Science.gov

Sample records for oncology nurse practitioner

  1. 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.

  2. Systematic review of oncology nurse practitioner navigation metrics.

    PubMed

    Johnson, Frances

    2015-06-01

    Nurse practitioners should become more active in patient navigation and its subcomponent, care coordination, because research has shown that these roles are influential in improving patient care at all levels of an organization. Well-defined process and outcome measures, as well as educational initiatives, are critical to these programs because they serve as the structure for program evaluation. This article aims to assess and define metrics that nurse practitioners in the oncology setting can use to evaluate navigation programs, which is essential for the evolution of research pertaining to the navigation field. The current article is a systematic review that describes oncology nurse practitioner navigation metrics using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) format for the systematic literature review process. These metrics are then compared to current standards of care. Seven studies met the criteria for this review. Research is emerging that shows benefit in using an oncology nurse practitioner navigator for ensuring timely care and patient and staff satisfaction. These metrics are in line with expert consensus recommendations. The need for more research identifying sound research tools that have been rigorously tested has been identified.

  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. Collaboration among nurse practitioners and registered nurses in outpatient oncology settings in Canada.

    PubMed

    Moore, Jane; Prentice, Dawn

    2013-07-01

    This article is a report on a case study that described and analysed the collaborative process among nurse practitioners and registered nurses in oncology outpatient settings to understand and improve collaborative practice among nurses. Changes in the health system have created new models of care delivery, such as collaborative nursing teams. This has resulted in the increased opportunity for enhanced collaboration among nurse practitioners and registered nurses. The study was guided by Corser's Model of Collaborative Nurse-Physician Interactions (1998). Embedded single case design with multiple units of analysis. Qualitative data were collected in 2010 using direct participant observations and individual and joint (nurse dyads) interviews in four outpatient oncology settings at one hospital in Ontario, Canada. Thematic analysis revealed four themes: (1) Together Time Fosters Collaboration; (2) Basic Skills: The Brickworks of Collaboration; (3) Road Blocks: Obstacles to Collaboration; and (4) Nurses' Attitudes towards their Collaborative Work. Collaboration is a complex process that does not occur spontaneously. Collaboration requires nurses to not only work together but also spend time socially interacting away from the clinical setting. While nurses possess the conceptual knowledge of the meaning of collaboration, findings from this study showed that nurses struggle to understand how to collaborate in the practice setting. Strategies for improving nurse-nurse practitioner collaboration should include: the support and promotion of collaborative practice among nurses by hospital leadership and the development of institutional and organizational education programmes that would focus on creating innovative opportunities for nurses to learn about intraprofessional collaboration in the practice setting. © 2012 Blackwell Publishing Ltd.

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

    PubMed

    Johnson, Frances

    2016-04-01

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

    PubMed

    Stahlke, Sarah; Rawson, Krista; Pituskin, Edith

    2017-09-01

    The purpose of this study was to add to what is known about patient satisfaction with nurse practitioner (NP) care, from the perspective of breast cancer patients who were followed by an NP. This study utilized Interpretive Description, a qualitative method aimed at making sense of the experiential aspects of health care and developing practical knowledge for improved care. Nine patients receiving NP-led care in an outpatient breast cancer clinic were interviewed about their perspectives on and experiences with NP-led care. Interview transcripts were thematically analyzed. The NP role has long been regarded as a way of addressing many contemporary health system problems, although there continue to be barriers to the effective utilization of the role, including public and patient misunderstandings. This study revealed that, despite persistent traditional role understandings about health professionals, the patient participants appreciated the benefits of NP care and were highly satisfied with both the physical care and holistic support they received during the course of their treatment. Today's healthcare system is characterized by accessibility issues, unmet patient need, workforce issues, and funding pressures. This research supports and enriches what is known about the benefits and usefulness of NP-provided care from the viewpoint of those receiving the care. The findings offer guidance to NPs in the clinical setting regarding patient needs and optimal care strategies. © 2017 Sigma Theta Tau International.

  7. Non-physician practitioners in radiation oncology: advanced practice nurses and physician assistants.

    PubMed

    Kelvin, J F; Moore-Higgs, G J; Maher, K E; Dubey, A K; Austin-Seymour, M M; Daly, N R; Mendenhall, N P; Kuehn, E F

    1999-09-01

    With changes in reimbursement and a decrease in the number of residents, there is a need to explore new ways of achieving high quality patient care in radiation oncology. One mechanism is the implementation of non-physician practitioner roles, such as the advanced practice nurse (APN) and physician assistant (PA). This paper provides information for radiation oncologists and nurses making decisions about: (1) whether or not APNs or PAs are appropriate for their practice, (2) which type of provider would be most effective, and (3) how best to implement this role. Review of the literature and personal perspective. Specific issues addressed regarding APN and PA roles in radiation oncology include: definition of roles, regulation, prescriptive authority, reimbursement, considerations in implementation of the role, educational needs, and impact on resident training. A point of emphasis is that the non-physician practitioner is not a replacement or substitute for either a resident or a radiation oncologist. Instead, this role is a complementary one. The non-physician practitioner can assist in the diagnostic work-up of patients, manage symptoms, provide education to patients and families, and assist them in coping. This support facilitates the physician's ability to focus on the technical aspects of prescribing radiotherapy.

  8. A descriptive study of the role of the oncology nurse practitioner.

    PubMed

    Kinney, A Y; Hawkins, R; Hudmon, K S

    1997-06-01

    To describe the characteristics and activities of nurse practitioners (NP) with a focus in oncology. Descriptive. 129 NPs employed in an oncology setting who completed on NP program and were functioning in the NP role. Subjects completed an eight-page, self-administered questionnaire comprised of fixed-choice and open-ended questions. Demographics, employment settings, populations served, advanced practice subroles, clinical functions, practice privileges, reimbursement issues, job descriptions, performance appraisals, job satisfaction, and facilitators/barriers to role implementation. The majority of oncology NPs (ONPs) were located in the eastern United States in university-affiliated hospitals. The most common patient population served by the respondents was adults in the medical oncology outpatient setting. More than three-quarters of the respondents worked from protocols, almost two-thirds performed procedures traditionally performed by physicians, and approximately half had prescriptive authority. Few NP respondents reported that they obtained direct reimbursement for their services from third-party payors. Physicians were cited as the most facilitative of the NP role, and administrators were cited as the most frequent barrier. The vast majority of the respondents were satisfied with their roles. The NP role in oncology is established and expanding. The scope of practice and more detailed characterization of the role is an area for future research. Data on the effectiveness of ONPs, particularly regarding cost-effectiveness, quality of care, and patient satisfaction, are needed to maintain their viability within the healthcare system.

  9. Effect and Efficiency of an Embedded Palliative Care Nurse Practitioner in an Oncology Clinic.

    PubMed

    Walling, Anne M; D'Ambruoso, Sarah F; Malin, Jennifer L; Hurvitz, Sara; Zisser, Ann; Coscarelli, Anne; Clarke, Robin; Hackbarth, Andrew; Pietras, Christopher; Watts, Frances; Ferrell, Bruce; Skootsky, Samuel; Wenger, Neil S

    2017-09-01

    To test a simultaneous care model for palliative care for patients with advanced cancer by embedding a palliative care nurse practitioner (NP) in an oncology clinic. We evaluated the effect of the intervention in two oncologists' clinics beginning March 2014 by using implementation strategies, including use of a structured referral mechanism, routine symptom screening, integration of a psychology-based cancer supportive care center, implementation team meetings, team training, and a metrics dashboard for continuous quality improvement. After 1 year of implementation, we evaluated key process and outcome measures for supportive oncology and efficiency of the model by documenting tasks completed by the NP during a subset of patient visits and time-motion studies. Of approximately 10,000 patients with active cancer treated in the health system, 2,829 patients had advanced cancer and were treated by 42 oncologists. Documentation of advance care planning increased for patients of the two intervention oncologists compared with patients of the other oncologists. Hospice referral before death was not different at baseline, but was significantly higher for patients of intervention oncologists compared with patients of control oncologists (53% v 23%; P = .02) over the intervention period. Efficiency evaluation revealed that approximately half the time spent by the embedded NP potentially could have been completed by other staff (eg, a nurse, a social worker, or administrative staff). An embedded palliative care NP model using scalable implementation strategies can improve advance care planning and hospice use among patients with advanced cancer.

  10. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    PubMed

    Vogel, Wendy H

    2016-01-01

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

  11. Bridging the Gap: A Descriptive Study of Knowledge and Skill Needs in the First Year of Oncology Nurse Practitioner Practice

    PubMed Central

    Rosenzweig, Margaret; Giblin, Joan; Mickle, Marsha; Morse, Allison; Sheehy, Patricia; Sommer, Valerie

    2017-01-01

    Purpose/Objectives To identify the knowledge and skill needs of oncology nurse practitioners (ONPs) as they enter cancer care practice, and to identify necessary educational resources. Design Cross-sectional, descriptive. Setting A national e-mail survey. Sample 610 self-described ONPs from the Oncology Nursing Society’s database. Methods The project team developed a 28-item electronic survey. The survey was randomly distributed via e-mail. Main Research Variables ONPs’ feelings of preparedness in the first year of ONP practice. Findings In the first year of practice, 90% of ONPs rated themselves as prepared or very prepared in obtaining patient history, performing physical examination, and documenting findings. ONPs rated themselves as not at all or somewhat prepared in clinical issues of chemotherapy/biotherapy competency (n = 81, 78%), recognizing and managing oncologic emergencies, (n = 77, 70%), and recognizing and managing drug toxicities (n = 63, 61%). The primary source of oncology education for ONPs new to practice was almost exclusively the collaborating or supervising physician (n = 84, 81%). Conclusions Specific knowledge and skills, such as information about chemotherapy, oncologic emergencies, and side effects of therapy, are needed before an ONP enters a cancer care practice. Implications for Nursing Cancer-specific education should be made available to new ONPs as they begin independent practice. PMID:22374493

  12. The attitudes and beliefs of oncology nurse practitioners regarding direct-to-consumer advertising of prescription medications.

    PubMed

    Viale, Pamela Hallquist; Sanchez Yamamoto, Deanna

    2004-07-01

    To obtain information about the knowledge and attitudes of oncology nurse practitioners (ONPs) concerning the effect of direct-to-consumer (DTC) advertising of prescription medications on prescribing patterns. Exploratory survey. Oncology Nursing Society Nurse Practitioner Special Interest Group members in the United States. 221 of 376 ONPs completed the survey (58%). Researcher-developed 12-question postal survey. Knowledge and attitudes of ONPs on DTC advertising effects on prescribing patterns. The findings were similar to those of previous studies of physicians regarding the number of visits when patients requested DTC-advertised medications. Major differences were the positive attitudes of ONPs toward potentially longer patient visits to explain and educate patients regarding medication requests based on DTC advertising and smaller percentages of ONPs who felt "pressured" to prescribe requested medications. ONPs have mixed opinions regarding the practice of DTC advertising but do not believe that they are influenced heavily by advertising with regard to prescriptive practices. ONPs consider patient encounters for education purposes as appropriate and include information about requested DTC-advertised medications in their approach to patient care. This is an exploratory survey of a specialty group of ONPs. More research is needed to further explore the practice of DTC advertising and potential influences on the prescribing patterns of ONPs. DTC advertising of prescription medications is increasing; ONPs need to increase their knowledge base about the potential for influences of prescriptive practices.

  13. Effect of an audit and feedback intervention on hospitalized oncology patients' perception of nurse practitioner care.

    PubMed

    Dulko, Dorothy; Mooney, Kathi

    2010-01-01

    Although patient satisfaction has been used traditionally as a measure of excellence, research has suggested that the perception of being well cared for is likely a more promising indicator of quality than satisfaction alone. Expectations, physical environment, communication, participation and involvement, technical competence, and the influence of healthcare organizations are factors that may impair patients' ability to distinguish nursing care from their overall healthcare experience. This study evaluated the effect of a nurse practitioner audit and feedback intervention on hospitalized patients' perception of care.

  14. 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. Also, many doctors share office space with ...

  15. Oncology Nursing Society

    MedlinePlus

    ... Account Login Cart Search the ONS website Continuing Nursing Education Courses and Activities Access Devices: The Virtual ... Vomiting Chemotherapy for Non-Oncology Conditions Clinical Trials Nursing 101 Cognitive Impairment Fundamentals of Blood and Marrow ...

  16. Nursing: What's a Nurse Practitioner?

    MedlinePlus

    ... is a big part of the pediatric NP's role. Pediatric and family practice NPs can treat acute ( ... Nurse Practitioners (NAPNAP) and through local hospitals or nursing schools. Also, many doctors share office space with ...

  17. 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…

  18. 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…

  19. Nurse practitioners & reimbursement.

    PubMed

    Sullivan, E M

    1992-05-01

    Nursing's Agenda for Health Care Reform (1991) embraces primary health care as the focus of a restructured health care system. As part of this reformed system, consumers would access the most cost-effective providers in community-based settings. Removal of financial and regulatory barriers that limit consumer access to providers, such as lack of direct reimbursement by Medicare for nurse practitioners, should be eliminated according to this plan. Senate bills S2103 and S2104 have been recently introduced to the U.S. Senate mandating reimbursement for services provided by nurse practitioners, clinical nurse specialists, nurse midwives, and physician assistants at 97% of physician payment. The aim of this global legislation is to eliminate the current piecemeal mechanisms for nurse practitioner reimbursement and remove financial disincentives. Case examples presented in this article illustrate how obstacles to reimbursement limit access to care for consumers. Quality of care, opportunities for autonomous practice, and control of nursing practice issues have been highlighted as well by the case format. It is intended that these cases would be useful to support changes in patterns of nurse practitioner reimbursement.

  20. 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,…

  1. 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.

  2. Nurse practitioner reimbursement.

    PubMed

    Wriston, S

    1981-01-01

    The Rural Health Clinics Act demonstrates the current trend in reimbursement of nurse practitioners: Congress intends to move slowly and continuously with mid-level practitioner reimbursement, limiting NP practice first to rural underserved areas, and reimbursing at a cost-related rate to avoid unnecessarily inflating costs. The Act's recognition of the NP as a reimbursable provider of traditional medical services, needing only indirect supervision, is important, especially with regard to the mandatory Medicaid coverage of "rural health clinic services." All states which do not explicitly prohibit NPs have been affected by this mandate, precipitating state legislative efforts to more clearly define NP scope of practice. There is still a need to clarify the ambiguity surrounding NP Medicaid reimbursement policies; Medicaid plans are frequently not well coordinated with nurse practice statutes. Altering third-party payor practices to permit reimbursement for services of nurse practitioners would alleviate some of the current restrictions on NP practice. However, medical society opposition also plays a significant role in such restriction. Antitrust courts, free of the tremendous lobbying power of medical interest groups, may be able to provide remedies which will facilitate greater competition and innovation in the health care industry. Legal test cases are necessary to begin contesting obstacles to the implementation of the Rural Health Clinic Services Act. The aggregate surplus of physicians projected for 1990 will continue to be an issue in the development of new financial programs concerning NP services. Demonstration projects which utilize various reimbursement strategies should evaluate the effect on health manpower of reimbursement for medical services provided by nurse practitioners.

  3. Nursing 436A: Pediatric Oncology for Nurses.

    ERIC Educational Resources Information Center

    Jackman, Cynthia L.

    A description is provided of "Pediatric Oncology for Nurses," the first in a series of three courses offered to fourth-year nursing students in pediatric oncology. The first section provides a course overview, discusses time assignments, and describes the target student population. Next, a glossary of terms, and lists of course goals, long-range…

  4. Nursing 436A: Pediatric Oncology for Nurses.

    ERIC Educational Resources Information Center

    Jackman, Cynthia L.

    A description is provided of "Pediatric Oncology for Nurses," the first in a series of three courses offered to fourth-year nursing students in pediatric oncology. The first section provides a course overview, discusses time assignments, and describes the target student population. Next, a glossary of terms, and lists of course goals, long-range…

  5. Perceived roles of oncology nursing.

    PubMed

    Lemonde, Manon; Payman, Naghmeh

    2015-01-01

    The Canadian Association of Nurses in Oncology (CANO) Standards of Care (2001) provides a framework that delineates oncology nursing roles and responsibilities. The purpose of this study was to explore how oncology nurses perceive their roles and responsibilities compared to the CANO Standards of Care. Six focus groups were conducted and 21 registered nurses (RNs) from a community-based hospital participated in this study. Transcripts were analyzed using qualitative inductive content analysis. Three themes were identified: (1) Oncology nurses perceive a gap between their defined roles and the reality of daily practice, as cancer care becomes more complex and as they provide advanced oncology care to more patients while there is no parallel adaptation to the health care system to support them, such as safe staffing; (2) Oncology nursing, as a specialty, requires sustained professional development and leadership roles; and (3) Oncology nurses are committed to providing continuous care as a reference point in the health care team by fostering interdisciplinary collaboration andfacilitating patient's navigation through the system. Organizational support through commitment to appropriate staffing and matching scope ofpractice to patient needs may lead to maximize the health and well-being of nurses, quality of patient care and organizational performance.

  6. Oncology Nursing and Shared Decision Making for Cancer Treatment.

    PubMed

    Tariman, Joseph D; Mehmeti, Enisa; Spawn, Nadia; McCarter, Sarah P; Bishop-Royse, Jessica; Garcia, Ima; Hartle, Lisa; Szubski, Katharine

    2016-10-01

    This study aimed to describe the contemporary role of the oncology nurse throughout the entire cancer shared decision-making (SDM) process. Study participants consisted of 30 nurses and nurse practitioners who are actively involved in direct care of patients with cancer in the inpatient or outpatient setting. The major themes that emerged from the content analysis are: oncology nurses have various roles at different time points and settings of cancer SDM processes; patient education, advocacy, and treatment side effects management are among the top nursing roles; oncology nurses value their participation in the cancer SDM process; oncology nurses believe they have a voice, but with various degrees of influence in actual treatment decisions; nurses' level of disease knowledge influences the degree of participation in cancer SDM; and the nursing role during cancer SDM can be complicated and requires flexibility.
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  7. Comparison between cancer specialists and general physicians regarding the education of nurse practitioners in Japan: a postal survey of the Japanese Society of Clinical Oncology.

    PubMed

    Ishida, Yasushi; Hatao, Masahiko; Fukushima, Osamu; Mori, Michiko; Isozaki, Fumiko; Okuyama, Asako

    2013-10-01

    Japanese physicians' attitudes regarding the education of nurse practitioners (NPs) are not well described. A survey was mailed to 1,094 board members of the Japanese Society of Clinical Oncology (JSCO) and the Japanese Primary Care Association (JPCA), and the directors of the clinical training program for physicians. The physicians of JSCO were classified as the cancer specialist group, and both the board members of JPCA and the directors of the clinical training program for physicians constituted the general physician group. We compared the responses of cancer specialists and general physicians. The survey response rate was 25.9% (69 of 266) in the cancer specialist group and 19.4% (161 of 828) in the general physician group. The median age of respondents was 53 and 55 years, respectively, of which 84 and 79%, respectively, were men. We found that the percentages of respondents who considered NP education necessary were almost identical in the 2 groups (r = 0.898, p < 0.0001). Education items considered necessary for NPs by >80% respondents in both groups included many symptoms, emergency management, basic procedures, general screening, palliative care including management against adverse effects, health education, and communication. More cancer specialists than general physicians (p < 0.01) expected NPs to be educated in multidisciplinary practice and palliative care, including management against adverse effects. Our study suggests that cancer specialists expect NPs to provide symptom management and psychosocial support, clarify information, provide education, and work as a member of a multidisciplinary team.

  8. Nurse practitioner malpractice data: Informing nursing education.

    PubMed

    Sweeney, Casey Fryer; LeMahieu, Anna; Fryer, George E

    Nurse practitioners (NPs) are often identified in medical malpractice claims. However, the use of malpractice data to inform the development of nursing curriculum is limited. The purpose of this study is to examine medical errors committed by NPs. Using National Practitioner Data Bank public use data, years 1990 to 2014, NP malpractice claims were classified by event type, patient outcome, setting, and number of practitioners involved. The greatest proportion of malpractice claims involving nurse practitioners were diagnosis related (41.46%) and treatment related (30.79%). Severe patient outcomes most often occurred in the outpatient setting. Nurse practitioners were independently responsible for the event in the majority of the analyzed claims. Moving forward, nurse practitioner malpractice data should be continuously analyzed and used to inform the development of nurse practitioner education standards and graduate program curriculum to address areas of clinical weakness and improve quality of care and patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Measuring nurse practitioner productivity.

    PubMed

    Rhoads, Jacqueline; Ferguson, Laurie Anne; Langford, Cynthia A

    2006-02-01

    As the role of the nurse practitioner (NP) evolves, the need to demonstrate productivity becomes more important. Productivity data provides NPs with practice statistics to generate business or use in contract negotiations with potential clients such as employers, managed care organizations, and insurance companies. However, beyond the numbers of patients seen per day or amount of reimbursement a provider brings to the practice, NPs may provide additional benefit that is not captured with physician productivity measures. Information to acquaint NPs with key aspects of recording productivity and ways NPs can organize productivity data within their practice to determine worth of service are presented.

  10. Stress in pediatric oncology nurses.

    PubMed

    Hecktman, Hillary Michelle

    2012-01-01

    Although the onset of physiological and emotional stress can greatly affect outcomes for a child with cancer, the focus of this review targets pediatric oncology nurses and their daily occupation-related stress. Literature currently exists that discusses the etiology of stress in the oncology work environment as well as coping strategies and their effects on pediatric oncology nurses' stress levels. To date, however, no literature review has been assembled to comprehensively address practice implications and provide recommendations for pediatric oncology staff nurses. This review of literature seeks to provide a general overview of stress experienced in the pediatric oncology work environment and supportive interventions to decrease negative outcomes such as compassion fatigue and burnout. Recommendations and conclusions are made based on existing interventions, thus creating a framework for future research to be conducted to compare the effectiveness of these measures and optimize patient experiences through caregiver well-being.

  11. Whither the "Nurse" in Nurse Practitioner?

    ERIC Educational Resources Information Center

    Weston, Jerry L.

    1975-01-01

    The author sees a need for the nursing profession to evaluate the extended role of the nurse to determine differences in the patient care provided by nurse practitioners and physician's assistants. From the data, appropriate nursing education and nursing practice planning can follow. (EA)

  12. General practitioners and district nurses

    PubMed Central

    Richardson, I. M.

