through the strength of partnerships and other capacity-building efforts, member countries can support each other to address the global nursing education and health challenges while respecting the local issues.

  16. 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…

  17. Addressing the Shortage of Geriatricians: What Medical Educators Can Learn From the Nurse Practitioner Training Model.

    PubMed

    Golden, Adam G; Silverman, Michael A; Issenberg, S Barry

    2015-09-01

    Physicians' career interest in geriatric medicine continues to wane at a time when the health care needs of older adults are increasing. Nurse practitioners have helped fill the U.S. physician gap by delivering outpatient care to older adults and can practice with full autonomy in many states. Nursing graduate school programs are preparing adult-gerontology primary care nurse practitioners to successfully deliver outpatient care services using a model of training with fewer requirements that is more flexible and of shorter duration compared with the training model for geriatricians. Nurse practitioners can also obtain initial certification and recertification with less time commitment and at lower cost than geriatricians. Whether the outpatient care provided by nurse practitioners is comparable to the care provided by physicians remains a subject of debate. However, as nurse practitioners' scope of practice expands, the perception exists that the outpatient clinical roles of adult-gerontology primary care nurse practitioners and geriatricians are similar. This raises questions about whether there are too many educational and certification requirements for geriatricians. The authors encourage medical educators to learn from the success of the nurse practitioner education model for training large numbers of primary care providers. They propose decreasing the duration of medical school and graduate medical education training for geriatricians and providing educational debt repayment programs as potential incentives to stimulate career interest in geriatric medicine.

  18. NAPNAP Position Statement. Position Statement on Credentialing and Privileging for Nurse Practitioners.

    PubMed

    2016-01-01

    The National Association of Pediatric Nurse Practitioners (NAPNAP) recommends that all nurse practitioners (NPs) be credentialed and privileged to perform services that allow them to practice to the full extent of their education, certification, and licensure. This recommendation is supported by the Institute of Medicine in the report The Future of Nursing: Leading Change, Advancing Health (Institute of Medicine, 2011). Through the process of credentialing and privileging, individual NPs demonstrate competence for the skills required of their role and responsibility. PMID:27326432

  19. 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

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

    PubMed

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

    1989-09-01

    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.

  1. Self-determination, end-of-life decisions, and the role of nurse practitioners.

    PubMed

    Bradley, Heather

    2015-01-01

    Nurse practitioners should be aware that societal changes could lead to their being asked to actively assist terminally ill patients who wish to end their lives, as opposed to their current supportive role in palliative care. With physician staff shortages and the need for nurse practitioners to fill the gaps, end-of-life responsibilities could be placed in the hands of nurse practitioners, rather than being reserved for physicians alone (Sagon, 2013). End-of-life matters raise uncertainties about the nurse practitioner role because it differs state by state, relates to ethics, reflects the religious beliefs of those involved, and concerns the conflict of nurses simultaneously caring for their patients while advocating for their right to self-determination in choosing to end their lives.

  2. [Present and future ambulatory nursing care in Switzerland: what general practitioners should know].

    PubMed

    Weber-Yaskevich, Olga; Reber, Alexandra; Gillabert, Cédric

    2011-09-28

    In response to the ambulatorization of medical care, the panel of ambulatory nursing medical care is operating important changes. Since 2011, "acute and transitional medical care" is being prescribed by hospital practitioners, implying a new definition of the nurse's profession. The consequence is more complex and more autonomous nursing care: an academic formation has been created for nurses (bachelor and master) and their assistants (healthcare and community assistants). The futur will probably be made of ambulatory case management by nurses (advanced nurse practictioner). General practictioners will not only collaborate with the nurses but also assign them with tasks handled until then by themselves, prescribing, among other things, domiciliary "long-term" medical care.

  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. 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

  5. Nurse practitioners--where do they belong within the organizational structure of the acute care setting?

    PubMed

    el-Sherif, C

    1995-01-01

    Nurse practitioners are expanding their scope of practice and moving into acute care settings. Striving to be part of the nursing organizational structure in the acute care setting will keep NP's practice firmly rooted in nursing theory. Remaining within the nursing realm will enable them to receive support and guidance from their nursing colleagues while advancing the profession through their knowledge and expertise. Within the nursing organizational structure, NPs can become leaders as clinicians and role models. Without the formal support of the nursing organizational structure, the unique skills and contributions nurse practitioners furnish to the profession will be lost, as others will then dictate the NP role and scope of practice within the acute care setting.

  6. Classroom to clinic: incorporating adolescent spiritual/faith assessment into nurse practitioner education & practice.

    PubMed

    Haley, Janice M

    2014-01-01

    Although nursing is well grounded in the conceptualization of person as body-mind-spirit, there is little evidence that advanced practice nurses routinely address the spirit in giving patient care, especially with adolescents in the outpatient setting. The neglect of spiritual aspects of care may be related to lack of a framework, or education/incorporation into nurse practitioner preparation. This article describes one method of integrating adolescent spiritual/faith assessment into a nurse practitioner clinical course. Readings, assignments, and a grading rubric are offered.

  7. Student perceptions: the influence of a Nursing Workforce Diversity Grant on retention.

    PubMed

    Evans, Bronwynne C

    2007-08-01

    This article reports the perceptions of Hispanic/Latino and American Indian students concerning the influence of a Nursing Workforce Diversity Grant (ALCANCE) on their educational experiences in a baccalaureate nursing program. The grant provided an educational pipeline for these students, supporting them financially, personally, and academically from middle school through graduation from the nursing program. Fifteen students receiving grant services during the upper-division nursing major completed a 76-item questionnaire assessing the influence of such services at the end of each of four semesters in the nursing program. Analysis of these questionnaires and examination of responses to open-ended questions at the end of each instrument indicated a generally positive influence of ALCANCE on student experiences. However, there remains a need for the creation of additional caring educational environments and further research to better understand effective strategies for addressing recruitment and retention in American Indian and Hispanic/Latino nursing students. PMID:17726998

  8. Community of practice: a nurse practitioner collaborative model.

    PubMed

    Burgess, Judith; Sawchenko, Linda

    2011-06-01

    A study was undertaken with nurse practitioners (NPs) in 2008-2009 to examine post-legislation role development in British Columbia. The authors used a participatory action research approach to engage NPs in social investigation, education and action, and to explore, from the participants' perspective, how collaboration advances NP role integration in primary healthcare. A particular discovery of the study was the Interior Health Authority Community of Practice (CoP) established in collaboration with health leaders and NPs. The purpose of this paper is to report on the CoP and the five characteristics describing this collaborative CoP model, including sanctioned social structure, knowledge exchange network, practice discovery and innovation, generating meaning and value, and power sharing for strategic improvement. The CoP helped NPs to build collegial and collaborative relationships, enhance practice learning and competence, extend and apply new knowledge, enrich professional identities, and shape health organizational policy and politics. Because healthcare research about CoPs is limited, principles of a collaborative CoP model are offered for broader healthcare use. The authors conclude that a collaborative CoP model addresses the internal interests and needs of participating members while attending to the external concerns of the organization, and thus contributes to healthcare improvement. PMID:21730772

  9. Nurse practitioner role in preparing families for pediatric outpatient surgery.

    PubMed

    Frisch, Ashley M; Johnson, Arlene; Timmons, Shirley; Weatherford, Carol

    2010-01-01

    Due to medical advances in surgery and anesthesia and cost of hospital stays, more elective pediatric surgical procedures are being performed in outpatient settings. One proposed advantage of outpatient surgery is decreased anxiety or a shorter period of anxiety for pediatric patients and their families because they are able to go home shortly after the surgery. A literature review was conducted to describe anxiety experienced by pediatric patients and their families in the outpatient surgery setting and to explore ways to decrease that anxiety. Both children and parents reported not feeling emotionally and educationally prepared for outpatient surgery. Developmentally appropriate pre-surgical educational programs and parental involvement in the surgical experience can help alleviate the anxiety of both children and parents during the pediatric surgical experience. Nurse practitioners (NPs) are currently being used in pre-operative outpatient settings to conduct physical examinations and provide pre-op education. Pre-op education programs provided by NPs are beneficial in decreasing the anxiety state among children and parents prior to surgery.

  10. 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)

  11. 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

  12. Nursing Workforce in Hubei China: Implications for the Development of Traditional Chinese Medicine Education.

    PubMed

    Cai, Yi; Mao, Zongfu; Corazzini, Kirsten; Petrini, Marcia A; Wu, Bei

    2015-01-01

    Research evidence suggests that educating nurses about traditional Chinese medicine (TCM) significantly improves their nursing care practice and the health care outcomes of community residents. The purpose of this study was to describe the current use of TCM by China's nursing workforce, as well as the typical nurse to physician ratio and types of TCM education that nurses receive in health care facilities. A large retrospective survey was conducted in Hubei Province, China, in 2010. The sample included 620 non-TCM hospitals, 120 TCM hospitals, and 1254 community health centers (CHCs). Descriptive analysis and 1-way analysis of variance were used to test statistical differences. There were 79 447 nurses employed, of which 1527 had a TCM degree and 5689 had on-the-job TCM education. Non-TCM hospitals employed more nurses than TCM hospitals and CHCs, and TCM hospitals employed more TCM nurses than non-TCM hospitals and CHCs. The median nurse to physician ratio varied by level of urbanization and type of health care facility, from 0.6 in rural CHCs to 1.3 in rural non-TCM hospitals. Differences in TCM education preparation of nurses were significantly different in the urban and rural settings and by type of health care facility. The study suggested a shortage of nurses educated in TCM in Hubei Province China, as well as uneven TCM workforce distribution. More opportunities for TCM education are needed for nurses, especially in CHCs where health promotion and chronic disease management are the most important and mandated functions.

  13. The struggle for recognition: The nurse practitioner in New South Wales, Australia.

    PubMed

    Appel, A L; Malcolm, P

    1999-09-01

    Recognition of clinical expertise seems to be a worldwide struggle for nurses. In New South Wales (NSW), Australia, nurse practitioners (NPs) are currently struggling for formal recognition of their position. The role of NP is seen as a means of fulfilling the desire of expert nurses for optimal autonomy and recognition in the health care system. This article examines advanced nursing practice within the context of the Australian health care system and the NP movement in NSW, including the pilot projects conducted. Discussion includes contentious issues such as nurse-prescribed medications, Medicare funding, and support for the NP role from within the nursing and medical professions. PMID:11188555

  14. Does teaching an entire nursing degree rurally have more workforce impact than rural placements?

    PubMed

    Playford, Denese; Wheatland, Belynda; Larson, Ann

    2010-01-01

    Education plays a key role in recruitment of health workforce to rural and remote locations. In Australia, Schools of Nursing have set up a variety of educational programmes to encourage rural workforce choices. These programmes include rural campuses and short-term rural placement programmes out of urban campuses. This study compares the relative workforce impacts of rural campus versus short-term rural placements out of urban campus. The single outcome measure - rural or urban location after graduation - showed that the rural school graduated a significantly higher proportion of rural-working graduates (chi(2) 4.46, p = 0.04). However there was no difference in the rural workforce choices of students from rural backgrounds, irrespective of their university location (chi(2) = 1.45, p = 0.23). We conclude that both rural universities and affirmative action for selecting rural students into nursing programmes are effective workforce strategies, but that rural campuses have the added benefit of encouraging under-represented rural students to access university education. PMID:20636179

  15. 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…

  16. Connecting the Dots: The Labor Market Information View of Workforce Development. Essays for the Practitioner.

    ERIC Educational Resources Information Center

    Froeschle, Richard, Ed.

    This monograph is comprised of 12 essays related to the federal Workforce Investment Act of 1998 (WIA), each of which serves as a generic primer on a topic relevant to work force development staff and researchers nationwide. The essays are "Learning the Language of LMI (Labor Market Information): Basic Labor Market Information Terms and Concepts"…

  17. Effect of Prior Health-Related Employment on the Registered Nurse Workforce Supply.

    PubMed

    Yoo, Byung-kwan; Lin, Tzu-chun; Kim, Minchul; Sasaki, Tomoko; Spetz, Joanne

    2016-01-01

    Registered nurses (RN) who held prior health-related employment in occupations other than licensed practical or vocational nursing (LPN/LVN) are reported to have increased rapidly in the past decades. Researchers examined whether prior health-related employment affects RN workforce supply. A cross-sectional bivariate probit model using the 2008 National Sample Survey of Registered Nurses was esti- mated. Prior health-related employment in relatively lower-wage occupations, such as allied health, clerk, or nursing aide, was positively associated with working s an RN. ~>Prior health-related employ- ment in relatively higher-wage categories, such as a health care manager or LPN/LVN, was positively associated with working full-time as an RN. Policy implications are to promote an expanded career ladder program and a nursing school admission policy that targets non-RN health care workers with an interest in becoming RNs. PMID:27055308

  18. Master's-Level Nurse Practitioner Educational Programs: Findings from the 2000-2001 Collaborative Curriculum Survey.

    ERIC Educational Resources Information Center

    Berlin, Linda E.; Harper, Doreen; Werner, Kathryn E.; Stennett, Janis

    Based on a survey of master's level nurse practitioner (NP) educational programs, this report presents data on: (1) types of programs and their characteristics; (2) programs by NP role preparation (single track, dual track, or combined NP/clinical nurse specialist); (3) course content areas included in core master's and clinical (didactic and/or…

  19. 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…

  20. 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…

  1. 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…

  2. A community college model to support nursing workforce diversity.

    PubMed

    Colville, Janet; Cottom, Sherry; Robinette, Teresa; Wald, Holly; Waters, Tomi

    2015-02-01

    Community College of Allegheny County (CCAC), Allegheny Campus, is situated on the North Side of Pittsburgh. The neighborhood is 60% African American. At the time of the Health Resources and Services Administration (HRSA) application, approximately one third of the students admitted to the program were African American, less than one third of whom successfully completed it. With the aid of HRSA funding, CCAC developed a model that significantly improved the success rate of disadvantaged students. Through the formation of a viable cohort, the nursing faculty nurtured success among the most at-risk students. The cohort was supported by a social worker, case managers who were nursing faculty, and tutors. Students formed study groups, actively participated in community activities, and developed leadership skills through participation in the Student Nurse Association of Pennsylvania. This article provides the rationale for the Registered Nurse (RN) Achievement Model, describes the components of RN Achievement, and discusses the outcomes of the initiative.

  3. Florida public health nurse workforce initiative: opportunity through crisis.

    PubMed

    2005-06-01

    The National Public Health Leadership Institute (NPHLI), a partnership between the Centers for Disease Control and Prevention and the University of North Carolina at Chapel Hill invites public health professionals to participate in a 2 year leadership program. Three Florida nurses participated in the NPHLI along with a cadre of 40 to 50 participants from the United States and foreign countries. Part of the commitment involved implementing a leadership project. This team chose to address the nursing shortage by developing and piloting mentorship program. Baseline research included a basic review of the literature and involvement in several work groups addressing various aspects of employing and retaining qualified public health nurses in Florida. During their NPHLI scholar year, team members sought input from a variety of professional sources on the reasons for the shortage of public health nurses in Florida. Based on responses from nurses, professional association members, and employees in the Florida Department of Health, team members developed a nursing mentorship project designed to address public health nursing retention and education. The goal was to develop a two-pronged mentorship program, which supported the attainment of clinical competence and workplace confidence while also improving the public health theoretical knowledge base of more experienced nurses. Nursing leadership at both the state and local levels agreed and embraced the concept. The Florida Team developed a Mentorship Handbook, which contains recruitment criteria, baseline, midterm and end of project assessment tools, and numerous other documents. The Team gained endorsement for the project and a commitment to see it through from the Department of Health's Nursing Office. The Florida Nurses Association partnered with the team to initiate the kickoff and involve team members in important discussion groups. In effecting change it is vital to have engaged and included the targeted "community" in

  4. 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.

  5. The application of the acute care nurse practitioner role in a cardiovascular patient population.

    PubMed

    Hernandez-Leveille, Marygrace; Bennett, Jasmiry D; Nelson, Nicole

    2014-12-01

    This article presents an overview of the role of an acute care nurse practitioner (ACNP) in an acute care setting caring for patients with cardiovascular issues. Discussion includes the evolution of the ACNP role, the consensus model for advanced practice registered nurse regulation, and a case study highlighting the role of the ACNP while caring for a hemodynamically unstable patient. The case study articulates the ACNP's role as liaison between the patient, family members, collaborating physicians, and nurses.

  6. HIGH PATIENT SATISFACTION WITH NURSE PRACTITIONER DELIVERED SERVICES AT TWO HEALTH CENTRES IN URBAN JAMAICA.

    PubMed

    Jones, Khadene; Hepburn-Brown, Cerese; Anderson-Johnson, Pauline; Lindo, Jascinth Lm

    2014-07-19

    Abstract Background: Nurse practitioners are playing an increasing role in the delivery of primary healthcare. Patient satisfaction with their services patients is an important factor to the expansion of their role in the health services. Objective: To explore the level of patient satisfaction with nurse practitioner delivered services at two health centres in urban Jamaica. Method: A cross sectional survey of 120 adult clients (age ≥18 years old) seen by Nurse Practitioner at a Type 3 or Type 5 health centre in Kingston, Jamaica was conducted using a modified self-administered Nurse Practitioner Satisfaction Survey questionnaire. Data were analyzed using SPSS® version 18 for Windows®. Results: The study achieved response rate of 91.6% (n=120). The majority were females (77%) with an average age of 40 ± 16 years. Most (63%) were from the Type 5 health centre and the rest (37%) were from a Type 3 facility. The mean general satisfaction score was 81 out of a possible 90 and 83% of the respondents reported they were very satisfied with another 17% expressing that they were satisfied with the nurse practitioner services at both facilities. No respondent was dissatisfied. The mean satisfaction score was significantly higher among respondents 40 years and older than that of their younger counterparts. Socio demographic and organization characteristics were not associated with the mean satisfaction score. Conclusions: A high level of satisfaction exists among patients seen by nurse practitioners at two facilities in Kingston, Jamaica. This may represent an opportunity for expanded role of Nurse practitioners in the delivery of primary in Jamaica.

  7. The Role of Organizational Culture in Retaining Nursing Workforce

    PubMed Central

    Banaszak-Holl, Jane; Castle, Nicholas G.; Lin, Michael K.; Shrivastwa, Nijika; Spreitzer, Gretchen

    2015-01-01

    Purpose of the Study: We examined how organizational culture in nursing homes affects staff turnover, because culture is a first step to creating satisfactory work environments. Design and Methods: Nursing home administrators were asked in 2009 to report on facility culture and staff turnover. We received responses from 419 of 1,056 administrators contacted. Respondents reported the strength of cultural values using scales from a Competing Values Framework and percent of staff leaving annually for Registered Nurse (RN), Licensed Practice Nurse (LPN), and nursing aide (NA) staff. We estimated negative binomial models predicting turnover.  Results: Turnover rates are lower than found in past but remain significantly higher among NAs than among RNs or LPNs. Facilities with stronger market values had increased turnover among RNs and LPNs, and among NAs when turnover was adjusted for facilities with few staff. Facilities emphasizing hierarchical internal processes had lower RN turnover. Group and developmental values focusing on staff and innovation only lowered LPN turnover. Finally, effects on NA turnover become insignificant when turnover was adjusted if voluntary turnover was reported. Implications: Organizational culture had differential effects on the turnover of RN, LPN, and NA staff that should be addressed in developing culture-change strategies. More flexible organizational culture values were important for LPN staff only, whereas unexpectedly, greater emphasis on rigid internal rules helped facilities retain RNs. Facilities with a stronger focus on customer needs had higher turnover among all staff. PMID:24218146

  8. Fast-track for fast times: catching and keeping generation Y in the nursing workforce.

    PubMed

    Walker, Kim

    2007-04-01

    There is little doubt we find ourselves in challenging times as never before has there been such generational diversity in the nursing workforce. Currently, nurses from four distinct (and now well recognised and discussed) generational groups jostle for primacy of recognition and reward. Equally significant is the acute realisation that our ageing profession must find ways to sustain itself in the wake of huge attrition as the 'baby boomer' nurses start retiring over the next ten to fifteen years. These realities impel us to become ever more strategic in our thinking about how best to manage the workforce of the future. This paper presents two exciting and original innovations currently in train at one of Australia's leading Catholic health care providers: firstly, a new fast-track bachelor of nursing program for fee-paying domestic students. This is a collaborative venture between St Vincent's and Mater Health, Sydney (SV&MHS) and the University of Tasmania (UTas); as far as we know, it is unprecedented in Australia. As well, the two private facilities of SV&MHS, St Vincent's Private (SVPH) and the Mater Hospitals, have developed and implemented a unique 'accelerated progression pathway' (APP) to enable registered nurses with talent and ambition to fast track their career through a competency and merit based system of performance management and reward. Both these initiatives are aimed squarely at the gen Y demographic and provide potential to significantly augment our capacity to recruit and retain quality people well into the future.

  9. 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

  10. 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.

  11. The shape of the recovery: economic implications for the nursing workforce.

    PubMed

    Buerhaus, Peter I

    2009-01-01

    Given this analysis of the factors behind the apparent end to the recession, the uncertain shape of the recovery and whether the overall job market will rebound quickly or slowly, and the implications for nurse employment and earnings, what can nurse executives and managers do to prepare for the future? Nursing executives and unit-level managers should assess their nursing staff's attitudes toward their jobs, job satisfaction, and their spouse's employment status. Executives should also identify the major employers in their local economy and establish a strategy to monitor their economic performance. Working with the human resources department, nurse leaders should develop an action plan to identify initiatives that can be implemented in the near term, such as taking steps to increase job satisfaction, promote better relationships between management and nurses, and improve the ergonomic environment of the workplace to ease the physical and mental strain on older RNs. Nurse executives and managers must sharpen their focus on how quickly the job recovery unfolds and prepare for how the recovery will affect the nursing workforce in their own institution and community. PMID:19927451

  12. Leadership attributes: a key to optimal utilization of the community health nursing workforce.

    PubMed

    Ganann, Rebecca; Underwood, Jane; Matthews, Sue; Goodyear, Rosemarie; Stamler, Lynnette Leeseberg; Meagher-Stewart, Donna Marie; Munroe, Val

    2010-05-01

    This research examined leadership attributes that support the optimal utilization and practice of community health nurses (CHNs). Community health nursing is facing challenges in workforce capacity and sustainability. To meet current and future demands on the community sector, it is essential to understand workplace attributes that facilitate effective utilization of existing human resources and recruitment of new nurses. This pan-Canadian, mixed-methods study included a demographic analysis of CHNs in Canada, a survey involving responses from approximately 6,700 CHNs to identify enablers and barriers to community health nursing practice and 23 focus groups to examine organizational attributes that "best" support optimal practice within the public health nursing subsector. Nursing leadership was identified as an important attribute in organizations' utilization and support of CHNs working to work effectively. This effectiveness, in turn, will enhance community health programs and overall healthcare system efficiency. This paper highlights findings related to the role of nursing leadership and leadership development in optimizing community health nursing practice.