    1974-01-01

    Variation between Aberdeen general practitioners in referral rates for home and surgery nursing care is shown to be substantial and is related to the proportion of elderly patients in the practice, inversely to list size, to the doctor's experience, and to practice attachment of nurses. There is, however, a large unexplained variation which, it is suggested, reflects differing general practitioner perception of nursing need and nursing skill, a situation that could be improved by joint training. PMID:4413552

  13. The work of nurse practitioners.

    PubMed

    Gardner, Glenn; Gardner, Anne; Middleton, Sandy; Della, Phillip; Kain, Victoria; Doubrovsky, Anna

    2010-10-01

    This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover 2 weeks of work time from a sampling frame of 6 weeks. A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36.1% of how nurse practitioners spend their time, indirect care accounted for 32.0% and service-related activities made up 31.9%. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

  14. 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…

  15. Integrative oncology imperative for nurses.

    PubMed

    Bauer-Wu, Susan; Decker, Georgia M

    2012-02-01

    To provide an overview of key issues and resources related to complementary and alternative medical (CAM) and integrative approaches in cancer care. Peer-reviewed publications and web sites of professional, federal, and academic institutions and organizations. The field of integrative oncology is growing and research evidence in this area is burgeoning. Many cancer patients are using and can benefit from CAM. There are many resources and educational opportunities available to oncology nurses to enhance their CAM knowledge and skills. Nurses must keep abreast of the growing evidence in integrative oncology that documents the safety and efficacy of different CAM approaches for cancer patients. It is critical that nurses be aware of reputable resources and legal implications related to use of CAM. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Creating Quality Online Materials for Specialty Nurse Practitioner Content: Filling a Need for the Graduate Nurse Practitioner.

    PubMed

    Hoffmann, Rosemary L; Klein, Sara Jo; Rosenzweig, Margaret Q

    2016-01-18

    Nurse practitioners are entering specialized areas of practice immediately after graduation from nurse practitioner (NP) education and certification and are finding employment in specialized areas such as oncology. Rapidly achieving a knowledge base in this highly specialized area of medicine coupled with the stress of the new nurse practitioner role can lead to a very difficult orientation and transition period. There are several methods to provide specialized education to NPs during their orientation period. Unfortunately, limitations such as a lack of motivated mentors, limited opportunities to practice the desired skill set or a lack of structure in regards to curriculum quality, and the learning needs of the new nurse hinder the NP's transition to practice. In response to either inadequate or non-standardized orientation to the specialty role of the oncology NP (ONP), a web-enhanced educational tool, funded through the National Cancer Institute, was developed for use in the USA: Oncology Nurse Practitioner Web Education Resource (ONc-PoWER). The development of ONc-PoWER was based upon essential education for NPs new to cancer care, adult learning theory, Bloom's Taxonomy, and foundations of quality online education. The five interactive web-based modules provide specialized education for the nurse practitioner new to oncology along with an on-site mentor to assist the NP in applying the course content to clinical practice.

  17. 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)

  18. Informatics competencies for nurse practitioners.

    PubMed

    Curran, Christine R

    2003-08-01

    Informatics knowledge and skills are essential if clinicians are to master the large volume of information generated in healthcare today. Thus, it is vital that informatics competencies be defined for nursing and incorporated into both curricula and practice. Staggers, Gassert, and Curran have defined informatics competencies for four general levels of nursing practice. However, informatics competencies by role (eg, those specific for advanced practice nursing) have not been defined and validated. This article presents an initial proposed list of informatics competencies essential for nurse practitioner education and practice. To this list, derived from the work of Staggers et al., 1 has been added informatics competencies related to evidence-based practice. Two nurse informaticists and six nurse practitioners, who are program directors, were involved in the development of the proposed competencies. The next step will be to validate these competencies via research.

  19. Advanced practice nursing role: nurse practitioner.

    PubMed

    Pastorino, C

    1998-01-01

    Nurse Practitioners are advanced practice nurses (APNs) who provide primary and acute care to individuals in many settings. The NP diagnoses and treats medical and surgical conditions that require acute, short-term management and chronic, long-term treatment. States vary in regulating processes regarding collaborative agreements, prescriptive authority, medical staff privileges, and insurance/third party reimbursement.

  20. 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)

  1. 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)

  2. Nurse practitioner employment, unemployment, reemployment.

    PubMed

    Roos, P D

    1979-01-01

    An estimate for nurse practitioner unemployment is attempted, based on responses of 260 graduates of a single program and published data. Reasons for not working are examined. The activity of NPs is compared to registered nurses. Job changers are compared to those who remained in the same job since graduation. Some of the reasons for unemployment and nonparticipation in the labor force are examined. Suggestive evidence on job changing is reviewed. Finally, policy implications are discussed.

  3. [Nurse practitioners as counselors].

    PubMed

    Hulskers, H; Niederer-Frei, I

    1997-04-01

    Giving advice is among the most important tasks of the clinical nurse specialist. In this article, the authors examine various aspects of counselling in order to contribute to the further analysis and development of the specialist's professional agenda. Starting out with a brief discussion of recent changes in nursing, the authors analyse the main activities of the clinical nurse specialist on the basis of their respective areas of expertise. The actual process of counselling is examined against the background of the acquired level of professional counselling skills. The article sums up a thesis completed at the end of a course on organizational development, team counselling, supervision, and coaching under the auspices of the Swiss Association for Applied Psychology (SAAP).

  4. Surgical Oncology Nursing: Looking Back, Looking Forward.

    PubMed

    Crane, Patrick C; Selanders, Louise

    2017-02-01

    To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. Review of the literature and Web sites of key organizations. The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Expanding the role of the oncology nurse

    PubMed Central

    Quinn, A

    2008-01-01

    Oncology nursing continues to evolve in response to advances in cancer treatment, information and biotechnology. As new scientific and technological discoveries are integrated into cancer care, oncology nurses need to play a key role in the management of this patient population. The role of the oncology nurse has expanded significantly and can differ greatly across cultures. Sophisticated treatments and the growth of targeted therapies will create the challenge of ensuring that all nurses working in this arena are well-educated, independent thinkers. Thus the future success of oncology nurses will focus on enhancement of nursing practice through advanced education. The increased globalisation of healthcare offers exciting opportunities to accomplish this goal by allowing for collaborative relationships among oncology nurses across the globe. PMID:21611002

  6. 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)

  7. Integrating Nurse Practitioners Into Intensive Care Units.

    PubMed

    Simone, Shari; McComiskey, Carmel A; Andersen, Brooke

    2016-12-01

    As demand for nurse practitioners in all types of intensive care units continues to increase, ensuring successful integration of these nurses into adult and pediatric general and specialty intensive care units poses several challenges. Adding nurse practitioners requires strategic planning to define critical aspects of the care delivery model before the practitioners are hired, develop a comprehensive program for integrating and training these nurses, and create a plan for implementing the program. Key strategies to ensure successful integration include defining and implementing the role of nurse practitioners, providing options for orientation, and supporting and training novice nurse practitioners. Understanding the importance of appropriate role utilization, the depth of knowledge and skill expected of nurse practitioners working in intensive care units, the need for a comprehensive training program, and a commitment to continued professional development beyond orientation are necessary to fully realize the contributions of these nurses in critical care. ©2016 American Association of Critical-Care Nurses.

  8. Oncology nurses' experience of collaboration: A case study.

    PubMed

    Moore, Jane; Prentice, Dawn

    2015-10-01

    Changes in the health system have created new models of healthcare delivery such as nurse-led teams. This has resulted in the increased opportunity for enhanced collaboration among nurses. Oncology nurses have a long history of working together, yet little is known about their perceptions about collaboration in the practice setting. This paper aimed to explore and describe the experiences of collaboration among oncology nurses, and to understand the factors that influenced collaboration. Qualitative, case study design was used to study fourteen oncology nurses from one cancer center in Canada. Participants were registered nurses or nurse practitioners, employed full-time or permanent part-time in an oncology nurse role, and working on an in-patient or out-patient unit. Data were collected in 2013 using individual telephone interviews and document reviews. Thematic analysis revealed two themes: Art of dancing together, and the stumbling point. The first theme related to the facilitators of collaboration including having: regular face-to-face interaction, an existing and/or previous relationship, oncology nursing experience, and good interpersonal skills. The second theme related to the barriers to collaboration such as: role ambiguity, organizational leadership, and multi-generational differences. Collaboration is a complex process that does not occur spontaneously. To improve collaboration nursing leadership needs to support and promote opportunities for nurses to build the relationships required to effectively collaborate. It is equally important that individual nurses be willing to collaborate and possess the interpersonal skills required to build and maintain the collaborative relationship despite differences in age, generation, and clinical experience. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Tobacco control policies of oncology nursing organizations.

    PubMed

    Sarna, Linda; Bialous, Stella Aguinaga

    2004-05-01

    Nurses, the largest group of health care professionals, and the policies of nursing organizations, have tremendous potential to promote health and tobacco control. Policies addressing tobacco use have been implemented by a variety of national and international nursing organizations. This article reviews existing tobacco control policies in oncology nursing organizations.

  10. The art of pediatric oncology nursing practice.

    PubMed

    Cantrell, Mary Ann

    2007-01-01

    Pediatric oncology nursing practice must incorporate both the science and the art of the discipline to foster positive physical and psychosocial treatment outcomes for pediatric oncology patients, especially those outcomes related to their health-related quality of life. In this article, the art of nursing care is described within the context of scientifically based care, and the art of nursing practice is evident in the implementation of the scientific principles and standards for pediatric oncology nursing practice. The author proposes that the art of pediatric oncology nursing practice ought to be evident in care activities that the nurse provides within a therapeutic relationship that is steeped in nursing presence. Although the art of nursing care and the nature of an effective therapeutic relationship is tacit, valued knowledge among pediatric oncology nurses, as well as children and adolescents with cancer and their families, it is difficult to describe and challenging to quantify its effect on patient care outcomes. This article discusses the art of pediatric oncology nursing practice and its influence on treatment outcomes.

  11. 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…

  12. [The New Era of the Nurse Practitioner].

    PubMed

    Chiu, Hui-Ju; Tsay, Shiow-Luan; Tung, Heng-Hsin

    2017-02-01

    The scope of practice of nurse practitioners is not defined by law but by the administrative directives of the Ministry of Health and Welfare. Prior to promulgation of Article 24, Paragraphs 3 and 4 of the "Nursing Personnel Act" and of the "Regulation of the Scope of Practice of Nurse Practitioners", the scope of practice of nurse practitioners was defined in accordance with relevant laws and regulations. Since promulgation, nurse practitioners have been authorized to practice medical interventions under the supervision of physicians and in accordance with physician-established protocols. These changes have made the scope of practice of nurse practitioners clearer and more specific. Today, nurse practitioners are authorized to perform 21 invasive procedures and 9 non-invasive procedures, which represents a new milestone in establishing the professionalism of nurse practitioners. The purpose of this article is to describe these new regulations governing the scope of practice of nurses and their legislative background and process. It is hoped that nurses may better understand the scope of practice of nurse practitioners and the importance of legislation in promoting and protecting the rights of nurses.

  13. Immunotherapy Administration: Oncology Nursing Society Recommendations
.

    PubMed

    Wiley, Kathleen; LeFebvre, Kristine B; Wall, Lisa; Baldwin-Medsker, Abigail; Nguyen, Kim; Marsh, Lisa; Baniewicz, Diane

    2017-04-01

    As the use of immunotherapeutic agents increases in single-agent and multimodality treatment regimens, oncology nurses face the challenge of administering and caring for patients receiving new and unique agents. Oncology Nursing Society clinical staff and clinical nurses collaborated to produce a set of recommendations to educate nurses involved with the monitoring of patients receiving immunotherapy on administration procedures and safe handling of these agents to ensure patient and staff safety and to reduce risk of error. The recommendations are meant to provide clinical nurses with a framework on which to build policies and procedures for administering new treatment modalities.
.

  14. Nurse Practitioner Research Agenda Roundtable, October 2015.

    PubMed

    Roberts, Mary Ellen; Goolsby, Mary Jo

    2017-01-01

    This is a report of the 2015 nurse practitioner (NP) Research Agenda Roundtable hosted by the Fellows of the American Association of Nurse Practitioners. A consensus was reached on four major categories where the need for research is greatest: 1) policy and regulation, 2) practice models, 3) education, and 4) workforce. Specific gaps in the existing body of research on NPs as essential elements of the broader health care environment were identified. ©2016 American Association of Nurse Practitioners.

  15. The Evolution of Gero-Oncology Nursing

    PubMed Central

    Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

    2016-01-01

    Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

  16. Nursing practice environment and outcomes for oncology nursing.

    PubMed

    Shang, Jingjing; Friese, Christopher R; Wu, Evan; Aiken, Linda H

    2013-01-01

    It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses' participation in hospital decision making.

  17. Exploring resilience in paediatric oncology nursing staff.

    PubMed

    Zander, Melissa; Hutton, Alison; King, Lindy

    2013-01-01

    Resilience has been suggested as an important coping strategy for nurses working in demanding settings, such as paediatric oncology. This qualitative study explored paediatric oncology nurses' perceptions of their development of resilience and how this resilience underpinned their ability to deal with work-related stressors. Five paediatric oncology nurses were interviewed about their understanding of the concept of resilience, their preferred coping mechanisms, and their day-today work in paediatric oncology. Using thematic analysis, the interviews were subsequently grouped together into seventeen initial themes. These themes were then grouped into seven major aspects that described how the participants perceived resilience underpinned their work. These "seven aspects of forming resilience" contributed to an initial understanding of how paediatric oncology nurses develop resilience in the face of their personal and professional challenges. Several key strategies derived from the findings, such as improved rostering, support to a nurse's friend and family, and a clinical support nursing role, could be implemented at an organizational level to support resilience development within the paediatric oncology setting.

  18. Nursing Practice Environment and Outcomes for Oncology Nursing

    PubMed Central

    Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

    2012-01-01

    Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

  19. Essential Genetic and Genomic Nursing Competencies for the Oncology Nurse

    PubMed Central

    Jenkins, Jean

    2010-01-01

    Objectives To review the opportunities and possibilities for advancing oncology nursing competencies in genetic/genomics through the illustration of case scenarios in clinical care. Data Sources Literature; research reports. Conclusions Oncology nurses have the potential to influence whether or not cutting edge research discoveries are utilized at the bedside. Clinical integration of genetic/genomic information has the potential to optimize health outcomes and lengthen patient lives. Implications for Nursing Practice Oncology nurses need to include genetics/genomics in their practice in order to impact quality patient care today and for the future. PMID:21255714

  20. Neonatal nurse practitioner workforce survey executive summary.

    PubMed

    Timoney, Paula; Sansoucie, Debra

    2012-06-01

    The Neonatal Nurse Practitioner Workforce Survey, led by Paula Timoney, DNP, ARNP, NNP-BC, and Debra Sansoucie, EdD, RN, NNP-BC, with the National Association of Neonatal Nurse Practitioners (NANNP), provides data collected from more than 600 neonatal nurse practitioners to examine workforce characteristics and needs. NANNP commissioned the survey because no comprehensive data existed for the neonatal nurse practitioner workforce. The executive summary given in this article highlights some of the survey's key findings in the areas of demographics, practice environment, scope of responsibilities, and job satisfaction. Readers are encouraged to review the complete text of the Neonatal Nurse Practitioner Workforce Survey for more in-depth data and recommendations regarding NNP education, scope of practice, and scope of responsibility in the ever-changing health care environment. The report will be available for purchase at http://www.nannstore.org in summer 2012.

  1. Life's final journey: the oncology nurse's role.

    PubMed

    Fairbrother, Cheryl A; Paice, Judith A

    2005-10-01

    Despite advances in technology and science, many people diagnosed with cancer are likely to die from the disease. Because of the long-term relationships that oncology nurses develop with patients and their families during lengthy treatment periods, they are the most appropriate clinicians to provide care across the continuum and through the final journey. Care of patients in the final days of life requires a comprehensive knowledge of common syndromes, skillful assessment, and adept clinical management. Nurses cannot focus solely on the needs of patients; family members often are unaware of the dying process. Oncology nurses are uniquely qualified to provide education and support to families at the bedside witnessing the final days and hours of their loved ones. Finally, oncology nurses involved in the care of dying patients are at risk for burnout and need to provide care for their own needs to find balance between their professional and personal lives.

  2. Employment and salary characteristics of nurse practitioners.

    PubMed

    Rogers, B; Sweeting, S; Davis, B

    1989-09-01

    Nurse practitioners provide high-quality, cost-effective care to health care consumers, yet they continue to experience low economic compensation and salary compression. The nursing literature is limited with respect to data regarding salaries, benefits and trends in compensation for nurse practitioners. In order to provide baseline data for nurse practitioners to use in negotiating compensation benefits and packages, 459 certified nurse practitioners in North Carolina were surveyed regarding demographic and employment characteristics and job satisfaction. Of the 83 percent who responded, nearly two-thirds earned less than $30,000 per year. Benefits and salary adjustment for certification are reported, and techniques for compensation negotiation are discussed. Although information obtained is specific to North Carolina, geographic similarities may be apparent.

  3. Reimbursement for acute care nurse practitioner services.

    PubMed

    Richmond, T S; Thompson, H J; Sullivan-Marx, E M

    2000-01-01

    Until the passage of the Balanced Budget Act of 1997, acute care nurse practitioners could not be directly reimbursed for inpatient services provided to Medicare patients. With the enactment of this legislation, acute care nurse practitioners may now be directly compensated for care provided. The historical and contextual issues that surround reimbursement for nursing and advanced practice nursing services are reviewed to serve as a foundation for understanding the current Medicare reimbursement regulations. The implications of the Balanced Budget Act of 1997 for acute care nurse practitioners and their professional colleagues are critically examined. The language of the Balanced Budget Act of 1997 and the subsequent rules and regulations issued by the Health Care Financing Administration are reviewed with specific focus on implications for acute care nurse practitioners. The opportunities for reimbursement for services provided by acute care nurse practitioners are more extensive than ever before. Acute care nurse practitioners and their physician colleagues will be wise to become fully conversant with the changes in Medicare reimbursement regulations.

  4. The impact of genomics on oncology nursing.

    PubMed

    Beamer, Laura Curr; Linder, Lauri; Wu, Bohua; Eggert, Julia

    2013-12-01

    Since 2003, genetics and genomics information has led to exciting new diagnostics, prognostics, and treatment options in oncology practice. Profiling of cancers offers providers insight into treatment and prognostic factors. Germline testing provides an individual with information for surveillance or therapy that may help them prevent cancer in their lifetime and options for family members as yet untouched by malignancy. This offers a challenge for oncology nurses and other oncology health care providers to become comfortable with incorporating education about genetics/genomics into their clinical practice and patient education.

  5. Reimbursement for nurse practitioner services.

    PubMed

    Buppert, C

    1998-01-01

    Whether a nurse practitioner (NP) is employed by a medical practice or is self-employed, the reimbursement policies of third-party payers will determine whether an NP continues to provide care on a long-term basis. The payers--Medicare, Medicaid, indemnity insurers, and managed care organizations--each have their own reimbursement policies and fee schedules, and each operates under a separate body of law. Some payers have a history of reimbursing for NP services in the same manner as they reimburse for physician services. On the other hand, some payers have recently begun to reimburse NPs directly, either as separate and apart from an employment relationship with a physician practice or following NP-specific rules and policies regarding reimbursement. This article offers basic information necessary to communicate with practice managers, billing experts, and the payers about reimbursement mechanisms and problems. It covers how to set up provider relationships with the various payers, how to submit bills, and how to deal with denial of reimbursement when it occurs.

  6. Japanese nurse practitioner practice and outcomes in a nursing home.

    PubMed

    Ono, M; Miyauchi, S; Edzuki, Y; Saiki, K; Fukuda, H; Tonai, M; Magilvy, J K; Murashima, S

    2015-06-01

    By describing the practice of a Japanese nurse practitioner, this descriptive case study discusses role development and outcomes before and after the intervention. One of the first Japanese nurse practitioners intervened at a nursing home during the government-designated trial period for nurse practitioner practice. Because of the nurse practitioner's meticulous observation and timely care provision to the residents in collaboration with the physician and the other staff in the facility, comparative data showed improvement in daily health status management of every resident and decreased deterioration of residents' health conditions requiring ambulance transfer and hospitalization. © 2014 The Authors. International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

  7. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.166 Nurse practitioner services. (a) Definition of nurse practitioner services. Nurse practitioner services means services that... 42 Public Health 4 2010-10-01 2010-10-01 false Nurse practitioner services. 440.166 Section...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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 are...

  13. Promoting visibility for the nurse practitioner role.

    PubMed

    Edmunds, M W

    1988-03-01

    In promoting greater public awareness of nurse practitioners' contributions to health care, two major strategies may be used. Creating broad-based visibility through the use of the basic media and marketing strategies, and utilizing individual client encounters to educate clients about the NP role are both effective. NPs should assume the initiative in seeking out opportunities to create positive images for the nurse practitioner.

  14. 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)

  15. 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)

  16. Using Data to Strengthen Ambulatory Oncology Nursing Practice.

    PubMed

    Friese, Christopher R; Siefert, Mary Lou; Thomas-Frost, Kaitlin; Walker, Stacy; Ponte, Patricia Reid

    2016-01-01

    Efforts to measure quality of care do not capture the unique aspects of ambulatory oncology settings. To retain nurses, ensure a safe practice environment, and encourage behaviors that support high-quality care, there is a need to identify factors associated with job satisfaction and turnover with measures that reflect the ambulatory setting. The objective of this study was to examine the patterns and correlates of the work environment for nurses and nurse practitioners working in a National Cancer Institute-designated Comprehensive Cancer Center. Web-based questionnaires were disseminated to employees with a registered nurse license in ambulatory settings and related support services and included 3 affiliated satellite locations. Participants completed the Practice Environment Scale of the Nursing Work Index, revised for ambulatory oncology settings, the Safety Organizing Scale, and items to assess job satisfaction, perceived quality of care, and intention to leave their current position. Logistic and linear regression models were used to examine factors associated with these outcomes. From 403 individuals, 319 (79.2%) participated. The majority of respondents endorsed excellent quality of care (57.7%), job satisfaction (69.3%), and intention to stay in current position (77.4%). Endorsement of favorable collegial nurse-physician relationships was significantly associated with all 3 outcomes and increased performance of safety organizing behaviors. Nurses reported variations in practice environments and safety organizing behaviors across units. Work environment assessments are useful to retain experienced nurses and support the delivery of high-quality patient care. Routine assessment of the work environment for registered nurses and advanced practice nurses is feasible and informative.

  17. 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…

  18. 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…

  19. 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…

  20. Nurse practitioner roles in Australian healthcare settings.

    PubMed

    Lowe, Grainne; Plummer, Virginia; Boyd, Leanne

    2013-05-01

    There is evidence of support for nurse practitioner (NP) roles in national and international literature. However, despite this, and numerous Australian government feasibility and evaluation studies, barriers to implementing NP roles in mainstream health care and developing them to their full potential remain. A study was undertaken to explore nurse practitioners', managers' and nurse policymakers' perceptions of the roles in general, and this article reports on the findings from the initial survey phase. The article also discusses barriers to full integration and development of NPs.

  1. Oncology Nurse Participation in Survivorship Care

    PubMed Central

    Grant, Marcia; Economou, Denice; Ferrell, Betty

    2011-01-01

    Oncology nurses are playing an important role in the provision of survivorship care. Their involvement includes educating and coordinating multidiscipline teams to initiate and provide care to patients and families. Oncology nurses participate in this evolving model of care in a variety of ways. Using the IOM report recommendations for the provision of quality cancer care nurses provide care based on the specific characteristics of individual health care settings and the populations they serve. Evaluating the settings resources and goals for desired survivorship activities as part of the planning process can be the difference between success and failure. Collaborating with local and national resources for cancer survivors can help expand services for a setting in an efficient and cost effective manner. Models of care vary and resources and communication differs among cancer care settings. Survivorship care differs as a result, across different models. Nurses are key to the dissemination and coordination of survivorship activities and are critical in facilitating communication between health care providers, the patients and caregivers. Nurses have a significant role in the dissemination and coordination of information between the patient and other health care providers. Oncology care does not end when treatment ends. PMID:21112849

  2. Mapping the literature of nurse practitioners

    PubMed Central

    Shams, Marie-Lise Antoun

    2006-01-01

    Objectives: This study was designed to identify core journals for the nurse practitioner specialty and to determine the extent of their indexing in bibliographic databases. Methods: As part of a larger project for mapping the literature of nursing, this study followed a common methodology based on citation analysis. Four journals designated by nurse practitioners as sources for their practice information were selected. All cited references were analyzed to determine format types and publication years. Bradford's Law of Scattering was applied to identify core journals. Nine bibliographic databases were searched to estimate the index coverage of the core titles. Results: The findings indicate that nurse practitioners rely primarily on journals (72.0%) followed by books (20.4%) for their professional knowledge. The majority of the identified core journals belong to non-nursing disciplines. This is reflected in the indexing coverage results: PubMed/MEDLINE more comprehensively indexes the core titles than CINAHL does. Conclusion: Nurse practitioners, as primary care providers, consult medical as well as nursing sources for their information. The implications of the citation analysis findings are significant for collection development librarians and indexing services. PMID:16710457

  3. Ethical problems experienced by oncology nurses1

    PubMed Central

    da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

    2015-01-01

    Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude. PMID:26626012

  4. The Oncology Nurse Prescribing: A Catalonian Survey

    PubMed Central

    Fernández-Ortega, Paz; Cabrera-Jaime, Sandra; Estrada-Masllorens, Joan María

    2016-01-01

    Objective: This study identifies the capability, knowledge, and satisfaction of oncology nurses in Spain after approval of the nurse prescribing law in 2006. Methods: A descriptive cross-sectional study was conducted among 140 nurses in three cancer centers in Catalonia, Spain, by using convenience sampling method. The principal variables of this study were nurse satisfaction, knowledge about what products nurses are allowed to prescribe, the nurses’ perception of their own prescribing ability, and their opinion on education and training needs with regard to the new approved law. The secondary variables included years of professional experience, place of work, and sociodemographic variables. Data were collected during a 3 months period by using a piloted 29-item self-assessment questionnaire. Results: Analyses of univariate and bivariate data showed that 82.2% of the nurses were aware of the approved law, but 94.2% indicated that they lack information about it. The mean satisfaction with the approval of the law was 6.64 ± 1.76 (numerical scale 0-10). In addition, 68.1% and 55.1% of the nurses were prepared to prescribe medical devices and drugs, respectively. To date, 61.1% of the nurses prescribe medical devices and 66% prescribe pharmacological products daily. Conclusions: Nurses expressed general satisfaction with the approval of the Law 29/2006. Nurses currently provide prescriptions, but widespread knowledge of the allowed prescriptions is lacking. PMID:27981146

  5. Social Interaction and Collaboration among Oncology Nurses.

    PubMed

    Moore, Jane; Prentice, Dawn; McQuestion, Maurene

    2015-01-01

    Collaboration is a complex process influenced by organizational, professional, interpersonal, and personal factors. Research has demonstrated that collaboration may also be influenced by social factors. Nurses spend much of their time working in collaborative teams, yet little is known about how they socially interact in practice. This qualitative case study explored nurse perceptions of social interaction in relation to collaboration. Data were collected using telephone interviews and documentary reviews from fourteen oncology nurses employed at one cancer center in Canada. Thematic analysis revealed two themes: knowing you is trusting you and formal and informal opportunities. Nurses reported that social interaction meant getting to know someone personally as well as professionally. Social interaction was enacted inside of work during breaks/meals and outside of work at planned events. Social interaction was facilitated by having a long-term current and/or previous professional and personal relationship. The barriers to social interaction included a lack of time to get to know each other, workload issues, and poor interpersonal skills. Findings suggest that social interaction is an important factor in the collaborative relationship among oncology nurses. Nurse leaders need to promote social interaction opportunities and facilitate educational sessions to improve social and interpersonal skills.

  6. Nurse Practitioners and Men's Primary Health Care.

    PubMed

    Rosu, Marina B; Oliffe, John L; Kelly, Mary T

    2017-09-01

    Though life expectancy sex differences are decreasing in many Western countries, men experience higher mortality rates at all ages. Men are often reluctant to seek medical care because health help-seeking is strongly linked to femininity, male weakness, and vulnerability. Many men are also more likely to access emergency care services in response to injury and/or severe pain instead of engaging primary health care (PHC) services. Nurse practitioners are well positioned to increase men's engagement with PHC to waylay the pressure on emergency services and advance the well-being of men. This article demonstrates how nurse practitioners can work with men in PHC settings to optimize men's self-health and illness prevention and management. Four recommendations are discussed: (1) leveling the hierarchies, (2) talking it through, (3) seeing diversity within patterns, and (4) augmenting face-to-face PHC services. In terms of leveling the hierarchies nurse practitioners can engage men in effectual health decision making. Within the interactions detailed in the talking it through section are strategies for connecting with male patients and mapping their progress. In terms of seeing diversity with in patterns and drawing on the plurality of masculinities, nurse practitioners are encouraged to adapt a variety of age sensitive assessment tools to better intervene and guide men's self-health efforts. Examples of community and web based men's health resources are shared in the augmenting face-to-face PHC services section to guide the work of nurse practitioners. Overall, the information and recommendations shared in this article can proactively direct the efforts of nurse practitioners working with men.

  7. Cyberbullying: implications for the psychiatric nurse practitioner.

    PubMed

    Carpenter, Lindsey M; Hubbard, Grace B

    2014-08-01

    The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.

  8. Puget sound oncology nursing education cooperative.

    PubMed

    Whipple, V T; Hogeland-Drummond, S; Purrier, M; Tofthagen, C

    2000-01-01

    The purpose of the Leadership & Professional Development feature is to provide readers with information, ideas, and exemplars of leadership competencies and professional roles in oncology nursing. Manuscripts submitted to the Leadership & Professional Development feature should be prepared according to the Information for Authors published in the Oncology Nursing Forum (ONF) but limited to six to eight double-spaced typed pages. Submit two copies of the manuscript using IBM-compatible software along with a computer disk copy, or submit a copy of the manuscript as an e-mail attachment to Joan Such Lockhart, PhD, RN, CORLN, ONF Associate Editor, 1365 Simona Drive, Pittsburgh, PA 15201; lockhart /duq.edu (e-mail). Manuscripts should be referenced and include tables, figures, or illustrations as appropriate. Ideas for possible manuscripts are welcome.

  9. [Coordination in oncology, pivot nurses].

    PubMed

    Feld, Dominique

    2016-06-01

    The function of the pivot nurse was created when the Cancer Plans were first introduced to improve patient management and has constantly developed since then. It is an essential role for the coordination of care and the different players involved along the patient's care pathway.

  10. Exploring boundaries in pediatric oncology nursing.

    PubMed

    Hartlage, Heather N

    2012-01-01

    Professional patient boundaries are an issue that is relevant across all realms of nursing practice. By nature, nurses are caring individuals. Therapeutic relationships are integral to the care of patients. When caring for patients on a daily basis for extended periods of time, it can be difficult for nurses to know when their care goes beyond professional boundaries. Providing care to patients in a pediatric oncology situation substantially increases this ethical dilemma. Length of stay, degree of crisis, embedded relationships, and emotional turmoil, along with the nurturing connection between adult and child, are among the reasons that boundaries are often blurred within the context of this sensitive patient population. This article explores the differences between nursing care, boundary crossings, and boundary violations. Strategies to evaluate nursing actions for appropriateness, along with reflection and development of individual boundaries, are offered. The information presented is relevant not only to nursing care of pediatric patients who are facing chronic or life-threatening conditions but also to each nurse-client relationship established in nursing practice.

  11. 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…

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

    ERIC Educational Resources Information Center

    Brady, Margaret A.

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

  13. 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)

  14. 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)

  15. 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)

  16. 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)

  17. Recommendations for nurse practitioner residency programs.

    PubMed

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

    2015-01-01

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

  18. 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)

  19. Nurse Practitioner Research: Some Neglected Issues

    ERIC Educational Resources Information Center

    Williams, Carolyn A.

    1975-01-01

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

  20. Nurse practitioner prescribing practices: the most frequently prescribed medications.

    PubMed

    Buckley, Thomas; Cashin, Andrew; Stuart, Meg; Browne, Graeme; Dunn, Sandra V

    2013-07-01

    To explore which medications Australian nurse practitioners most frequently prescribe. Although nurse practitioners in Australia have prescriptive authority, little is known about which specific medications nurse practitioners are prescribing and how frequently they do so. Descriptive electronic survey. A total of 209 nurse practitioners reported current prescribing practices. Medications reported were categorised according to the Australian Medicines Handbook major drug classifications and frequencies presented. Seventy-eight per cent of respondents reported prescribing medications as part of their Nurse Practitioner practice. In total, participants reported prescribing 234 separate medications from most Australian Medicines Handbook major drug classifications. Medications from the classification anti-infective drugs were most frequently prescribed followed by medications from analgesic, psychotropic, cardiovascular, musculoskeletal, genitourinary and gastrointestinal classifications. The majority of nurse practitioners in Australia prescribe medications in their clinical practice, although the proportion of nurse practitioners prescribing has not changed significantly in the past four years. The medications prescribed are comparable with those most frequently prescribed by all prescribers in Australia and highlight the diversity in scope of practice among nurse practitioners. Findings highlight the importance of Nurse Practitioner's a capacity to prescribe wide variety of medications, especially in practice areas such acute, primary and emergency care. The unique role nurse practitioners in relation to management of patients with infective processes and patients requiring pain relief is highlighted. Insight into current Nurse Practitioner prescribing trends informs future Nurse Practitioner curricular and future continuing education programmes. Findings give unique insight for future service planning, especially service providers considering introducing nurse

  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. The rural nurse-practitioner: concepts and issues.

    PubMed

    Roberts, K L

    1996-08-01

    This paper reviews concepts, issues and research findings related to the role of the nurse-practitioner; in particular, findings related to the role of the rural nurse-practitioner are considered. Issues related to the nurse-practitioner, including effectiveness, physician acceptance, client acceptance, models of practice, legal issues, reimbursement, licensure and educational implications are discussed. It is concluded that the nurse-practitioner is a valuable profession.

  3. Evolving role of pediatric nurse practitioners.

    PubMed

    Aruda, Mary M; Griffin, Valerie J; Schartz, Kathryn; Geist, Melissa

    2016-02-01

    To report and interpret findings from national pediatric nurse practitioner (PNP) job analysis surveys reflecting the changes in the knowledge and skills required for advanced practice. National role delineation studies (RDS) conducted by American Nurses Credentialing Center (ANCC) in 2003, 2008, and 2011. Since the first nurse practitioner (NP) program was established in 1965 to train pediatric nurses for advanced practice, the role of the PNP has continued to develop. The RDS results demonstrate the increased autonomy of PNP's prescription of medication as the top work activity category identified, followed by the reporting of suspected abuse, exploitation, and/or neglect and immunizing based on current recommendations. Analysis of the changes in role or work activities, tied to the knowledge and skills required to perform those activities, can provide content for educators updating curriculum, for clinicians to remain current in their practice and impact healthcare policy. The current PNP role has evolved to meet the workforce demands of providing primary care to the pediatric population with increasing complex social and healthcare needs. Role analysis is important as NPs move forward to practice to the full extent of their education and training. ©2015 American Association of Nurse Practitioners.

  4. 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)

  5. 42 CFR 410.75 - Nurse practitioners' services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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 professional...

  10. The first nurse practitioner graduate programme in Japan.

    PubMed

    Fukuda, H; Miyauchi, S; Tonai, M; Ono, M; Magilvy, J K; Murashima, S

    2014-12-01

    This paper describes the establishment of the first Japanese nurse practitioner graduate programme and legislative activities to institutionalize nurse practitioners in Japan. To address the super-ageing population, Oita University of Nursing and Health Sciences initiated the first academic graduate level nurse practitioner programme in Japan, based upon the global standard defined by the International Council of Nurses. In 2010, Oita University of Nursing and Health Sciences graduated the first nurse practitioner. We believe that nurse practitioners will be highly valued in Japan for thoughtful nursing care to the fragile elders living in rural and urban Japan. © 2014 The Authors. International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

  11. Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists.

    PubMed

    Jonker, J M; Smorenburg, C H; Schiphorst, A H; van Rixtel, B; Portielje, J E A; Hamaker, M E

    2014-11-01

    To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel.

  12. Nurse practitioners and intent to retire.

    PubMed

    Falk, Nancy L; Rudner, Nancy; Chapa, Deborah; Greene, Jessica

    2017-03-01

    Demand for primary care services is rising. Nurse practitioners (NPs) serve vital roles in meeting primary care demands. Workforce planning requires understanding NP retirement intentions. This study examines factors that relate to NPs, aged 55 years and older, and their intent to retire within 5 years. We used the 2012 National Sample Survey of Nurse Practitioners to examine the relationship between NP demographic characteristics (gender, race/ethnicity, marital status, nursing degree), work environment characteristics (part-time vs. full-time status, primary or specialty care, earnings, job satisfaction), and intent to retire. Descriptive, bivariate, and multivariate analyses were conducted. A total of 3171 working NPs, 55 years of age and older, were included. Fifty-nine percent of NPs 60 years and older and 15% of NPs 55-59 intend to retire in the next 5 years. Working part-time and having less than a master's degree were associated with intent to retire. Being "very satisfied" with one's job was related to lower odds of intent to retire versus being "satisfied." Being "dissatisfied" with one's job and working in primary care were related to intending to retire for the NPs 55-59. Given the relationship between higher job satisfaction and lower intent to retire, efforts to increase NPs' job satisfaction may result in less early retirement. ©2016 American Association of Nurse Practitioners.

  13. International cancer care: what is the role of oncology nursing?

    PubMed

    Sheldon, Lisa Kennedy

    2010-10-01

    Comprehensive cancer care continues to improve in the United States, but many developing countries carry a high cancer burden. With limited resources, nurses in such countries often are unable to improve cancer detection and treatment or relieve patient suffering. The Oncology Nursing Society has developed collaborative relationships with many international organizations to educate nurses around the world. Global partnerships have the potential to improve cancer care internationally and encourage more oncology nurses to use their expertise and become "citizens of the world."

  14. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... are furnished by a registered professional nurse who meets a State's advanced educational and clinical... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a registered professional nurse who meets the requirements specified in either paragraphs (b)(1) or (b)(2)...

  15. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... are furnished by a registered professional nurse who meets a State's advanced educational and clinical... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a registered professional nurse who meets the requirements specified in either paragraphs (b)(1) or (b)(2)...

  16. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... are furnished by a registered professional nurse who meets a State's advanced educational and clinical... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a registered professional nurse who meets the requirements specified in either paragraphs (b)(1) or (b)(2)...

  17. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... are furnished by a registered professional nurse who meets a State's advanced educational and clinical... registered nurses. (b) Requirements for certified pediatric nurse practitioner. The practitioner must be a registered professional nurse who meets the requirements specified in either paragraphs (b)(1) or (b)(2)...

  18. Job satisfaction in an oncology nursing team.

    PubMed

    Silva, Vagnára Ribeiro da; Velasque, Luciane de Souza; Tonini, Teresa

    2017-01-01

    to identify the level of attributed, perceived and real job satisfaction of oncology nursing professionals and analyze the relationships between the levels of satisfaction among these workers. a descriptive, quantitative cross-sectional study was conducted using the Index of Work Satisfaction (IWS) to evaluate the nursing team, nurses and technicians/auxiliaries. A total of 348 workers answered the questionnaire, of which 216 were fully completed and considered for the IWS calculation. Autonomy was considered the most important item in attributed satisfaction for the nursing team and nurses. Salary was valorized most by the technicians/auxiliaries. For perceived satisfaction, Professional Status was the most important for all workers. Regarding real satisfaction, Interaction was the most important for the nursing team and technicians/auxiliaries; while the nurses valorized Autonomy. The nurses presented the greatest job satisfaction. a discrepancy was observed in job satisfaction among the oncology nurses, indicating the importance of further quantitative research. identificar o nível de satisfação profissional atribuído, percebido e o real no trabalho de profissionais de enfermagem oncológica e analisar as relações entre os níveis de satisfação desses trabalhadores. estudo quantitativo, descritivo, transversal que utilizou o Índice de Satisfação Profissional (ISP) para avaliar a equipe de enfermagem, enfermeiros e técnicos/auxiliares. Dentre os profissionais, 348 destes responderam o questionário, dos quais 216 foram totalmente preenchidos e considerados para o cálculo do ISP. Autonomia foi mais importante na satisfação atribuída para a equipe de enfermagem e enfermeiros, Remuneração foi mais valorizada pelos técnicos/auxiliares. Para a satisfação percebida, Status profissional foi mais importante para todos os profissionais. Sobre a real satisfação, Interação foi o mais importante para a equipe de enfermagem e técnicos/auxiliares; os

  19. It takes chutzpah: oncology nurse leaders.

    PubMed

    Green, E

    1999-01-01

    Chutzpah, according to the Oxford Dictionary of Current English (1996) is a slang term from the Yiddish language which means shameless audacity. Chutzpah has been used to identify people with courage who take on situations that others avoid and somehow achieve the impossible. Tim Porter-O'Grady (1997) recently wrote that management is dead, and has been replaced by process leadership. Health care organizations have made shifts from hierarchical structures to process or program models where people have dual/multiple reporting/communication relationship. In this new orientation, management functions of controlling, directing, organizing and disciplining are replaced by process leadership functions of coordinating, facilitating, linking and sustaining (Porter O'Grady, 1997). Herein lies the challenge for oncology nurse leaders: "what lies behind us and what lies before us are tiny matters compared to what lies within us" (Ralph Waldo Emerson). Leadership is not a function of job title. The evidence for this is clear in current practice.... There are no/few positions of nurse leaders. Titles have changed to eliminate the professional discipline, and reflect a non-descript orientation. The new titles are process leaders, program leaders, professional practice leaders. Nurse leaders need new points of reference to take in the challenges of influencing, facilitating and linking. Those points of reference are: principle-centered leadership, integrity and chutzpah. This presentation will focus on examining current thinking, defining key characteristics and attributes, and using scenarios to illustrate the impact of leadership. We, as leaders in oncology nursing, must use chutzpah to make positive change and long-term gains for patient care and the profession of nursing.

  20. Stress Levels of Nurses in Oncology Outpatient Units.

    PubMed

    Ko, Woonhwa; Kiser-Larson, Norma

    2016-04-01

    Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.

  1. The role of nurse practitioners in reinventing primary care.

    PubMed

    Naylor, Mary D; Kurtzman, Ellen T

    2010-05-01

    Nurse practitioners are the principal group of advanced-practice nurses delivering primary care in the United States. We reviewed the current and projected nurse practitioner workforce, and we summarize the available evidence of their contributions to improving primary care and reducing more costly health resource use. We recommend that nurse practice acts--the state laws governing how nurses may practice--be standardized, that equivalent reimbursement be paid for comparable services regardless of practitioner, and that performance results be publicly reported to maximize the high-quality care that nurse practitioners provide.

  2. 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.

  3. Pediatric nurse practitioners: influences on career choice.

    PubMed

    Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura

    2014-01-01

    The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  4. 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

  5. A systematic review on the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.

    PubMed

    Gi, Toh Shir; Devi, Kamala M; Neo Kim, Emily Ang

    2011-01-01

    Nursing shortage is a global issue that which affects oncology nursing. Oncology nurses are more prone to experience job dissatisfaction, stress and burnout when they work in units with poor staffing. There is thus a need for greater understanding of the relationship between the nursing shortage and nursing outcomes in oncology/haematology settings. This review aimed to establish the best available evidence concerning the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings; and to make recommendations for practice and future research. Types of participants: This review considered studies that included oncology registered nurses (RNs) who were more than 18 years of age and worked in either inpatient or outpatient oncology/haematology wards or units for the adult or paediatric patients.Types of intervention: This review considered studies that evaluated the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.Types of outcomes: This review included studies that measured job satisfaction, stress and burnout levels using different outcomes measures. Job satisfaction was determined by the Measure of Job Satisfaction scale, the Misener Nurse Practitioner Job Satisfaction Scale and the Likert scale, stress by the Pediatric Oncology Nurse Stressor Questionnaire and burnout by the Maslash Burnout Inventory scale.Types of studies: This review included descriptive/descriptive-correlational studies which were published in English. The search strategy sought to identify published and unpublished studies conducted between 1990 and 2010. Using a three-step search strategy, the following databases were accessed: CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar. Two independent reviewers assessed each paper for methodological validity prior to inclusion in

  6. Cognitive dissonance experienced by nurse practitioner faculty.

    PubMed

    Fontenot, Holly B; Hawkins, Joellen W; Weiss, Josie A

    2012-08-01

    The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid. Expecting all faculty members to excel in practice, research, teaching, and service may create unrealistic workloads for NP faculty members. Examining expectations and considering creation of a clinical track for faculty who practice may be options administrators of NP programs might explore. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  7. Decreasing barriers for nurse practitioner social entrepreneurship.

    PubMed

    Sharp, Dayle B; Monsivais, Diane

    2014-10-01

    To describe difficulties associated with the business-related aspects of practice in role transition of rural nurse practitioners (NPs), and to give practice implications. This focused ethnographic study derived data from semi-structured interviews. Participants provided information about rural NP practice ownership and barriers. The sample consisted of 24 rural NPs living throughout the United States. The majority were 51-60 years of age (45%) and females (93%) who had been in rural practice for 1 to over 20 years. NP social entrepreneurs experience difficulties related to scope of practice, business skills, and role conflict. To decrease barriers for NP clinic ownership and management, NPs need to receive education related to financing a rural practice, legal/regulatory practices, strategic planning, leadership, and clinic management. ©2014 American Association of Nurse Practitioners.