  13. Generational differences of the frontline nursing workforce in relation to job satisfaction: what does the literature reveal?

    PubMed

    Saber, Deborah A

    2013-01-01

    The job satisfaction of registered nurses has been found to be associated with retention, organizational commitment, workforce safety, and cost savings to health care organizations. Satisfaction of the workforce is vital because nursing turnover can be detrimental for a labor force that is growing older. However, the summation of the most important variables that are linked to job satisfaction has been difficult to discern in part because the workforce includes 3 main generations (ie, Baby Boomers, Gen Xers, and Millennials) with unique work values that drive their job satisfiers. This article provides a review of existing literature to examine the differences in variables that are linked to job satisfaction that exist between the generational cohorts. Differences in stress sources, need for work-life balance, and compensation are discussed. The knowledge about generationally driven variables that influence job satisfaction can help managers develop strategies to maintain a diverse nursing workforce. PMID:24168868

  14. Nursing workforce planning: insights from seven Malaysian hospitals.

    PubMed

    Drake, Robert

    In 2010, the Royal College of Nursing asked: 'What is the optimal level and mix of nurses required to deliver quality care as cost-effectively as possible?' This question implies there is a relationship between staffing levels, quality of care and financial efficiency. This paper examines the relationship between the staff budget, the number of staff required to achieve a target level of care and the actual number of staff employed in seven hospitals in Malaysia. It seeks to critically evaluate local challenges arising from staff budgeting/planning procedures, identify general issues that apply beyond Malaysian healthcare institutions and, finally, to propose a model that combines finance, staffing and level of care.

  15. The report of the Task Force on the North Carolina Nursing Workforce--May 2004.

    PubMed

    2004-01-01

    of well-prepared and motivated nurses remains a challenge now and in the future. But, as these discussions and the interactions with Task Force members have demonstrated over and over again, nursing is both a dynamic and exciting field of professional practice. And North Carolina is considered by most to be one of the very best states within which to be a nurse. It is hoped that all the 47 recommendations offered in this report, only 16 of which are specified here, will serve as a template for a deliberate policy agenda through which the nursing workforce for North Carolina can continue to be the vibrant example of the highest standards of practice for which its reputation has been well-earned. PMID:15457832

  16. Challenges of assessing critical thinking and clinical judgment in nurse practitioner students.

    PubMed

    Gorton, Karen L; Hayes, Janice

    2014-03-01

    The purpose of this study was to determine whether there was a relationship between critical thinking skills and clinical judgment in nurse practitioner students. The study used a convenience, nonprobability sampling technique, engaging participants from across the United States. Correlational analysis demonstrated no statistically significant relationship between critical thinking skills and examination-style questions, critical thinking skills and scores on the evaluation and reevaluation of consequences subscale of the Clinical Decision Making in Nursing Scale, and critical thinking skills and the preceptor evaluation tool. The study found no statistically significant relationships between critical thinking skills and clinical judgment. Educators and practitioners could consider further research in these areas to gain insight into how critical thinking is and could be measured, to gain insight into the clinical decision making skills of nurse practitioner students, and to gain insight into the development and measurement of critical thinking skills in advanced practice educational programs.

  17. Nursing and health sciences workforce diversity research using PhotoVoice: a college and high school student participatory project.

    PubMed

    Benavides-Vaello, Sandra; Katz, Janet R; Peterson, Jeffery Chaichana; Allen, Carol B; Paul, Robbie; Charette-Bluff, Andrea Lelana; Morris, Phyllis

    2014-04-01

    This participatory study used PhotoVoice and qualitative description to (a) mentor baccalaureate nursing and college students in workforce diversity research; (b) explore barriers and facilitators encountered by rural American Indian, Hispanic, and other high school students when attending college and pursuing careers in nursing or the health sciences; and (c) model a process of social action to help existing and future students. Baccalaureate nursing and graduate students participated in all stages of research, including dissemination. Five themes emerged from analysis of PhotoVoice data: (a) being afraid; (b) believing; (c) taking small steps; (d) facing fears; and (e) using support systems. Findings underscore the importance of helping students participate in efforts to increase work-force diversity through research. Increasing nursing and health sciences workforce diversity may require strategies developed within and tailored to specific cultures and communities.

  18. A Mixed-Method Evaluation of a Workforce Development Intervention for Nursing Assistants in Nursing Homes: The Case of WIN A STEP UP

    ERIC Educational Resources Information Center

    Morgan, Jennifer Craft; Konrad, Thomas R.

    2008-01-01

    Purpose: The purpose of this study was to evaluate WIN A STEP UP, a workforce development program for nursing assistants (NAs) in nursing homes (NHs) involving continuing education by onsite trainers, compensation for education modules, supervisory skills training of frontline supervisors, and short-term retention contracts for bonuses and/or wage…

  19. Evaluating Student Services Provided by School-based Health Centers: Applying the Shuler Nurse Practitioner Practice Model.

    ERIC Educational Resources Information Center

    Shuler, Pamela A.

    2000-01-01

    Presents guidelines for evaluating school-based health clinic services coordinated and/or staffed by nurse practitioners from a holistic approach. The Shuler Nurse Practitioner Practice Model is used as a theoretical framework for the guidelines because it presents a holistic approach to patient assessment, problem identification/diagnosis…

  20. 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...

  1. Nurse Practitioner Preferences for Distance Education Methods Related To Learning Style, Course Content, and Achievement.

    ERIC Educational Resources Information Center

    Andrusyszyn, Mary-Anne; Cragg, C. E.; Humbert, Jennie

    2001-01-01

    Nurse practitioner students using distance education (n=86) indicated a preference for self-direction, concrete examples, and small-group discussion. Print was their most preferred and audiotapes their least preferred format. Convenience, self-direction, and timing were more important than delivery method or learning style. Preferred order of…

  2. 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.…

  3. 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…

  4. Nurse Practitioner Curriculum for the 21st Century: A Model for Evaluation and Revision.

    ERIC Educational Resources Information Center

    Gagan, Mary Jo; Berg, Judy; Root, Sylvia

    2002-01-01

    Presents a model for revision of nurse practitioner curricula that has three components: (1) curriculum goals; (2) health policy and state regulation; and (3) community needs and demands. Describes data sources for the revision process: current students, graduates, faculty, community, and federal, state, and local agencies. (SK)

  5. 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…

  6. 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...

  7. Outpatient Antibiotic Prescribing Among United States Nurse Practitioners and Physician Assistants

    PubMed Central

    Sanchez, Guillermo V.; Hersh, Adam L.; Shapiro, Daniel J.; Cawley, James F.; Hicks, Lauri A.

    2016-01-01

    We examined US nurse practitioner (NP) and physician assistant (PA) outpatient antibiotic prescribing. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). Antibiotic stewardship interventions should target NPs and PAs. PMID:27704022

  8. Treating venomous snakebites in the United States: a guide for nurse practitioners.

    PubMed

    Evans, Dian Dowling; Nelson, Leah Welbourn

    2013-07-10

    This article discusses the current, evidence-based guidelines for managing venomous snakebites indigenous to the United States. A review of common varieties of venomous snakes, venom effects, risk factors for snakebites, and management strategies are presented to assist nurse practitioners in caring for snakebite victims.

  9. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner and physician assistant services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... nurse practitioner or a physician; and (5) In the case of a service, furnished by a member of the clinic... THE AGED AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services § 405.2415... type commonly rendered either without charge or included in the rural health clinic's bill;...

  10. The CNS with practitioner preparation: an emerging role in advanced practice nursing.

    PubMed

    Busen, N H; Engleman, S G

    1996-05-01

    As health care reform continues, CNSs are retooling for nurse practitioner (NP) roles. Although the debate regarding role integration is ongoing, advanced practice nurses (APNs) with blended preparation are appearing in the workplace. Much has been written about attributes the NP brings to the practice setting, but little has been said about the unique skills and knowledge base that the CNS brings. CNSs, with additional preparation as practitioners, will be marketable providers with population-specific knowledge, technological expertise, and comfort with higher acuity levels. This will allow APNs to combine a preventive model with high acuity levels, practice holistically, improve quality, and decrease costs of care. A case study of care given by a pediatric critical care CNS returning to school for practitioner preparation, which demonstrates several of the above concepts, is presented.

  11. Nannies, Nursery Nurses and Early Years Professionals: Constructions of Professional Identity in the Early Years Workforce in England

    ERIC Educational Resources Information Center

    McGillivray, Gill

    2008-01-01

    Recent policy in England has created a new status of "Early Years Professional", thus imposing professionalisation of the early years workforce. There has been an increase in policy focus on those working with young children, and such a focus raises questions about practitioners' own responses to the debate about their training, education,…

  12. An emergency department-based mental health nurse practitioner outpatient service: part 2, staff evaluation.

    PubMed

    Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

    2011-12-01

    The nurse practitioner role incorporates enhancing access to health-care services, particularly for populations that are underserved. This entails working collaboratively with colleagues across multidisciplinary teams and emphasizing a nursing model of practice within the nurse practitioner role. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based in the emergency department (ED) is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. One component of the evaluation involved semistructured interviews conducted with a random selection of study participants and a stratified sample of ED staff. This is the second of a two-part paper that presents an analysis of the qualitative data derived from the staff interviews (n = 20). Emergency staff were very supportive of the outpatient service, and perceived that it enhanced overall service provision and improved outcomes for patients. Moreover, staff expressed interest in receiving more formal feedback on the outcomes of the service. Staff also felt that service provision would be enhanced through additional mental health liaison nurses working in the department, especially after hours. An ED-based MHNP outpatient service expedites access to follow up to individuals with a broad range of problems, and supports ED staff in the provision of safe, effective, and more holistic care.

  13. 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.

  14. 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.

  15. 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

  16. Trends in nurse practitioners' prescribing to older adults in Ontario, 2000-2010: a retrospective cohort study

    PubMed Central

    Tranmer, Joan E.; Colley, Lindsey; Edge, Dana S.; Sears, Kim; VanDenKerkhof, Elizabeth; Levesque, Linda

    2015-01-01

    Background: Nurse prescribing is a practice that has evolved and will continue to evolve in response to emerging trends, particularly in primary care. The goal of this study was to describe the trends and patterns in medication prescription to adults 65 years of age or older in Ontario by nurse practitioners over a 10-year period. Methods: We conducted a population-based descriptive retrospective cohort study. All nurse practitioners registered in the Corporate Provider Database between Jan. 1, 2000, and Dec. 31, 2010, were identified. We identified actively prescribing nurse practitioners through linkage of dispensed medications to people aged 65 years or older from the Ontario Drug Benefit database. For comparison, all prescription medications dispensed by family physicians to a similar group were identified. Geographic location was determined based on site of nurse practitioner practice. Results: The number and proportion of actively prescribing nurse practitioners prescribing to older adults increased during the study period, from 44/340 (12.9%) to 888/1423 (62.4%). The number and proportion of medications dispensed for chronic conditions by nurse practitioners increased: in 2010, 9 of the 10 top medications dispensed were for chronic conditions. There was substantial variation in the proportion of nurse practitioners dispensing medication to older adults across provincial Local Health Integration Networks. Interpretation: Prescribing by nurse practitioners to older adults, particularly of medications related to chronic conditions, increased between 2000 and 2010. The integration of nurse practitioners into primary care has not been consistent across the province and has not occurred in relation to population changes and perhaps population needs. PMID:26457291

  17. 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.

  18. 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

  19. Retaining the mental health nursing workforce: early indicators of retention and attrition.

    PubMed

    Robinson, Sarah; Murrells, Trevor; Smith, Elizabeth M

    2005-12-01

    In the UK, strategies to improve retention of the mental health workforce feature prominently in health policy. This paper reports on a longitudinal national study into the careers of mental health nurses in the UK. The findings reveal little attrition during the first 6 months after qualification. Investigation of career experiences showed that the main sources of job satisfaction were caregiving opportunities and supportive working relationships. The main sources of dissatisfaction were pay in relation to responsibility, paperwork, continuing education opportunities, and career guidance. Participants were asked whether they predicted being in nursing in the future. Gender and ethnicity were related to likelihood to remain in nursing in 5 years time. Age, having children, educational background, ethnic background, and time in first job were associated with likelihood of remaining in nursing at 10 years. Associations between elements of job satisfaction (quality of clinical supervision, ratio of qualified to unqualified staff, support from immediate line manager, and paperwork) and anticipated retention are complex and there are likely to be interaction effects because of the complexity of the issues. Sustaining positive experiences, remedying sources of dissatisfaction, and supporting diplomats from all backgrounds should be central to the development of retention strategies. PMID:16296990

  20. The globalisation of the nursing workforce: barriers confronting overseas qualified nurses in Australia.

    PubMed

    Hawthorne, L

    2001-12-01

    Recent decades have coincided with the rapid globalisation of the nursing profession. Within Australia there has been rising dependence on overseas qualified nurses (OQNs) to compensate for chronic nurse shortages related to the continued exodus of Australian nurses overseas and to emerging opportunities in other professions. Between 1983/4 and 1994/5, 30 544 OQNs entered Australia on either a permanent or temporary basis, counter-balancing the departure overseas of 23 613 locally trained and 6519 migrant nurses (producing a net gain of just 412 nurses in all). The period 1995/6--1999/2000 saw an additional 11 757 permanent or long-term OQN arrivals, with nursing currently ranked third target profession in Australia's skill migration program, in the context of continuing attrition among local nurses. This pattern of reliance on OQNs is a phenomenon simultaneously occurring in the UK, the US, Canada and the Middle East --- the globalisation of nursing reflecting not merely Western demand but the growing agency and participation of women in skilled migration, their desire for improved quality of life, enhanced professional opportunity and remuneration, family reunion and adventure.

  1. 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.

  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. Nurse practitioners in primary care. VI. Assessment of their deployment with the Utilization and Financial Index.

    PubMed Central

    Spitzer, W. O.; Roberts, R. S.; Delmore, T.

    1976-01-01

    The impact of multidisciplinary teams that incorporate nurse practitioners on total use of health services was measured with the new Utilization and Financial Index (UF-Index). The data from two studies, a randomized controlled trial and a before-and-after study, showed that, in spite of large increases in use of ambulatory services by practice populations served by family physician-nurse practitioner teams, the ultimate effect has been a substantial reduction in total use of health services. The effect was associated with major reductions in hospital care for the same populations. Such economic advantages to society proved feasible within a fee-for-service context and in settings where rigorous evidence demonstrated no concurrent deterioration in health status of patients or in quality of care. PMID:819120

  4. Team science of nursing, engineering, statistics, and practitioner in the development of a robotic reflexology device.

    PubMed

    Wyatt, Gwen; Sikorskii, Alla; Bush, Tamara Reid; Mukherjee, Ranjan

    2010-01-01

    The purpose of this article is to share the lessons learned in forming an interdisciplinary team that implements a team science approach to integrative medicine (IM) research. The disciplines of nursing, statistics, and engineering, along with consultants and a reflexology practitioner, formed this university-based team to conceptualize and develop a prototype robotic device for reflexology for breast cancer patients. The nurse investigator contributed the intervention background and access to the population; the statistician guided the team thinking on factors that needed to be controlled for; the engineers provided the expertise in device design and development; consultants facilitated the team's thinking in new directions; and the reflexology practitioner prescribed the protocol. We discuss the contributions and achievements of each discipline, as well as the challenges, and share the team experiences with the intent to help guide the formation of new IM teams that promote a conducive atmosphere for carrying out cutting-edge IM research and advancing the science.

  5. Nurse practitioners in aged care: documentary analysis of successful project proposals.

    PubMed

    Clark, Shannon J; Parker, Rhian M; Davey, Rachel

    2014-11-01

    Meeting the primary health care needs of an aging population is an increasing challenge for many Western nations. In Australia, the federal government introduced a program to develop, test, and evaluate nurse practitioner models in aged care settings. In this article, we present a documentary analysis of 32 project proposals awarded funding under the Nurse Practitioner-Aged Care Models of Practice Program. Successfully funded models were diverse and were operated by a range of organizations across Australia. We identified three key priorities as underlying the proposed models: "The right care," "in the right place," and "at the right time." In this article, we explore how these priorities were presented by different applicants in different ways. Through the presentation of their models, the program's applicants identified and proposed to address current gaps in health services. Applicants contrasted their proposed models with available services to create persuasive and competitive applications for funding.

  6. Managing the marketing function for advanced nurse practitioners in a managed care environment.

    PubMed

    Pakis, S

    1997-09-01

    Delivering quality, cost-efficient health care is a desired service in the health care market today. Advanced nurse practitioners are positioned to deliver this product. The key in today's market is clearly defining the product, identifying the customers of the product, and crafting the message for each customer. The development of marketing strategies to address each of the above points will assist an organization in targeting resources and evaluating the effectiveness of the message being delivered.

  7. Financial viability, benefits and challenges of employing a nurse practitioner in general practice.

    PubMed

    Helms, Christopher; Crookes, Jo; Bailey, David

    2015-04-01

    This case study examines the financial viability, benefits and challenges of employing a primary healthcare (PHC) nurse practitioner (NP) in a bulk-billing healthcare cooperative in the Australian Capital Territory. There are few empirical case reports in the Australian literature that demonstrate financial sustainability of this type of healthcare professional in primary healthcare. This case study demonstrates that the costs of employing a PHC-NP in general practice are offset by direct and indirect Medicare billings generated by the PHC-NP, resulting in a cost-neutral healthcare practitioner. The success of this model relies on bidirectional collaborative working relationships amongst general practitioners and NPs. PHC-NPs should have a generalist scope of practice and specialist expertise in order to maximise their utility within the general practice environment. PMID:25528465

  8. 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

  9. Financial viability, benefits and challenges of employing a nurse practitioner in general practice.

    PubMed

    Helms, Christopher; Crookes, Jo; Bailey, David

    2015-04-01

    This case study examines the financial viability, benefits and challenges of employing a primary healthcare (PHC) nurse practitioner (NP) in a bulk-billing healthcare cooperative in the Australian Capital Territory. There are few empirical case reports in the Australian literature that demonstrate financial sustainability of this type of healthcare professional in primary healthcare. This case study demonstrates that the costs of employing a PHC-NP in general practice are offset by direct and indirect Medicare billings generated by the PHC-NP, resulting in a cost-neutral healthcare practitioner. The success of this model relies on bidirectional collaborative working relationships amongst general practitioners and NPs. PHC-NPs should have a generalist scope of practice and specialist expertise in order to maximise their utility within the general practice environment.

  10. Working together as a team: adolescent transplant recipients and nurse practitioners.

    PubMed

    Lerret, Stacee M; Stendahl, Gail

    2011-12-01

    Nurse practitioners are a critical part of the transplant team, enhancing the quality of patient care with their knowledge and skill with respect to disease-specific populations of patients. Adolescent transplant recipients are a vulnerable population and require specific considerations. Nurse practitioners can successfully tailor care to the adolescent developmental stages in order to promote quality of life, adherence to the medical regimen, and successful transition to adult transplant centers and to minimize risk-taking behaviors. Teamwork between the patient's family and the entire transplant team is important to optimize not only the patient's health but also to ensure quality of life after transplant. Adolescents can be especially challenging after transplant, given their complex and evolving psychosocial and cognitive development. Nurse practitioners are in a unique position to be central in adolescents' successful adaptation to their medical condition. Facilitating identification and management of medication-related side effects, awareness of emotional health and quality of life, adherence to the medical regimen, and eventual transition to adult caregivers all remain critically important steps in care that are ideally suited for advance practice leadership. PMID:22548989

  11. EDUCATIONAL PREPARATION FOR NURSE PRACTITIONERS AND ASSISTANTS TO NURSES, A POSITION PAPER.

    ERIC Educational Resources Information Center

    American Nurses' Association, New York, NY.

    THE ASSOCIATION'S FIRST POSITION PAPER ON NURSING EDUCATION WAS PREPARED BY ITS COMMITTEE ON EDUCATION AFTER 2 YEARS OF STUDYING THE MAJOR CHANGES AND TRENDS IN AND AROUND NURSING, ESPECIALLY AS THEY AFFECT PATIENT CARE. THE ASSOCIATION BELIEVES THAT--(1) EDUCATION FOR ALL WHO ARE LICENSED TO PRACTICE NURSING SHOULD TAKE PLACE IN INSTITUTIONS OF…

  12. Process and outcomes evaluation of retention strategies within a nursing workforce diversity project.

    PubMed

    Escallier, Lori A; Fullerton, Judith T

    2009-09-01

    A commitment to enhancing the diversity of the nursing workforce is reflected in the recruitment and retention strategies designed by Stony Brook University with support of a grant received from the Department of Health and Human Services, Health Resources and Services Administration. Three specific student retention strategies are evaluated in terms of their influence on student inclusion and promotion of student success. A review of the cultural competence of teaching and learning strategies and the promotion of cultural self-awareness underpinned these strategies. A mentorship program designed to provide individual support for students, particularly for those engaged in distance learning, proved to be challenging to implement and underused by students. Students found other means of support in their workplace and through individual connections with the faculty. Instructional programs that enhanced individual skills in the use of computer hardware and software were particularly effective in promoting student success. PMID:19645372

  13. Process and outcomes evaluation of retention strategies within a nursing workforce diversity project.

    PubMed

    Escallier, Lori A; Fullerton, Judith T

    2009-09-01

    A commitment to enhancing the diversity of the nursing workforce is reflected in the recruitment and retention strategies designed by Stony Brook University with support of a grant received from the Department of Health and Human Services, Health Resources and Services Administration. Three specific student retention strategies are evaluated in terms of their influence on student inclusion and promotion of student success. A review of the cultural competence of teaching and learning strategies and the promotion of cultural self-awareness underpinned these strategies. A mentorship program designed to provide individual support for students, particularly for those engaged in distance learning, proved to be challenging to implement and underused by students. Students found other means of support in their workplace and through individual connections with the faculty. Instructional programs that enhanced individual skills in the use of computer hardware and software were particularly effective in promoting student success.