  8. Assisted suicide: nurse practitioners as providers?

    PubMed

    Hall, J K

    1996-10-01

    Changes in the law of death are being made. Nurse practitioners will be asked to help their patients commit suicide, and to help euthanize their patients. Currently most nurse practitioners have legal authority to prescribe the drugs that can potentially kill patients. NPs may be more likely than physicians to be asked for these drugs. Assisted suicide, euthanasia, and related terms are defined. The specific changes in the law of causing death are provided. Collective payment for illness care may be one reason that changes in the law are now being made. Society projects that dying people do not want to live; but that assumption is wrong. NPs in the future may choose to act at the lowest standard of behavior (the law) or they may behave in accord with a higher standard, their personal ethics. NPs should assert that their professional duty is to do good for the patient, not to help kill the patient.

  9. Intervention patterns of pivot nurses in oncology.

    PubMed

    Skrutkowski, Myriam; Saucier, Andréanne; Ritchie, Judith A; Tran, Ngoc; Smith, Kevin

    2011-01-01

    The Pivot Nurse in Oncology (PNO) is a health care professional dedicated to providing patients with cancer and their families with continuing and consistent supportive care throughout the care trajectory. The purpose of this paper is to describe the variation and frequency of nursing interventions delivered by 12 PNOs at our health centre. An administrative analysis over a three-year period revealed a total of 43,906 interventions that were grouped into 10 categories. This analysis provided a description of the intervention frequency and these interventions were further collapsed into the four role functions of the PNO. Coordination/continuity of care and the assessment of needs and symptoms were identified as the dominant practice domains of the PNO in the professional cancer navigator role.

  10. International collaboration for pediatric oncology nursing leadership: Nicaragua and Canada.

    PubMed

    Orozco, A; Marin, V; Reyes, S; Challinor, J; Carpio, B

    2009-01-01

    In 2005, with financial support from the Pediatric Oncology Group of Ontario, a pilot nursing leadership project linked pediatric oncology nurses from Canada with nurses at the La Mascota Hospital in Managua, Nicaragua. Following consultation with the pediatric oncology team in Nicaragua, a program was developed to strengthen clinical nursing leadership in a clinical setting through continuing education. The nurses believed that care of the patient and family improved due to the increased leadership skills of nurses in the unit and as the profile and credibility of nurses as peers in the health care team became evident. Providing nurses with the autonomy and financing for a project related directly to nursing care represented an important development for leadership in the profession.

  11. New Health Practitioners: The Nurse Practitioner and the Physician's Assistant. Extension Studies 80.

    ERIC Educational Resources Information Center

    Woolley, Barbara H.

    Based on the trend toward greater reliance on new health practitioners, this book focuses on the nurse practitioner and the physician's assistant. The first of four sections describes the nurse practitioner and the physician's assistant and what their functions are in the delivery of health care services. Discussing why new health practitioners…

  12. Nurse practitioner role transition: a concept analysis.

    PubMed

    MacLellan, Lorna; Levett-Jones, Tracy; Higgins, Isabel

    2015-07-01

    Transitioning from registered nurse to nurse practitioner (NP) can be challenging personally and professionally. Insight into transition experiences may help validate the experiences of new NPs and provide greater understanding of the challenges faced during their professional journey. The purpose of this article is to report a concept analysis of transition from registered nurse to NP. The article provides new knowledge, understanding, and clarity about the concept of transition. Walker and Avants' framework for concept analysis was used to identify the attributes, antecedents, and consequences of the concept. A literature review of refereed journals was undertaken. Model cases from an ethnographic study conducted in Australia provide real life examples of the attributes of transition. Transitioning to the role of NP is complex and dependent on the individual and the attitudes of healthcare colleagues. Change and adaptation are required of both the NP and members of the healthcare team. Failure to adapt by either party undermines the potential for NPs to deliver improved health care. Mentorship along with a nurturing environment may be effective strategies for increasing the NP's self-confidence and ensuring a smooth and successful transition period. ©2014 American Association of Nurse Practitioners.

  13. Nurse Practitioner Role Transition: A Concept Analysis.

    PubMed

    Barnes, Hilary

    2015-01-01

    A concept analysis of nurse practitioner (NP) role transition. The Affordable Care Act is expected to provide 32 million Americans with health insurance, and NPs are gaining attention in addressing this increasing demand for healthcare providers. However, there is limited analysis of the transition from registered nurse to NP. Oftentimes, during this transition, there is a shift from an experienced, expert status to an inexperienced, novice status, with a subsequent loss of confidence in one's ability and competence. This can hinder successful role development and affect employment continuity within the first year of practice. NP role transition was examined using Walker and Avant's method of concept analysis. Electronic databases were searched using the terms role transition and nurse practitioner. Thirty articles from nursing, psychology, and business were included. The four defining attributes of NP role transition are absorption of the role, the shift from provider of care to prescriber of care, straddling two identities, and mixed emotions. Personal and environmental antecedents and consequences of the concept are identified. The development of empirical knowledge on NP role transition through further research is important in order for new-to-practice NPs to become high-quality, full-functioning providers. © 2014 Wiley Periodicals, Inc.

  14. Team Development Manual. Family Nurse Practitioner/Physician Assistant Program.

    ERIC Educational Resources Information Center

    Dostal, Lori

    A manual is presented to help incorporate team development into training programs for nurse practitioners, physician assistants, and primary care physicians. It is also directed to practitioners who wish to improve teamwork and is designed to improve the utilization of the nurse practitioners and physician assistants. A group of one or more…

  15. Team Development Manual. Family Nurse Practitioner/Physician Assistant Program.

    ERIC Educational Resources Information Center

    Dostal, Lori

    A manual is presented to help incorporate team development into training programs for nurse practitioners, physician assistants, and primary care physicians. It is also directed to practitioners who wish to improve teamwork and is designed to improve the utilization of the nurse practitioners and physician assistants. A group of one or more…

  16. How nurse practitioners obtained provider status: lessons for pharmacists.

    PubMed

    O'Brien, John Michael

    2003-11-15

    The history of nurse practitioners, their efforts to achieve provider status, and lessons learned from their activism are discussed. The nurse practitioner profession arose out of a need to meet a rising demand for primary care services, especially in rural areas. Some nurses and physicians vehemently opposed the nurse practitioner model, but studies documented the value of nurse practitioner services, and the utilization of these practitioners continued to grow. Compensation was provided via salary or per-member-per-month agreements. Nurse practitioners recognized that direct federal reimbursement (provider status) was needed to recognize them as independent health care providers and assign specific monetary values to their services, so they undertook an aggressive lobbying campaign. Contacts on Capitol Hill were exploited, and nursing organizations encouraged nurse practitioners to get involved in grass-roots activism. Nurse practitioners discussed their patients during meetings with their representatives in Congress, and legislators were invited to make site visits. In 1993, the American College of Nurse Practitioners was formed to unite the profession and move the campaign forward. Ultimately, the Balanced Budget Act of 1997 granted nurse practitioners provider status and authorized them to bill Medicare directly for services furnished in any setting. The key strategies that contributed to this victory were (1) gaining recognition that nursing had the potential to expand its role, (2) documenting nurse practitioners' value, (3) establishing standards in education and credentialing, (4) using professional organizations to empower individuals, and (5) being willing to accept small, incremental gains over time. The experience of nurse practitioners in obtaining Medicare provider status offers valuable lessons for pharmacists as they pursue the same goal.

  17. 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' and clinical nurse specialists' services. (a) Rural areas. For services furnished beginning January...

  18. 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' and clinical nurse specialists' services. (a) Rural areas. For services furnished beginning January...

  19. 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 nurse specialists' services. (a) Rural areas. For services furnished beginning January 1, 1992 and...

  20. Creating opportunities to support oncology nursing practice: surviving and thriving.

    PubMed

    Rashleigh, Laura; Cordon, Charissa; Wong, Jiahui

    2011-01-01

    There is a growing body of evidence to support that specialization in nursing leads to improved outcomes for patients, including increased QOL, improved symptom management, and fewer hospital admissions. Oncology nurses face several challenges in pursuing specialization, due to individual and system issues such as limited time and resources. To address these challenges, de Souza Institute launched a province-wide study group for nurses in Ontario who planned to write the Canadian Nurses Association (CNA) Oncology Certification Exam. The study group was led by educators from de Souza and Princess Margaret Hospital and drew expertise from nursing leaders across Ontario who shared the same vision of oncology nursing excellence. The study group was innovative by embracing telemedicine and web-based technology, which enabled flexibility for nurses' work schedules, learning styles, physical location and practice experience. The study group utilized several theoretical perspectives and frameworks to guide the curriculum: Adult Learning Theories, Cooperative Learning, Generational Learning Styles, CANO standards for practice and the CNA exam competencies. This approach enabled 107 oncology nurses across the province in 17 different sites to connect, as a group, study interactively and fully engage in their learning. A detailed evaluation method was utilized to assess baseline knowledge, learning needs, cooperative group process, exam success rates, and document unexpected outcomes. Ninety-four per cent of participants passed the CNA Oncology Exam. Lessons learned and future implications are discussed. The commitment remains to enable thriving through generating new possibilities, building communities of practice, mentoring nurses and fostering excellence in oncology practice.

  1. The primary healthcare nurse practitioner role in Canada.

    PubMed

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

    2010-12-01

    Primary healthcare nurse practitioners (PHCNPs), also known as family or all-ages nurse practitioners, are the fastest growing advanced practice nursing role in Canada. All 10 provinces and three territories now have legislation that authorizes their role. Their introduction is linked to countrywide health reform efforts to improve the accessibility and quality of primary healthcare.

  2. [Development trends and future challenges in community nurse practitioner].

    PubMed

    Chen, Ching-Min

    2012-04-01

    Community health nursing is an innovative aspect of healthcare that has grown in response to changing environmental and social structure changes into a worldwide movement. Taiwan's fast growing elderly population, improving health technologies and rising healthcare costs impact significantly upon the development and definition of the scope of practice for community health nurse nurses. This paper explores the innovative community care model development experiences of several countries and reviews the scope of practice of community health nurse practitioners in each. We further explore the current situation of nurse practitioners in Taiwan and suggest a future path for Taiwan community health nurse practitioners development and policymaking.

  3. The journey to independent nurse practitioner practice.

    PubMed

    Rigolosi, Rebecca; Salmond, Susan

    2014-12-01

    The aim is to achieve a comprehensive understanding of the journey of states that achieved independent nurse practitioner (NP) practice from 2007 to 2011. Qualitative, retrospective, descriptive study with interviews of NP state leaders in those states as well as literature review. There are key strategies that should be utilized by states when attempting to pass independent NP practice legislation. Strategies that have been tried and tested by states that have successfully passed legislation are collated and presented. Data from key national movements and legislation with release of the 2010 Institute of Medicine Report The Future of Nursing and the passage of the Patient Protection and Affordable Care Act add weight and supportive context to the independent NP legislative process, and were used in addition to and as groundwork for arguments and evidence of a national trend toward increasing access to primary care services and decreasing barriers to practice. Kingdon's model illustrates these research findings and suggests the open window for policy change is now. ©2014 American Association of Nurse Practitioners.

  4. Genetics and Genomics in Oncology Nursing: What Does Every Nurse Need to Know?

    PubMed

    Eggert, Julie

    2017-03-01

    In addition to the need for basic education about genetics/genomics, other approaches are suggested to include awareness campaigns, continuing education courses, policy review, and onsite clinical development. These alternative learning strategies encourage oncology nurses across the continuum of care, from the bedside/seatside to oncology nurse research, to integrate genomics into all levels of practice and research in the specialty of oncology nursing. All nurses are warriors in the fight against cancer. The goal of this article is to identify genomic information that oncology nurses, at all levels of care, need to know and use as tools in the war against cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Preceptorship and the Nurse Practitioner Student: Navigating the Liminal Space.

    PubMed

    Billay, Diane; Myrick, Florence; Yonge, Olive

    2015-08-01

    The purpose of this study was to explore the process occurring in preceptorship to prepare nurse practitioner students for their future role in professional practice. The researchers examined this process through the eyes of the preceptors, nurse practitioner students, and faculty. A grounded theory method was used to explore the process involved in preceptorship to prepare nurse practitioner students in the clinical setting. The process of navigating the liminal space emerged from the data to explain what actually was occurring throughout the nurse practitioner student preceptorship. This process was reflected on three levels: (a) positioning in preceptorship, (b) repositioning on the threshold of nurse practitioner, and (c) embracing the new nurse practitioner role. As the data emerged, the researchers uncovered a multidimensional process that was occurring in preceptorship. This process was identified as navigating the liminal space. Copyright 2015, SLACK Incorporated.

  6. Compassion Fatigue: Exploring Early-Career Oncology Nurses' Experiences
.

    PubMed

    Finley, Brooke A; Sheppard, Kate G

    2017-06-01

    Oncology nurses have a higher risk and rate of compassion fatigue (CF) compared to professionals in other specialties. CF exhibits tangible negative outcomes, affecting nurses' health and professional practice.
. Early-career oncology nurses' unique CF experiences lack thorough scientific exploration. This secondary analysis seeks to qualitatively augment this paucity and illuminate targeted interventions.
. Open-ended interviews were conducted with five early-career inpatient oncology nurses. Subsequent transcripts were explored for CF themes secondarily using thematic analysis.
. Themes indicate that early-career oncology nurses enjoy connecting with patients and families, but over-relating, long patient stays, and high patient mortality rates trigger CF. Symptoms include internalizing patients' and families' pains and fears, being haunted by specific patient deaths, feeling emotionally depleted, assuming that all patients will die, and experiencing burnout, physical exhaustion, and hypervigilance protecting loved ones.

  7. The attitudes of GPs towards the nurse-practitioner role.

    PubMed

    Carr, J; Bethea, J; Hancock, B

    2001-09-01

    In recent years, nursing and health-care policy have promoted the advanced role of the nurse -- that of nurse practitioner. But such a role has not been integrated widely into the primary health-care team. This study investigates the knowledge and attitudes of GPs who do not employ nurse practitioners to find out what prevents them doing so. Ten GPs who did not already employ a nurse practitioner took part in semi-structured interviews. Our findings show that GPs, although confused about the role, were generally supportive of advanced nursing practice. Skills identified with the role were prescribing, disease diagnosis and minor-illness management. GPs thought that protocols and guidelines should govern practice, which differs fundamentally from the Royal College of Nursing definition. None of the GPs had encountered the role in primary care, and the lack of professional regulation and role definition for practice nurses and nurse practitioners who work in primary care may have affected GPs' perceptions.

  8. Anabolic steroids: implications for the nurse practitioner.

    PubMed

    Duncan, D J; Shaw, E B

    1985-12-01

    Anabolic steroids are being used by athletes in a wide variety of sports in efforts to enhance their athletic performances. Steroid abuse is complex to evaluate due to the highly emotional subject matter and the limitations in researching anabolic steroids. This article has been written to heighten the practitioner's awareness of the problem of "sports doping" with anabolic steroids. It will provide practical information on possible consequences of steroid use and outline essential information to obtain through the history, physical exam and laboratory studies. Intervention strategies based on the three levels of prevention are described. With awareness of the problem of sports doping and knowledge of how to deal with it in primary care, the nurse practitioner can enhance the health care provided to aspiring athletes, athletes and retired athletes.

  9. 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

  10. The role of the nurse practitioner in congenital heart surgery.

    PubMed

    O'Brien, Patricia

    2007-01-01

    Pediatric nurse practitioners are often members of the interdisciplinary team caring for children with congenital heart disease. The collaborative practice model, in which a physician-led team of physicians, nurse practitioners, and other clinicians work together to provide comprehensive, quality patient care, has had positive benefits for patients and their families, physicians, and nurses. The acute care pediatric nurse practitioner combines advanced training in assessment, diagnosis, and management of common pediatric health problems with advanced nursing expertise in patient education, counseling, and health promotion to meet the specialized needs of children with complex acute and chronic illnesses. This article focuses on the development and current practice of pediatric nurse practitioners in acute care settings and concludes with a discussion of the role of nurse practitioners on the postoperative cardiac surgery service at Children's Hospital, Boston.

  11. 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.

  12. Nurse practitioner services: content and relative work value.

    PubMed

    Sullivan-Marx, E M; Happ, M B; Bradley, K J; Maislin, G

    2000-01-01

    The resource-based relative value scale is used to quantify work for reimbursement of services in the Medicare Fee Schedule. This pilot study explored use of the resource-based relative value scale for services provided by nurse practitioners. Estimation of relative work values for office visits by nurse practitioners was consistent with the Medicare Fee Schedule. Content analysis revealed that nurse practitioners provide additional services including comprehensive patient evaluation and education and attendance to social factors. Future research is needed to examine systems that identify and reimburse nurse practitioners for their services.

  13. Pediatric Nurse Practitioners in a School-Based CHDP Program.

    ERIC Educational Resources Information Center

    Dungy, Claibourne I.; And Others

    1980-01-01

    The California Child Health Disability Prevention (CHDP) program provides direct patient care by pediatric nurse practitioners in a school setting. Guidelines for instituting similar programs are provided. (JMF)

  14. Establishment of the Asia Oncology Nursing Society (AONS)

    PubMed Central

    Onishi, Kazuko

    2014-01-01

    Over the past several years, whenever an informal group of Asian oncology nurses gathered, they talked about their mutual desire to create an organization closer to their homes that would be similar to the European Oncology Nursing Society (EONS). They saw this as a means for more of their colleagues to learn about the latest in cancer nursing and to have a time and place to network among themselves. This message continued to gain strength whenever these nurses met at other international meetings such as the International Conference on Cancer Nursing (ICCN), the Multinational Association of Supportive Care in Cancer (MASCC) and the Oncology Nursing Society in US. A definite and planned step toward forming an Asian organization as the first meeting was taken on June 24 2011 when several Asian nurses were attending a MASCC meeting in Greece. The second meeting was held in Prague, Czech Republic, in conjunction with the 17th ICCN meeting on September 10 2012, where the participants of the meeting included 21 oncology nurses from Asian countries. Finally, the first official meeting of the board directors from nine countries was held on November 21 2013 in Bangkok, Thailand. Now, and in the future, sharing and collaborating in the practice, education and research for oncology nursing in Asia is needed. PMID:27981075

  15. Mary Grant Seacole: the first nurse practitioner.

    PubMed

    Messmer, P R; Parchment, Y

    1998-01-01

    Mary Grant Seacole was born in 1805, in Kingston, Jamaica, to a Jamaican doctress (medicine woman) and a Scottish naval officer. Later Seacole became a doctress, nursing British soldiers during epidemics of cholera, dysentery, and yellow fever in Jamaica, Cuba, and Panama. After refusals by both the British government and Florence Nightingale to be allowed to practice in Scutari, she financed her own way to the scene of the Crimean War and then established the British Hotel to serve both the comfort and medical needs of the wounded soldiers. At night, Seacole worked side by side with Nightingale at Scutari as a volunteer nurse. Seacole's fame grew proportionately after she was seen helping wounded soldiers on the battlefields even while the battles were still raging. Seacole died on May 14, 1881, in London. One hundred years later, many members of the London black community, a few members of the Nurses Association of Jamaica and the Friends of Mary Seacole marched to her grave, honoring her as one of the greatest women of all times. Mary Grant Seacole rose above the barriers of racial prejudice and demonstrated the determinism, compassion, and caring that have became the hallmark of nurse practitioners.

  16. 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)

  17. Nurse practitioner faculty research: Results from the 2012 National Organization of Nurse Practitioner Faculties Survey.

    PubMed

    Buchholz, Susan Weber; Bloch, Joan Rosen; Westrin, David; Fogg, Louis

    2015-12-01

    To better understand the research capacity and productivity of nurse practitioner (NP) faculty, a study was conducted to describe the types of research that have been and are being completed by National Organization of Nurse Practitioner Faculties (NONPF) members. A web-based survey was developed with input from members of the NONPF Research Special Interest Group and the NONPF Board. This 23-question survey included demographic, academic degree, NP population focus, and research-related questions. Three e-mails were sent to NONPF members over a 10-week period of time (late December 2012 to early February 2013). Respondents (N = 344) in the sample were Advanced Practice Registered Nurses with either a Masters, Doctor of Nursing Practice, DNS or PhD as their highest academic degree. Study results demonstrated that current NP faculty research includes a wide breadth of clinical areas studied, types of methodologies used, variety of funding mechanisms, and successful publication records. Because NP faculty conduct a wide array of research on clinically relevant topics, and demonstrate successful funding and publication track records, they are poised to continue to be leaders in healthcare research. ©2015 American Association of Nurse Practitioners.

  18. Quality measures for nurse practitioner practice evaluation.

    PubMed

    Kleinpell, Ruth; Kapu, April N

    2017-08-01

    Evaluating the impact of nurse practitioner (NP) practice has become a priority area of focus for demonstrating outcomes. A number of quality measures are available to enable practice-specific evaluation of NP roles and initiatives. This article reviews sources of quality measures that can be used to facilitate quantifying the outcomes of NP practice as part of an overall evaluation agenda. National resources and published literature on NP quality measures were reviewed. Various resources and toolkits exist to assist NPs in identifying outcomes of practice using quality measures. The need to demonstrate outcomes of NP practice remains an ongoing priority area regardless of the clinical practice setting. A variety of sources of quality measures exist that can be used to showcase the effect of NP care. The use of quality measures can be effectively integrated into evaluation of NP role and NP-directed initiatives to demonstrate impact, and enhance the conduct of an NP outcomes assessment. The use of organizational, NP-specific, and national-related quality measures can help to showcase how NP care improves the quality, safety, and costs of health care. ©2017 American Association of Nurse Practitioners.

  19. Oncology clinical trials nursing: developing competencies for the novice.

    PubMed

    Lubejko, Barbara; Good, Marjorie; Weiss, Patricia; Schmieder, Linda; Leos, David; Daugherty, Penny

    2011-12-01

    Oncology clinical trials are important in the improvement of outcomes for people with or at risk for cancer. Because of the complexity of oncology clinical trials and the needs of patients with cancer, nurses play a crucial and unique role in the trial setting. However, great variability exists in how the role of the nurse on a research team is defined and implemented. An Oncology Nursing Society project team set out to identify the core competencies required of a novice oncology clinical trials nurse (CTN) across diverse settings. This article describes the process used to develop core competencies for the novice CTN, presents the final core competencies, and offers examples of how those competencies might be used in practice.

  20. 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.

  1. Clinical productivity of primary care nurse practitioners in ambulatory settings.

    PubMed

    Xue, Ying; Tuttle, Jane

    Nurse practitioners are increasingly being integrated into primary care delivery to help meet the growing demand for primary care. It is therefore important to understand nurse practitioners' productivity in primary care practice. We examined nurse practitioners' clinical productivity in regard to number of patients seen per week, whether they had a patient panel, and patient panel size. We further investigated practice characteristics associated with their clinical productivity. We conducted cross-sectional analysis of the 2012 National Sample Survey of Nurse Practitioners. The sample included full-time primary care nurse practitioners in ambulatory settings. Multivariable survey regression analyses were performed to examine the relationship between practice characteristics and nurse practitioners' clinical productivity. Primary care nurse practitioners in ambulatory settings saw an average of 80 patients per week (95% confidence interval [CI]: 79-82), and 64% of them had their own patient panel. The average patient panel size was 567 (95% CI: 522-612). Nurse practitioners who had their own patient panel spent a similar percent of time on patient care and documentation as those who did not. However, those with a patient panel were more likely to provide a range of clinical services to most patients. Nurse practitioners' clinical productivity was associated with several modifiable practice characteristics such as practice autonomy and billing and payment policies. The estimated number of patients seen in a typical week by nurse practitioners is comparable to that by primary care physicians reported in the literature. However, they had a significantly smaller patient panel. Nurse practitioners' clinical productivity can be further improved. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Results of an Oncology Clinical Trial Nurse Role Delineation Study.

    PubMed

    Purdom, Michelle A; Petersen, Sandra; Haas, Barbara K

    2017-09-01

    To evaluate the relevance of a five-dimensional model of clinical trial nursing practice in an oncology clinical trial nurse population. 
. Web-based cross-sectional survey.
. Online via Qualtrics.
. 167 oncology nurses throughout the United States, including 41 study coordinators, 35 direct care providers, and 91 dual-role nurses who provide direct patient care and trial coordination.
. Principal components analysis was used to determine the dimensions of oncology clinical trial nursing practice.
. Self-reported frequency of 59 activities.
. The results did not support the original five-dimensional model of nursing care but revealed a more multidimensional model.
. An analysis of frequency data revealed an eight-dimensional model of oncology research nursing, including care, manage study, expert, lead, prepare, data, advance science, and ethics.
. This evidence-based model expands understanding of the multidimensional roles of oncology nurses caring for patients with cancer enrolled in clinical trials.

  3. Effects of a sexual health care nursing record on the attitudes and practice of oncology nurses.

    PubMed

    Jung, Dukyoo; Kim, Jung-Hee

    2016-10-01

    A nursing record focused on sexual health care for patients with cancer could encourage oncology nurses to provide sexual health care for oncology patients in a simple and effective manner. However, existing electronic information systems focus on professional use and not sexual health care, which could lead to inefficiencies in clinical practice. To examine the effects of a sexual health care nursing record on the attitudes and practice of oncology nurses. Twenty-four full-time registered nurses caring for oncology patients were randomly assigned to the intervention and control groups in Korea. The researchers developed a sexual health care record and applied it to the intervention group for one month. Data were analyzed by Mann-Whitney U test and chi-square test. Content analysis was used to analyze interviews. Oncology nurses using the sexual health care record had significantly higher levels of sexual health care practice at 4 weeks post-intervention as compared to those who provided usual care to patients with cancer. A sexual health care record may have the potential to facilitate oncology nurses' practice of sexual health care. This study highlighted the importance of using SHC records with oncology patients to improve nursing practice related to sexuality issues. A nursing record focused on SHC for patients with cancer could make it easier and more effective for oncology nurses to provide such care to their patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Mentoring Nurse Practitioners in a Hospital Setting.

    PubMed

    Pop, Rodica S

    2016-06-15

    Nursing philosophy is the foundation of nurse practitioner (NP) training. However, NP practice is based on the medical care model. Thus, the necessity of mediating between these two approaches is often problematic for new NPs who are transitioning into their new roles. Mentoring has been used successfully to facilitate role transition and role understanding for nurses, NPs, and physicians. However, mentoring has been rarely studied in NPs. The purpose of this study was to develop a theory of mentoring for new NPs in a hospital setting. Grounded theory methodology was used. The sampling approach was initially purposive and was then shifted to theoretical to ensure the collection of meaningful data. Semistructuredinterviews were recorded and transcribed into Word documents for analysis. The three-phase analysis developed by Corbin and Strauss was initiated after the second interview. Sixteen participants (eight mentors and eight mentees) were interviewed between February and June 2011. The core category that emerged from the data was "defining self," and the main categories were forming the relationship, developing the relationship, and mentoring outcomes. A well-designed formal mentoring program may greatly improve the transition of NPs into a new role. The theory generated by the data from these study participants provides clearly defined categories that may be operationally defined and utilized to develop evaluation tools for mentoring programs.

  5. Mentoring Nurse Practitioners in a Hospital Setting.

    PubMed

    Pop, Rodica S

    2017-08-01

    Nursing philosophy is the foundation of nurse practitioner (NP) training. However, NP practice is based on the medical care model. Thus, the necessity of mediating between these two approaches is often problematic for new NPs who are transitioning into their new roles. Mentoring has been used successfully to facilitate role transition and role understanding for nurses, NPs, and physicians. However, mentoring has been rarely studied in NPs. The purpose of this study was to develop a theory of mentoring for new NPs in a hospital setting. Grounded theory methodology was used. The sampling approach was initially purposive and was then shifted to theoretical to ensure the collection of meaningful data. Semistructuredinterviews were recorded and transcribed into Word documents for analysis. The three-phase analysis developed by Corbin and Strauss was initiated after the second interview. Sixteen participants (eight mentors and eight mentees) were interviewed between February and June 2011. The core category that emerged from the data was "defining self," and the main categories were forming the relationship, developing the relationship, and mentoring outcomes. A well-designed formal mentoring program may greatly improve the transition of NPs into a new role. The theory generated by the data from these study participants provides clearly defined categories that may be operationally defined and utilized to develop evaluation tools for mentoring programs.

  6. 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.

  7. 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

  8. 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…

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

    ERIC Educational Resources Information Center

    Dostal, Lori

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

  10. A Cooperative Education Program for Nurse Practitioners/Physician's Assistants.

    ERIC Educational Resources Information Center

    Fowkes, Virginia; And Others

    1979-01-01

    Traditionally, nurse practitioners and physician's assistants have been trained separately. In l977, the Family Nurse Practitioner Program at the University of California, Davis, and the Primary Care Associate Program at Stanford University merged clinical curricula. The cooperative program is described and its first year evaluated. (Author/JMD)

  11. Competence and Commitment: The Making of a Nurse Practitioner.

    ERIC Educational Resources Information Center

    White, Martha Sturm; Highley, Betty L.

    Data were gathered on 134 maternity and pediatric nurse practitioners to determine what types of work experience, educational backgrounds, and personality traits were most conducive to successful orientation and commitment to the nurse practitioner role. The study population, comprising six separate groups trained in six-month continuing education…

  12. Oncology nurses' attitudes toward prognosis-related communication: a pilot mailed survey of oncology nursing society members.

    PubMed

    Helft, Paul R; Chamness, Amy; Terry, Colin; Uhrich, Margaret

    2011-07-01

    To assess oncology nurses' attitudes toward prognosis-related communication and experiences of the quality of such communication among physicians. Cross-sectional study. Nationwide survey in the United States. 394 Oncology Nursing Society members who completed surveys. Pilot mailed survey. Demographic variables, measures of attitudes toward and experiences of prognosis-related communication. Nurses had mixed views of prognosis-related communication and identified common barriers to their own more effective participation in prognosis-related communication. Nurses with more experience and those who worked in inpatient settings were more likely to be present for physicians' prognosis-related communication with patients. Respondents identified uncertainties regarding the scope of oncology nurses' role in prognosis-related communication. Respondents also identified opportunities for improved interdisciplinary communication, most importantly the inclusion of oncology nurses in prognosis-related communication. Opportunities for oncology nurses to bridge some gaps in prognosis-related communication likely exist, although barriers surrounding nurses' role, education, and communication within the context of the larger healthcare team need to be clarified if potential solutions are to be developed.

  13. Impact of nurse practitioners on workload of general practitioners: randomised controlled trial

    PubMed Central

    Laurant, Miranda G H; Hermens, Rosella P M G; Braspenning, Jozé C C; Sibbald, Bonnie; Grol, Richard P T M

    2004-01-01

    Objective To examine the impact on general practitioners' workload of adding nurse practitioners to the general practice team. Design Randomised controlled trial with measurements before and after the introduction of nurse practitioners. Setting 34 general practices in a southern region of the Netherlands. Participants 48 general practitioners. Intervention Five nurses were randomly allocated to general practitioners to undertake specific elements of care according to agreed guidelines. The control group received no nurse. Main outcome measures Objective workload, derived from 28 day diaries, included the number of contacts per day for each of three conditions (chronic obstructive pulmonary disease or asthma, dementia, cancer), by type of consultation (in practice, telephone, home visit), and by time of day (surgery hours, out of hours). Subjective workload was measured by using a validated questionnaire. Outcomes were measured six months before and 18 months after the intervention. Results The number of contacts during surgery hours increased in the intervention group compared with the control group (P < 0.06), particularly for patients with chronic obstructive pulmonary disease or asthma (P < 0.01). The number of consultations out of hours declined slightly in the intervention group compared with the control group, but this difference did not reach significance. No significant changes became apparent in subjective workload. Conclusion Adding nurse practitioners to general practice teams did not reduce the workload of general practitioners, at least in the short term. This implies that nurse practitioners are used as supplements, rather than substitutes, for care given by general practitioners. PMID:15069024

  14. Occupational health nurse practitioners' roles in workers' compensation.

    PubMed

    Foster, Donna

    2008-05-01

    The occupational health nurse practitioner is an integral part of coordinating care for the injured or ill worker. Decisions regarding whether an injury or illness is related to work are based on the practitioner's diagnosis and reports of the worker's progress. Understanding workers' compensation laws will enable the practitioner to provide efficient care for the worker.

  15. Primary care nurse practitioner clinical education: challenges and opportunities.

    PubMed

    Sroczynski, Maureen; Dunphy, Lynne M

    2012-12-01

    The Institute of Medicine report and the passage of the Patient Protection and Affordable Care Act present significant opportunities for the nursing profession. As the largest group of primary care providers, nurse practitioners are the critical element in the provision of comprehensive primary care, and a critical element to the success of the redesigned health care system. Nurse practitioners can bridge the gap between coverage and access and provide the patient-centered innovative approaches needed. There are, however, significant barriers that need to be addressed. This article presents a framework for creating innovative approaches to the redesign of nurse practitioner clinical education. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. 42 CFR 405.2415 - Services and supplies incident to nurse practitioner, physician assistant, certified nurse...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Services and supplies incident to nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker... nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or...

  17. Role of advanced paediatric nurse practitioners.

    PubMed

    Lisa, Egerton

    2012-07-01

    Children's attendance at emergency departments (EDs) is increasing every year, yet many children present with minor, self-limiting illnesses that could be managed at home. In light of Williams et al (2009) suggestion that healthcare professionals should improve the care available to patients at point of contact rather than try to change their health-seeking behaviours, this article describes how Tameside and Glossop Primary Care Trust has developed an advanced paediatric nurse practitioner (APNP) service in the ED to improve the care of children, and to reduce the number of admissions. The APNPs treat children in the ED then divert them to more appropriate services where support is given to the families to care for their children at home. The role contributes to meeting ED clinical quality indicators, frees up medical staff to deal with more seriously ill patients, and makes financial savings for the trust.

  18. Physician Assistant and Nurse Practitioner Malpractice Trends.

    PubMed

    Brock, Douglas M; Nicholson, Jeffrey G; Hooker, Roderick S

    2016-07-25

    Trends in malpractice awards and adverse actions (e.g., revocation of provider license) following an act or omission constituting medical error or negligence were examined. The National Practitioner Data Bank was used to compare rates of malpractice reports and adverse actions for physicians, physician assistants (PAs), and nurse practitioners (NPs). During 2005 through 2014, there ranged from 11.2 to 19.0 malpractice payment reports per 1,000 physicians, 1.4 to 2.4 per 1,000 PAs, and 1.1 to 1.4 per 1,000 NPs. Physician median payments ranged from 1.3 to 2.3 times higher than PAs or NPs. Diagnosis-related malpractice allegations varied by provider type, with physicians having significantly fewer reports (31.9%) than PAs (52.8%) or NPs (40.6%) over the observation period. Trends in malpractice payment reports may reflect policy enactments to decrease liability. © The Author(s) 2016.

  19. Reflections on independence in nurse practitioner practice.

    PubMed

    Weiland, Sandra A

    2008-07-01

    To examine factors that influence the ability of nurse practitioners (NPs) to practice as independent primary care providers. Extensive literature search on CINAHL, OVID, MEDLINE, Internet journal sources, and professional association Web sites. The legal authority for NPs to practice independently is recognized; however, the ability to put that authority into practice is undermined by the historical failure of political, professional, and social entities to recognize NPs as providers capable of providing primary care autonomously. Nonrecognition is responsible for complex reimbursement policies (both federal and state) that economically and professionally restrain the NP role; hence, NPs remain in a financially dependent relationship despite 40 years of proven safe practice. NPs must articulate their independence as practitioners more vociferously in order to meet society's healthcare requirements, as well as to attain professional fulfillment and forge collegial relationships. NPs will never be seen as members of a profession by either themselves or others without the practicality of independence and autonomy. Although legal independence is a fact, real practice independence in the pragmatic sense is contingent upon reimbursement. Without fiscal sustainability, practice independence is an impossibility. And, without professional autonomy, NPs will have only an employee's voice in the dynamic healthcare system in which they are really key players in providing healthcare services to the poor and undeserved populations.

  20. Interventions to manage compassion fatigue in oncology nursing.

    PubMed

    Aycock, Nancy; Boyle, Deborah

    2009-04-01

    Work-related stress emanating from close interpersonal contact with patients with cancer and their families may result in physical, emotional, social, and spiritual adversity for oncology nurses. The negative result of this cumulative distress has historically been referred to as burnout. However, this dated term does not truly depict the result of the longitudinal workplace ramifications of sadness and despair on nursing staff. This article proposes that the phrase compassion fatigue replace the outdated notion of burnout in describing this phenomenon. Although not clearly and uniformly described in the literature, this occurrence is seen regularly in clinical practice and is conceptually known by nurses. Limited information is available about interventions to manage compassion fatigue; therefore, a national survey was conducted to identify resources available to oncology nurses to counter this phenomenon. Participants provided information about the availability of interventions in three major categories: on-site professional resources, educational programs, and specialized retreats. The availability of resources ranged from 0%-60%. Survey findings, along with narrative comments by respondents, provide relevant information for oncology nurses and their employers. By recognizing the perils of inattention to this frequent nursing phenomenon and the scope of existing workplace options that may augment nurse coping, oncology nurses' recognition and management of this entity may be enhanced. Organizations also may be encouraged to periodically inventory their support and lobby for workplace interventions to manage this critical work-related issue.

  1. Continuing Education Needs of the Office Oncology Nurse.

    ERIC Educational Resources Information Center

    Rogers, Miriam P.

    1999-01-01

    A study determined the learning needs of office oncology nurses (n=290)as a critical first step in planning education programs. Participants ranked cancer-care topics similarly, regardless of age, background, or experience. The highest-ranked needs were clustered in the areas of cancer nursing practice, major cancers, and cancer treatment.…

  2. Continuing Education Needs of the Office Oncology Nurse.

    ERIC Educational Resources Information Center

    Rogers, Miriam P.

    1999-01-01

    A study determined the learning needs of office oncology nurses (n=290)as a critical first step in planning education programs. Participants ranked cancer-care topics similarly, regardless of age, background, or experience. The highest-ranked needs were clustered in the areas of cancer nursing practice, major cancers, and cancer treatment.…

  3. Rural nurse to nurse practitioner: an ad hoc process.

    PubMed

    Carryer, Jenny; Boddy, Julie; Budge, Claire

    2011-03-01

    Despite a 10-year history of nurse practitioner (NP) development in New Zealand (NZ) there is no formalised or universal process for ensuring the transition of willing nurses to NP status. This unmet need is of particular interest in the rural context where workforce issues are paramount. The aim of this study was to explore the transition from rural nurse to NP in NZ. A qualitative descriptive survey was sent to all NZ nurses with a rural address. Ninety-two questionnaires were returned, of which 21 respondents were working in a rural location and aiming to become an NP. Data analysis included description of demographic data and thematic analysis of open-ended question responses. Four themes encompassed the experiences of the 21 potential NP candidates: uncertainty about opportunities for employment as an NP and legislative and funding barriers for NP practice; support or resistance from GPs and nurse colleagues, self-doubt, and the importance of mentoring; difficulties with the NP authorisation process; and meeting the NP competencies within the challenges imposed by rural location. At the systems level of workforce design, stronger linkages between policy development, investment, employment creation, funding streams, professional regulation and overall communication require attention.

  4. 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.

  5. Using Simulation to Improve Communication Skills in Nurse Practitioner Preceptors.

    PubMed

    Murray, Linda Aveni; Buckley, Kathleen

    Role transitions in nursing may lead to stress and anxiety or the novice, which can be decreased with appropriate mentoring by preceptors. However, preceptors commonly describe having a lack of mentoring skills. This project focused on nurse practitioner preceptors and their gap in mentoring communication skills when handling difficult communications with novice nurse practitioners. The use of a simulation as a means for learning communication skills was evaluated for its effect on increasing preceptor skill level in mentoring.

  6. Moral distress in nurses in oncology and haematology units.

    PubMed

    Lazzarin, Michela; Biondi, Andrea; Di Mauro, Stefania

    2012-03-01

    One of the difficulties nurses experience in clinical practice in relation to ethical issues in connection with young oncology patients is moral distress. In this descriptive correlational study, the Moral Distress Scale-Paediatric Version (MDS-PV) was translated from the original language and tested on a conventional sample of nurses working in paediatric oncology and haematology wards, in six north paediatric hospitals of Italy. 13.7% of the total respondents claimed that they had changed unit or hospital due to moral distress. The items with the highest mean intensity in the sample were almost all connected with medical and nursing competence and have considerably higher values than frequency. The instrument was found to be reliable. The results confirmed the validity of the MDS-PV (Cronbach's alpha = 0.959). This study represents the first small-scale attempt to validate MDS-PV for use in paediatric oncology-haematology nurses in Italy.

  7. Stressing factors and coping strategies used by oncology nurses.

    PubMed

    Rodrigues, Andrea Bezerra; Chaves, Eliane Corrêa

    2008-01-01

    In the oncology specialty, many factors can result in occupational stress in nursing professionals. As an attempt to controlling this situation, individuals may use coping strategies. Coping is a cognitive and behavioral effort one uses to face a stressful situation. The aims of this study were to identify the stressful factors regarding oncology nurses, and to verify what coping strategies they use. Two questionnaires were used: a demographic data inventory, designed by the researcher, and the Folkman and Lazarus coping strategies inventory. The results showed that the main stressful factors for oncology nurses are patient death (28.6%), emergency situations (16.9%), relationship issues with the nursing team (15.5%), and work-process situations (15.5%). In the studied population, the main coping strategy used was positive reappraisal.

  8. 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.

  9. 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...

  10. 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...

  11. 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...

  12. Factors influencing job satisfaction of oncology nurses over time.

    PubMed

    Cummings, Greta; Olson, Karin; Raymond-Seniuk, Christy; Lo, Eliza; Masaoud, Elmabrok; Bakker, Debra; Fitch, Margaret; Green, Esther; Butler, Lorna; Conlon, Michael

    2013-01-01

    In this study, we tested a structural equation model to examine work environment factors related to changes in job satisfaction of oncology nurses between 2004 and 2006. Relational leadership and good physician/nurse relationships consistently influenced perceptions of enough RNs to provide quality care, and freedom to make patient care decisions, which, in turn, directly influenced nurses' job satisfaction over time. Supervisor support in resolving conflict and the ability to influence patient care outcomes were significant influences on job satisfaction in 2004, whereas, in 2006, a clear philosophy of nursing had a greater significant influence. Several factors that influence job satisfaction of oncology nurses in Canada have changed over time, which may reflect changes in work environments and work life. These findings suggest opportunities to modify work conditions that could improve nurses' job satisfaction and work life.

  13. Experiences of pediatric oncology nurses: the first year of hire.

    PubMed

    Linder, Lauri

    2009-01-01

    As the number of specialty pediatric oncology units increases, many units are hiring increasing numbers of newly graduated registered nurses. Intense specialty training and an emotionally demanding work environment place new nurses at risk for job frustration and early job resignation. The purpose of this study is to investigate experiences of pediatric oncology nurses during their first year of hire using a phenomenological approach. Participants were 6 nurses employed on an inpatient pediatric oncology unit in a tertiary care center located in the Intermountain West. A purposive sampling approach was used. Data were collected via semistructured interviews, which were analyzed for specific statements and themes providing description and meaning to nurses' experiences. Eleven themes in the categories of professional role development, a unique practice, and personal reflection were identified. Practice implications include supporting new nurses beyond the acquisition of skills and knowledge and including opportunities for personal reflection as part of the orientation experience. Successful role development is essential to ensure the retention of new pediatric oncology nurses as well as their future achievements within the subspecialty.

  14. Oncology nurses and indoor tanning: stylish or risky behavior?

    PubMed

    Leong, Christina Marie; Palos, Guadalupe R

    2014-06-01

    Being tan has become a social norm, and some nurses engage in that widely accepted lifestyle. Mounting evidence of the increased risk to melanoma and nonmelanoma skin cancers associated with indoor tanning supports the need for nurses to integrate skin cancer education, counseling, and referrals into routine practice. The current article presents an overview of the risks associated with indoor tanning, discusses its acceptance as a social norm, and offers strategies to support oncology nurses in changing the widespread trend.

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

    PubMed Central

    Cunningham, Patricia D.

    1999-01-01

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

  16. Nurse practitioner-led surgical spine consultation clinic.

    PubMed

    Sarro, Angela; Rampersaud, Yoga Raja; Lewis, Stephen

    2010-12-01

    This study is a report of a study of patient satisfaction with non-surgical nurse practitioner management of pre-selected spinal referrals. Nurse practitioners are linked to particular patient populations or specific physicians in a medical setting. In a universal healthcare delivery system, patients are often faced with long and anxiety-provoking waiting times, particularly for sub-specialized consultations such as spinal surgery. A nurse practitioner-led spine consultation ambulatory clinic was implemented at a Canadian neuroscience centre. A prospective patient satisfaction and clinical accuracy study was performed in 2008. All patients assessed by the nurse practitioner completed a post-consultation validated patient satisfaction questionnaire. All patients were reviewed with the surgeon for confirmation of diagnosis and management. A total of 177 pre-selected patients (disc-herniations, spinal stenosis, degenerative disc disease) were assessed by the nurse practitioner. Mean time from referral to nurse practitioner clinic assessment was 12 weeks (range: 9·8-21 weeks) compared with 10-52 weeks if seen in a conventional clinic. Nurse practitioner clinical diagnosis and management plan were in agreement with those of the surgeon (100% and 95% respectively). Patient satisfaction was 97% with the consultation and 94% and with examination thoroughness. Preference for a longer waiting period for direct consultation with the surgeon was 26%. Nurse practitioners can play an effective and efficient role in providing care to patients requiring specific disease management in a specialty setting. The nurse practitioner-run clinic offers accurate and earlier assessment, thus facilitating a timelier diagnosis and management plan. © 2010 Blackwell Publishing Ltd.