  14. United States nurse practitioner students' attitudes, perceptions, and beliefs working with the uninsured.

    PubMed

    Rasmor, Melody; Kooienga, Sarah; Brown, Carol; Probst, Tahira M

    2014-11-01

    To reduce health disparities, nurses are expected to provide compassionate and high quality care to all patients regardless of socioeconomic and insurance status. In the United States (US) nurse practitioner (NP) educators need to expose students to clinical practice settings, such as free clinics, where the vulnerable populations like the non-documented immigrants and uninsured receive care. The purpose of this mixed method study was to provide an immersion experience for (NP) students at free clinics. Then researchers evaluated the impact of a clinical immersion experience on NP students' attitudes, perceptions, and beliefs about the uninsured and determine whether the clinical experience impacted their willingness to consider working with vulnerable populations in the future. Qualitative and quantitative data suggests students challenged their own beliefs and attitudes regarding the vulnerable populations, gained insight into care provided at these free clinics, and expressed their intent to volunteer at these settings. In the era of health care reform both nationally and internationally and the need to improve primary care access globally, educational initiatives are needed to expose NP students to economically vulnerable populations. Future research needs to replicate and extend the findings of this study, focusing on teaching-learning experiences for nurse practitioners and other advanced practice nursing students.

  15. The history of the neonatal nurse practitioner: reflections from "under the looking glass".

    PubMed

    Johnson, Patricia J

    2002-08-01

    The neonatal nurse practitioner (NNP) emerged in the 1970s. During the first two decades, nurses who functioned in this new advanced-practice role were forced to overcome interprofessional isolation, variable educational preparation, underutilization, and title ambiguity. However, after nearly 30 years of evolution influenced by the changing health care environment, technological advancements in newborn care, medical personnel shortages, and the advanced-practice nurse movement, the NNP is now a recognized member of the neonatal health care team nationwide. The NNP has achieved the level of provider status, but only after successfully overcoming many practice restrictions and restraints over the decades. This article chronicles the history of the NNP and recounts the external and internal elements that contributed to the development of this profession.

  16. Seeing the forest and the trees: increasing nurse practitioner students' observational and mindfulness skills.

    PubMed

    Grossman, Sheila; Deupi, Jill; Leitao, Kathleen

    2014-01-01

    Accurate, objective observation is a critical component of clinical diagnosis and patient management, which in turn is essential for successful diagnostic reasoning by advanced practice nurses. The purpose of this quasi-experimental study was to enhance nurse practitioner students' observation and reflective thinking skills using Looking Is Not Seeing, a reflective practice/experiential learning technique that uses art objects to teach observation (Pellico, Friedlaender, & Fennie, 2009). Students' posttest observation and interpretation scores showed statistically significant improvement over pretest scores. Students' mindfulness scores and their own perceived observational and interpretive ability were statistically significantly higher after participating in the study. Building on the established record of successful visual literacy programs for nursing and medical students at other institutions, this research can help educators implement the Looking Is Not Seeing pedagogy.

  17. Why we need multi-level health workforce governance: Case studies from nursing and medicine in Germany.

    PubMed

    Kuhlmann, Ellen; Larsen, Christa

    2015-12-01

    Health workforce needs have moved up on the reform agendas, but policymaking often remains 'piece-meal work' and does not respond to the complexity of health workforce challenges. This article argues for innovation in healthcare governance as a key to greater sustainability of health human resources. The aim is to develop a multi-level approach that helps to identify gaps in governance and improve policy interventions. Pilot research into nursing and medicine in Germany, carried out between 2013 and 2015 using a qualitative methodology, serves to illustrate systems-based governance weaknesses. Three explorative cases address major responses to health workforce shortages, comprising migration/mobility of nurses, reform of nursing education, and gender-sensitive work management of hospital doctors. The findings illustrate a lack of connections between transnational/EU and organizational governance, between national and local levels, occupational and sector governance, and organizations/hospital management and professional development. Consequently, innovations in the health workforce need a multi-level governance approach to get transformative potential and help closing the existing gaps in governance. PMID:26321192

  18. Why we need multi-level health workforce governance: Case studies from nursing and medicine in Germany.

    PubMed

    Kuhlmann, Ellen; Larsen, Christa

    2015-12-01

    Health workforce needs have moved up on the reform agendas, but policymaking often remains 'piece-meal work' and does not respond to the complexity of health workforce challenges. This article argues for innovation in healthcare governance as a key to greater sustainability of health human resources. The aim is to develop a multi-level approach that helps to identify gaps in governance and improve policy interventions. Pilot research into nursing and medicine in Germany, carried out between 2013 and 2015 using a qualitative methodology, serves to illustrate systems-based governance weaknesses. Three explorative cases address major responses to health workforce shortages, comprising migration/mobility of nurses, reform of nursing education, and gender-sensitive work management of hospital doctors. The findings illustrate a lack of connections between transnational/EU and organizational governance, between national and local levels, occupational and sector governance, and organizations/hospital management and professional development. Consequently, innovations in the health workforce need a multi-level governance approach to get transformative potential and help closing the existing gaps in governance.

  19. 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…

  20. Engaging a Nursing Workforce in Evidence-Based Practice: Introduction of a Nursing Clinical Effectiveness Committee.

    PubMed

    McKeever, Stephen; Twomey, Bernadette; Hawley, Meaghan; Lima, Sally; Kinney, Sharon; Newall, Fiona

    2016-02-01

    This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787. PMID:26606269

  1. 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

  2. Emergency nurse practitioners: a three part study in clinical and cost effectiveness

    PubMed Central

    Sakr, M; Kendall, R; Angus, J; Saunders, A; Nicholl, J; Wardrope, J

    2003-01-01

    Aims: To compare the clinical effectiveness and costs of minor injury services provided by nurse practitioners with minor injury care provided by an accident and emergency (A&E) department. Methods: A three part prospective study in a city where an A&E department was closing and being replaced by a nurse led minor injury unit (MIU). The first part of the study took a sample of patients attending the A&E department. The second part of the study was a sample of patients from a nurse led MIU that had replaced the A&E department. In each of these samples the clinical effectiveness was judged by comparing the "gold standard" of a research assessment with the clinical assessment. Primary outcome measures were the number of errors in clinical assessment, treatment, and disposal. The third part of the study used routine data whose collection had been prospectively configured to assess the costs and cost consequences of both models of care. Results: The minor injury unit produced a safe service where the total package of care was equal to or in some cases better than the A&E care. Significant process errors were made in 191 of 1447 (13.2%) patients treated by medical staff in the A&E department and 126 of 1313 (9.6%) of patients treated by nurse practitioners in the MIU. Very significant errors were rare (one error). Waiting times were much better at the MIU (mean MIU 19 minutes, A&E department 56.4 minutes). The revenue costs were greater in the MIU (MIU £41.1, A&E department £40.01) and there was a great difference in the rates of follow up and with the nurses referring 47% of patients for follow up and the A&E department referring only 27%. Thus the costs and cost consequences were greater for MIU care compared with A&E care (MIU £12.7 per minor injury case, A&E department £9.66 per minor injury case). Conclusion: A nurse practitioner minor injury service can provide a safe and effective service for the treatment of minor injury. However, the costs of such a service

  3. Family nurse practitioner students utilization of Personal Digital Assistants (PDAs): implications for practice.

    PubMed

    Tilghman, Joan; Raley, Dionne; Conway, Jia Joyce

    2006-01-01

    Personal Digital Assistants (PDAs) are a readily accessible source of information to aid in the delivery of patient care. A pilot group of five Family Nurse Practitioner students used PDAs to organize data and access information relevant to patient care. Utilization of the PDAs in the clinical setting provided practice guidelines, textbook information and protocols that were readily accessible. The PDA made it possible for students to utilize preexisting knowledge with additional learning resources. The PDAs were purchased with funds provided from a United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) grant.

  4. Nurse practitioner education: enhancing performance through the use of the Objective Structured Clinical Assessment.

    PubMed

    Bramble, K

    1994-02-01

    An Objective Structured Clinical Assessment (OSCA) was implemented in a graduate nurse practitioner (NP) program to determine the effect that participation in this type of clinical simulation would have on the cognitive and clinical competency of students. Based on the analysis of data, participation in the OSCA simulations did not lead to significantly better cognitive or clinical performance. Support for the OSCA was shown, however, by NP students when subjectively evaluating their experiences. All students agreed or strongly agreed that OSCA participation was a valuable learning experience and that the feedback provided was beneficial to their clinical and cognitive performance.

  5. The successful implementation of nurse practitioner model of care for threatened or inevitable miscarriage.

    PubMed

    Webster-Bain, Debora

    2011-03-01

    The NP project has been successful in a variety of ways. Feedback through a patient satisfaction survey was very positive and showed that patients appreciated and responded well to the NP model of care (Scully 2006). According to the hospital patient advocate, Ruth Reid (March 2006), this has led to not only a reduction in waiting and treatment times for this cohort of patients, but also to complete elimination in complaints when the NP service is running. Medical staff support the service and find it a sensible use of nursing and medical resources. This mirrors the overseas experience of NPs who offer primary health care in EDs. Finally, through successful collaboration between the nurse practitioner, supportive emergency physicians and the O&G team, this service is now a permanent part of Sunshine Hospital. PMID:21661480

  6. 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

  7. Preparing a 21st century workforce: is it time to consider clinically based, competency-based training of health practitioners?

    PubMed

    Nancarrow, Susan A; Moran, Anna M; Graham, Iain

    2014-02-01

    Health workforce training in the 21st century is still based largely on 20th century healthcare paradigms that emphasise professionalisation at the expense of patient-focussed care. This is illustrated by the paradox of increased training times for health workers that have corresponded with workforce shortages, the limited career options and pathways for paraprofessional workers, and inefficient clinical training models that detract from, rather than add to, service capacity. We propose instead that a 21st century health workforce training model should be: situated in the clinical setting and supported by outsourced university training (not the other way around); based on the achievement of specific milestones rather than being time-defined; and incorporate para-professional career pathways that allow trainees to 'step-off' with a useable qualification following the achievement of specific competencies. Such a model could be facilitated by existing technology and clinical training infrastructure, with enormous potential for economies of scale in the provision of formal training. The benefits of a clinically based, competency-based model include an increase in clinical service capacity, and clinical training resources become a resource for the delivery of healthcare, not just education. Existing training models are unsustainable, and are not preparing a workforce with the flexibility the 21st century demands. PMID:24351806

  8. Preparing a 21st century workforce: is it time to consider clinically based, competency-based training of health practitioners?

    PubMed

    Nancarrow, Susan A; Moran, Anna M; Graham, Iain

    2014-02-01

    Health workforce training in the 21st century is still based largely on 20th century healthcare paradigms that emphasise professionalisation at the expense of patient-focussed care. This is illustrated by the paradox of increased training times for health workers that have corresponded with workforce shortages, the limited career options and pathways for paraprofessional workers, and inefficient clinical training models that detract from, rather than add to, service capacity. We propose instead that a 21st century health workforce training model should be: situated in the clinical setting and supported by outsourced university training (not the other way around); based on the achievement of specific milestones rather than being time-defined; and incorporate para-professional career pathways that allow trainees to 'step-off' with a useable qualification following the achievement of specific competencies. Such a model could be facilitated by existing technology and clinical training infrastructure, with enormous potential for economies of scale in the provision of formal training. The benefits of a clinically based, competency-based model include an increase in clinical service capacity, and clinical training resources become a resource for the delivery of healthcare, not just education. Existing training models are unsustainable, and are not preparing a workforce with the flexibility the 21st century demands.

  9. A model for nurse practitioner regulation: principles underpinning a three-registration category approach.

    PubMed

    Wearing, Jo; Black, Joyce; Kline, Karen

    2010-01-01

    The issue of professional regulation of advanced nursing practice is one of the most controversial in the area of nursing regulation today. The controversy affects the roles and scope of advanced practice as well as education requirements. Nurse practitioner (NP) practice is one kind of advanced nursing practice receiving attention currently, with a view to developing consistent educational and regulatory approaches. Consistency is needed to enhance the mobility and flexibility of these important healthcare provider resources in time of shortages. This paper describes how the regulatory body in British Columbia decided to register only three categories of NP: family/all ages, adult and pediatrics. It describes the state of NP regulation when the work began, the consultation process used in coming to this decision and the principles underlying the decision. Regulators, educators and administrators may benefit from understanding the issues and reasoning presented. Literature to guide this work was lacking, a gap this paper addresses to help inform decision-making in other settings and contexts. Dialogue about this approach may facilitate movement towards consistent approaches to the regulation, education and deployment of NPs in Canada and elsewhere.

  10. Nurse practitioners in primary care. VII. A cohort study of 99 nurses and 79 associated physicians.

    PubMed Central

    Scherer, K.; Fortin, F.; Spitzer, W. O.; Kergin, D. J.

    1977-01-01

    Long-term surveillance of the employment experience and developing roles of 99 nurses and 79 associated physicians who participated in the first 5 years of the McMaster University educational program for family practice nurses was undertaken with a descriptive survey. Data were gathered by mailed questionnaires; a 97.8% response rate was attained. Sociodemographic profiles of both groups and characteristics of the practice setting where copractitioner teams functioned were determined. Selected noteworthy results show that 92.7% of the nurses were currently employed, and that 82.5% of the graduates continued in their original practice. Nurses' time invested in patient care activities increased by 105%; time devoted to clerical and housekeeping duties decreased by 42%. Changes in roles for both categories of copractitioners were important. The interdisciplinary arrangements resulted in appreciable financial disadvantages to physicians and only modest income incentives to nurses. A series of successes of the model of practice under assessment has been identified; offsetting ongoing difficulties and problems have also been enumerated. The data from this project and preceding studies can facilitate the solution of unresolved problems on the basis of evidence rather than opinion. PMID:856429

  11. 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…

  12. Students' perspectives on the outcomes of the joint international programme for nurse practitioners.

    PubMed

    Chung, Hae Soo; Choi, Eun Jin; Kang, Se Won; An, Minjeong; Choi, Jungmin; Kim, Eun Jung

    2011-07-01

    Nurse practitioners (NPs) play a vital role in the primary healthcare systems in several countries. However, the NP system has either only recently been established or has yet to be set up in many Asian countries. The Joint International Programme for Nurse Practitioners (JIPNP), developed by a university in South Korea and one in the United States, has been running since 1998. The purpose of this study was to evaluate this programme by assessing student satisfaction through an e-mail-based questionnaire survey. The results of the survey indicated that the students found that this programme helped refine their professional skills. The students were most satisfied with the practicum. Their responses to the open-ended question regarding their individual experiences during the course indicated that they were most satisfied with their improvement in the following areas: understanding of the role of the NP, the responsibility and limitations of NPs with regard to diagnosing and prescribing, familiarity with culture and language, and understanding of healthcare systems. They were also pleased with the teaching methods deployed. It is anticipated that the graduates who completed this programme will help develop the NP system in Korea by assuming leading positions in many NP fields in South Korea.

  13. Evaluating the implementation of an online clinical log system for family nurse practitioner students.

    PubMed

    Joy, Liberty; Berner, Barbara; Tarrant, Dianne

    2012-01-01

    This pilot study analyzed the adoption of the Nurse Practitioner Student Tracking (NPST) system by a public university's family nurse practitioner graduate program. Using the diffusion-of-innovations research framework, the ease of transition, acceptance, and perceived advantage of the system were studied in a unique group of students (n = 9) and faculty members (n = 6). The study results pointed to a more rapid progression through the stages of technological adoption for students than for faculty members, a more pronounced acceptance of the database by students than by faculty, a higher learning curve for faculty than for students, and improved efficiency in clinical logging for students. The NPST system served to begin addressing identified issues within the program. Half (n = 3) of the faculty thought that the NPST system assisted them in ensuring student competencies were met. The system also helped them analyze how time was spent in clinical practice, identify how much time was spent conferring with preceptor in clinical practice, helped students improve the quality of their charting practices, and eliminated the concern of dishonest duplication of records. In addition, 80% of faculty stated the NPST system helped them see how much time was spent with each patient in clinical practice. PMID:21849888

  14. 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...

  15. 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...

  16. 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.

  17. 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

  18. 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

  19. Extending nurse practitioner care using the virtual reality world of second life.

    PubMed

    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.

  20. Revisiting scope of practice facilitators and barriers for primary care nurse practitioners: a qualitative investigation.

    PubMed

    Poghosyan, Lusine; Nannini, Angela; Smaldone, Arlene; Clarke, Sean; O'Rourke, Nancy C; Rosato, Barbara G; Berkowitz, Bobbie

    2013-02-01

    Revisiting scope of practice (SOP) policies for nurse practitioners (NPs) is necessary in the evolving primary care environment with goals to provide timely access, improve quality, and contain cost. This study utilized qualitative descriptive design to investigate NP roles and responsibilities as primary care providers (PCPs) in Massachusetts and their perceptions about barriers and facilitators to their SOP. Through purposive sampling, 23 NPs were recruited and they participated in group and individual interviews in spring 2011.The interviews were audio recorded and transcribed. Data were analyzed using Atlas.ti 6.0 software, and content analysis was applied. In addition to NP roles and responsibilities, three themes affecting NP SOP were: regulatory environment; comprehension of NP role; and work environment. NPs take on similar responsibilities as physicians to deliver primary care services; however, the regulatory environment and billing practices, lack of comprehension of the NP role, and challenging work environments limit successful NP practice. PMID:23528433

  1. Facilitating the nurse practitioner's research role: using a microcomputer for data entry in clinical settings.

    PubMed

    Matteson, P S; Hawkins, J W

    1993-01-01

    Data coding and entry can be a tedious and error-prone component of research. Statistical packages for a microcomputer are now available that enable the researcher to create data entry forms in a spread sheet format. In this article the use of software that can be used for data entry, manipulation, and analysis is discussed. In a practice setting these features are particularly useful, because the nurse practitioner can take the microcomputer to the clinical facility and enter data directly from client-provider interactions or from records. In clinical settings where client data are entered directly into a computer database as part of assessment and care giving, data can be downloaded onto this or similar programs for manipulation and analysis.

  2. Understanding whole systems change in health care: the case of nurse practitioners in Canada.

    PubMed

    Edwards, Nancy; Rowan, Margo; Marck, Patricia; Grinspun, Doris

    2011-02-01

    Nurse practitioners (NPs) were introduced into the Canadian health system almost half a century ago. Despite early evidence of their effectiveness, it took decades to establish a substantial critical mass of NPs. Using the NP as a case study exemplar, we adopted a whole system change perspective to understand what else besides evidence was needed to ensure the success of desirable health systems innovations. We identified elements of whole systems change to analyze literature on the NP movement in terms of leverages, blockages, and system dynamics. Results suggest that evidence was only one of many factors shaping the uptake of NP services as part of larger, ongoing, adaptive whole systems change. The changes required to integrate the NP role within the health system reflect a socio-ecological perspective that may be used to understand sustainable health systems innovation and improvement. PMID:21555317

  3. 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

  4. 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,…

  5. 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…

  6. The Nurse Practitioner Role: A pilot study based on the Interview Schedule from the AUSPRAC Research Toolkit.

    PubMed

    Bourgeois, Sharon; Blanchard, Denise; Doldissen, Rebecca; Maher, Laura; Stoddart, Kiea; Johnston, Nicole; Hungerford, Catherine

    2013-12-21

    Abstract Within any professional practice, knowledge developments to support service delivery and to understand roles inherent within that practice context are critical. The purpose of this article is to present findings from case study research that used the AUSPRAC Research Toolkit Interview Schedule and to propose an additional theme to the Interview Schedule. Case Study method was used to explore the role of a nurse practitioner within a specific context of practice in an Australian Healthcare institution. Three semi-structured interviews with a Nurse Practitioner using the AUSPRAC Research Toolkit Interview Schedule and one additional interview were employed. Data was analysed where initial free coding, then theme generation contributed to knowledge development. The AUSPRAC Research Toolkit Interview Schedule generated knowledge about the nurse practitioner role. Themes identified for interviews in the Schedule were; the organisation of care, team functioning and patient service. Analysis of data from these themes identified that information related to ongoing development of professional practice was not forthcoming from the participant. The authors recommend adding a fourth theme to the Interview Schedule to enable exploration of the professional elements of the Nurse Practitioner role.

  7. Integrating physiotherapists within primary health care teams: perspectives of family physicians and nurse practitioners.

    PubMed

    Dufour, Sinéad Patricia; Brown, Judith; Deborah Lucy, S

    2014-09-01

    The international literature suggests a number of benefits related to integrating physiotherapists into primary health care (PHC) teams. Considering the mandate of PHC teams in Canada, emphasizing healthy living and chronic disease management, a broad range of providers, inclusive of physiotherapists is required. However, physiotherapists are only sparsely integrated into these teams. This study explores the perspectives of "core" PHC team members, family physicians and nurse practitioners, regarding the integration of physiotherapists within Ontario (Canada) PHC teams. Twenty individual semi-structured in-depth interviews were conducted, transcribed verbatim, and then analyzed following an iterative process drawing from an interpretive phenomenological approach. Five key themes emerged which highlighted "how physiotherapists could and do contribute as team members within PHC teams particularly related to musculoskeletal health and chronic disease management". The perceived value of physiotherapists within Ontario, Canada PHC teams was a unanimous sentiment particularly in terms of musculoskeletal health, chronic disease management and maximizing health human resources efficiency to ensure the right care, is delivered by the right practitioner, at the right time.