  17. The Role of the Advanced Practice Nurse in Geriatric Oncology Care.

    PubMed

    Morgan, Brianna; Tarbi, Elise

    2016-02-01

    To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Comparison of the work of a nurse practitioner with that of a general practitioner

    PubMed Central

    Salisbury, Christopher J.; Tettersell, Monica J.

    1988-01-01

    The work of a nurse practitioner was compared with that of a general practitioner. Both were equally available to the same patient population over the same period. The nurse practitioner saw a similar age and sex distribution of patients to the doctor but saw different types of problems. More of the patients she saw were for followup of chronic diseases, health advice and screening measures while fewer were acutely ill. The doctor dealt with four times as many patients. The nurse practitioner managed 78% of her consultations without referral to a doctor, and 89% without resorting to prescribed drugs. There was a high level of patient satisfaction with her work and 97% of the patients who saw the nurse would choose to consult her again. The role of the nurse practitioner in our practice has developed differently from a similar post in another setting, thus emphasizing the need for flexibility when defining the role. Nurse practitioners are a valuable extra resource for the development of new areas of care, rather than a cheaper substitute for a general practitioner. PMID:3255828

  19. Ambulatory care centers: a unique opportunity for nurse practitioners.

    PubMed

    Henne, S J; Warner, N E; Frank, K J

    1988-10-01

    Nurse practitioners continue to struggle to find avenues for professional fulfillment. Urgent care or ambulatory care centers (ACCs) may, because of their need to respond to consumer demands for more comprehensive services, offer nurse practitioners a unique opportunity to establish productive primary care practices based on the concepts of total patient care. A model for such a practice has operated successfully since 1983, establishing that both professional and business success can result from the collaborative efforts of nurse practitioners and physicians in an ACC setting.

  20. Defining the unique role of the specialist district nurse practitioner.

    PubMed

    Barrett, Anne; Latham, Dinah; Levermore, Joy

    2007-10-01

    Due to the reorganization of primary care trusts across the country, certain trusts proposed a reduction in the specialist district nurse practitioner numbers in favour of less qualified community nurses and health care assistants. Such proposals in one PCT were blocked, partly in response to documentation compiled by practitioners at the sharp end of nursing practice. With the new agenda of practice based commissioning, it is imperative that commissioners and management alike are aware of the scope of specialist district nurse practitioners. This is the first of a series of articles looking at specific case histories where the role of the district nurse is highlighted. It is the intention to stress the importance of the clinical expertise and confidence required by the district nurse to care for patients with complex needs in the community.

  1. Improving oncology nurses' communication skills for difficult conversations.

    PubMed

    Baer, Linda; Weinstein, Elizabeth

    2013-06-01

    When oncology nurses have strong communication skills, they play a pivotal role in influencing patient satisfaction, adherence to plans of care, and overall clinical outcomes. However, research studies indicate that nurses tend to keep communication with patients and families at a superficial, nontherapeutic level. Processes for teaching goals-of-care communication skills and for implementing skills into clinical practice are not clearly defined. Nurses at a large comprehensive cancer center recognized the need for help with this skill set and sought out communication experts to assist in providing the needed education. An educational project was developed to improve therapeutic communication skills in oncology nurses during goals-of-care discussions and giving bad news. The program was tailored to nurses and social workers providing care to patients in a busy, urban, academic, outpatient oncology setting. Program topics included exploring the patient's world, eliciting hopes and concerns, and dealing with conflict about goals. Sharing and discussing specific difficult questions and scenarios were encouraged throughout the program. The program was well attended and well received by oncology nurses and social workers. Participants expressed interest in the continuation of communication programs to further enhance skills.

  2. What do nurse practitioners do? Analysis of a skills survey of nurse practitioners.

    PubMed

    Laustsen, Gary

    2013-01-01

    To report findings from a survey, analysis, and evaluation of the frequency and criticality of clinical skills and procedures (CSPs) used by nurse practitioners (NPs). In addition, data regarding NP demographic, geographic, and educational preparation were also obtained. Participants were a convenience sample of 452 NPs in Oregon (31% response rate). Findings point to the importance of assessing both frequency and criticality of practice skills. Demographic and geographic data reflected significant dichotomies between urban and rural practice. Rural NPs face challenges of providing care with more distant physician specialists and reported the use of a greater number of CSPs. A majority of participants reported learning most of the CSPs used in practice outside of their NP educational programs. The frequency and criticality of CSPs utilized in practice are both important considerations for NP clinicians and educators. NPs planning to practice in rural areas may need broader exposure and training in CSPs. An understanding of CSPs used by NPs may better inform administrative, reimbursement, licensure, and certification issues for advanced practice nursing. NP clinicians and faculty involved in NP education should seek to promote improved congruence between the CSPs taught in programs and those used in clinical practice. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  3. Nurse practitioner job satisfaction: looking for successful outcomes.

    PubMed

    Pasarón, Raquel

    2013-09-01

    To examine overall job satisfaction and its association with extrinsic and intrinsic characteristics of job satisfaction among nurse practitioners at the chosen practice site. The objectives were to identify relevant retention and recruitment strategies, from the nurse practitioners perspective, by examining (1) what role aspects are most satisfying, and (2) approaches for successful, professional development and integration in the role. Supportive professional practice environments are particularly important to nurses' satisfaction with their work and the quality of patient care provided. Hence, research that examines nurse practitioners practice implications and barriers in today's healthcare system is essential. A descriptive-correlational design using survey methodology. A nonprobability sample of convenience was used. The outcome measures were: The Misener Nurse Practitioner Job Satisfaction Scale and two investigator-developed surveys. Participants expressed dissatisfaction with professional and monetary recognition, assertive influence, administrative support and collegial relationships. Interaction of subscale factors on overall job satisfaction and demographic survey findings has important implications for health administrators and nurse practitioners in similar organisations. Stakeholders in healthcare milieus need to be fully engaged in the redesign of the American healthcare system heeding the recommendations of the Institute of Medicine to provide safer health systems to the public. By doing this, issues related to frustration by nurse practitioners related to job satisfaction will be addressed. The need for cooperation, participation, collaboration and instrumental communication are essential in the delivery of safe, quality patient care. A better understanding of intrinsic professional rewards needs to be learned by nurse practitioners who want to seek professional satisfaction and engage in the survival and growth of the profession. Nurse

  4. 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

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for a physician assistant's, nurse 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...

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

    PubMed

    Lattimer, Jennie Greco

    2013-12-01

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

  6. Nurse practitioner prescribing practice in Australia.

    PubMed

    Dunn, Sandra V; Cashin, Andrew; Buckley, Thomas; Newman, Claire

    2010-03-01

    In Australia, nurse practitioner (NP) services are a relatively new development with little being known about the prescribing practices of Australian NPs. The aim of this study was to conduct the first national study of Australian NP prescribing practices. Focus groups were conducted to inform construction of an electronic survey that was available for all NPs and NP candidates across Australia to complete. Seventy-two percent of authorized NPs and 39% of NP candidates reported that their practice involved prescribing pharmaceutical agents. Of those respondents who did prescribe during the course of their practice, 59% (n = 29) of the authorized NPs and 64% (n = 16) of the NP candidates reported that they usually prescribe at least once a day. The results from this study suggest that fewer Australian NPs prescribe than do NPs in the United States, and those who do prescribe do so less frequently. The current health policy framework in Australia while creating space for the role of the NP is restricting the role's utility and potential contribution to the health care of Australians.

  7. Tort reform: an issue for nurse practitioners.

    PubMed

    Klutz, Diane L

    2004-02-01

    To inform nurse practitioners (NPs) about the issues related to tort reform and its relationship to malpractice insurance costs. Current journals, newspapers, professional newsletters, and Internet sites. NPs are paying more for their malpractice premiums, and many are losing their places of employment as clinics close due to the increased cost of premiums. One method proposed for curbing the flow of monies spent on premiums and litigation is tort law reform. California serves as an example; its Medical Injury Compensation Reform Act (MICRA) tort reform law was passed 25 years ago, and it has maintained stable malpractice premiums. Other states have proposed similar laws, but some have not had similar success. To curb litigation costs, not only should tort laws be reformed, but NPs and physicians should keep abreast of current practice standards in order to provide quality medical care. Like physicians, NPs are affected directly by tort laws. These laws hold NPs accountable at the same level as physicians. In addition, many states limit NPs' practice to delegation of authority by a physician. Liability is therefore transferred from the NP to the physician and vice versa in cases of injury or wrongful act. In addition, many NPs are finding it increasingly difficult to locate insurers who will write policies for medical liability.

  8. 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)

  9. The evolving role of the nurse practitioner in neurosurgery.

    PubMed

    Rimel, R W; Langfitt, T W

    1980-12-01

    The authors examine the many important roles for the nurse practitioner in neurosurgery, including patient care in academic departments and private practice, and research and scholarship. The responsibilities of nurse practitioners in a hospital can be varied: they may take some responsibility for all patients on the neurosurgery service, or their assignment may be more specific, such as to the intensive care unit; or they may be assigned to all patients with a specified neurosurgical disorder, such as head injury of intractable pain. Nurse practitioners can become coordinators of clinical research programs, with responsibility for collecting and collating the data and assisting in data analysis and manuscript preparation. Detailed clinical protocols must be developed for nurse practitioners, and those protocols then become the basis for their employment and legal status. Licensure requirements vary greatly among states, and are continuing to change.

  10. 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)

  11. A New Teacher in Medical Education: The Family Nurse Practitioner

    ERIC Educational Resources Information Center

    Andrus, Len Hughes; And Others

    1977-01-01

    At the University of California, Davis, family nurse practitioners who are faculty members in the Department of Family Practice have proven to be effective teachers of medical students and family practice residents. (Author/LBH)

  12. Being an expert nurse in pediatric oncology care: nurses' descriptions in narratives.

    PubMed

    Enskär, Karin

    2012-01-01

    Pediatric oncology has become a highly specialized area, and the transition from novice nurse to expert can be complicated. The aim of this study was to describe the perceptions of nurses in pediatric oncology regarding the role of an expert nurse in pediatric oncology. Nurses (n = 66) working in pediatric oncology participated by writing their narratives. The data were analyzed by means of content analysis, and 3 categories were found: an expert has confidence in his or her knowledge, an expert provides high-quality care, and an expert is given possibilities for professional growth. It can be concluded that when nurses are given possibilities for continuous education and reflection, and have a feeling of satisfaction at being able to fulfill a child and his or her family's needs, this enhances their possibility to become experts and maintain expert competence.

  13. Empathy, Burnout, Demographic Variables and their Relationships in Oncology Nurses.

    PubMed

    Taleghani, Fariba; Ashouri, Elaheh; Saburi, Morteza

    2017-01-01

    Development of nurse-patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. Mean nurses' empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = -0.189, P = 0.04), depersonalization (r = -0.218, P = 0.02), and personal accomplishment (r = -0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04). Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses.

  14. 2016 Neonatal Nurse Practitioner Workforce Survey: Report of Findings.

    PubMed

    Staebler, Suzanne; Bissinger, Robin

    2017-10-01

    The National Association of Neonatal Nurse Practitioners (NANNP) conducted its second workforce survey of certified neonatal nurse practitioners in the fall of 2016. National Association of Neonatal Nurse Practitioners partnered with the National Certification Corporation and the American Association of Nurse Practitioners to conduct this electronic survey, containing 69 questions and focusing on practice sites and total compensation packages (including benefits) and workforce deficits.Findings indicate a rising neonatal nurse practitioners (NNPs) position vacancy rate across the country. Regional salary data indicated that the southeast had lower compensation rates for NNPs, with regions 4 and 11 (South) having the lowest rates. A promising trend indicated that new graduate NNPs with a doctorate are earning more. The study findings indicate that tailoring benefit packages to the age and years of experience for the individual NNP may aid in recruiting and retaining NNPs in practice. For experienced NNPs, altered shift lengths (shorter), higher employer matching rates in retirement plans, and less employee cost sharing for health insurance benefits are more appealing strategies.It is critical for NNPs to continually evaluate the profession's workforce data. There are more than 205,000 nurse practitioners practicing in the United States, with neonatal NPs making up approximately 3% of the larger whole. Increased participation in future surveys will assist in creating sustainable solutions to the workforce crisis facing the profession.

  15. The Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United Kingdom.

    PubMed

    Norris, Tracey; Melby, Vidar

    2006-03-01

    This study explored the opinions of nurses and doctors working in emergency departments towards the development of the Acute Care Nurse Practitioner service in the United Kingdom. Studies carried out in the United States and Canada suggest that the Acute Care Nurse Practitioner can have a positive impact on the critically ill or injured patients' experiences in the emergency department. This role is well developed in the United States and Canada, but is still in its infancy in the United Kingdom. A descriptive, exploratory design incorporating questionnaires (n = 98) and semi-structured interviews (n = 6) was employed. The sample included nurses and doctors from seven emergency departments and minor injury units. Respondents felt it was important for the Acute Care Nurse Practitioner to have obtained a specialist nurse practitioner qualification and that the Acute Care Nurse Practitioner should retain a clinical remit. While participants seemed comfortable with nurses undertaking traditional advanced skills such as suturing, reluctance was displayed with other advanced skills such as needle thoracocentesis. Three main themes were identified from the interviews: inter-professional conflict, autonomy and the need for the Acute Care Nurse Practitioner. Doctors were reluctant to allow nurses to practise certain additional advanced skills and difficulties appear to be centred on the autonomy and other associated inter-professional conflicts with the role of the Acute Care Nurse Practitioner. Nurses and doctors identified a need for the Acute Care Nurse Practitioner, but the blurring of boundaries between doctors and nurses can result in inter-professional conflict unless this is addressed prior to the introduction of such advanced practitioners. Relevance to clinical practice. As the role of the emergency nurse diversifies and expands, this study re-affirms the importance of inter-professional collaboration when seeking approval for role expansions in nursing.

  16. Nurse-Physician Relationships in Ambulatory Oncology Settings

    PubMed Central

    Friese, Christopher R.; Manojlovich, Milisa

    2012-01-01

    Purpose The purpose of this study was to explore nurses’ perceptions of nurse-physician relationships in ambulatory oncology settings, which are linked to patient safety. Design This cross-sectional, descriptive study analyzed survey data collected in 2010 from oncology nurses employed in ambulatory settings. The sampling frame was the nurse licensure database in one state in the Southeastern United States. Nurses completed the Practice Environment Scale of the Nursing Work Index (PES-NWI), reported on the quality of care in their setting, and commented on factors that promoted or inhibited high-quality care delivery. Methods Data analysis used three study variables: empirically-derived values from the PES-NWI, a scale of nurse-reported quality of care in their setting, and open-text comments about features in their workplace that promoted or hindered high-quality care. After categorizing open-text comments, ANOVA was used to evaluate differences in PES-NWI subscales by comment category. Chi-square test statistics were calculated to examine differences in overall practice environment and quality of care by comment category. Results Nurses reported their relationships with physicians as generally favorable. Qualitative findings suggest two themes that influence how nurses characterize their working relationships with physicians: 1) physician behaviors and 2) structural factors. Both PES-NWI scores and quality of care were rated significantly higher by nurses who wrote favorably about physicians. Conclusions Favorable nurse-physician relationships in ambulatory settings may reflect positive workplaces and promote high-quality care. Clinical Relevance Consistent with findings from inpatient units, nurse-physician relationships are important to the quality of ambulatory oncology care. Systematic measurement and attention to reported deficits in these relationships may promote higher quality care. PMID:22812518

  17. Supplementing Intensivist Staffing With Nurse Practitioners: Literature Review.

    PubMed

    White, Tracie; Kokiousis, Justin; Ensminger, Stephanie; Shirey, Maria

    2017-01-01

    In the United States, providing health care to critically ill patients is a challenge. An increase in patients older than 65 years, a decrease in critical care physicians, and a decrease in work hours for residents cause intensivist staffing issues. In this article, use of nurse practictioners to fill the intensive care unit intensivist staffing gap is assessed and evidence-based recommendations are identified to better incorporate nurse practitioners as part of intensive care unit intensivist staffing. The literature reveals that when nurse practitioners are part of a staffing model, outcomes are either positively impacted or no different from physician outcomes. However, successfully integrating nurse practitioners into an intensive care unit team is not adequately discussed in the literature. This gap is addressed and 3 mechanisms to integrate nurse practitioners into the intensive care unit are identified: (1) use of a multidisciplinary staffing model, (2) completion of onboarding programs, and (3) evaluation of nurse practitioner productivity. ©2017 American Association of Critical-Care Nurses.

  18. Qualitative Distinctions and Similarities in the Practice of Clinical Nurse Specialists and Nurse Practitioners.

    ERIC Educational Resources Information Center

    Fenton, Mary V.; Brykczynski, Karen A.

    1993-01-01

    A comparison of results of two studies regarding the actual practice of clinical nurse specialists and nurse practitioners revealed a shared core of advanced practice competencies as well as distinct differences between practice roles. (JOW)

  19. 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)

  20. 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

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

    PubMed

    Whelan, Kathleen M; Wishnia, Gracie S

    2003-01-01

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

  2. Designing a mixed methods study in pediatric oncology nursing research.

    PubMed

    Wilkins, Krista; Woodgate, Roberta

    2008-01-01

    Despite the appeal of discovering the different strengths of various research methods, mixed methods research remains elusive in pediatric oncology nursing research. If pediatric oncology nurses are to succeed in mixing quantitative and qualitative methods, they need practical guidelines for managing the complex data and analyses of mixed methods research. This article discusses mixed methods terminology, designs, and key design features. Specific areas addressed include the myths about mixed methods research, types of mixed method research designs, steps involved in developing a mixed method research study, and the benefits and challenges of using mixed methods designs in pediatric oncology research. Examples of recent research studies that have combined quantitative and qualitative research methods are provided. The term mixed methods research is used throughout this article to reflect the use of both quantitative and qualitative methods within one study rather than the use of these methods in separate studies concerning the same research problem.

  3. Stress in the professional practice of oncology nurses.

    PubMed

    de Carvalho, Emilia Campos; Muller, Melina; de Carvalho, Patricia Bachion; de Souza Melo, Alexandra

    2005-01-01

    Oncology nurses have been identified as a group at risk for stress. This project aimed at identifying stress-generating situations. There was an attempt at identifying stressful situations through the application of a stress evaluation scale (Stressor Scale for Pediatric Oncology Nursing) (Hinds et al, Cancer Nurs. 1990;13:354-360). In the opinion of 35 oncology nurses, 88.57% of whom were women and 73% of whom had more than 24 months of experience, 38 out of the 50 analyzed statements involving work situations were considered stressful in some way. Fifty-four percent of the statements disclosed a medium or high stressor capacity, and 22% were seen as extremely high stressors. These situations were included in the categories "work organization," "relationships among staff members," and "care restrictions." It is reiterated that the set of activities developed by oncology nurses is stressful, and that there is a need for institutional intervention, due to the narrow relation between work environment and care results.

  4. The role of resilience and mindful leadership in oncology nursing.

    PubMed

    Rishel, Cindy J

    2015-03-01

    When oncology nurses think of the word resilient, they often describe the term in the context of the patients and families they care for each day. When patients face a diagnosis of cancer, their lives have suddenly been altered in a frightening manner. Everything changes, and they must find a way to navigate the troubled waters ahead. 
.

  5. The advance nurse practitioner in critical care: a workload evaluation.

    PubMed

    Jackson, Audrey; Carberry, Martin

    2015-03-01

    The Advanced Nurse Practitioner in Critical Care role was developed to support the critical care team by undertaking specific roles traditionally associated with medical staff in the intensive care unit and high dependency unit. The rationale for the evaluation was to establish the specific tasks undertaken and scope of workload of these newly created posts. To report on an evaluation of the specific activities, workload and patterns of prescribing of advanced nursing practice posts within a critical care settings A data collection form was designed to capture clinically and patient-related activities of these post-holders. Data from 1 week were recorded on one post-holder and subsequently analysed. During the evaluation the nurse practitioners worked with the consultant anaesthetist. Data were entered into Microsoft Excel and analysed using descriptive statistics. The intensive care and high dependency unit ward round attributed to 46% of the nurse practitioners weekly activity and mainly consisted of patient assessments and prescribing. The rest of the time was mainly split between documentation and unsupervised patient assessments. The nurse practitioners contributed to the majority of interventions traditionally performed by anaesthetic trainees. Independent patient assessment was highlighted as a significant part of that workload (12%). The evaluation also highlighted the broad nature required of nurse practitioner prescribing and thus reinforced the strategic decision not to introduce a restricted formulary. Advanced nurse practitioners in critical care effectively carried out the traditional medical tasks in which they were trained. As already experienced nurses with new enhanced skills they successfully contributed to and enhanced the delivery of care to the critically ill. © 2014 British Association of Critical Care Nurses.

  6. International family-planning training for nurse practitioners.

    PubMed

    Vansintejan, G A; Purdy, P J

    1986-01-01

    Since the mid-1970s, the Margaret Sanger Center of Planned Parenthood of New York City has prepared nurses and nurse midwives from less developed countries to be family-planning nurse practitioners. These nurse practitioners then provide services to patients, train other staff, and manage integrated family-planning clinics. More than 120 nurses and nurse midwives have arrived in groups of 10 at the Sanger Center, with 72 attending since 1981. Each course lasts 10 weeks. The core curriculum provides trainees with skills in women's health care including contraception, in training and advocacy, and in management of clinics. Whether, in the current period of scarce resources, cross-cultural training programs of this type remain a worthwhile investment, and if so, which of their components are most important to this success, is assessed.

  7. 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.

  8. The role of the nurse practitioner in psychiatric/mental health nursing: exploring consumer satisfaction.

    PubMed

    Wortans, J; Happell, B; Johnstone, H

    2006-02-01

    There is a substantial body of literature pertaining to the role of the nurse practitioner. Research directed towards consumer satisfaction suggests that the care provided by nurse practitioners is perceived as at least equal to that provided by a medical practitioner. However, there is a paucity of literature examining the nurse practitioner role in the psychiatric/mental health field. An evaluation of a Nurse Practitioner demonstration model has recently been undertaken in the Crisis, Assessment and Treatment Team in Victoria, Australia. This article presents the findings of a qualitative, exploratory study. Individual interviews were conducted with consumers (n = 7) who had received care and treatment provided by the nurse practitioner candidate. Data analysis revealed two main themes: the quality of the service provided, and the unique role of the nurse. The findings supported the available literature in articulating the specific aspects of the nurse practitioner role that are favourably perceived by consumers of services. This study contributes to the limited body of knowledge in the psychiatric/mental health nursing field and specifically emphasizes the importance of the relationship between nurse practitioner and consumer in facilitating the provision of effective care and treatment.

  9. Oncology nurses' use of nondrug pain interventions in practice.

    PubMed

    Kwekkeboom, Kristine L; Bumpus, Molly; Wanta, Britt; Serlin, Ronald C

    2008-01-01

    Cancer pain management guidelines recommend nondrug interventions as adjuvants to analgesic medications. Although physicians typically are responsible for pharmacologic pain treatments, oncology staff nurses, who spend considerable time with patients, are largely responsible for identifying and implementing nondrug pain treatments. Oncology nurses' use of nondrug interventions, however, has not been well studied. The purpose of this study was to describe oncology nurses' use of four nondrug interventions (music, guided imagery, relaxation, distraction) and to identify factors that influence their use in practice. A national sample of 724 oncology staff nurses completed a mailed survey regarding use of the nondrug interventions in practice, beliefs about the interventions, and demographic characteristics. The percentages of nurses who reported administering the strategies in practice at least sometimes were 54% for music, 40% for guided imagery, 82% for relaxation, and 80% for distraction. Use of each nondrug intervention was predicted by a composite score on beliefs about effectiveness of the intervention (e.g., perceived benefit; P<0.025) and a composite score on beliefs about support for carrying out the intervention (e.g., time; P<0.025). In addition, use of guided imagery was predicted by a composite score on beliefs about characteristics of patients who may benefit from the intervention (e.g., cognitive ability; P<0.05). Some nurse demographic, professional preparation, and practice environment characteristics also predicted use of individual nondrug interventions. Efforts to improve application of nondrug interventions should focus on innovative educational strategies, problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses.

  10. Empathy, Burnout, Demographic Variables and their Relationships in Oncology Nurses

    PubMed Central

    Taleghani, Fariba; Ashouri, Elaheh; Saburi, Morteza

    2017-01-01

    Introduction: Development of nurse–patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. Materials and Methods: This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. Results: Mean nurses’ empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = −0.189, P = 0.04), depersonalization (r = −0.218, P = 0.02), and personal accomplishment (r = −0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04). Conclusions: Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses. PMID:28382057

  11. Fostering psychosocial wellness in oncology nurses: addressing burnout and social support in the workplace.

    PubMed

    Medland, Jacqueline; Howard-Ruben, Josie; Whitaker, Elizabeth

    2004-01-01

    To identify psychosocial wellness and the avoidance of burnout as key priorities for the retention of oncology nurses and to describe a program designed for a specific setting to enhance the psychosocial wellness and coping skills of oncology nurses. Published research, books, and journal articles; theory; practice; and personal experience. Oncology nurses benefit from programs designed to bolster the development of coping skills to reduce stress, foster supportive relationships in the workplace, facilitate work-related grief and bereavement, and reduce burnout. Fostering psychosocial wellness in the workplace potentially can increase oncology nurse retention. A renewed recognition of the stressful nature of oncology nursing should give rise to programs that address the psychological well-being of oncology nurses. Oncology nursing leadership, recognizing the potential for stress and burnout inherent in this profession, should research and develop programs to enhance staff coping skills and mutual support.

  12. 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.

  13. 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.

  14. Does vicarious traumatisation affect oncology nurses? A literature review.

    PubMed

    Sinclair, Helen A H; Hamill, Conal

    2007-09-01

    It is widely documented that nurses experience work-related stress [Quine, L., 1998. Effects of stress in an NHS trust: a study. Nursing Standard 13 (3), 36-41; Charnley, E., 1999. Occupational stress in the newly qualified staff nurse. Nursing Standard 13 (29), 32-37; McGrath, A., Reid, N., Boore, J., 2003. Occupational stress in nursing. International Journal of Nursing Studies 40, 555-565; McVicar, A., 2003. Workplace stress in nursing: a literature review. Journal of Advanced Nursing 44 (6), 633-642; Bruneau, B., Ellison, G., 2004. Palliative care stress in a UK community hospital: evaluation of a stress-reduction programme. International Journal of Palliative Nursing 10 (6), 296-304; Jenkins, R., Elliott, P., 2004. Stressors, burnout and social support: nurses in acute mental health settings. Journal of Advanced Nursing 48 (6), 622-631], with cancer nursing being identified as a particularly stressful occupation [Hinds, P.S., Sanders, C.B., Srivastava, D.K., Hickey, S., Jayawardene, D., Milligan, M., Olsen, M.S., Puckett, P., Quargnenti, A., Randall, E.A., Tyc, V., 1998. Testing the stress-response sequence model in paediatric oncology nursing. Journal of Advanced Nursing 28 (5), 1146-1157; Barnard, D., Street, A., Love, A.W., 2006. Relationships between stressors, work supports and burnout among cancer nurses. Cancer Nursing 29 (4), 338-345]. Terminologies used to capture this stress are burnout [Pines, A.M., and Aronson, E., 1988. Career Burnout: Causes and Cures. Free Press, New York], compassion stress [Figley, C.R., 1995. Compassion Fatigue. Brunner/Mazel, New York], emotional contagion [Miller, K.I., Stiff, J.B., Ellis, B.H., 1988. Communication and empathy as precursors to burnout among human service workers. Communication Monographs 55 (9), 336-341] or simply the cost of caring (Figley, 1995). However, in the mental health field such as psychology and counselling, there is terminology used to captivate this impact, vicarious traumatisation. Vicarious

  15. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

    PubMed

    Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

    2016-12-01

    Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

  16. The acute care nurse practitioner in collaborative practice.

    PubMed

    Buchanan, L

    1996-01-01

    Nurse-physician relationships remain, for the most part, hierarchical in nature. A hierarchical structure allows the person at the top, most notably the physician, the highest level of authority and power for decision making. Other health care providers are delegated various tasks related to the medical plan of care. One role of nonmedical health care providers, including nurses, is to support the medical plan of care and increase the productivity of physicians. Medical centers have house staff, usually interns and residents, who work collaboratively with the attending physicians in care delivery. At one medical center, a shortage of medical house staff for internal medicine prompted the development and evaluation of an alternative service. The alternative service utilized master prepared, certified nurse practitioners on a nonteaching service to provide care for selected types of medical patients. Physicians consulted with nurse practitioners, but retained decision-making authority concerning patient admission to the service. This paper describes the development and evaluation of an alternative service based on a collaborative practice model and the role of nurse practitioners working under such a model. Discussion includes suggestions for process guideline development for organizations that want to improve collaborative practice relationships between unit nursing staff, nurse practitioners, and physicians.

  17. The discursive practices of nurse practitioner legislation in Australia.

    PubMed

    Harvey, Clare; Driscoll, Andrea; Keyzer, Dirk

    2011-11-01

    The aim of this paper was to examine the nurse practitioner legislative framework in Australia from a critical social theory perspective. National regulation for nurses and midwives has superseded all previous state legislation with effect from July 2010. The aim of this change was to streamline regulation processes across all health professionals requiring regulation, in order to eliminate diverse state-based regulatory policies that were identified as hindering transferability of the workforce across Australia. This paper explores the changes with reference to nurse practitioners. Since their introduction to Australia different legislative practices between states have presented difficult endorsement procedures which have affected employment. Information for the paper is drawn from a doctoral study which examined the politics of advancing nursing in Australia, with particular reference to the discourses of nurse practitioners. This is augmented by more recent legislative documents and policies, as well as media reports, to examine the process of change in legislation and the unfolding discourses on employment and practice. IMPLICATIONS TO NURSING: Nurse practitioner endorsement may be more complicated, defeating the original premise of transferability of a skilled workforce across state jurisdictions. This paper exposes the influence that powerful discourses can have on a major change to professional practice. © 2011 Blackwell Publishing Ltd.

  18. Nurse practitioners' perceptions and participation in pharmaceutical marketing.

    PubMed

    Crigger, Nancy; Barnes, Kristen; Junko, Autumn; Rahal, Sarah; Sheek, Casey

    2009-03-01

    This paper reports on a study conducted to describe family nurse practitioners' perceptions towards and participation in pharmaceutical marketing and to explore the relationships among related variables. The pharmaceutical industry's intense global marketing strategies have resulted in widespread concern in healthcare professionals and professional groups, sectors of the public in many countries, and in the World Health Organization. Research on healthcare providers' participation in pharmaceutical marketing indicates that these relationships are conflicts of interests and compromise healthcare providers' prescribing practices and trust. Nursing, as a discipline, appears to be slow to address the impact of pharmaceutical marketing on nursing practice. Questionnaires about perceptions and participation in pharmaceutical marketing were completed by a random sample of 84 licensed family nurse practitioners in the United States of America in 2007. Family nurse practitioners viewed pharmaceutical company marketing uncritically as educational and beneficial. They also perceived other providers but not themselves as influenced by pharmaceutical marketing. The findings supported those found in previous research with nurses and physicians. Lack of education, participation in marketing and psychological and social responses may impede family nurse practitioners' ability to respond critically and appropriately to marketing strategies and the conflict of interest it creates.

  19. 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…

  20. Oncology Nurses' Use of the Internet for Continuing Education: A Survey of Oncology Nursing Society Congress Attendees.

    ERIC Educational Resources Information Center

    Cobb, Susan C.; Baird, Susan B.

    1999-01-01

    A survey to determine whether oncology nurses (n=670) use the Internet and for what purpose revealed that they use it for drug information, literature searches, academic information, patient education, and continuing education. Results suggest that continuing-education providers should pursue the Internet as a means of meeting the need for quick,…

  1. Oncology Nurses' Use of the Internet for Continuing Education: A Survey of Oncology Nursing Society Congress Attendees.

    ERIC Educational Resources Information Center

    Cobb, Susan C.; Baird, Susan B.

    1999-01-01

    A survey to determine whether oncology nurses (n=670) use the Internet and for what purpose revealed that they use it for drug information, literature searches, academic information, patient education, and continuing education. Results suggest that continuing-education providers should pursue the Internet as a means of meeting the need for quick,…

  2. Occupational stress in oncology nurse caregiving: caring for ourselves.

    PubMed

    Boyle, Deborah A

    2015-10-01

    The emotional work of oncology nurses is complex. Inherent in our job is the requirement to be exquisitely empathic. We must look after, respond to, and support numerous patients and their families. Fully present, we repeatedly listen to stories of sadness and despair. Intermittently, we must either display or suppress our emotions. All of this takes place in an occupational environment where support for the nurses' emotional well-being is nonexistent. Lacking are opportunities to vent emotions, sufficient time to grieve patients' deaths, and resources to help nurses cope with work-related stress.

  3. Developing an advanced nurse practitioner service in emergency care: attitudes of nurses and doctors.

    PubMed

    Griffin, Miriam; Melby, Vidar

    2006-11-01

    This paper reports a study to determine the attitudes of nurses, doctors and general medical practitioners towards the development of an advanced nurse practitioner service within an emergency department. The role of advanced nurse practitioner in emergency care has emerged in a number of countries, and has brought with it confusion about titles, role boundaries, clinical accountability and educational requirements. Initially, the role resulted from a need for healthcare professionals to provide a service to the increased numbers of patients presenting to hospital with less urgent problems. Since then, the service has evolved to one where nurse practitioners provide high-quality and cost-effective care to persons who seek help for non-urgent, urgent or emergent conditions in a variety of emergency care settings. However, little research could be identified on the attitudes of relevant nursing and medical staff towards the development of this role. A questionnaire survey was carried out, and a 29-item Likert rating scale was developed to measure attitudes. Along with some demographic variables, two open-ended questions were added to allow respondents to elaborate on what they perceived as benefits and difficulties associated with an advanced nurse practitioner service. All general practitioners, emergency nurses and emergency doctors in one health board in the Republic of Ireland were targeted, and 25 emergency nurses, 13 emergency doctors and 69 general practitioners were approached to take part. Data were collected in February 2004. An overall response rate of 74.8% was achieved. All respondents were positive towards the development of an advanced nurse practitioner service, with general practitioners being less positive. The principal differences appeared between general practitioners and hospital emergency care staff. There is a need for a multidisciplinary approach to the planning of advanced nurse practitioner services. To achieve multiprofessional acceptance

  4. Oncology nurse communication barriers to patient-centered care.

    PubMed

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ferrell, Betty

    2013-04-01

    Although quality communication has been identified as a necessary component to cancer care, communication skills training programs have yet to focus on the unique role of nurses. This study explored communication barriers as reported by seven nurse managers to better identify communication skills needed for oncology nurses to practice patient-centered care. Thematic analysis of transcripts was used to identify barriers to patient and family communication and desirable patient-centered nursing communication skills. Overall, the nurse managers reported that nurses experience patient and family communication difficulties as a result of inconsistent messages to patients and family from other healthcare staff. Physician assumptions about nursing left nurses feeling uncomfortable asking for clarification, creating a barrier to team communication processes. Patient-centered communication and care cannot be actualized for nurses unless team roles are clarified and nurses receive training in how to communicate with physicians, patients, and family. Therefore, the authors of this article created the COMFORT communication training protocol, and key concepts and resources for nurse communication training through COMFORT are detailed in this article.

  5. Current Status of Fellowship Programs for Advanced Practice Registered Nurses in the Nurse Practitioner Role.

    PubMed

    Camal Sanchez, Carlos Alberto

    2017-05-31

    Students completing an advanced practice RN program for practice as a nurse practitioner may seek options for further advancement. Although postgraduate clinical fellowship programs exist, information about such programs is not readily available. This article offers a resource for faculty to assist graduate students in finding advanced practice RN nurse practitioner fellowship programs in the United States.

  6. Neonatal nurse practitioners provide quality, cost-effective care.

    PubMed

    Geiss, Donna M; Cavaliere, Terri A

    2003-09-01

    Loretta Ford, the pioneer of nurse practitioners, was the recipient of the Crystal Trailblazer Award from the American College of Nurse Practitioners in February 2003. In her acceptance speech, the stated that "in some ways, the profession had expanded beyond my wildest dreams," but cautioned against the medicalization of the NP role: "The profession is rooted in nursing ... and we enhance, advance, and influence through nursing." She added: "Medical and nursing interdependency sets the stage for the highest level of care. No one profession can deliver comprehensive health care themselves." NNPs, functioning collaboratively with neonatologists as part of a multidisciplinary team, illustrate the truth of Ford's words. They have clearly and unequivocally made significant strides during the past 20 years. Their achievements and contributions have been many but their potential has yet to be reached.

  7. General practitioners' experiences as nursing home medical consultants.

    PubMed

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-03-01

    To describe general practitioners' experiences of being the principal physician responsible for a nursing home. Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety. The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems. © 2016 Nordic College of Caring Science.

  8. Levels of Conscience and Related Factors among Iranian Oncology Nurses.

    PubMed

    Gorbanzadeh, Behrang; Rahmani, Azad; Mogadassian, Sima; Behshid, Mojhgan; Azadi, Arman; Taghavy, Saied

    2015-01-01

    Having a conscience is one of the main pre-requisite of providing nursing care. The knowledge regarding levels of conscience among nurses in eastern countries is limited. So, the purpose of this study was to examine the level of conscience and its related factors among Iranian oncology nurses. This descriptive-correlational study was conducted in 3 hospitals in Tabriz, Iran. Overall, 68 nurses were selected using a non-probability sampling method. The perceptions of conscience questionnaire was used to identify the levels of conscience among nurses. The data were analyzed using SPSS version 13.0. The mean nurses' level of conscience scores was 72.7. In the authority and asset sub-scales nurses acquired higher scores. The mean of nurses' scores in burden and depending on culture sub-scales were the least. Also, there were no statistical relationship between some demographic characteristics of participants and their total score on the perceptions of conscience questionnaire. According to study findings Iranian nurses had high levels of conscience. However, understanding all the factors that affect nurses' perception of conscience requires further studies.

  9. A self-care retreat for pediatric hematology oncology nurses.

    PubMed

    Altounji, Diane; Morgan, Helene; Grover, Monica; Daldumyan, Sona; Secola, Rita

    2013-01-01

    Pediatric hematology oncology nurses face a variety of stressors while working in this specialty field. Through hematology oncology staff group discussions, nurses identified a myriad physical and emotional stressors they experienced, and expressed concern regarding possible burnout. They described facing stressors related to experiencing loss, grief, moral and ethical dilemmas, and administering complex treatment regimens. To address these concerns, a hematology oncology nursing supportive care committee envisioned and implemented 3 off-site self-care retreats. The committee's primary purpose was to create a therapeutic and supportive environment for all participants, while allowing time for relaxation, reflection, and serenity. The primary goals for the retreats were to heal nurses from their reported past trauma and stress and to provide them effective coping strategies for the ongoing stressors they will inevitably face. In a collaborative effort, the committee members developed an agenda including presentations, group discussions, and relaxation activities. Written evaluations were completed by each participant to assess the benefit of the retreat. Overall feedback was extremely positive, with the majority of the participants finding great value in this experience.

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

    PubMed

    Roemer, R

    1977-06-01

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

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

    PubMed

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

    2007-01-01

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

  12. 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.

  13. Professional organization membership: Advancing the nurse practitioner role.

    PubMed

    Goolsby, Mary Jo; DuBois, Janet C

    2017-08-01

    With a paucity of literature on professional organization membership by nurse practitioners (NPs), the authors base the discussion of the personal benefits associated with membership on literature focusing on clinicians other than NPs and their personal experiences as members of multiple organizations. Membership is described as related to NP socialization, engagement, networking, mentorship, advocacy, policy, leadership development, research dissemination, professional development, and volunteerism. In addition to encouraging active participation in one or more professional organizations, the need for research into factors influencing the degree to which NPs participate in organizations and the associated benefits is identified. ©2017 American Association of Nurse Practitioners.

  14. Complementary and alternative medicine: oncology nurses' experiences, educational interests, and resources.

    PubMed

    Rojas-Cooley, M Teresa; Grant, Marcia

    2006-05-03

    To describe oncology nurses' experiences with patients communicating interest in or use of complementary and alternative medicine (CAM) therapies along with oncology nurses' CAM resources and educational interests. National mailed survey. A national medical center and research institute. A random sample of 850 Oncology Nursing Society (ONS) members who are RNs involved in direct patient care. Respondents completed a demographic questionnaire and the Nurse Complementary and Alternative Medicine Knowledge and Attitude Survey. Initial analysis compared the demographics of the sample to the ONS membership. Descriptive analysis was used to further describe nurses' experiences with patients communicating interest in or use of CAM, nurses' interest in CAM education, and nurses' use of CAM resources. Experiences, resources, interests, and CAM therapies. Oncology nurses reported their experiences with patients who communicated interest in or use of CAM therapies. Respondents demonstrated considerable interest in learning more about specific CAM therapies and used a variety of resources to find information on CAM therapies. Assessing oncology nurses' experiences, resources used, and interest in learning about CAM therapies is the first step in determining the learning needs of oncology nurses in the direct patient care environment. The next step is to obtain baseline information on oncology nurses' CAM knowledge and attitudes for developing and providing appropriate education. CAM education will provide nurses with knowledge to support and advocate for their patients. Oncology nurses are the bridge to help patients safely integrate evidence-based CAM therapies into conventional treatment.

  15. Practice patterns and organizational commitment of inpatient nurse practitioners.

    PubMed

    Johnson, Janet; Brennan, Mary; Musil, Carol M; Fitzpatrick, Joyce J

    2016-07-01

    Nurse practitioners (NPs) deliver a wide array of healthcare services in a variety of settings. The purpose of this study was to examine the practice patterns and organizational commitment of inpatient NPs. A quantitative design was used with a convenience sample (n = 183) of NPs who attended the American Association of Nurse Practitioners (AANP) national conference. The NPs were asked to complete a demographic questionnaire, the Practice Patterns of Acute Nurse Practitioners tool and the Organizational Commitment Questionnaire. Over 85% of inpatient practice time consists of direct and indirect patient care activities. The remaining nonclinical activities of education, research, and administration were less evident in the NP's workweek. This indicates that the major role of inpatient NPs continues to be management of acutely ill patients. Moderate commitment was noted in the Organizational Commitment Questionnaire. Supportive hospital/nursing leadership should acknowledge the value of the clinical and nonclinical roles of inpatient NPs as they can contribute to the operational effectiveness of their organization. By fostering the organizational commitment behaviors of identification, loyalty, and involvement, management can reap the benefits of these professionally dedicated providers. ©2015 American Association of Nurse Practitioners.

  16. A fellowship program preparing students for employment as new graduate nurses in oncology nursing.

    PubMed

    Coakley, Amanda Bulette; Ghiloni, Carol A

    2009-01-01

    The Carol A. Ghiloni Oncology Fellowship Program (OFP), developed in 2001, provides an opportunity for student nurses between their junior and senior years in a baccalaureate program to learn about the role that nurses play in providing care to patients with cancer. To explore whether former fellows felt prepared for employment in oncology nursing after their fellowship experience, a focus group discussion with former student nurse oncology fellows was conducted. The discussion was audiotaped and transcribed. Content analysis of the transcripts revealed four key findings: OFP provides an opportunity to make informed career choices; OFP provides confidence-building experience; OFP provides an experience of preceptor role modeling; and OFP provides an opportunity to build relationships with staff, patients, and patients' families.

  17. Exploring the mental health nurse practitioner scope of practice in youth early psychosis: an anecdotal account.

    PubMed

    Baker, Neville

    2010-01-01

    The development of the Victorian mental health nurse practitioner youth early psychosis, is a pioneer advance in clinical psychiatric/mental health nursing. This paper will explore and describe the scope of practice for the youth early psychosis mental health nurse practitioner candidate, and how the model is informed by relevant literature. The role description and context of the nurse practitioner candidate, which is synonymous with the role of the endorsed nurse practitioner, is described. Advanced practice nursing is discussed in terms of what the nurse practitioner literature says and contrasted with perceptions of a clinical nurse's everyday practice. Inherent challenges and issues are highlighted that need to sit in the background of any picture being painted of the mental health nurse practitioner role in Victoria into the future. An alternative perspective in the mental health care of the young person is proposed for the nurse practitioner scope of practice.

  18. 42 CFR 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists' services and services furnished incident to their professional... for Determining Reasonable Charges § 405.520 Payment for a physician assistant's, nurse...

  19. Supporting staff nurses to train as community specialist district nurse practitioners.

    PubMed

    Elliott, Lorraine

    The removal of district nurses from the Nursing and Midwifery Council's recognised specialist practitioner list has resulted in many employers not commissioning district nurse courses and a lack of clarity about the skills required to be a team leader. This article discusses a practice development initiative to support learning through a practice based competency programme, to develop skills of local staff members.

  20. 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

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payment for a physician assistant's, nurse 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...

  1. 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

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payment for a physician assistant's, nurse 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...