  8. Public Health Service--Grants for construction of teaching facilities, educational improvements, scholarships and student loans; grants for nurse practitioner traineeship programs. Interim-final regulations.

    PubMed

    1980-05-01

    These regulations set forth requirements for grants to schools of nursing, medicine, and public health, to public or nonprofit private hospitals, and to other nonprofit entities to meet the costs of traineeships for the training of nurse practitioners. Trainees must reside in health manpower shortage areas and sign a commitment with the Secretary to practice full-time as nurse practitioners in areas having shortages of primary medical care manpower.

  9. Retention of the rural allied health workforce in New South Wales: a comparison of public and private practitioners

    PubMed Central

    2013-01-01

    Background Policy initiatives to improve retention of the rural health workforce have relied primarily on evidence for rural doctors, most of whom practice under a private business model. Much of the literature for rural allied health (AH) workforce focuses on the public sector. The AH professions are diverse, with mixed public, private or combined practice settings. This study explores sector differences in factors affecting retention of rural AH professionals. Methods This study compared respondents from the 2008 Rural Allied Health Workforce (RAHW) survey recruiting all AH professionals in rural New South Wales. Comparisons between public (n = 833) and private (n = 756) groups were undertaken using Chi square analysis to measure association for demographics, job satisfaction and intention to leave. The final section of the RAHW survey comprised 33 questions relating to retention. A factor analysis was conducted for each cohort. Factor reliability was assessed and retained factors were included in a binary logistic regression analysis for each cohort predicting intention to leave. Results Six factors were identified: professional isolation, participation in community, clinical demand, taking time away from work, resources and ‘specialist generalist’ work. Factors differed slightly between groups. A seventh factor (management) was present only in the public cohort. Gender was not a significant predictor of intention to leave. Age group was the strongest predictor of intention to leave with younger and older groups being significantly more likely to leave than middle aged. In univariate logistic analysis (after adjusting for age group), the ability to get away from work did not predict intention to leave in either group. In multivariate analysis, high clinical demand predicted intention to leave in both the public (OR = 1.40, 95% CI = 1.08, 1.83) and private (OR = 1.61, 95% CI = 1.15, 2.25) cohorts. Professional isolation (OR = 1

  10. Altschul's legacy in mediating British and American psychiatric nursing discourses: common sense and the 'absence' of the accountable practitioner.

    PubMed

    Tilley, S

    1999-08-01

    This paper contributes to an archaeology of knowledge in the field of psychiatric and mental health nursing. It focuses on a principal concern of contributors to literature on British psychiatric nursing: the problem of defining psychiatric nursing. Early British writers describing psychiatric nursing accomplished the 'presence' of psychiatric nursing as a discursive object, by discursively constructing the 'absence' of the psychiatric nurse doing, and being accountable for, 'appropriate' work. Altschul's (1972) Patient-nurse Interaction was the key text in this tradition, mediating British and American discourses, setting the methodological and substantive agenda for an important body of subsequent British psychiatric nursing research. The paper examines a number of topics in the American and British discourses mediated by Altschul: the privileging of nurses' presence and language in communication with patients; lay versus professional knowledge, and interaction as gossip; 'common sense' as a topic; common sense as different from 'identifiable perspective'; the problem of accountability and the hierarchy of credibility; accountability, the 'absent' nurse, and issues of method. Altschul's later work keeps in tension two potentially conflicting claims--on the one hand, that the practice of psychiatric nursing depends on the 'kind of person' the nurse is, and on the other, that specialist discourses have priority in determining the basis for practice. Altschul played a crucial role in establishing the role of research in British psychiatric nursing discipline: locating the accountable individual practitioner, and devising remedies for 'absence'. In doing so, she anticipated current discourses on nurses' accountability, particularly their inability to demonstrate 'evidence' of their 'effectiveness'.

  11. An emergency department-based mental health nurse practitioner outpatient service: part 1, participant evaluation.

    PubMed

    Wand, Timothy; White, Kathryn; Patching, Joanna; Dixon, Judith; Green, Timothy

    2011-12-01

    The mental health liaison nurse role in the emergency department (ED) has demonstrated a range of positive outcomes for both consumers and staff. In Australia, the added value associated with establishing mental health nurse practitioner (MHNP) positions based on this model is emerging. This paper presents qualitative findings from a study using a mixed-method design to evaluate an ED-based MHNP outpatient service in Sydney, Australia. In evaluating this new service, semistructured interviews were conducted with a random selection of study participants and a stratified sample of ED staff. This is the first of a two-part paper that presents an analysis of qualitative data from interviews conducted with study participants (n = 23). Participants reported numerous therapeutic benefits from the service, such as support, understanding, and a focus on solutions rather than problems, and high levels of satisfaction with the accessibility of the service and follow up. Suggestions for improving the service were also offered. Participants emphasized that overall ED service provision would be enhanced through additional resources, especially an extension of operating hours. Findings from these participant interviews provide strong support for an ED-based MHNP outpatient service.

  12. Examining the potential of nurse practitioners from a critical social justice perspective.

    PubMed

    Browne, Annette J; Tarlier, Denise S

    2008-06-01

    Nurse practitioners (NPs) are increasingly called on to provide high-quality health-care particularly for people who face significant barriers to accessing services. Although discourses of social justice have become relatively common in nursing and health services literature, critical analyses of how NP roles articulate with social justice issues have received less attention. In this study, we examine the role of NPs from a critical social justice perspective. A critical social justice lens raises morally significant questions, for example, why certain individuals and groups bear a disproportionate burden of illness and suffering; what social conditions contribute to disparities in health and social status; and what social mandate NPs ought to develop in response to these realities. In our analysis, we draw on lessons learned from the initial Canadian experience with the introduction of NPs in the 1970s to consider the renewed and burgeoning interest in NPs in Canada, Australia and elsewhere. As we argue, a critical social justice perspective (in addition to the biomedical foci of NP practice) will be essential to sustaining long-term, socially responsive NP roles and achieving greater equity in health and health-care.

  13. Impact of primary care nursing workforce characteristics on the control of high-blood pressure: a multilevel analysis

    PubMed Central

    Parro-Moreno, Ana; Serrano-Gallardo, Pilar; Díaz-Holgado, Antonio; Aréjula-Torres, Jose L; Abraira, Victor; Santiago-Pérez, Isolina M; Morales-Asencio, Jose M

    2015-01-01

    Objective To determine the impact of Primary Health Care (PHC) nursing workforce characteristics and of the clinical practice environment (CPE) perceived by nurses on the control of high-blood pressure (HBP). Design Cross-sectional analytical study. Setting Administrative and clinical registries of hypertensive patients from PHC information systems and questionnaire from PHC nurses. Participants 76 797 hypertensive patients in two health zones within the Community of Madrid, North-West Zone (NWZ) with a higher socioeconomic situation and South-West Zone (SWZ) with a lower socioeconomic situation, and 442 reference nurses. Segmented analyses by area were made due to their different socioeconomic characteristics. Primary outcome measure: Poor HBP control (adequate figures below the value 140/90 mm Hg) associated with the characteristics of the nursing workforce and self-perceived CPE. Results The prevalence of poor HBP control, estimated by an empty multilevel model, was 33.5% (95% CI 31.5% to 35.6%). In the multilevel multivariate regression models, the perception of a more favourable CPE was associated with a reduction in poor control in NWZ men and SWZ women (OR=0.99 (95% CI 0.98 to 0.99)); the economic immigration conditions increased poor control in NWZ women (OR=1.53 (95% CI 1.24 to 1.89)) and in SWZ, both men (OR=1.89 (95% CI 1.43 to 2.51)) and women (OR=1.39 (95% CI 1.09 to 1.76)). In all four models, increasing the annual number of patient consultations was associated with a reduction in poor control (NWZ women: OR=0.98 (95% CI0.98 to 0.99); NWZ men: OR=0.98 (95% CI 0.97 to 0.99); SWZ women: OR=0.98 (95% CI 0.97 to 0.99); SWZ men: OR=0.99 (95% CI 0.97 to 0.99). Conclusions A CPE, perceived by PHC nurses as more favourable, and more patient–nurse consultations, contribute to better HBP control. Economic immigration condition is a risk factor for poor HBP control. Health policies oriented towards promoting positive environments for nursing practice are

  14. 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

  15. The Future of Neonatal Advanced Practice Registered Nurse Practice: White Paper.

    PubMed

    Staebler, Suzanne; Meier, Susan R; Bagwell, Gail; Conway-Orgel, Margaret

    2016-02-01

    In recent years, the National Association of Neonatal Nurses and the National Association of Neonatal Nurse Practitioners have been monitoring aspects of neonatal advanced practice nursing and providing leadership and advocacy to address concerns related to workforce, education, competency, fatigue, safety, and scope of practice. This white paper discusses current barriers within neonatal advanced practice registered nurse practice as well as strategies to promote the longevity of the neonatal advanced practice registered nurse roles. PMID:26742097

  16. Training the Workforce in Evidence-Based Public Health: An Evaluation of Impact Among US and International Practitioners

    PubMed Central

    Keating, Shannon M.; Jacobs, Julie A.; Dodson, Elizabeth; Baker, Elizabeth; Diem, Gunter; Giles, Wayne; Gillespie, Kathleen N.; Grabauskas, Vilius; Shatchkute, Aushra; Brownson, Ross C.

    2013-01-01

    Introduction The Prevention Research Center in St. Louis developed a course on evidence-based public health in 1997 to train the public health workforce in implementation of evidence-based public health. The objective of this study was to assess use and benefits of the course and identify barriers to using evidence-based public health skills as well as ways to improve the course. Methods We used a mixed-method design incorporating on-site pre- and post-evaluations among US and international course participants who attended from 2008 through 2011 and web-based follow-up surveys among course participants who attended from 2005 through 2011 (n = 626). Respondents included managers, specialists, and academics at state health departments, local health departments, universities, and national/regional health departments. Results We found significant improvement from pre- to post-evaluation for 11 measures of knowledge, skill, and ability. Follow-up survey results showed at least quarterly use of course skills in most categories, majority endorsement of most course benefits, and lack of funding and coworkers who do not have evidence-based public health training as the most significant barriers to implementation of evidence-based public health. Respondents suggested ways to increase evidence-based decision making at their organization, focusing on organizational support and continued access to training. Conclusion Although the evidence-based public health course is effective in improving self-reported measures of knowledge, skill, and ability, barriers remain to the implementation of evidence-based decision making, demonstrating the importance of continuing to offer and expand training in evidence-based public health. PMID:24007676

  17. 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

  18. 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

  19. 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

  20. 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

  1. The use of a customized training needs analysis tool for nurse practitioner development.

    PubMed

    Hicks, C; Hennessy, D

    1997-08-01

    The role and professional boundaries of the nurse practitioner (NP) in the UK have not yet been unequivocally defined. This confusion has served to limit the expansion of the NP in both the acute and primary care sectors, despite a mounting body of evidence that attests to their value. This lack of coherence has necessarily impacted upon the educational provision currently available for NP development, with a range of courses of variable nature and standards being provided. The lack of nationally agreed educational criteria and the importance of taking account of local needs, together suggest that a formal training needs analysis might be valuable in systematizing and unifying the present position. Such a survey would have the function of informing both the definition and regional training requirements of NPs, provided the data were obtained through the use of a reliable assessment instrument. To this end a total population survey of all nurses employed in general practice within a large regional health authority was undertaken, using a psychometrically valid and reliable training needs analysis questionnaire. The information obtained provided a preliminary definition of the NP role and a clear index of the content and level of prospective educational provision. In addition, the survey offered an estimate of the numbers of potential participants on NP courses, by FHSA and preferred educational institution. In this way, the use of a scientifically constructed and specifically customized training needs analysis tool may have the potential to inform precise educational commissioning, thereby rationalizing resources and enhancing the quality of both training and ultimate care provision. PMID:9292375

  2. Acute care nurse practitioners: creating and implementing a model of care for an inpatient general medical service.

    PubMed

    Howie, Jill N; Erickson, Mitchel

    2002-09-01

    Changes in medical education and healthcare reimbursement are recent threats to most academic medical centers' dual mission of patient care and education. Financial pressures stem from reduced insurance reimbursement, capitation, and changes in public funding for medical residency education. Pressures for innovation result from increasing numbers of patients, higher acuity of patients, an aging population of patients with complex problems, and restrictions on residency workloads. A framework for addressing the need for innovation in the medical service at a large academic medical center is presented. The framework enables acute care nurse practitioners to provide inpatient medical management in collaboration with a hospitalist. The model's development, acceptance, successes, pitfalls, and evaluation are described. The literature describing the use of nurse practitioners in acute care settings is reviewed.

  3. Innovations and issues in the delivery of continuing education to nurse practitioners in rural and northern communities.

    PubMed

    Tilleczek, Kate; Pong, Raymond; Caty, Suzanne

    2005-03-01

    This paper addresses the need to provide rural nurse practitioners (NPs) with the distance education that is considered vital to the upgrading of their professional skills. The method of delivering the courses is a critical aspect of their success. The authors trace and describe the innovative delivery of the Rural Ontario Nurse Practitioner Continuing Education Initiative, from the initial needs assessment study through to the implementation and evaluation study. In each study, a multi-method action research model was used. The respondents showed a preference for face-to-face modalities that were perceived to be constrained by barriers. These barriers were subsequently addressed by the pilot project. Those living in rural areas recognized the benefits of information technologies. Implementation was effectively weighted on multiple modes of online course delivery and the use of constructivist pedagogy. The findings suggest that the delivery of continuing education to rural and remote NPs is still wrought with challenges.

  4. Training a system-literate care coordination workforce.

    PubMed

    Naccarella, Lucio; Osborne, Richard H; Brooks, Peter M

    2016-04-01

    People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators are not a homogenous workforce - but an applied professional role, providing direct and indirect care, and is often undertaken by nurses, allied health professionals, social workers or general practitioners. In Australia, there is no training curriculum nor courses, nor nationally recognised professional quality standards for the care coordinator workforce. With the growing complexity and fragmentation of the health care system, health system literacy - shared understanding of the roles and contributions of the different workforce professions, organisations and systems, among patients and indeed the health workforce is required. Efforts to improve health system literacy among the health workforce are increasing at a policy, practice and research level. However, insufficient evidence exists about what are the health system literacy needs of care coordinators, and what is required for them to be most effective. Key areas to build a health system literate care coordination workforce are presented. Care coordination is more than an optional extra, but one of the only ways we are going to be able to provide equitable health services for people with chronic complex conditions. People with low health literacy require more support with the coordination of their care, therefore we need to build a high performing care coordinator workforce that upholds professional quality standards, and is health literacy responsive.

  5. Analysis of touch used by occupational therapy practitioners in skilled nursing facilities.

    PubMed

    Morris, Douglas; Henegar, J; Khanin, S; Oberle, G; Thacker, S

    2014-09-01

    Instrumental touch is identified as having purposeful physical contact in order to complete a task. Expressive touch is identified as warm, friendly physical contact and is not solely for performing a task. Expressive touch has been associated with improved client status, increased rapport and greater gains made during therapy. The purpose of the study was to observe the frequency of expressive and instrumental touch utilized by an occupational therapist during an occupational therapy session. Thirty-three occupational therapy professionals, including occupational therapists and occupational therapy assistants, employed at skilled nursing facilities in southwest Florida were observed. Data were collected on the Occupational Therapy Interaction Assessment. The results of the data analysis showed a positive relationship between the gender of the therapist and the frequency of expressive touch. The data also showed that a large majority of touches were instrumental touch and pertained to functional mobility. The results of the study can contribute to a better understanding of the holistic aspects of occupational therapy. By the use of more expressive touch, occupational therapy practitioners may have a positive, beneficial effect on both the client and the therapy process as a whole. Further research is needed to determine the effect an occupational therapy setting has on the frequency of instrumental and expressive touch. A larger sample size and a distinction between evaluation and treatment sessions would benefit future studies.

  6. Physician assistants and nurse practitioners perform effective roles on teams caring for Medicare patients with diabetes.

    PubMed

    Everett, Christine; Thorpe, Carolyn; Palta, Mari; Carayon, Pascale; Bartels, Christie; Smith, Maureen A

    2013-11-01

    One approach to the patient-centered medical home, particularly for patients with chronic illnesses, is to include physician assistants (PAs) and nurse practitioners (NPs) on primary care teams. Using Medicare claims and electronic health record data from a large physician group, we compared outcomes for two groups of adult Medicare patients with diabetes whose conditions were at various levels of complexity: those whose care teams included PAs or NPs in various roles, and those who received care from physicians only. Outcomes were generally equivalent in thirteen comparisons. In four comparisons, outcomes were superior for the patients receiving care from PAs or NPs, but in three other comparisons the outcomes were superior for patients receiving care from physicians only. Specific roles performed by PAs and NPs were associated with different patterns in the measure of the quality of diabetes care and use of health care services. No role was best for all outcomes. Our findings suggest that patient characteristics, as well as patients' and organizations' goals, should be considered when determining when and how to deploy PAs and NPs on primary care teams. Accordingly, training and policy should continue to support role flexibility for these health professionals.

  7. Nurse practitioners' knowledge, experience, and intention to use health literacy strategies in clinical practice.

    PubMed

    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.

  8. 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.

  9. Nurse practitioner and physician assistant students' knowledge, attitudes, and perspectives of chiropractic

    PubMed Central

    Bowden, Briana S.; Ball, Lisa

    2016-01-01

    Objective: The purpose of this study was to assess nurse practitioner (NP) and physician assistant (PA) students' views of chiropractic. As the role of these providers progresses in primary care settings, providers' views and knowledge of chiropractic will impact interprofessional collaboration and patient outcomes. Understanding how NP and PA students perceive chiropractic may be beneficial in building integrative health care systems. Methods: This descriptive quantitative pilot study utilized a 56-item survey to examine attitudes, knowledge, and perspectives of NP and PA students in their 2nd year of graduate studies. Frequencies and binomial and multinomial logistic regression models were used to examine responses to survey totals. Results: Ninety-two (97%) students completed the survey. There were conflicting results as to whether participants viewed chiropractic as mainstream or alternative. The majority of participants indicated lack of awareness regarding current scientific evidence for chiropractic and indicated a positive interest in learning more about the profession. Students who reported prior experience with chiropractic had higher attitude-positive responses compared to those without experience. Participants were found to have substantial knowledge deficits in relation to chiropractic treatments and scope of practice. Conclusion: The results of this study emphasize the need for increased integrative initiatives and chiropractic exposure in NP and PA education to enhance future interprofessional collaboration in health care. PMID:26771903

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. Comparing the information seeking strategies of residents, nurse practitioners, and physician assistants in critical care settings

    PubMed Central

    Kannampallil, Thomas G; Jones, Laura K; Patel, Vimla L; Buchman, Timothy G; Franklin, Amy

    2014-01-01

    Objective Critical care environments are information-intensive environments where effective decisions are predicated on successfully finding and using the ‘right information at the right time’. We characterize the differences in processes and strategies of information seeking between residents, nurse practitioners (NPs), and physician assistants (PAs). Method We conducted an exploratory study in the cardiothoracic intensive care units of two large academic hospitals within the same healthcare system. Clinicians (residents (n=5), NPs (n=5), and PAs (n=5)) were shadowed as they gathered information on patients in preparation for clinical rounds. Information seeking activities on 96 patients were collected over a period of 3 months (NRes=37, NNP=24, NPA=35 patients). The sources of information and time spent gathering the information at each source were recorded. Exploratory data analysis using probabilistic sequential approaches was used to analyze the data. Results Residents predominantly used a patient-based information seeking strategy in which all relevant information was aggregated for one patient at a time. In contrast, NPs and PAs primarily utilized a source-based information seeking strategy in which similar (or equivalent) information was aggregated for multiple patients at a time (eg, X-rays for all patients). Conclusions The differences in the information seeking strategies are potentially a result of the differences in clinical training, strategies of managing cognitive load, and the nature of the use of available health IT tools. Further research is needed to investigate the effects of these differences on clinical and process outcomes. PMID:24619926

  15. 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

  16. 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

  17. Managers' use of nursing workforce planning and deployment technologies: protocol for a realist synthesis of implementation and impact

    PubMed Central

    Burton, Christopher; Rycroft-Malone, Jo; Williams, Lynne; Davies, Siân; McBride, Anne; Hall, Beth; Rowlands, Anne-M; Jones, Adrian

    2016-01-01

    Introduction Nursing staffing levels in hospitals appear to be associated with improved patient outcomes. National guidance indicates that the triangulation of information from workforce planning and deployment technologies (WPTs; eg, the Safer Nursing Care Tool) and ‘local knowledge’ is important for managers to achieve appropriate staffing levels for better patient outcomes. Although WPTs provide managers with predictive information about future staffing requirements, ensuring patient safety and quality care also requires the consideration of information from other sources in real time. Yet little attention has been given to how to support managers to implement WPTs in practice. Given this lack of understanding, this evidence synthesis is designed to address the research question: managers’ use of WPTs and their impacts on nurse staffing and patient care: what works, for whom, how and in what circumstances? Methods and analysis To explain how WPTs may work and in what contexts, we will conduct a realist evidence synthesis through sourcing relevant evidence, and consulting with stakeholders about the impacts of WPTs on health and relevant public service fields. The review will be in 4 phases over 18 months. Phase 1: we will construct an initial theoretical framework that provides plausible explanations of what works about WPTs. Phase 2: evidence retrieval, review and synthesis guided by the theoretical framework; phase 3: testing and refining of programme theories, to determine their relevance; phase 4: formulating actionable recommendations about how WPTs should be implemented in clinical practice. Ethics and dissemination Ethical approval has been gained from the study's institutional sponsors. Ethical review from the National Health Service (NHS) is not required; however research and development permissions will be obtained. Findings will be disseminated through stakeholder engagement and knowledge mobilisation activities. The synthesis will develop an

  18. An Assessment of the Current US Radiation Oncology Workforce: Methodology and Global Results of the American Society for Radiation Oncology 2012 Workforce Study

    SciTech Connect

    Vichare, Anushree; Washington, Raynard; Patton, Caroline; Arnone, Anna; Olsen, Christine; Fung, Claire Y.; Hopkins, Shane; Pohar, Surjeet

    2013-12-01

    Purpose: To determine the characteristics, needs, and concerns of the current radiation oncology workforce, evaluate best practices and opportunities for improving quality and safety, and assess what we can predict about the future workforce. Methods and Materials: An online survey was distributed to 35,204 respondents from all segments of the radiation oncology workforce, including radiation oncologists, residents, medical dosimetrists, radiation therapists, medical physicists, nurse practitioners, nurses, physician assistants, and practice managers/administrators. The survey was disseminated by the American Society for Radiation Oncology (ASTRO) together with specialty societies representing other workforce segments. An overview of the methods and global results is presented in this paper. Results: A total of 6765 completed surveys were received, a response rate of 19%, and the final analysis included 5257 respondents. Three-quarters of the radiation oncologists, residents, and physicists who responded were male, in contrast to the other segments in which two-thirds or more were female. The majority of respondents (58%) indicated they were hospital-based, whereas 40% practiced in a free-standing/satellite clinic and 2% in another setting. Among the practices represented in the survey, 21.5% were academic, 25.2% were hospital, and 53.3% were private. A perceived oversupply of professionals relative to demand was reported by the physicist, dosimetrist, and radiation therapist segments. An undersupply was perceived by physician's assistants, nurse practitioners, and nurses. The supply of radiation oncologists and residents was considered balanced. Conclusions: This survey was unique as it attempted to comprehensively assess the radiation oncology workforce by directly surveying each segment. The results suggest there is potential to improve the diversity of the workforce and optimize the supply of the workforce segments. The survey also provides a benchmark for

  19. Accelerating the Global Workforce Demand for Nurse Informaticians: Advanced Health Informatics Certification (AHIC).

    PubMed

    Gadd, Cynthia; Delaney, Connie W; de Fátima Marin, Heimar; Greenwood, Karen; Williamson, Jeffrey J

    2016-01-01

    Advances in professional recognition of nursing informatics vary by country but examples exist of training programs moving from curriculum-based education to competency based frameworks to produce highly skilled nursing informaticians. This panel will discuss a significant credentialing project in the United States that should further enhance professional recognition of highly skilled nurses matriculating from NI programs as well as nurses functioning in positions where informatics-induced transformation is occurring. The panel will discuss the professionalization of health informatics by describing core content, training requirements, education needs, and administrative framework applicable for the creation of an Advanced Health Informatics Certification (AHIC). PMID:27332309

  20. Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals.

    PubMed

    Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S

    2013-10-01

    Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. PMID:22962847

  1. Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals.

    PubMed

    Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S

    2013-10-01

    Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care.

  2. The National Nursing Assistant Survey: Improving the Evidence Base for Policy Initiatives to Strengthen the Certified Nursing Assistant Workforce

    ERIC Educational Resources Information Center

    Squillace, Marie R.; Remsburg, Robin E.; Harris-Kojetin, Lauren D.; Bercovitz, Anita; Rosenoff, Emily; Han, Beth

    2009-01-01

    Purpose: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified nursing assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of…

  3. 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…

  4. 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

  5. Communication and Outcomes of Visits Between Older Patients and Nurse Practitioners

    PubMed Central

    Gilbert, Dorothy Ann; Hayes, Eileen

    2010-01-01

    Background Effective patient-clinician communication is at the heart of good health care and may be even more vital for older patients and their nurse practitioners (NPs). Objectives To examine contributions of older patients’ and NPs’ characteristics and the content and relationship components of their communication to patients’ proximal outcomes (satisfaction and intention to adhere) and longer-term outcomes (changes in presenting problems, physical health, and mental health), and contributions of proximal outcomes to longer-term outcomes. Methods Visits were videorecorded of a statewide sample of 31 NPs and 155 older patients. Patients’ and NPs’ communication during visits were measured using the Roter Interaction Analysis System for verbal activities, a check sheet for nonverbal activities, and an inventory of relationship dimension items. Proximal outcomes were measured with single items after visits. At 4 weeks, change in presenting problems was measured with a single item and physical and mental health changes were measured with the SF-12v2 Health Survey. Mixed models regression with backward deletion was conducted until only predictors with p ≤ .05 remained in the models. Results With the other variables in the models held constant, better outcomes were related to background characteristics of poorer baseline health, nonmanaged care settings, and more NP experience; to a content component of seeking and giving biomedical and psychosocial information; and to a relationship component of more positive talk and greater trust and receptivity and affection, depth, and similarity. Poorer outcomes were associated with higher rates of lifestyle discussion and NPs’ rapport building that patients may have perceived to be patronizing. Greater intention to adhere was associated with greater improvement in presenting problems. Discussion Older patient-NP communication was effective regarding seeking and giving biomedical and psychosocial information other

  6. The Evolving Role of the Pediatric Nurse Practitioner in Hospital Medicine

    PubMed Central

    Wall, Stacey; Scudamore, Douglas; Chin, James; Rannie, Michael; Tong, Suhong; Reese, Jennifer; Wilson, Karen

    2014-01-01

    Background This program evaluation sought to compare cost and pediatric patient outcomes between a pediatric nurse practitioner (PNP) hospitalist team, a combined PNP/MD team, and two resident teams without PNPs. Methods Administrative and electronic medical record data from July 1, 2009 to June 30, 2010 was retrospectively reviewed from Children's Hospital Colorado inpatient medical unit and inpatient satellite sites in the Children's Hospital Network of Care (NOC). The top three All Patient Refined Diagnosis Related Groups (APR-DRG) admission codes (Bronchiolitis & RSV Pneumonia, Pneumonia NEC, and Asthma) were selected for this analysis. Inpatient records representing these APR-DRG admission codes were reviewed (n=1,664). Measures included adherence with relevant clinical care guidelines (CCGs), length of stay (LOS), and cost of care. Chi square, t-tests, and ANOVA were used to analyze between-group differences. Results Approximately 20% of these admissions were on the PNP team, 45% were on the resident teams, and 35% were on the PNP/MD team in the NOC. PNP adherence to CCGs was comparable to resident teams for selected measures. There was no significant difference in LOS between the PNP team, the PNP/MD team, and the resident teams. The direct cost of patient care per encounter provided by the PNP team was significantly less than the PNP/MD team and the resident teams. Conclusions There is evidence to suggest that PNP hospitalists provide inpatient care comparable to resident teams at a lower cost for patients with uncomplicated bronchiolitis, pneumonia, and asthma. PMID:24616251

  7. 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

  8. Informing the scale-up of Kenya’s nursing workforce: a mixed methods study of factors affecting pre-service training capacity and production

    PubMed Central

    2014-01-01

    Background Given the global nursing shortage and investments to scale-up the workforce, this study evaluated trends in annual student nurse enrolment, pre-service attrition between enrolment and registration, and factors that influence nurse production in Kenya. Methods This study used a mixed methods approach with data from the Regulatory Human Resources Information System (tracks initial student enrolment through registration) and the Kenya Health Workforce Information System (tracks deployment and demographic information on licensed nurses) for the quantitative analyses and qualitative data from key informant interviews with nurse training institution educators and/or administrators. Trends in annual student nurse enrolment from 1999 to 2010 were analyzed using regulatory and demographic data. To assess pre-service attrition between training enrolment and registration with the nursing council, data for a cohort that enrolled in training from 1999 to 2004 and completed training by 2010 was analyzed. Multivariate logistic regression was used to test for factors that significantly affected attrition. To assess the capacity of nurse training institutions for scale-up, qualitative data was obtained through key informant interviews. Results From 1999 to 2010, 23,350 students enrolled in nurse training in Kenya. While annual new student enrolment doubled between 1999 (1,493) and 2010 (3,030), training institutions reported challenges in their capacity to accommodate the increased numbers. Key factors identified by the nursing faculty included congestion at clinical placement sites, limited clinical mentorship by qualified nurses, challenges with faculty recruitment and retention, and inadequate student housing, transportation and classroom space. Pre-service attrition among the cohort that enrolled between 1999 and 2004 and completed training by 2010 was found to be low (6%). Conclusion To scale-up the nursing workforce in Kenya, concurrent investments in expanding the

  9. 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…

  10. The shifting foundations of nursing.

    PubMed

    Law, Kate; Aranda, Kay

    2010-08-01

    In this paper we argue that the concerns generated by the development of Foundation Degrees and the Assistant and Associate Practitioner roles have rekindled some of the unresolved debates regarding the status and identity of nursing and nurses. Through the application of the sociological theories of professionalisation and nostalgia we have identified the shifting and unresolved nature of nursing. We argue that these theories continue to have resonance in the current climate of change and 'upskilling' of the health care workforce and argue, that the shifts illuminated are perhaps so significant as to demonstrate that we have entered a post-nursing era.

  11. A National Agenda for Nursing Workforce Racial/Ethnic Diversity. National Advisory Council on Nurse Education and Practice Report to the Secretary of Health and Human Services and Congress.

    ERIC Educational Resources Information Center

    National Advisory Council on Nurse Education and Practice, Rockville, MD.

    The National Advisory Council on Nurse Education and Practice (NACNEP) convened the Expert Workgroup on Diversity to advise the NACNEP on development of a national agenda for increasing workforce diversity. The workgroup's 18 members developed recommended goals and actions covering the following broad themes: (1) enhance efforts to increase the…

  12. Parents' Perception of Satisfaction With Pediatric Nurse Practitioners' Care And Parental Intent to Adhere To Recommended Health Care Regimen.

    PubMed

    Kinder, Frances DiAnna

    2016-01-01

    The purposes of this study were to explore parents' perceptions of satisfaction with care from primary care pediatric nurse practitioners (PNPs) and to explore the relationships of the four components of parental satisfaction with parents' intent to adhere to recommended health care regimen. The study used a descriptive correlational research design. A convenience sample of 91 participants was recruited from practices in southeastern Pennsylvania. The 28-item, Parents' Perceptions of Satisfaction with Care from Pediatric Nurse Practitioners (PPSC-PNP) tool was developed to measure four components of satisfaction and overall satisfaction of parents with PNP care after the health visit. A 100 mm visual analog (VAS) scale measured parental intent to adhere to the care regimen recommended by the PNP. Parents' perceptions of overall satisfaction with care from PNPs and satisfaction with each of the four components (communication, clinical competence, caring behavior, and decisional control) were high as measured by the PPSC-PNP. Multiple regression analysis revealed that clinical competence had the strongest positive relationship with parental intent to adhere to PNP recommended health regimen and was the only variable to enter the regression equation. The findings of this study have implications for nursing practice. The PPSC-PNP instrument may be used with a variety of pediatric populations and settings as a benchmark for quality care. Clinical competence is important for the role of the PNP. Other variables of parental intent to adhere to the health regimen should be explored in future studies. PMID:27468517

  13. The Right Jobs: Identifying Career Advancement Opportunities for Low-Skilled Workers. A Guide for Public and Private Sector Workforce Development Practitioners. Advancement for Low-Wage Workers

    ERIC Educational Resources Information Center

    Goldberger, Susan; Lessell, Newell; Biswas, Radha Roy

    2005-01-01

    The Right Jobs provides workforce policymakers and directors of workforce development programs with a structured approach to: (1) Identifying the most promising employment opportunities within reach of low-skill workers; (2) Determining the postsecondary training and career preparation routes that will yield results for their clients; and (3)…

  14. Is Academic Nursing Preparing Practitioners to Meet Present and Future Societal Needs?

    ERIC Educational Resources Information Center

    Felton, Geraldene

    The adequacy of nursing education programs in preparing nurses to meet current and future societal needs is addressed, with attention directed to baccalaureate programs, faculty, and graduates. It is suggested that research findings and anecdotal reports have validated the dysfunction phenomena between baccalaureate nursing education, the practice…

  15. 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

  16. Population-focused care: a new rubric in the role definition for geriatric nurse practitioners in primary care practice?

    PubMed

    Kauffman, K S; Barlow, A R

    1999-03-01

    Traditionally, geriatric nurse practitioners (GNPs) provide care to individual older adults and their families in a primary care practice. Although the goal is to provide high-quality, cost-effective care, GNPs may be providing ineffective care by narrowly focusing on individuals and their families. Given today's health care climate, it is essential that GNPs practice with a wider perspective. This is done by noting health issue trends among the specific older adult population that are targeted for care and planning that care with a population focus delineated by either health issues or characteristics of the older adult population.

  17. 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%.

  18. Nursing Workforce: Recruitment and Retention of Nurses and Nurse Aides Is a Growing Concern. Testimony before the Committee on Health, Education, Labor and Pensions, U.S. Senate.

    ERIC Educational Resources Information Center

    Scanlon, William J.

    The General Accounting Office examined existing and anticipated concerns related to the recruitment and retention of nurse and nurses aides. Special attention was paid to the following aspects of the problem: (1) factors contributing to the current and anticipated shortage among nurses; (2) what is known about the current and projected supply of…

  19. 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.

  20. Physician - nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care.

    PubMed

    Litaker, David; Mion, Lorraine; Planavsky, Loretta; Kippes, Christopher; Mehta, Neil; Frolkis, Joseph

    2003-08-01

    Increasing demand to deliver and document therapeutic and preventive care sharpens the need for disease management strategies that accomplish these goals efficiently while preserving quality of care. The purpose of this study was to compare selected outcomes for a new chronic disease management program involving a nurse practitioner - physician team with those of an existing model of care. One hundred fifty-seven patients with hypertension and diabetes mellitus were randomly assigned to their primary care physician and a nurse practitioner or their primary care physician alone. Costs for personnel directly involved in patient management, calculated from hourly rates and encounter time with patients, and pre- and post-study glycosylated hemoglobin (HbA(1c)), high-density lipoprotein cholesterol (HDL-c), satisfaction with care and health-related quality of life (HRQoL) were assessed. Although 1-year costs for personnel were higher in the team-treated group, participants experienced significant improvements in mean HbA(1c) ( - 0.7%, p = 0.02) and HDL-c ( + 2.6 mg dL( - 1), p = 0.02). Additionally, satisfaction with care improved significantly for team-treated subjects in several sub-scales whereas the mean change over time in HRQoL did not differ significantly between groups. This study demonstrates the value of a complementary team approach to chronic disease management in improving patient-derived and clinical outcomes at modest incremental costs.

  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.

  2. Educational Implications of Nurse Practitioner Students and Medical Residents' Attitudes toward Managed Care.

    ERIC Educational Resources Information Center

    Breer, M. Lynn; Pohl, Joanne M.; Stommel, Manfred; Barkauskas, Violet H.; Schillo, Barbara; Oakley, Deborah

    2002-01-01

    Attitudes toward managed care of 431 medical residents and 153 advanced practice nursing students were compared. Medical students were more likely to agree that managed care emphasizes cost over quality and threatens autonomy. Nursing students were more likely to agree that it encourages preventive care. Medical students were less enthusiastic…

  3. Measuring the Success of a Pipeline Program to Increase Nursing Workforce Diversity.

    PubMed

    Katz, Janet R; Barbosa-Leiker, Celestina; Benavides-Vaello, Sandra

    2016-01-01

    The purpose of this study was to understand changes in knowledge and opinions of underserved American Indian and Hispanic high school students after attending a 2-week summer pipeline program using and testing a pre/postsurvey. The research aims were to (a) psychometrically analyze the survey to determine if scale items could be summed to create a total scale score or subscale scores; (b) assess change in scores pre/postprogram; and (c) examine the survey to make suggestions for modifications and further testing to develop a valid tool to measure changes in student perceptions about going to college and nursing as a result of pipeline programs. Psychometric analysis indicated poor model fit for a 1-factor model for the total scale and majority of subscales. Nonparametric tests indicated statistically significant increases in 13 items and decreases in 2 items. Therefore, while total scores or subscale scores cannot be used to assess changes in perceptions from pre- to postprogram, the survey can be used to examine changes over time in each item. Student did not have an accurate view of nursing and college and underestimated support needed to attend college. However students realized that nursing was a profession with autonomy, respect, and honor.

  4. Australia's primary health care workforce--research informing policy.

    PubMed

    Douglas, Kirsty A; Rayner, Frith K; Yen, Laurann E; Wells, Robert W; Glasgow, Nicholas J; Humphreys, John S

    2009-07-20

    In 2008, the Australian Primary Health Care Research Institute (APHCRI) held a Primary Health Care Workforce Roundtable with practising clinicians, policymakers and researchers, which drew on Australian evidence in health care policy, systematic reviews, and expertise and experience of participants. Key recommendations for an adequate, sustainable and effective primary health care workforce that arose from the meeting included: simplifying the Medicare Benefits Schedule, which is unnecessarily complex and inflexible; effectively funding undergraduate and prevocational medical and nursing education and training in primary health care; developing career structure and training pathways for general practitioners and primary health care nurses; developing of functional primary health care teams; and using a blended funding model, comprising fee-for-service as well as capitation for patients with chronic or complex needs. A report from the meeting, detailing these policy options, was submitted to the National Health and Hospitals Reform Commission for inclusion in their deliberations. PMID:19619091

  5. An Assessment of How Nurse Practitioners Create Access to Primary Care in Canadian Residential Long-Term Care Settings.

    PubMed

    Carter, Nancy; Sangster-Gormley, Esther; Ploeg, Jenny; Martin-Misener, Ruth; Donald, Faith; Wickson-Griffiths, Abigail; Kaasalainen, Sharon; McAiney, Carrie; Brazil, Kevin; Taniguchi, Alan; Martin, Lori Schindel

    2016-01-01

    The aim of this paper is to explore the role and activities of nurse practitioners (NPs) working in long-term care (LTC) to understand concepts of access to primary care for residents. Utilizing the "FIT" framework developed by Penchanksy and Thomas, we used a directed content analysis method to analyze data from a pan-Canadian study of NPs in LTC. Individual and focus group interviews were conducted at four sites in western, central and eastern regions of Canada with 143 participants, including NPs, RNs, regulated and unregulated nursing staff, allied health professionals, physicians, administrators and directors and residents and family members. Participants emphasized how the availability and accessibility of the NP had an impact on access to primary and urgent care for residents. Understanding more about how NPs affect access in Canadian LTC will be valuable for nursing practice and healthcare planning and policy and may assist other countries in planning for the introduction of NPs in LTC settings to increase access to primary care. PMID:27673401

  6. Educating ethnic minority students for the nursing workforce: facilitators and barriers to success.

    PubMed

    Loftus, Jocelyn; Duty, Susan

    2010-07-01

    The number of ethnic minorities graduating from nursing programs does not meet the number of ethnic minority nurses that are needed for patient care. In order to identify the facilitators and barriers to success, a survey was sent to current students and to those who graduated within 2 years. There were 314 responses, which was an overall response rate of 39.6%. Among the 4 facilitator factors, only the general academic support factor was perceived as more helpful by African-American students (p = 0.001). Among the 5 barrier factors, African-American students and Other Ethnic Minority students perceived program workload and pace (African-Americans p < 0.005; Other multicultural groups p < 0.02), computer access (African-Americans p < 0.05; Other multicultural groups p < 0.05) and technology competence (African-Americans p < 0.02) to be barriers. Any student, regardless of ethnicity, who worked at a job 13 to 40 hours a week, perceived family and financial concerns as a barrier. Results indicated that curriculum content should include technology basics and testing for competence. Financial support for students must be expanded through loans and scholarships so workload and pace become more manageable.

  7. Nurse practitioner-staffed clinic at Virginia Mason improves care and lowers costs for women with benign breast conditions.

    PubMed

    Blackmore, C Craig; Edwards, Jordan W; Searles, Carly; Wechter, Debra; Mecklenburg, Robert; Kaplan, Gary S

    2013-01-01

    The implementation of a breast clinic based on the use of an advanced registered nurse practitioner at Virginia Mason Medical Center in Seattle, Washington, substantially improved care timeliness and efficiency for women with symptomatic benign breast conditions. Women received their final benign diagnosis in an average of four rather than sixteen days, with fewer imaging studies and physician visits, when compared to a control group. Savings to the employer were estimated at $316 per woman, primarily from increased work productivity. Direct care costs decreased an estimated 19 percent, to $213 per woman. By decreasing both direct medical costs and indirect costs such as work absenteeism and presenteeism, the Virginia Mason Breast Clinic has created substantial savings for providers and employers while delivering care that patients rate highly. This model demonstrates the feasibility of achieving higher quality at lower cost through integrated care.

  8. Evaluation of a nurse practitioner disease management model for chronic heart failure: a multi-site implementation study.

    PubMed

    Lowery, Julie; Hopp, Faith; Subramanian, Usha; Wiitala, Wyndy; Welsh, Deborah E; Larkin, Angela; Stemmer, Karen; Zak, Cassandra; Vaitkevicius, Peter

    2012-01-01

    While disease management appears to be effective in selected, small groups of CHF patients from randomized controlled trials, its effectiveness in a broader CHF patient population is not known. This prospective, quasi-experimental study compared patient outcomes under a nurse practitioner-led disease management model (intervention group) with outcomes under usual care (control group) in both primary and tertiary medical centers. The study included 969 veterans (458 intervention, 511 control) treated for CHF at six VA medical centers. Intervention patients had significantly fewer (p<0.05) CHF and all-cause admissions at one-year follow-up, and lower mortality at both one- and two-year follow-up. These data provide support for the potential effectiveness of the intervention, and suggest that the evidence from RCTs of disease management models for CHF can be translated into clinical practice, even without the benefits of a selected patient population and dedicated resources often found in RCTs.

  9. Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles. OECD Health Working Papers, No. 17

    ERIC Educational Resources Information Center

    Buchan, James; Calman, Lynn

    2005-01-01

    An important potential contribution to the efficient use of the health workforce, is the possibility of "skill mix" changes. "Skill mix" is a relatively broad term which can refer to the mix of staff in the workforce or the demarcation of roles and activities among different categories of staff. Most of the policy attention on using skill-mix…

  10. New Choices for Continuing Education: A Statewide Survey of the Practices and Preferences of Nurse Practitioners.

    ERIC Educational Resources Information Center

    Charles, Patricia A.; Mamary, Edward M.

    2002-01-01

    Responses from 103 licensed advanced practice nurses in Nevada showed that they used in-person and live satellite conferences most often for continuing education. However, they preferred in-person, print-based, and interactive video modes; satellite, Internet, and CD-ROM were least preferred. (SK)

  11. 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

  12. 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.

  13. 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

  14. The rural allied health workforce study (RAHWS): background, rationale and questionnaire development.

    PubMed

    Keane, Sheila; Smith, Tony N; Lincoln, Michelle; Wagner, Scott R; Lowe, Shelagh E

    2008-01-01

    The allied health professions form approximately 18% of the health workforce in Australia and are well placed to contribute to future multidisciplinary models of health care. There are many reports describing the health workforce in Australia for the medical and nursing professions but there is very little information available about the nature of the allied health workforce. Recent studies have highlighted the need for more current and detailed information about the rural allied health workforce to inform future workforce planning. National health policy reform requires that new healthcare models take into account future workforce requirements, the distribution and work contexts of existing practitioners, training needs, workforce roles and scope of practice. The absence of accurate data profiling the existing rural allied health workforce makes this impossible. The Rural Allied Health Workforce Study (RAHWS) aims to use a cross-sectional survey instrument with high validity to provide a large scale but detailed profile of the allied health workforce in regional, rural and remote Australia. The RAHWS survey instrument used in this study is the result of a comprehensive consultation with clinicians, academics and managers. The RAHWS survey instrument has been designed to provide uniform data across a wide range of healthcare settings. Good concurrent and face validity have been demonstrated and its design allows for data analysis using a wide range of variables. Cross-correlation of responses can answer a number of research questions in relation to rural recruitment and retention, professional education and service delivery models. This valid and feasible instrument will be used to explore the rural allied health workforce by implementing the RAHWS survey in rural regions on a state-by-state basis in Australia during 2009 and 2010. PMID:19182857

  15. 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.

  16. Role clarification processes for better integration of nurse practitioners into primary healthcare teams: a multiple-case study.

    PubMed

    Brault, Isabelle; Kilpatrick, Kelley; D'Amour, Danielle; Contandriopoulos, Damien; Chouinard, Véronique; Dubois, Carl-Ardy; Perroux, Mélanie; Beaulieu, Marie-Dominique

    2014-01-01

    Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration.

  17. Role Clarification Processes for Better Integration of Nurse Practitioners into Primary Healthcare Teams: A Multiple-Case Study

    PubMed Central

    D'Amour, Danielle; Contandriopoulos, Damien; Chouinard, Véronique; Dubois, Carl-Ardy

    2014-01-01

    Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration. PMID:25692039

  18. Developing a public health policy-research nexus: an evaluation of Nurse Practitioner models in aged care.

    PubMed

    Prosser, Brenton; Clark, Shannon; Davey, Rachel; Parker, Rhian

    2013-10-01

    A frustration often expressed by researchers and policy-makers in public health is an apparent mismatch between respective priorities and expectations for research. Academics bemoan an oversimplification of their work, a reticence for independent critique and the constant pressure to pursue evaluation funding. Meanwhile, policy-makers look for research reports written in plain language with clear application, which are attuned to current policy settings and produced quickly. In a context where there are calls in western nations for evidence based policy with stronger links to academic research, such a mismatch can present significant challenges to policy program evaluation. The purpose of this paper is to present one attempt to overcome these challenges. Specifically, the paper describes the development of a conceptual framework for a large-scale, multifaceted evaluation of an Australian Government health initiative to expand Nurse Practitioner models of practice in aged care service delivery. In doing so, the paper provides a brief review of key points for the facilitation of a strong research-policy nexus in public health evaluations, as well as describes how this particular evaluation embodies these key points. As such, the paper presents an evaluation approach which may be adopted and adapted by others undertaking public health policy program evaluations.

  19. [Practice guideline 'Influenza prevention in nursing homes and care homes', issued by the Dutch Society of Nursing Home Specialists; division of tasks between nursing home specialist, general practitioner and company doctor].

    PubMed

    Cools, H J M; van Essen, G A

    2005-01-15

    The Dutch Society of Nursing Home Specialists has formulated a guideline for the prevention of influenza in nursing homes and care homes in The Netherlands. The guideline recommends the realisation of the highest possible degree of vaccination of both patients and health care workers. At the start of the flu season, the manager of the chronic care institute should organize a scheme for vaccination against influenza and a plan in case of an outbreak of influenza. The division of tasks between the nursing home specialist, the general practitioner and the company doctor should be recorded in both the vaccination scheme and the outbreak plan. In order to decrease the incidence of non-response to the vaccine a double dose of influenza vaccine for nursing home patients should be considered. The outbreak plan should raise the state of alertness for influenza and ensure that virological confirmation of clinical influenza is obtained quickly. Immediately after virological confirmation of clinical influenza, patients with influenza should be treated with oseltamivir and both patients and health care workers in the unit should receive prophylaxis with oseltamivir. Non-vaccinated patients should also be offered vaccination to restrict re-introduction of the virus. During an influenza outbreak, only patients with influenza or those who have had prophylactic treatment may be admitted to the facility. In the case of an influenza pandemic, national guidelines should be followed. PMID:15693586

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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.

  6. Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors. Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives.

    ERIC Educational Resources Information Center

    Heinrich, Janet

    Current evidence suggests emerging shortages of nurses available or willing to fill some vacant positions in hospitals, nursing homes, and home care. Total employment of registered nurses (RNs) per capita and the national unemployment rate for RNs have declined, and providers from around the country report growing difficulty recruiting and…

  7. 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

  8. 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.

  9. Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates

    PubMed Central

    Kaczorowski, Janusz; Hearps, Stephen J.C.; Lohfeld, Lynne; Goeree, Ron; Donald, Faith; Burgess, Ken; Sebaldt, Rolf J.

    2013-01-01

    Abstract Objective To evaluate the effect of the Provider and Patient Reminders in Ontario: Multi-Strategy Prevention Tools (P-PROMPT) reminder and recall system and pay-for-performance incentives on the delivery rates of cervical and breast cancer screening in primary care practices in Ontario, with or without deployment of nurse practitioners (NPs). Design Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP–augmented strategies of the P-PROMPT reminder and recall system. Setting Southwestern Ontario. Participants A total of 232 physicians from 24 primary care network or family health network groups across 110 different sites eligible for pay-for-performance incentives. Interventions The P-PROMPT project combined pay-for-performance incentives with provider and patient reminders and deployment of NPs to enhance the delivery of preventive care services. Main outcome measures The mean delivery rates at the practice level of time-appropriate mammograms and Papanicolaou tests completed within the previous 30 months. Results Before-and-after comparisons of time-appropriate delivery rates (< 30 months) of cancer screening showed the rates of Pap tests and mammograms for eligible women significantly increased over a 1-year period by 6.3% (P < .001) and 5.3% (P < .001), respectively. The NP-augmented strategy achieved comparable rate increases to the automated strategy alone in the delivery rates of both services. Conclusion The use of provider and patient reminders and pay-for-performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario. PMID:23766067

  10. 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

  11. Transition of New Graduate Nurses to the Workforce: Challenges and Solutions in the Changing Health Care Environment.

    PubMed

    Hofler, Linda; Thomas, Kendal

    2016-01-01

    New graduate nurses face a host of challenges that impact successful transition to practice. Health care organizations thus need to understand how changes in the health care landscape impact new graduate nurses who are transitioning to the practice environment. This commentary discusses challenges and possible solutions to successful transition of new graduates into the work environment. PMID:26961840

  12. Building Workforce Strength: Creating Value through Workforce and Career Development

    ERIC Educational Resources Information Center

    Elsdon, Ron

    2010-01-01

    This book explores the perspectives of experienced practitioners, sharing ideas about building and sustaining organizational strength through workforce development practices and systems. As the saying goes, a company's greatest resource is its people. When managers really believe that and work to develop organizational capabilities, productivity,…

  13. Nurse practitioner (NP)

    MedlinePlus

    ... more states are requiring NPs to have a master's degree and national certification. In some states, NP ... these organizations require that NPs complete an approved master's-level NP program before taking the certification exam. ...

  14. Workforce planning. Catching the drift.

    PubMed

    Jinks, C; Ong, B N; Paton, C

    1998-09-17

    NHS workforce planning has traditionally ignored the role of doctors and nurses trained in continental Europe and Scandinavia. At present doctors trained in the European Economic Area make up 10 per cent of senior house officers in England and Wales. But the numbers coming to the UK are falling. Falling medical unemployment in Europe will mean these doctors have less incentive to come to the UK, leaving a considerable gap in the NHS workforce. More local research is needed into working patterns and career plans of European-trained nurses and doctors.

  15. 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

  16. 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.

  17. Education for Public Health Capacity in the Nursing Workforce: Findings from a Review of Education and Practice Issues.

    ERIC Educational Resources Information Center

    Latter, Sue; Speller, Viv; Westwood, Greta; Latchem, Susan

    2003-01-01

    Literature review and interviews with nine public health and nursing education informants in Britain indicated that, although National Health Service policy highlights public health, clinical placements in this area are limited and curriculum content needs to be applicable to public health. Needs assessments show skills gaps in practicing nurses…

  18. Using staffing ratios for workforce planning: evidence on nine allied health professions

    PubMed Central

    2012-01-01

    Background Modern healthcare managers are faced with pressure to deliver effective, efficient services within the context of fixed budget constraints. Managers are required to make decisions regarding the skill mix of the workforce particularly when staffing new services. One measure used to identify numbers and mix of staff in healthcare settings is workforce ratio. The aim of this study was to identify workforce ratios in nine allied health professions and to identify whether these measures are useful for planning allied health workforce requirements. Methods A systematic literature search using relevant MeSH headings of business, medical and allied health databases and relevant grey literature for the period 2000-2008 was undertaken. Results Twelve articles were identified which described the use of workforce ratios in allied health services. Only one of these was a staffing ratio linked to clinical outcomes. The most comprehensive measures were identified in rehabilitation medicine. Conclusion The evidence for use of staffing ratios for allied health practitioners is scarce and lags behind the fields of nursing and medicine. PMID:22293082

  19. 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

  20. 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…

  1. Becoming willing to role model. Reciprocity between new graduate nurses and experienced practice nurses in general practice in New Zealand: a constructivist grounded theory.

    PubMed

    Hoarea, Karen J; Millsc, Jane; Francis, Karen

    2013-01-01

    Graduate nurses in general practice became a feature of New Zealand's health care system in 2008 following an expansion of the New Entrant to Practice Programme. General practice in New Zealand comprises general practitioner business owners who employ nursing and administration staff. Practice nurses are an ageing workforce in New Zealand, it is imperative therefore to attract younger nurses into general practice. This paper reports a section of the findings from a constructivist grounded theory study which examines the use of information by practice nurses in New Zealand. Initially data were collected using the ethnographic technique of observation and field notations in one general practice. Theoretical sensitivity to the value of role models was heightened by this first phase of data collection. A total of eleven practice nurses were interviewed from six general practices. One practice nurse agreed to a second interview; five of the interviewees were new graduate nurses and the other six were experienced practice nurses. The grounded theory constructed from this research was reciprocal role modelling which comprises the following three categories, becoming willing, realising potential and becoming a better practitioner. Graduate nurses and experienced practice nurses enter into a relationship of reciprocal role modelling. Becoming willing, the first core category of this grounded theory features three sub-categories: building respectful relationships, proving yourself and discerning decision making which are reported in this paper. Findings from this study may address the reported phenomenon of 'transition shock' of newly graduated nurses in the work place.

  2. Becoming willing to role model. Reciprocity between new graduate nurses and experienced practice nurses in general practice in New Zealand: a constructivist grounded theory.

    PubMed

    Hoarea, Karen J; Millsc, Jane; Francis, Karen

    2013-01-01

    Graduate nurses in general practice became a feature of New Zealand's health care system in 2008 following an expansion of the New Entrant to Practice Programme. General practice in New Zealand comprises general practitioner business owners who employ nursing and administration staff. Practice nurses are an ageing workforce in New Zealand, it is imperative therefore to attract younger nurses into general practice. This paper reports a section of the findings from a constructivist grounded theory study which examines the use of information by practice nurses in New Zealand. Initially data were collected using the ethnographic technique of observation and field notations in one general practice. Theoretical sensitivity to the value of role models was heightened by this first phase of data collection. A total of eleven practice nurses were interviewed from six general practices. One practice nurse agreed to a second interview; five of the interviewees were new graduate nurses and the other six were experienced practice nurses. The grounded theory constructed from this research was reciprocal role modelling which comprises the following three categories, becoming willing, realising potential and becoming a better practitioner. Graduate nurses and experienced practice nurses enter into a relationship of reciprocal role modelling. Becoming willing, the first core category of this grounded theory features three sub-categories: building respectful relationships, proving yourself and discerning decision making which are reported in this paper. Findings from this study may address the reported phenomenon of 'transition shock' of newly graduated nurses in the work place. PMID:23898596

  3. Retooling the RN workforce in long-term care: nursing certification as a pathway to quality improvement.

    PubMed

    Cramer, Mary E; High, Robin; Culross, Beth; Conley, Deborah Marks; Nayar, Preethy; Nguyen, Anh T; Ojha, Diptee

    2014-01-01

    This article describes a project to improve nursing care quality in long-term care (LTC) by retooling registered nurses' (RN) geriatric clinical competence. A continuing education course was developed to prepare LTC RNs (N = 84) for national board certification and improve technological competence. The certification pass-rate was 98.5%. The study used a mixed methods design with retrospective pretests administered to RN participants. Multivariate analysis examined the impact of RN certification on empowerment, job satisfaction, intent to turnover, and clinical competence. Results showed certification significantly improved empowerment, satisfaction, and competence. A fixed effects analysis showed intent to turnover was a function of changes in empowerment, job dissatisfaction, and competency (F = 79.2; p < 0.001). Changes in empowerment (t = 1.63, p = 0.11) and competency (t = -0.04, p = 0.97) did not affect changes in job satisfaction. Findings suggest RN certification can reduce persistently high RN turnover rates that negatively impact patient safety and LTC quality.

  4. Results and Lessons Learned from a Nurse Practitioner-Guided Dementia Care Intervention for Primary Care Patients and Their Family Caregivers

    PubMed Central

    Fortinsky, Richard H.; Delaney, Colleen; Harel, Ofer; Pasquale, Karen; Schjavland, Elena; Lynch, John; Kleppinger, Alison; Crumb, Suzanne

    2014-01-01

    Older adults with dementia care needs often visit primary care physicians (PCPs), but PCP dementia care limitations are widely documented. This study tested the value of employing a nurse practitioner (NP) with geropsychiatric expertise to augment PCP care for newly and recently diagnosed patients and family caregivers. Twenty-one dyads received the NP intervention; 10 dyads were controls. Outcomes included patient neuropsychiatric symptom and quality of life changes, and caregiver depression, burden, and self-efficacy changes. Intervention acceptability by patients, caregivers, and PCPs was determined. No outcome differences were found; however, the NP intervention was deemed highly satisfactory by all stakeholders. Patients experienced no significant cognitive decline during their 12-month study period, helping explain why outcomes did not change. Given widespread acceptability, future tests of this PCP-enhancing intervention should include patients with more progressive cognitive decline at study entry. NPs with geropsychiatric expertise are ideal interventionists for this rapidly growing target population. PMID:24444453

  5. Trends in Practice Patterns and Perspectives of Colorado Certified Nurse-Midwives.

    PubMed

    Hastings-Tolsma, Marie; Tanner, Tanya; Hensley, Jennifer G; Anderson, Jessica; Patterson, Elisa; Dunemn, Kathleen N; Purcell, Susan K

    2015-08-01

    Healthcare resources are stretched perilously thin and the demand for primary healthcare services has never been greater. Despite this demand for service, relatively little is known about the practice environment of primary healthcare providers, particularly certified nurse-midwives (CNMs), where workforce surveys frequently include these specialists within the broader nurse practitioner category. A distinct professional discipline, nurse-midwives are one type of primary care provider recommended to enhance access to services. The objective of this study was to understand the nature of the nurse-midwifery practice environment in the state of Colorado. Online survey of Colorado CNMs (N = 328) found little ethnic/racial diversity and an aging workforce, with most providing care in an urban, hospital/medical center environment. Several key legislative issues were identified though respondents felt ill prepared to engage in legislative change. Overall, CNMs were optimistic about the future of midwifery and were largely satisfied with their practice. PMID:26351217

  6. Back to the future: making a case for including the history of mental health nursing in nurse education programmes.

    PubMed

    Leishman, June L

    2005-05-01

    Reflections on nursing history, the nature of its workforce and its evolution as a profession can be powerful tools in the development of professional identity. Historical accounts of mental health nurses' practice and how they are socially, politically and culturally positioned within a particular time frame serve to illustrate that as practitioners we are precariously placed within a certain point in history. This paper emphasises the importance of mental health nursing historical research within nurse education curricula as a means of situating current theories, practice and professional identity. It further proposes that as today's practice becomes tomorrow's history, mental health nursing will continue to respond in a dynamic way to the practices and policies of the day.

  7. 42 CFR 405.2416 - Visiting nurse services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., nurse midwife, or specialized nurse practitioner and reviewed at least every 60 days by a supervising physician; and (ii) Signed by the nurse practitioner, physician assistant, nurse midwife, specialized...

  8. Workforce: Hawaii

    ERIC Educational Resources Information Center

    Western Interstate Commission for Higher Education, 2006

    2006-01-01

    Employment in Hawaii (including hourly and salaried jobs and self-employment) is projected to grow by 14 percent from 2002 to 2012, adding over 78,000 new jobs to the state's economy and growing the workforce from 558,220 to 636,480. The rate of growth is slightly lower than the 15 percent increase projected for the nation as a whole. Over the…

  9. Workforce: Montana

    ERIC Educational Resources Information Center

    Western Interstate Commission for Higher Education, 2006

    2006-01-01

    Employment in Montana (including hourly and salaried jobs and self-employment) is projected to grow by 17 percent from 2002 to 2012, adding over 96,000 new jobs to the state's economy and growing the workforce from 554,456 to 651,135. The rate of growth is higher than the 15 percent increase projected for the nation as a whole. Growth will occur…

  10. Improving Workforce Literacy for 21st Century Jobs.

    ERIC Educational Resources Information Center

    Ott, Joyce A.

    This document introduces community leaders and practitioners to innovative approaches to improving workforce literacy by building accessible lifelong learning systems to prepare adults with the array of skills needed to prosper in the new economy. The introduction defines literacy and workforce literacy and outlines the challenges that education,…

  11. The potent lever of toil: nursing development and exportation in the postcolonial Philippines.

    PubMed

    Brush, Barbara L

    2010-09-01

    Although the colonial relationship between the Philippines and the United States precipitated nurse education and migration patterns that exist today, little is known about the factors that sustained them. During the first half of the twentieth century, for example, the Philippines trained its nurse workforce primarily for domestic use. After the country's independence in 1946, however, that practice reversed. Nurse education in the Philippines was driven largely by US market demand in tandem with local messages linking work and nationalism and explicit policies to send nurses abroad. As these ideologies and practices became firmly entrenched, nurse production not only exceeded the country's numerical requirements but focused largely on preparing practitioners for the health care needs of developed nations rather than the public health needs of the indigenous population. This historical trend has important present-day ramifications for the Philippines, whose continued exodus of nurses threatens its public health. PMID:20634458

  12. Evidence-Guided Integration of Interprofessional Collaborative Practice into Nurse Managed Health Centers.

    PubMed

    Pilon, Bonita A; Ketel, Christian; Davidson, Heather A; Gentry, Chad K; Crutcher, Terri D; Scott, Aaron W; Moore, R Maldonado; Rosenbloom, S Trent

    2015-01-01

    The Division of Nursing, Bureau of Health Workforce, has spearheaded a 3-year effort to increase the skills of nurses to lead interprofessional collaborative practice (IPCP) teams. Since 2012, the Nurse Education, Practice, Quality and Retention program has funded 53 sites engaged in this work. The purposes of this report are to describe the IPCP framework undergirding implementation at one such site, describe the evaluation components and approach, describe how health professions students are integrated into this model, and discuss implications of IPCP for future nurse-managed/nurse-led initiatives within an evolving health care environment. Core team members include a family nurse practitioner, physician, pharmacist, social worker, and community health advocate. The clinic is located within a public housing complex; the target population is largely uninsured or underinsured with a historically high rate of emergency department utilization. PMID:26194966

  13. The Potent Lever of Toil: Nursing Development and Exportation in the Postcolonial Philippines

    PubMed Central

    2010-01-01

    Although the colonial relationship between the Philippines and the United States precipitated nurse education and migration patterns that exist today, little is known about the factors that sustained them. During the first half of the twentieth century, for example, the Philippines trained its nurse workforce primarily for domestic use. After the country's independence in 1946, however, that practice reversed. Nurse education in the Philippines was driven largely by US market demand in tandem with local messages linking work and nationalism and explicit policies to send nurses abroad. As these ideologies and practices became firmly entrenched, nurse production not only exceeded the country's numerical requirements but focused largely on preparing practitioners for the health care needs of developed nations rather than the public health needs of the indigenous population. This historical trend has important present-day ramifications for the Philippines, whose continued exodus of nurses threatens its public health. PMID:20634458

  14. 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

  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. Inequality of Paediatric Workforce Distribution in China

    PubMed Central

    Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin

    2016-01-01

    Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of paediatric workforce distribution. This study aimed to analyse the inequality of the distributions of the paediatric workforce (including paediatricians and paediatric nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the paediatric workforce was the most inequitable regarding the distribution of children <7 years, the geographic distribution of the paediatric workforce highlighted very severe inequality across the nation, except the Central region. For different professional types, we found that, except the Central region, the level of inequality of paediatric nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the paediatric workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the paediatric workforce in China for the first time, substantial inequality of paediatric workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation. PMID:27420083

  17. 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.

  18. 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

  19. Are managed care organizations in the United States impeding the delivery of primary care by nurse practitioners? A 2012 update on managed care organization credentialing and reimbursement practices.

    PubMed

    Hansen-Turton, Tine; Ware, Jamie; Bond, Lisa; Doria, Natalie; Cunningham, Patrick

    2013-10-01

    In 2014, the Affordable Care Act will create an estimated 16 million newly insured people. Coupled with an estimated shortage of over 60,000 primary care physicians, the country's public health care system will be at a challenging crossroads, as there will be more patients waiting to see fewer doctors. Nurse practitioners (NPs) can help to ease this crisis. NPs are health care professionals with the capability to provide important and critical access to primary care, particularly for vulnerable populations. However, despite convincing data about the quality of care provided by NPs, many managed care organizations (MCOs) across the country do not credential NPs as primary care providers, limiting the ability of NPs to be reimbursed by private insurers. To assess current credentialing practices of health plans across the United States, a brief telephone survey was administered to 258 of the largest health maintenance organizations (HMOs) in the United States, operated by 98 different MCOs. Results indicated that 74% of these HMOs currently credential NPs as primary care providers. Although this represents progress over prior assessments, findings suggest that just over one fourth of major HMOs still do not recognize NPs as primary care providers. Given the documented shortage of primary care physicians in low-income communities in the United States, these credentialing policies continue to diminish the ability of NPs to deliver primary care to vulnerable populations. Furthermore, these policies could negatively impact access to care for thousands of newly insured Americans who will be seeking a primary care provider in 2014.

  20. The Workforce Task Force report: clinical implications for neurology.

    PubMed

    Freeman, William D; Vatz, Kenneth A; Griggs, Robert C; Pedley, Timothy

    2013-07-30

    The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient access exist due to looming concerns about further Medicare reimbursement cuts. This uncertainty is set against a backdrop of Congressional volatility on a variety of issues, including the repeal of the sustainable growth rate for physician reimbursement. The impact of these US health care changes on the neurology workforce, future increasing demands, reimbursement, and alternative health care delivery models including accountable care organizations, nonphysician providers such as nurse practitioners and physician assistants, and teleneurology for both stroke and general neurology are discussed. The data lead to the conclusion that neurologists will need to play an even larger role in caring for the aging US population by 2025. We propose solutions to increase the availability of neurologic services in the future and provide other ways of meeting the anticipated increased demand for neurologic care.

  1. The U.S. Presidential Election and Health Care Workforce Policy

    PubMed Central

    McHugh, Matthew D.; Aiken, Linda H.; Cooper, Richard A.; Miller, Phillip

    2009-01-01

    The candidates for the 2008 presidential election have offered a range of proposals that could bring significant changes in health care. Although few are aimed directly at the nurse and physician workforce, nearly all of the proposals have the potential to affect the health care workforce. Furthermore, the success of the proposed initiatives is dependent on a robust nurse and physician workforce. The purpose of this article is to outline the current needs and challenges for the nurse and physician workforce and highlight how candidates’ proposals intersect with the adequacy of the health care workforce. Three general themes are highlighted for their implications on the physician and nurse workforce supply, including (a) expansion of health care coverage, (b) workforce investment, and (c) cost control and quality improvement. PMID:18436702

  2. The continuing quest for parity: HBCU nursing students' perspectives on nursing and nursing education.

    PubMed

    Talley, Costellia; Talley, Henry; Collins-McNeil, Janice

    2016-08-01

    The benefits of a diverse nursing workforce are well-recognized, yet, the attainment of a sustainable, competent and diverse nursing workforce continues to be a global challenge. In this qualitative study, we describe nursing students' perceptions on nursing and nursing education at a Historically Black College/University (HBCU). Focus groups were conducted with 16 graduate and undergraduate nursing students. Four themes emerged: communication, lack of resources, support systems and professional socialization. Mentoring and civility were identified as factors important to enhance a diverse workforce. PMID:27286940

  3. The endodontic workforce.

    PubMed

    Johns, Beverly A; Brown, L Jackson; Nash, Kent D; Warren, Matthew

    2006-09-01

    The amount of endodontic care provided in the US requires an understanding of the supply and demand for such care. The supply side includes the number and location of endodontists, type of provider, and productivity. The demand side consists of the changing demographics of the age groups that endodontists predominantly treat along with changes in their dental health. To address these issues, we have compiled and analyzed data from American Dental Association (ADA) with other sources such as US government census data and the National Health and Nutrition Examination Surveys (NHANES). From 1982 to 2002, the supply of endodontists increased at a rate greater than that observed with general practitioners or the other specialty areas. The growth of endodontists in relation to general practitioners is important. The latter are co-providers of endodontic care as well as a primary source for referral of patients to endodontists. Demographic and disease changes are likely to impact the need and demand for endodontic services. Endodontists' patients are generally between the ages of 25 and 64 yrs. Currently, the majority of endodontists' patients are members of the large baby boom generation who in 2000 ranged in age from their late 30s to their late 50s. During the next 20 yrs the Baby Boom generation will be replaced by the numerically smaller Generation-X cohort. This generation has experienced substantially less total caries than baby-boomers and they most likely will have fewer endodontic sequela as they age. A moderating factor that could partially offset the predicted decline in numbers of patients is the increased number of teeth that Generation-Xers are likely to retain. A flexible endodontic workforce strategy must assess the impending demographic and disease trends in relation to future growth rates of both endodontists and general practitioners.

  4. Competency of Graduate Nurses as Perceived by Nurse Preceptors and Nurse Managers

    ERIC Educational Resources Information Center

    Wise, Vanessa

    2013-01-01

    As newly graduated associate degree nurses (ADN) and baccalaureate degree nurses (BSN) enter into the workforce, they must be equipped to care for a complex patient population; therefore, the purpose of this study was to address the practice expectations and clinical competency of new nurses as perceived by nurse preceptors and nurse managers.…

  5. 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

  6. 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.

  7. 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)

  8. Migration of nurses in Australia: where and why?

    PubMed

    Ohr, Se Ok; Parker, Vicki; Jeong, Sarah; Joyce, Terry

    2010-01-01

    The Australian health care workforce has benefited from an increasing migration of nurses over the past decades. The nursing profession is the largest single health profession, making up over half of the Australian health care workforce. Migration ofnurses into the Australian nursing workforce impacts significantly on the size ofthe workforce and the capacity to provide health care to the Australian multicultural community. Migration of nurses plays an important role in providing a solution to the ongoing challenges of workforce attraction and retention, hence an understanding of the factors contributing to nurse migration is important. This paper will critically analyse factors reported to impact on migration of nurses to Australia, in particular in relation to: (1) globalisation; (2) Australian society and nursing workforce; and (3) personal reasons. The current and potential implications of nurse migration are not limited to the Australian health care workforce, but also extend to political, socioeconomic and other aspects in Australia. PMID:21133293

  9. Migration of nurses in Australia: where and why?

    PubMed

    Ohr, Se Ok; Parker, Vicki; Jeong, Sarah; Joyce, Terry

    2010-01-01

    The Australian health care workforce has benefited from an increasing migration of nurses over the past decades. The nursing profession is the largest single health profession, making up over half of the Australian health care workforce. Migration ofnurses into the Australian nursing workforce impacts significantly on the size ofthe workforce and the capacity to provide health care to the Australian multicultural community. Migration of nurses plays an important role in providing a solution to the ongoing challenges of workforce attraction and retention, hence an understanding of the factors contributing to nurse migration is important. This paper will critically analyse factors reported to impact on migration of nurses to Australia, in particular in relation to: (1) globalisation; (2) Australian society and nursing workforce; and (3) personal reasons. The current and potential implications of nurse migration are not limited to the Australian health care workforce, but also extend to political, socioeconomic and other aspects in Australia.

  10. Health Workforce and International Migration: Can New Zealand Compete? OECD Health Working Papers No. 33

    ERIC Educational Resources Information Center

    Zurn, Pascal; Dumont, Jean-Christophe

    2008-01-01

    This paper examines health workforce and migration policies in New Zealand, with a special focus on the international recruitment of doctors and nurses. The health workforce in New Zealand, as in all OECD countries, plays a central role in the health system. Nonetheless, maybe more than for any other OECD country, the health workforce in New…

  11. Primary care clinical placements: The views of Australian registered nurse mentors and pre-registration nursing students (part 2).

    PubMed

    McInnes, Susan; Peters, Kath; Hardy, Jennifer; Halcomb, Elizabeth

    2015-11-01

    An increased burden of chronic and complex conditions treated in the community and an aging population have exacerbated the primary care workload. Predicted nursing shortages will place further stressors on this workforce. High quality clinical placements may provide a strategic pathway to introduce and recruit new nurses to this speciality. This paper is Part 2 of a two part series reporting the findings of a mixed methods project. Part 1 reported on the qualitative study and Part 2 reports on the quantitative study. Forty-five pre-registration nursing students from a single Australian tertiary institution and 22 primary care Registered Nurse (RN) mentors who supervised student learning completed an online survey. Students largely regarded their primary care placement positively and felt this to be an appropriate learning opportunity. Most RNs were satisfied with mentoring pre-registration nursing students in their setting. Furthermore, the RNs desire to mentor students and the support of general practitioners (GPs) and consumers were seen as key enablers of pre-registration nursing placements. Findings from this study provide a preliminary impression of primary care clinical placements from the perspective of pre-registration nursing students and registered nurse mentors. Further research should examine whether a broader scope of non-traditional health settings such as non-government organisations, charities, pharmacies, welfare and social services can also provide appropriate learning environments for pre-registration nursing students. PMID:25960063

  12. 42 CFR 405.2416 - Visiting nurse services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... supervising physician of the rural health clinic or established by a nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner and reviewed at least every 60 days by a supervising physician; and (ii) Signed by the nurse practitioner, physician assistant, nurse midwife, specialized...

  13. 42 CFR 405.2416 - Visiting nurse services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... supervising physician of the rural health clinic or established by a nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner and reviewed at least every 60 days by a supervising physician; and (ii) Signed by the nurse practitioner, physician assistant, nurse midwife, specialized...

  14. 42 CFR 405.2416 - Visiting nurse services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... supervising physician of the rural health clinic or established by a nurse practitioner, physician assistant, nurse midwife, or specialized nurse practitioner and reviewed at least every 60 days by a supervising physician; and (ii) Signed by the nurse practitioner, physician assistant, nurse midwife, specialized...

  15. Federal Support for the Preparation of the Clinical Nurse Specialist Workforce through Title VIII. Report to the Secretary of Health and Human Services.

    ERIC Educational Resources Information Center

    National Advisory Council on Nurse Education and Practice, Rockville, MD.

    This document presents the findings of the National Advisory Council on Nurse Education and Practice regarding the role, education, and supply of clinical nurse specialists (CNSs). The first section of the report examines the following eight background issues: (1) early development of the CNS; (2) current CNS supply; (3) roles and impact of the…

  16. A Data-Driven Examination of the Impact of Associate and Bachelor's Degree Programs on the Nation's Nursing Workforce. AACC Policy Brief 2011-02PBL

    ERIC Educational Resources Information Center

    Fulcher, Roxanne; Mullin, Christopher M.

    2011-01-01

    The nation relies on both 2- and 4-year institutions of higher education for the majority of its registered nurses (RNs), who are authorized to practice as RNs after achieving either an associate or bachelor's-level nursing degree and passing a national licensure exam. Due to job growth and retirements, the nation is projected to need more than 1…

  17. A guide to managing workforce transitions.

    PubMed

    Staring, S; Taylor, C

    1997-12-01

    Recognizing leadership styles and team-building interventions that work help nurse managers change skills and strategies to meet the demands of a workforce reorganization. Three key strategies are identified: emotional management, professional empowerment and empowerment by values. All members involved in the reorganization were given room to grow, to make mistakes and to learn from them.

  18. Health policy thoughtleaders' views of the health workforce in an era of health reform.

    PubMed

    Donelan, Karen; Buerhaus, Peter I; DesRoches, Catherine; Burke, Sheila P

    2010-01-01

    Although registered nurses rank similarly with physicians in the public's esteem, physicians are more visible than nurses in media coverage, public policy, and political spheres. Thus, nursing workforce issues are overshadowed by those of other health priorities, including Medicare and health reform. The purpose of this research was to understand the visibility and salience of the health workforce in general, gain an understanding about the effectiveness of messages concerning the nursing workforce in particular, and to understand why nursing workforce issues do not appear to have gained more traction in national health care policymaking. The National Survey of Thoughtleaders about the Health Workforce was administered via mail, telephone and online to health workforce and policy thoughtleaders from August 2009-October 2009. Of 301 thoughtleaders contacted, 123 completed questionnaires for a response rate of 41%. Thoughtleaders agree that nurses are critical to the quality and safety of our healthcare system, that there are current nursing shortages, and that nursing shortages will be intensified by health reform. Thoughtleaders reported that while they do hear about nursing issues frequently, they do not view most sources of information as proposing effective policy solutions. This study highlights a critical gap in effective policy advocacy and leadership to advance nurse workforce issues higher on the national health agenda. PMID:20637930

  19. 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

  20. Nursing Education for College Graduates.

    ERIC Educational Resources Information Center

    Slavinsky, Ann T.; Diers, Donna

    1982-01-01

    Describes the masters programs for nonnurse college graduates at Yale School of Nursing which offers both basic and advanced nursing preparation in a single three-year curriculum sequence. The program prepares nurses who can function in advanced-practice specialty roles as nurse-midwives, nurse practitioners, or clinical nurse specialists. (CT)

  1. Towards best practice in national health workforce planning.

    PubMed

    McCarty, Maureen V; Fenech, Bethany J

    2013-09-01

    Health Workforce Australia (HWA) was established by the Council of Australian Governments through its 2008 National Partnership Agreement on Hospital and Health Workforce Reform, as the national agency to progress health workforce reform and address the challenges of providing a skilled, innovative and flexible health workforce in Australia. The Australian Health Ministers' Conference commissioned HWA to undertake a workforce planning exercise for doctors, nurses and midwives over a planning horizon to 2025. Health Workforce 2025 (HW 2025) was conducted in two phases: developing projections for the size and type of the health workforce (doctors, nurses and midwives) needed to meet future service requirements from 2012 to 2025; and modelling the training pipeline necessary to meet the size and type of this health workforce. HWA has used a number of key principles in developing HW 2025 to ensure the projections are robust and able to be applied nationally. HW 2025 is not a one-off project. Projections will be updated as new data become available, and methodology and assumptions underpinning the projections will be periodically reviewed. To also ensure the continued improvement of national health workforce planning, HWA is pursuing other areas for improvement, including better national data collections and improved estimation methodology for demand. Results of HW 2025 were presented to the Australian Health Ministers (through the Standing Council on Health) in April 2012.

  2. Exploring health promotion practitioners' experiences of moral distress in Canada and Australia.

    PubMed

    Sunderland, Naomi; Harris, Paul; Johnstone, Kylie; Del Fabbro, Letitia; Kendall, Elizabeth

    2015-03-01

    This article introduces moral distress - the experience of painful feelings due to institutional constraints on personal moral action - as a significant issue for the international health promotion workforce. Our exploratory study of practitioners' experiences of health promotion in Australia and Canada during 2009-2010 indicated that practitioners who work in upstream policy- and systems-level health promotion are affected by experiences of moral distress. Health promotion practitioners at all levels of the health promotion continuum also described themselves as being engaged in a minority practice within a larger dominant system that does not always value health promotion. We argue that health promotion practitioners are vulnerable to moral distress due to the values-driven and political nature of the practice, the emphasis on systems change and the inherent complexity and diversity of the practice. This vulnerability to moral distress poses significant challenges to both workers and organisations and the communities they seek to benefit. We propose that further research should be undertaken to fully identify the causes and symptoms of moral distress in health promotion. Extensive existing research on moral distress in nursing provides ample resources to conduct such research.

  3. Exploring health promotion practitioners' experiences of moral distress in Canada and Australia.

    PubMed

    Sunderland, Naomi; Harris, Paul; Johnstone, Kylie; Del Fabbro, Letitia; Kendall, Elizabeth

    2015-03-01

    This article introduces moral distress - the experience of painful feelings due to institutional constraints on personal moral action - as a significant issue for the international health promotion workforce. Our exploratory study of practitioners' experiences of health promotion in Australia and Canada during 2009-2010 indicated that practitioners who work in upstream policy- and systems-level health promotion are affected by experiences of moral distress. Health promotion practitioners at all levels of the health promotion continuum also described themselves as being engaged in a minority practice within a larger dominant system that does not always value health promotion. We argue that health promotion practitioners are vulnerable to moral distress due to the values-driven and political nature of the practice, the emphasis on systems change and the inherent complexity and diversity of the practice. This vulnerability to moral distress poses significant challenges to both workers and organisations and the communities they seek to benefit. We propose that further research should be undertaken to fully identify the causes and symptoms of moral distress in health promotion. Extensive existing research on moral distress in nursing provides ample resources to conduct such research. PMID:24853825

  4. Mobile working: positively engaging community nurses.

    PubMed

    Turner, Christopher

    2015-03-01

    Mobile working refers to a practitioner's ability to access information systems and applications while 'on the move'. This relatively new concept has yielded a number of benefits, including the ability to access patients' electronic records in real time and a reduction in travelling time for clinicians, thereby improving efficiency within community nursing practice. For a change in practice to be successful, it is necessary to ensure that the proposals are discussed with the staff group implementing them and that appropriate help and support are provided during the period of transition. Maintaining engagement with community nursing teams may be challenging due to increasing workloads and limited resources, potentially affecting health professionals' ability to attend workshops and associated events. Considering the specific needs of the workforce requires consideration and planning, including provision of additional support for members of staff who may lack confidence in working with mobile devices. PMID:25754781

  5. The chlamydia knowledge, awareness and testing practices of Australian general practitioners and practice nurses: survey findings from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt)

    PubMed Central

    2013-01-01

    Background ACCEPt, a large cluster randomized control trial, aims to determine if annual testing for 16 to 29 year olds in general practice can reduce chlamydia prevalence. ACCEPt is the first trial investigating the potential role of practice nurses (PN) in chlamydia testing. To inform the design of the ACCEPt intervention, we aimed to determine the chlamydia knowledge, attitudes, and testing practices of participating general practitioners (GPs) and PNs. Methods GPs and PNs from 143 clinics recruited from 52 areas in 4 Australian states were asked to complete a survey at time of recruitment. Responses of PNs and GPs were compared using conditional logistic regression to account for possible intra cluster correlation within clinics. Results Of the PNs and GPs enrolled in ACCEPt, 81% and 72% completed the questionnaire respectively. Less than a third of PNs (23%) and GPs (32%) correctly identified the two age groups with highest infection rates in women and only 16% vs 17% the correct age groups in men. More PNs than GPs would offer testing opportunistically to asymptomatic patients aged ≤25 years; women having a pap smear (84% vs 55%, P<0.01); antenatal checkup (83% vs 44%, P<0.01) and Aboriginal men with a sore throat (79% vs 33%, P<0.01), but also to patients outside of the guideline age group at the time of the survey; 26 year old males presenting for a medical check (78% vs 30%, P = <0.01) and 33 year old females presenting for a pill prescription (83% vs 55%, P<0.01). More PNs than GPs knew that retesting was recommended after chlamydia treatment (93% vs 87%, P=0.027); and the recommended timeframe was 3 months (66% vs 26%, P<0.01). A high proportion of PNs (90%) agreed that they could conduct chlamydia testing in general practice, with 79% wanting greater involvement and 89% further training. Conclusions Our survey reveals gaps in chlamydia knowledge and management among GPs and PNs that may be contributing to low testing rates in general practice. The

  6. New systems of care can leverage the health care workforce: how many doctors do we really need?

    PubMed

    Garson, Arthur

    2013-12-01

    Improving access to appropriate health care, currently inadequate for many Americans, is more complex than merely increasing the projected number of physicians and nurses. Any attainable increase in their numbers will not solve the problem. To bring supply and demand closer, new systems of care are required, leveraging every member of the health care workforce, permitting professionals to provide their unique contributions.To increase supply: Redefine the roles of physicians and nurse practitioners (NPs), assess how much primary care must be delivered by a physician, and provide support from other team members to let the physician deal with complex patients. NPs can deliver much primary care and some specialty care. Care must be delivered in integrated systems permitting new payment models (e.g., salary with bonus) and team-based care as well as maximum use of electronic health records. Teams must make better use of nonprofessionals, such as Grand-Aides, using telephone protocols and portable telemedicine with home visits and online direct reporting of every encounter. The goals are to improve health and reduce unnecessary clinic and emergency department visits, admissions, and readmissions.To decrease demand: Physician payment must foster quality and appropriate patient volume (if accompanied by high patient satisfaction). Patients must be part of the team, work to remain healthy, and reduce inappropriate demand.The nation may not need as many physicians and nurses if the systems can be changed to promote integration, leveraging every member of the workforce to perform at his or her maximum competency.

  7. Views of Student Nurses on Caring and Technology in Nursing

    ERIC Educational Resources Information Center

    Brodell, Elizabeth Becky

    2009-01-01

    Nurses entering the workforce are faced with many challenges, but today the multiple demands of patient care are complicated by a nurse's need to keep abreast of fast-changing technology. This research is universally relevant to nursing practice in educational settings and practice areas because nursing education needs to develop strategies to…

  8. Practitioner States.

    ERIC Educational Resources Information Center

    1996

    This document contains four papers presented at a symposium on practitioner states moderated by Kay Bull at the 1996 conference of the Academy of Human Resource Development (AHRD). "The Effect of Locus of Control and Performance-Contingent Incentives on Productivity and Job Satisfaction in Self-Managing Teams" (Bonnie E. Garson, Douglas Stanwyck)…

  9. Nursing by numbers.

    PubMed

    Hurst, Keith

    In the face of NHS budget cuts, nurses are being asked to justify their workforce numbers. Keith Hurst reviews some of the tools available for calculating staffing levels, examines their pros and cons, and discusses their application. PMID:17087410

  10. Nursing: Supply and Demand through 2020

    ERIC Educational Resources Information Center

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem

    2015-01-01

    This report analyzes the growing need for qualified nurses. The study projects that the economy will create 1.6 million job openings for nurses through 2020. Yet, there will not be enough nurses to fill those openings. this report projects that the nursing workforce will be facing a shortfall of roughly 200,000 nursing professionals by 2020. One…

  11. Financial Recruitment Incentive Programs for Nursing Personnel in Canada.

    PubMed

    Mathews, Maria; Ryan, Dana

    2015-03-01

    Financial incentives are increasingly offered to recruit nursing personnel to work in underserved communities. The authors describe and compare the characteristics of federal, provincial and territorial financial recruitment incentive programs for registered nurses (RNs), nurse practitioners (NPs), licensed practical nurses (LPNs), registered practical nurses or registered psychiatric nurses. The authors identified incentive programs from government, health ministry and student aid websites and by contacting program officials. Only government-funded recruitment programs providing funding beyond the normal employee wages and benefits and requiring a service commitment were included. The authors excluded programs offered by hospitals, regional or private firms, and programs that rewarded retention. All provinces and territories except QC and NB offer financial recruitment incentive programs for RNs; six provinces (BC, AB, SK, ON, QC and NL) offer programs for NPs, and NL offers a program for LPNs. Programs include student loan forgiveness, tuition forgiveness, education bursaries, signing bonuses and relocation expenses. Programs target trainees, recent graduates and new hires. Funding and service requirements vary by program, and service requirements are not always commensurate with funding levels. This snapshot of government-funded recruitment incentives provides program managers with data to compare and improve nursing workforce recruitment initiatives. PMID:26154120

  12. Creating a brand image for public health nursing.

    PubMed

    Baldwin, Kathleen A; Lyons, Roberta L; Issel, L Michele

    2011-01-01

    Public health nurses (PHNs) have declined as a proportion of both the nursing and the public health workforces in the past 2 decades. This decline comes as 30 states report public health nursing as the sector most affected in the overall public health shortage. Taken together, these data point to a need for renewed recruitment efforts. However, the current public images of nurses are primarily those of professionals employed in hospital settings. Therefore, this paper describes the development of a marketable image aimed at increasing the visibility and public awareness of PHNs and their work. Such a brand image was seen as a precursor to increasing applications for PHN positions. A multimethod qualitative sequential approach guided the branding endeavor. From the thoughts of public health nursing students, faculty, and practitioners came artists' renditions of four award-winning posters. These posters portray public health nursing-incorporating its image, location of practice, and levels of protection afforded the community. Since their initial unveiling, these posters have been distributed by request throughout the United States and Canada. The overwhelming response serves to underline the previous void of current professional images of public health nursing and the need for brand images to aid with recruitment.

  13. DoD Acquisition Workforce Education: An SBA Education Case Study

    ERIC Educational Resources Information Center

    Davenport, Richard W.

    2009-01-01

    A Department of Defense (DoD) M&S education task force is in the process of studying the Modeling and Simulation (M&S) education of the acquisition workforce. Historically, DoD acquisition workforce education is not referred to as education, but rather what the Defense Acquisition University (DAU) refers to as "practitioner training, career…

  14. New graduate nurses as knowledge brokers in general practice in New Zealand: a constructivist grounded theory.

    PubMed

    Hoare, Karen J; Mills, Jane; Francis, Karen

    2013-07-01

    Practice nursing in New Zealand is not well described in the literature. One survey illustrated that most of the New Zealand practice nurses sampled did not know of the country's two premier evidence-based health websites. A recent review compared general practice in the UK, New Zealand and Australia and found that whereas there had been significant developments in empowering the practice nurse workforce to run nurse-led clinics in the UK, New Zealand and Australia lagged behind. The aim of this reported constructivist grounded theory study was to investigate practice nurses' use of information. Conducted in Auckland, New Zealand, data were collected through ethnographic techniques in one general practice between September 2009 and January 2010 to enhance theoretical sensitivity to the area of information use. Subsequently, six experienced practice nurses (one twice after moving jobs) and five new graduate nurses from five different general practices were interviewed, using open-ended questions, between January 2010 and August 2011. Concurrent data collection and analysis occurred throughout the study period. The use of memos, the constant comparative method, data categorisation and finally, data abstraction resulted in the final theory of reciprocal role modelling. Experienced practice nurses role modelled clinical skills to new graduate nurses. Unexpectedly, new graduate nurses were unconscious experts at sourcing information and role modelled this skill to experienced practice nurses. Once this attribute was acknowledged by the experienced practice nurse, mutual learning occurred that enabled both groups of nurses to become better practitioners. Graduate nurses of the millennial generation were identified as a resource for experienced practice nurses who belong to the baby boomer generation and generation X. PMID:23638795

  15. Integrated Workforce Modeling System

    NASA Technical Reports Server (NTRS)

    Moynihan, Gary P.

    2000-01-01

    There are several computer-based systems, currently in various phases of development at KSC, which encompass some component, aspect, or function of workforce modeling. These systems may offer redundant capabilities and/or incompatible interfaces. A systems approach to workforce modeling is necessary in order to identify and better address user requirements. This research has consisted of two primary tasks. Task 1 provided an assessment of existing and proposed KSC workforce modeling systems for their functionality and applicability to the workforce planning function. Task 2 resulted in the development of a proof-of-concept design for a systems approach to workforce modeling. The model incorporates critical aspects of workforce planning, including hires, attrition, and employee development.

  16. Policy on new workforce roles: a discussion paper.

    PubMed

    Bridges, Jackie; Meyer, Julienne

    2007-05-01

    Addressing workforce issues has increasingly become a central feature of the organisation and management of public sector services internationally. The introduction of new work roles to public services is one approach advocated in response to recruitment and retention difficulties with professional staff and to increasingly complex services. This paper aims to critically examine UK's new roles policy in a health care context and explore its wider relevance by drawing on findings from an action research Ph.D. study aimed at exploring one such new role. This deliberately flexible role was held by individuals without a recognised qualification but study findings illustrate that, over the time, the role came to include the complex discharge planning work with patients previously carried out by registered nurses (RNs). The analysis presented highlights shortcomings in current new roles policy including the unacknowledged influence of competing policy goals; the erroneous assumption that defining who does what is clear-cut in practice; the lack of longer-term review of new roles; and the incompatibility between role flexibility and needs for role clarity. Policy makers, managers and practitioners are urged to acknowledge the subtleties and complexities of new work roles in the public sector highlighted by this study.

  17. 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…

  18. Planning Australia's hospital workforce.

    PubMed

    Harris, Mary; Gavel, Paul; Conn, Warwick

    2002-01-01

    Growing government support has been evident during the past decade for macro-level workforce planning to ensure that future populations have access to appropriate health care services. Population ageing is impacting on workforce requirements and on workforce supply within Australia and internationally. Changes in financing and the organisation of health services are impacting on the availability of training and on the quality of working life. The age and gender profile and career expectations of young Australians are changing. These factors are all adding to the importance and complexity of workforce planning. This paper draws on data from various sources to describe Australia's hospital workforce, to explore supply-side workforce trends and to discuss some contemporary issues of concern to policy makers and workforce planners. The paper finds that in recent years there has been a 3 per cent decline in the number of full time equivalent staff in public hospitals, while the number in the private hospital workforce has increased by 28 per cent. The paper concludes that, nationally, there are serious limitations in the data available to describe and monitor the hospital workforce and that there is a need to remedy this situation.

  19. Some Implications of a Diversifying Workforce for Governance and Management

    ERIC Educational Resources Information Center

    Whitchurch, Celia; Gordon, George

    2011-01-01

    This paper suggests that as university missions have adapted to accommodate major developments associated with, for instance, mass higher education and internationalisation agendas, university workforces have diversified. They now, for instance, incorporate practitioners in areas such as health and social care, and professional staff who support…

  20. State's Labor Department working to increase Hawai'i's primary care workforce 20% by 2020.

    PubMed

    Yasutake, Jillian B; Caldwell, Ruth R; Powell, Anna S

    2012-04-01

    Hawai'i lacks the number of skilled professionals needed to meet current and future healthcare demands. In order to meet the growing needs of Hawai'i's residents, the Workforce Development Council, a state agency attached to the State Department of Labor and Industrial Relations, is looking to expand the primary care workforce 20% by the year 2020. Using funds from a Healthcare Workforce Planning grant, the state formed several Healthcare Industry Skill Panels, a workforce development best practice from the State of Washington, to address the gap in healthcare services and healthcare workforce opportunities for Hawai'i residents. Over 150 stakeholders--from employers, education, the public workforce system, economic development and labor--contributed their time and expertise to identify current workforce issues and develop action-oriented strategies to close industry skill gaps. So far these Skill Panels have developed a Critical Care Nursing Course Curriculum, a Workforce Readiness Curriculum and Certification pilot project, and a group to address specific barriers that are impeding Certified Nurse Aides (CNA). Upcoming initiatives include the distribution of a comprehensive statewide healthcare workforce development plan entitled Hawai'i's Healthcare Workforce 20/20 Plan & Report: Addendum to the Comprehensive State Plan for Workforce Development 2009-2014, and the creation of HawaiiHealthCareers.org, a website to both recruit and support individuals interested in pursuing careers in the healthcare industry. PMID:22737645

  1. Public health workforce taxonomy.

    PubMed

    Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J

    2014-11-01

    Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.

  2. Children's workforce strategy.

    PubMed

    2005-08-01

    The Green Paper, Every child matters, recognised the crucial importance of the children's workforce to improving outcomes for children and young people. The Children's Workforce Strategy sets out the government's vision of a world-class children's workforce which is increasingly competent and confident, inspiring trust and respect from parents and carers as well as from children and young people themselves. The document sets out four major strategic challenges: to recruit more high quality staff into the children's workforce; to retain people in the workforce including by offering better development and career progression; to strengthen interagency and multi-disciplinary working; and to promote stronger leadership and management. The strategy builds on work already in hand and on existing good practice. It puts forward proposals to tackle each of the strategic challenges with action nationally and locally.

  3. 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…

  4. How experienced practitioners gain knowledge.

    PubMed

    Vaughan, Barbara

    2014-01-01

    An evolution in nursing in the United Kingdom in the 1970s from rule-bound toward holistic, autonomous practice engendered an examination of nursing's body of knowledge and how it is incorporated into practice. This article describes Barbara Carper's (1978) Fundamental Patterns of Knowing in Nursing (empiric, ethical, aesthetic, and personal knowledge), and links it to three major worldviews of the way in which knowledge is sought (positivism, naturalism, and critical social theory). Carper's model was used in the United Kingdom as the basis for a curriculum of structured reflective practice using workshops, journaling, and clinical supervision. An example from a practitioner's diary demonstrates how Carper's model informs reflection on an interaction with a patient with newly diagnosed cancer. PMID:24730190

  5. Aging, experienced nurses: their value and needs.

    PubMed

    Fitzgerald, Dorcas C

    2007-04-01

    The nursing workforce mirrors the trend in population; that is, it is aging. Subsequently, older nurses experiencing some aging effects themselves are caring for more elderly patients needing more assistance with illness and wellness problems. To meet the growing demand for care in this era of nursing shortage, predicted to last beyond 2020, these nurses are needed to remain in the workforce longer. Lack of nurses in the workplace compromises patient care and increases job stress. Therefore, retention incentives need to be implemented to assist aging, experienced nurses to delay retirement or prevent them from leaving the profession early, as well as encouraging younger and future nurses to work longer. This article focuses on aging nurses, describing their demographics and needs, explicating their value and listing the resources and benefits needed to prolong their vital services in the workforce. (For this article, aging, older and mature refer to experienced nurses in their 40s, 50s and 60s.). PMID:17563332

  6. Unintended consequences: two critical events from the 1960s and '70s and their legacy for nursing in Ontario.

    PubMed

    MacMillan, Kathleen; Mallette, Claire

    2004-03-01

    In the late 1960s and early '70s, two key events occurred in Ontario that greatly affected the nursing profession: the unionization of the workforce and the move of diploma-granting nursing schools out of the hospitals (first to regional schools, then to the community colleges). At the same time, university nursing programs were undergoing significant changes. A paradigm shift occurred in which baccalaureate-prepared nurses were being educated for practice as well as for roles in education and administration. While all these activities had overall positive implications, there were unintended effects that continue to influence the profession today. These include the detachment of employers from clinical nursing education; fragmentation of the profession between front-line staff and the professional elites (proletarianization); rejection by front-line practitioners and college educators of nursing scholarship in favour of experiential and technical knowledge; and rivalry between college and university educators that has hampered the development of effective collaborations. For this study, interviews were undertaken with three informants, and their recollections were considered in the context of documentation from the College of Nurses of Ontario (the regulatory body), the Ontario Nurses Association (the union) and the Registered Nurses Association of Ontario (the professional association).

  7. How Could Hospitalisations at the End of Life Have Been Avoided? A Qualitative Retrospective Study of the Perspectives of General Practitioners, Nurses and Family Carers

    PubMed Central

    De Korte-Verhoef, Maria C.; Pasman, H. Roeline W.; Schweitzer, Bart P. M.; Francke, Anneke L.; Onwuteaka-Philipsen, Bregje D.; Deliens, Luc

    2015-01-01

    Background Although many patients prefer to stay and die at home at the end of life, many are hospitalised. Little is known about how to avoid hospitalisations for patients living at home. Aim To describe how hospitalisation at the end of life can be avoided, from the perspective of the GPs, nurses and family carers. Method A qualitative design with face-to-face interviews was used. Taking 30 cases of patients who died non-suddenly, 26 GPs, 15 nurses and 18 family carers were interviewed in depth. Of the 30 patients, 20 were hospitalised and 10 were not hospitalised in the last three months of life. Results Five key themes that could help avoid hospitalisation at the end of life emerged from the interviews. The key themes were: 1) marking the approach of death, and shifting the mindset; 2) being able to provide acute treatment and care at home; 3) anticipatory discussions and interventions to deal with expected severe problems; 4) guiding and monitoring the patient and family in a holistic way through the illness trajectory; 5) continuity of treatment and care at home. If these five key themes are adopted in an interrelated way, this could help avoid hospitalisations, according to GPs, nurses and family carers. Conclusions The five key themes described in this study can be seen as strategies that could help in avoiding hospitalisation at the end of life. It is recommended that for all patients residing at home, GPs and community nurses work together as a team from the moment that it is marked that death is approaching up to the end of life. PMID:25756184

  8. Nursing students assess nursing education.

    PubMed

    Norman, Linda; Buerhaus, Peter I; Donelan, Karen; McCloskey, Barbara; Dittus, Robert

    2005-01-01

    This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.

  9. Creating Workforce Development Systems That Work: A Guide for Practitioners.

    ERIC Educational Resources Information Center

    Kogan, Deborah; Dickinson, Katherine P.; Fedrau, Ruth; Midling, Michael J.; Wolff, Kristin E.

    This guide describes common One-Stop Career Center system-building goals and summarizes strategies used by states and local One-Stop sites to further each goal. Part I, Organizing and Governing One-Stop Systems, has these two chapters: Guiding One-Stop Systems: The State Role; and Building Local Partnerships and Governing One-Stop Systems. Part…

  10. 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…

  11. 78 FR 22890 - National Advisory Council on Nurse Education and Practice; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... workforce development to respond to the Affordable Care Act and health care system redesign, and to... nursing workforce development in meeting the health care needs of the nation; (2) to develop goals and... Coordination. BILLING CODE 4165-15-P...

  12. The future dental workforce?

    PubMed

    Gallagher, J E; Wilson, N H F

    2009-02-28

    The Editor-in-Chief of the BDJ has previously raised important questions about dental workforce planning and the implications for dental graduates of recent changes and pressures. It is now time to revisit this issue. Much has changed since the last workforce review in England and Wales, and the rate of change is in all probability set to increase. First, at the time of writing this paper the momentous step of including dental care professionals (DCPs) on General Dental Council (GDC) registers in the United Kingdom has recently been completed. Second, the Scope of Practice of all dental professionals has been under consultation by the General Dental Council, and research evidence suggests that greater use should be made of skill-mix in the dental team. Third, within England, Lord Darzi has just published the 'Final Report of the NHS Next Stage Review', which emphasises 'quality care' and 'team-working' as key features of healthcare; this report was accompanied by an important document entitled 'A High Quality Workforce', in which plans for local workforce planning within the NHS are outlined, placing responsibilities at national, local and regional levels. Fourth, policy makers across the UK are wrestling with addressing oral health needs, promoting health and facilitating access to dental care, all of which have implications for the nature and shape of the dental workforce. Fifth, with the impact of globalisation and European policies we are net gainers of dentists as well as having more in training. Sixth, although there have been reviews and policy initiatives by regulatory, professional and other bodies in support of shaping the dental workforce, there has been little serious consideration of skill-mix and funding mechanisms to encourage team-working. Together, these events demand that we enter a fresh debate on the future dental workforce which should extend beyond professional and national boundaries and inform workforce planning. This debate is of great

  13. The future dental workforce?

    PubMed

    Gallagher, J E; Wilson, N H F

    2009-02-28

    The Editor-in-Chief of the BDJ has previously raised important questions about dental workforce planning and the implications for dental graduates of recent changes and pressures. It is now time to revisit this issue. Much has changed since the last workforce review in England and Wales, and the rate of change is in all probability set to increase. First, at the time of writing this paper the momentous step of including dental care professionals (DCPs) on General Dental Council (GDC) registers in the United Kingdom has recently been completed. Second, the Scope of Practice of all dental professionals has been under consultation by the General Dental Council, and research evidence suggests that greater use should be made of skill-mix in the dental team. Third, within England, Lord Darzi has just published the 'Final Report of the NHS Next Stage Review', which emphasises 'quality care' and 'team-working' as key features of healthcare; this report was accompanied by an important document entitled 'A High Quality Workforce', in which plans for local workforce planning within the NHS are outlined, placing responsibilities at national, local and regional levels. Fourth, policy makers across the UK are wrestling with addressing oral health needs, promoting health and facilitating access to dental care, all of which have implications for the nature and shape of the dental workforce. Fifth, with the impact of globalisation and European policies we are net gainers of dentists as well as having more in training. Sixth, although there have been reviews and policy initiatives by regulatory, professional and other bodies in support of shaping the dental workforce, there has been little serious consideration of skill-mix and funding mechanisms to encourage team-working. Together, these events demand that we enter a fresh debate on the future dental workforce which should extend beyond professional and national boundaries and inform workforce planning. This debate is of great

  14. Pediatrician workforce policy statement.

    PubMed

    Basco, William T; Rimsza, Mary E

    2013-08-01

    This policy statement reviews important trends and other factors that affect the pediatrician workforce and the provision of pediatric health care, including changes in the pediatric patient population, pediatrician workforce, and nature of pediatric practice. The effect of these changes on pediatricians and the demand for pediatric care are discussed. The American Academy of Pediatrics (AAP) concludes that there is currently a shortage of pediatric medical subspecialists in many fields, as well as a shortage of pediatric surgical specialists. In addition, the AAP believes that the current distribution of primary care pediatricians is inadequate to meet the needs of children living in rural and other underserved areas, and more primary care pediatricians will be needed in the future because of the increasing number of children who have significant chronic health problems, changes in physician work hours, and implementation of current health reform efforts that seek to improve access to comprehensive patient- and family-centered care for all children in a medical home. The AAP is committed to being an active participant in physician workforce policy development with both professional organizations and governmental bodies to ensure a pediatric perspective on health care workforce issues. The overall purpose of this statement is to summarize policy recommendations and serve as a resource for the AAP and other stakeholders as they address pediatrician workforce issues that ultimately influence the quality of pediatric health care provided to children in the United States.

  15. Mitigating Knowledge Loss: A Strategic Imperative for Nurse Leaders.

    PubMed

    Bleich, Michael R; Cleary, Brenda L; Davis, Kathleen; Hatcher, Barbara J; Hewlett, Peggy O; Hill, Karen S

    2015-10-01

    With the aging of the nursing workforce and expected retirement of large numbers of experienced nurses in the next decade, mitigating the impact that lost knowledge will have on organizational performance and patient outcomes is critical. The authors raise awareness of the problem, summarize observations procured from hospital nurse executive regarding approaches for knowledge transfer through workforce development, and pose proactive strategies for nurse leaders who can provide direction to offset the issue before it becomes a crisis.

  16. 42 CFR 405.2416 - Visiting nurse services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... nurse practitioner, physician assistant or certified nurse midwife; and (2) Reviewed at least every 60 days by a supervising physician. (ii) Signed by the supervising physician, nurse practitioner... 42 Public Health 2 2014-10-01 2014-10-01 false Visiting nurse services. 405.2416 Section...

  17. Assessing new graduate nurse performance.

    PubMed

    Berkow, Steven; Virkstis, Katherine; Stewart, Jennifer; Conway, Lindsay

    2008-11-01

    New graduate nurses now comprise more than 10% of a typical hospital's nursing staff, with this number certain to grow given the increasing numbers of entrants into the nurse workforce. Concomitantly, only 10% of hospital and health system nurse executives believe their new graduate nurses are fully prepared to provide safe and effective care. As part of a multipronged research initiative on bridging the preparation-practice gap, the Nursing Executive Center administered a national survey to a cross section of frontline nurse leaders on new graduate nurse proficiency across 36 nursing competencies deemed essential to safe and effective nursing practice. Based on survey data analysis, the authors discuss the most pressing and promising opportunities for improving the practice readiness of new graduate nurses.

  18. 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).

  19. 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

  20. 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)