  2. 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

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payment for a physician assistant's, nurse 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...

  3. Personality Traits of Nurses in Anesthesia and Family Nurse Practitioner Masters Degree Programs

    DTIC Science & Technology

    1998-02-01

    are known, faculty can initiate programs to help the students better understand the methods of teaching, test taking, and communicating . This...anesthesia, family nurse practitioner or nurse midwifery . Nurses are drawn to specific career fields because they are interested in the job...the methods of teaching, test taking, and communicating . This valuable information could then be integrated into the educational curriculum and

  4. 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…

  5. 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…

  6. Big Data and Pharmacovigilance: The Role of Oncology Nurses.

    PubMed

    Glenn, David G

    2016-10-01

    When new anticancer medications are approved, their safety profiles are often not fully understood. Oncology nurses have a responsibility to file reports of adverse drug events with safety registries such as MedWatch. If these registries receive prompt, complete, and accurate data from clinicians, agencies such as the U.S. Food and Drug Administration will have a stronger ability to detect hazards and to issue safety recommendations.
.

  7. Creating a successful environment for neonatal nurse practitioners.

    PubMed

    Maguire, D; Carr, R; Beal, J A

    1995-12-01

    Factors that contribute to the neonatal nurse practitioner (NNP) practice environment have emerged from research grounded in the results of a nonexperimental, descriptive, and correlational study that described the role and nursing identity of 258 NNPs. These factors may be used as prescriptions for developing successful NNP environments or to strengthen a current practice. Nursing management has a responsibility to identify factors that enhance nursing identity of NNPs and to plan strategies to operationalize those factors to provide an optimal environment in which NNPs can practice to their fullest potential. Implications are raised for nursing administration and education to address the issues of role differentiation, socialization, and identity of advanced practice nurses in tertiary care.

  8. Professional development utilizing an oncology summer nursing internship.

    PubMed

    Mollica, Michelle; Hyman, Zena

    2016-01-01

    The aim of this study was to examine the effect of an oncology student nursing internship on role socialization and professional self-concept. This mixed-methods study utilized a convergent parallel approach that incorporated a quasi-experimental and qualitative design. Data was collected through pre and post-survey and open-ended questions. Participants were 11 baccalaureate nursing students participating in a summer oncology student nursing internship between their junior and senior years. Investigators completed a content analysis of qualitative questionnaires resulted in categories of meaning, while the Wilcoxon signed-ranks test was used to compare pre and post internship scores. Aggregated mean scores from all instruments showed an increase in professionalism, role socialization, and sense of belonging from pre to post-internship, although no differences were significant. Qualitative data showed participants refined their personal philosophy of nursing and solidified their commitment to the profession. Participants did indicate, however, that the internship, combined with weekly debriefing forums and conferences, proved to have a positive impact on the students' role socialization and sense of belonging. Despite quantitative results, there is a need for longitudinal research to confirm the effect of nursing student internships on the transition from student to professional.

  9. Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

    PubMed

    Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

    2017-07-01

    Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

  10. Development of a Post-Master's Fellowship Program in Oncology Nursing Education. Final Report.

    ERIC Educational Resources Information Center

    Siegele, Dorothy; Henderson, Billie

    A one-year Post-Master's Fellowship in Oncology Nursing Education for nurse educators was developed through the collaboration of San Jose State University (California) and University of Alabama at Birmingham. The project was designed to: develop or update undergraduate/graduate oncology nursing programs; provide continuing education for practicing…

  11. A self-assessment tool for oncology nurses: preliminary implementation and evaluation.

    PubMed

    Brixey, Molly Jo; Mahon, Suzanne M

    2010-08-01

    Nurses who fail to identify knowledge gaps in their practice and who do not maintain competence place patients with cancer at risk for adverse events and poor outcomes. Self-assessment tools can assist oncology nurses in identifying knowledge deficits in fundamental oncology concepts. This article describes the development and implementation of a self-assessment tool to assist nurses in maintaining competence to provide safe, effective oncology care. The tool was developed after an examination of relevant literature, collaboration with an oncology team, and consideration of the Oncology Nursing Society's and American Nursing Association's standards of care. Preliminary evaluation suggests it may offer an effective means for oncology nurses to identify knowledge deficits and tailor educational interventions to address identified needs.

  12. “It Depends”: Viewpoints of Patients, Physicians, and Nurses on Patient-Practitioner Prayer in the Setting of Advanced Cancer

    PubMed Central

    Balboni, Michael J.; Babar, Amenah; Dillinger, Jennifer; Phelps, Andrea C.; George, Emily; Block, Susan D.; Kachnic, Lisa; Hunt, Jessica; Peteet, John; Prigerson, Holly G.; VanderWeele, Tyler J.; Balboni, Tracy A.

    2012-01-01

    Context Although prayer potentially serves as an important practice in offering religious/spiritual support, its role in the clinical setting remains disputed. Few data exist to guide the role of patient-practitioner prayer in the setting of advanced illness. Objectives To inform the role of prayer in the setting of life-threatening illness, this study used mixed quantitative-qualitative methods to describe the viewpoints expressed by patients with advanced cancer, oncology nurses, and oncology physicians concerning the appropriateness of clinician prayer. Methods This is a cross-sectional, multisite, mixed-methods study of advanced cancer patients (n = 70), oncology physicians (n = 206), and oncology nurses (n = 115). Semistructured interviews were used to assess respondents’ attitudes toward the appropriate role of prayer in the context of advanced cancer. Theme extraction was performed based on interdisciplinary input using grounded theory. Results Most advanced cancer patients (71%), nurses (83%), and physicians (65%) reported that patient-initiated patient-practitioner prayer was at least occasionally appropriate. Furthermore, clinician prayer was viewed as at least occasionally appropriate by the majority of patients (64%), nurses (76%), and physicians (59%). Of those patients who could envision themselves asking their physician or nurse for prayer (61%), 86% would find this form of prayer spiritually supportive. Most patients (80%) viewed practitioner-initiated prayer as spiritually supportive. Open-ended responses regarding the appropriateness of patient-practitioner prayer in the advanced cancer setting revealed six themes shaping respondents’ viewpoints: necessary conditions for prayer, potential benefits of prayer, critical attitudes toward prayer, positive attitudes toward prayer, potential negative consequences of prayer, and prayer alternatives. Conclusion Most patients and practitioners view patient-practitioner prayer as at least occasionally

  13. Nurse practitioner prescribing in Australia: A comprehensive literature review.

    PubMed

    Fong, Jacqueline; Buckley, Thomas; Cashin, Andrew; Pont, Lisa

    2017-09-01

    In Australia, the nurse practitioner (NP) obtained prescriptive authority in some jurisdictions in 2001. One of the key aspects in which the scope of NPs differs from Registered Nurses (RNs) relates to the legal privilege to prescribe medications. Although NPs have had prescriptive authority in Australia since 2001, with access to the Commonwealth subsidy scheme (PBS) since 2010, little is known about NPs prescriptive patterns or outcomes of prescriptive practice. The aim of this scoping review was to examine the extent, range and nature of research conducted in relation to NP prescribing in the Australian health context as well as identify gaps in the existing literature. Whilst considerable research has been undertaken on medical prescribing, to date there is no published review of studies regarding NP prescribing in the Australian context. A structured search of the literature was undertaken using permutations of the following key words 'nurse practitioner prescribing Australia', 'nurse practitioner and prescribing', 'advanced practice nurse and prescribing', 'nurse practitioner and Australia'. Databases where searched from January 2000 to January 2016. Databases searched include PsycInfo, Pubmed, CINAHL and Medline. There are a number of distinguishing features of NP prescribing practices in the Australian context. Little is known about the prescribing behaviours of critical care NPs in both the international and Australian context. Key themes identified were: barriers to prescribing, attitudes to NP prescribing, frequency of prescribing, types of medications prescribed, prescribing practice behaviours and confidence in prescribing. The impact of legislative changes on Australian NPs clinical practice and service delivery is still evolving. This review should create impetus for further research to determine the outcomes of NP prescribing on both patient and health service outcomes in the Australian healthcare context including critical care settings. Copyright

  14. 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.

  15. 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…

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

    ERIC Educational Resources Information Center

    Heale, Roberta; Gorham, Robyn; Fournier, Jennifer

    2010-01-01

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

  17. 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…

  18. Evaluation of Medical Nurse Practitioner Program: Participant Instrument No. 1.

    ERIC Educational Resources Information Center

    Rott, Robert K.

    This instrument was designed to provide a goal-free evaluation of a pilot training program for Medical Nurse Practitioners. With minor modification, the instrument can be applied to programs at several educational levels: secondary, college, adult, and continuing. The instrument uses 5-point Likert-type scales (with positive and negative…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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)

  4. Open carpal tunnel decompression by specialist versus nurse practitioner.

    PubMed

    Patel, Nimesh; Roberton, Andy; Batten, Timothy; Millyard, Cathy; Birdsall, Paul

    2015-12-01

    To compare the outcome after open carpal tunnel decompression by specialists versus a nurse practitioner. Of 1361 cases of open carpel tunnel decompression under local anaesthesia from 1996 to 2008, 807 were performed by specialists (consultant, specialist registrar, or specialty and associate specialist) and 554 by a nurse practitioner (since May 2006). The 2 groups were compared in terms of surgical time, total theatre time, postoperative pain, and patient satisfaction with the service. The mean surgical time was shorter in cases performed by specialists (13 vs. 18 minutes, p<0.0001), as was the mean total theatre time (26 vs. 29 minutes, p=0.0154). The rate of postoperative pain was higher in cases performed by specialists (31.5% vs. 24.5%, p=0.0125), as was the rate of patient dissatisfaction (1.6% vs. 0.18%, 0.0113). Nonetheless, since May 2006, outcome was comparable for specialists and the nurse practitioner. This could be due to the change from short-acting to long-acting/mixed local anaesthetic, and the technique for infiltration. The waiting time for surgery reduced from a mean of 16 to 3 weeks. Specialists and the nurse practitioner achieved comparable outcome after open carpal tunnel decompression.

  5. National Association of Neonatal Nurse Practitioners (NANNP) Workforce Survey.

    PubMed

    Kaminski, Mary M; Meier, Susan; Staebler, Suzanne

    2015-06-01

    As an integral member of a healthcare team, neonatal nurse practitioners (NNPs) provide care in a variety of settings that include but are not limited to all levels of inpatient care, transport, acute and chronic care settings; delivery rooms; and outpatient care settings. Anecdotal evidence indicates that responsibilities, practice environment, and workload vary widely between regions and practice settings. Historically, the supply of neonatal nurse practitioners has rarely met the demand for services, although needs vary by region at any given time. Because the NNP role is a collaborative one, a shortage of NNPs leaves a gap in the team approach to care. In 2011, the National Association of Neonatal Nurse Practitioners (NANNP) commissioned the first national study of the current NNP workforce in the United States and Canada. In an effort to further explore the NNP workforce population, the NANNP Council partnered with the National Certification Corporation to perform a second workforce survey of NNPs in the spring of 2014. The online survey was conducted between March and April 2014. The goal of the study was to describe the demographics, practice environment, scope of responsibilities, benefits and reimbursement, and job satisfaction for the current NNP workforce. Key areas of concern identified by the 2014 Neonatal Nurse Practitioner Workforce Survey include an aging workforce; the need for NNP faculty; inadequate staffing ratios; the lack of downtime during prolonged shifts; and the need to assisting practices in developing competency and mentoring programs.

  6. Advanced nurse practitioner-led abdominal therapeutic paracentesis.

    PubMed

    Aplin, Neal

    2017-03-10

    Liver disease is a common cause of death in England and Wales, and ascites is associated with a 50% mortality rate. Most patients who present with ascites have underlying liver cirrhosis, and often require therapeutic paracentesis for symptomatic relief. This article describes a competency framework that was developed to enable advanced nurse practitioners to perform therapeutic paracentesis in an ambulatory care unit.

  7. Acute Care Pediatric Nurse Practitioner: The 2014 Practice Analysis.

    PubMed

    Reuter-Rice, Karin; Madden, Maureen A; Gutknecht, Sarah; Foerster, Adele

    2016-01-01

    Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study describes the current practice of the acute care pediatric nurse practitioner (AC PNP) to inform an update of the Certified Pediatric Nurse Practitioner-Acute Care (CPNP-AC) examination content outline. A descriptive analysis was performed of the responses of 319 pediatric nurse practitioners, practicing in an acute care role, who completed a practice survey in 2014. Respondents were primarily White women with a mean age of 40 years; 75% had been formally educated as AC PNPs, compared with 48% in 2009. Regional practice was most heavily concentrated in the Southeast (28%) and Midwest (27%). Most respondents (81%) practiced in urban areas. Respondents reported spending 75% of practice time in inpatient settings. The most frequently cited areas of practice were critical care (36%), followed by emergency department (9%) and subspecialty practices. This third analysis of AC PNP practice 10 years after initiation of the CPNP-AC certification examination demonstrates changes in clinical practice and educational preparation. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

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

    ERIC Educational Resources Information Center

    Taunton, Roma Lee; Soptick, John M.

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

  9. 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)

  10. Clinical Knowledge of Pediatric Nurse Practitioners, Medical Students, and Residents

    ERIC Educational Resources Information Center

    Davidson, Margaret H.; And Others

    1978-01-01

    An extensive written examination in pediatric clinical knowledge has been used to compare pediatric nurse practitioners with medical students and residents in pediatrics. Results of the study indicate that the PNPs were comparable in most areas except clinical pathology to the students and residents, sometimes even surpassing them. (LBH)

  11. 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.

  12. Utilization of Nurse Practitioners in Emergency Medical Treatment.

    DTIC Science & Technology

    1981-05-01

    study protocol as described in this report was submitted forSr- v’ew to nurse researchers familiar to and with the ANC and to e0mergency cure...Emergency Department Nurses’ Association in their published Core Curriculum. If the ENP concept is still considered a researchable question, recommend the...and Fo>, .. 1 c c Vi. , and Nurse Practitioners: A Survey of Baltimore Urban Residents. Vedical Care, 1979, 17:5 (May) 526-35 18. Waeckerle, J.F

  13. What does it mean to be an oncology nurse? Reexamining the life cycle concepts.

    PubMed

    Cohen, Marlene Z; Ferrell, Betty R; Vrabel, Mark; Visovsky, Constance; Schaefer, Brandi

    2010-09-01

    To summarize the current research pertaining to the concepts initially examined by the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force and related projects completed in 1994. Published articles on the 21 concepts from the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force work. Research published in English from 1995-2009 was obtained from PubMed, CINAHL(R), PsycINFO, ISI Science, and EBSCO Health Source(R): Nursing/Academic Edition databases. Most of the concepts identified from the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force have been examined in the literature. Relationships and witnessing suffering were common concepts among studies of the meaning of oncology nursing. Nurses provide holistic care, and not surprisingly, holistic interventions have been found useful to support nurses. Interventions included storytelling, clinical support of nurses, workshops to find balance in lives, and dream work. Additional support comes from mentoring. The research identified was primarily descriptive, with very few interventions reported. Findings have been consistent over time in diverse countries. This review indicates that although the healthcare system has changed significantly in 15 years, nurses' experiences of providing care to patients with cancer have remained consistent. The need for interventions to support nurses remains.

  14. Nurse practitioner caseload in primary health care: Scoping review.

    PubMed

    Martin-Misener, Ruth; Kilpatrick, Kelley; Donald, Faith; Bryant-Lukosius, Denise; Rayner, Jennifer; Valaitis, Ruta; Carter, Nancy; Miller, Patricia A; Landry, Véronique; Harbman, Patricia; Charbonneau-Smith, Renee; McKinlay, R James; Ziegler, Erin; Boesveld, Sarah; Lamb, Alyson

    2016-10-01

    To identify recommendations for determining patient panel/caseload size for nurse practitioners in community-based primary health care settings. Scoping review of the international published and grey literature. The search included electronic databases, international professional and governmental websites, contact with experts, and hand searches of reference lists. Eligible papers had to (a) address caseload or patient panels for nurse practitioners in community-based primary health care settings serving an all-ages population; and (b) be published in English or French between January 2000 and July 2014. Level one testing included title and abstract screening by two team members. Relevant papers were retained for full text review in level two testing, and reviewed by two team members. A third reviewer acted as a tiebreaker. Data were extracted using a structured extraction form by one team member and verified by a second member. Descriptive statistics were estimated. Content analysis was used for qualitative data. We identified 111 peer-reviewed articles and grey literature documents. Most of the papers were published in Canada and the United States after 2010. Current methods to determine panel/caseload size use large administrative databases, provider work hours and the average number of patient visits. Most of the papers addressing the topic of patient panel/caseload size in community-based primary health care were descriptive. The average number of patients seen by nurse practitioners per day varied considerably within and between countries; an average of 9-15 patients per day was common. Patient characteristics (e.g., age, gender) and health conditions (e.g., multiple chronic conditions) appear to influence patient panel/caseload size. Very few studies used validated tools to classify patient acuity levels or disease burden scores. The measurement of productivity and the determination of panel/caseload size is complex. Current metrics may not capture

  15. Comparison of nurse practitioner and family physician relative work values.

    PubMed

    Sullivan-Marx, E M; Maislin, G

    2000-01-01

    With the enactment of the Balanced Budget Act of 1997, American nurse practitioners were granted direct Medicare reimbursement for Part B services. Payment structures in fee-for-service and managed care systems are physician-based, leading to difficulties in constructing payments for other health care professionals. The purpose of this pilot study was to examine the feasibility of using nurse practitioner data for specifying relative work values in the Medicare Fee Schedule for three office-visit codes. An exploratory survey was designed to establish relative work values using magnitude-estimation scaling. Nurse practitioners (N = 43) responded to a structured questionnaire in a national mail survey. Physician data (N = 46) were obtained from a computerized database from the American Academy of Family Physicians. The methods used in this study were the same as the process used by the American Medical Association and the Health Care Financing Administration to establish relative work values in the Medicare Fee Schedule. Respondents established relative work values for three Current Procedural Terminology (CPT) codes for office visits (99203, 99213, 99215) commonly billed in primary care practice. Each CPT code descriptor and associated vignette were compared with reference services germane to the practice of nurse practitioners and family physicians, using magnitude-estimation scaling. To establish relative work values for each code, respondents were asked to consider the time to provide the service and intensity of the work involved for each CPT code. No significant differences between nurse practitioners and family physicians were found in the three CPT codes for relative work values and intensity. Nurse practitioners estimated significantly (p < .01) higher intraservice (face to face) time with patients than did family physicians, and family physicians estimated significantly (p < .05) higher pre-service time for two codes and significantly (p < .05) higher

  16. 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.

  17. Professionalism and professional quality of life for oncology nurses.

    PubMed

    Jang, Insil; Kim, Yuna; Kim, Kyunghee

    2016-10-01

    To identify the relationship between professionalism and professional quality of life among oncology nurses working at tertiary hospitals in Korea. Oncology nurses are combined with core competencies and qualities required in cancer patient care. Professionalism that means compassion satisfaction and compassion fatigue is a main concept in problem-solving strategies as motivation. Their satisfaction is representative of professionalism and professional quality of life. However, little research has focused on professionalism and professional quality of life. A cross-sectional study with self-administered questionnaires. A total of 285 nurses from two tertiary hospitals were included. Data collection was undertaken using Korean version of professionalism scale derived from the Hall Professional Inventory Scale and professional quality of life. Data were analysed by spss 21.0 for Windows Program using t-test, anova, and multiple regression. The mean score of professionalism in oncology nurses was 77·98 ± 7·31. The mean professional quality of life score for compassion satisfaction, compassion fatigue and secondary traumatic stress was 33·84 ± 5·62, 28·38 ± 5·36 and 28·33 ± 5·48. Compassion satisfaction was affected by factors of professionalism with an explanatory power of 49·2%. Burnout and secondary traumatic stress were affected by factors of professionalism with an explanatory power of 39·3% and 4·8%. The higher the professionalism leads to the higher the compassion satisfaction, the lower the compassion fatigue. The relationship between professionalism and professional quality of life for a health work environment requires further investigation. Our study supports the idea that enhancing professionalism can increase professional quality of life. It is necessary to develop professionalism by recognised qualifications and applied rewards in advanced nursing organisational culture. Furthermore, compassion satisfaction is increased by

  18. e-Mentorship: Navigation strategy for promoting oncology nurse engagement in research.

    PubMed

    Bryant-Lukosius, Denise

    2015-01-01

    There is a high need for research mentorship among Canadian oncology nurses. E-mentorship is an effective vehicle for linking oncology nurses with experienced researchers across the country who can help them navigate the road and increase their engagement in research. E-mentorship also has the potential to build research capacity more broadly by strengthening national networks and connections among researchers, cancer care organizations and oncology nurses at the point of care. Innovative strategies are needed to more easily identify and recruit researchers who are committed to advancing oncology nursing practice through effective mentorship.

  19. Nursing Service Innovation: a case study examining emergency nurse practitioner service sustainability.

    PubMed

    Fox, Amanda; Gardner, Glenn; Osborne, Sonya

    2017-09-14

    This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, 2014). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. Anti-mutagenicity Effects of Vitamin E on Oncology and Non-oncology Hospital Nurses by Ames Assay

    PubMed Central

    Rezaei-Basiri, Majid; Rezazadeh, Hassan; Aswadi-Kermani, Iraj; Ghazi-Khansari, Mahmud

    2013-01-01

    Introduction: The aim of this study is to determine the anti-mutagenic effects of Vitamin E among nurses of oncology and non-oncology hospitals exposed to chemotherapy drugs. Several studies have demonstrated that nurses occupationally exposes to cytostatic drugs. Material and Methods: A total of 138 female nurses from oncology and non-oncology hospitals participated in the study. All urine samples of nurses before and after Vitamin E consumption (200 mg/day) were evaluated by Ames Salmonella typhimorium mutagenicity test using histidine negative of tester strain TA100 with and without S-9mix. In all steps the collected urine samples extracts were prepared using amberlit XAD-2 resins and examined for mutagenicity activity. The data of Ames assay were analyzed with Anova one way and t-test statistical. Results: In the present study 25% of oncology nursing staff excrete carcinogenic compounds in their urine and oral consumption of Vitamin E for two weeks showed significant anti-mutagenic effects. Discussion: It was appeared that the urinary mutagenic activity will decrease by receiving Vitamin E. However, after Vitamin E consumption there was significantly depletion of urinary mutagenic activity in urine extracts among the exposed nursing personnel. Conclusion: We conclude that mild effects of Vitamin E against poor safety and significant adverse events among nurses handling cytotoxic drugs. There is, therefore, a need to improve the safety of the work environment, make available protective equipment, develop standard practice guidelines for oncology nurses and higher therapeutic doses of Vitamin E may be a promising compound for reducing mutagenic effects of anti-neoplastic drugs among oncology hospital nurses. PMID:24551674

  1. Nurse Practitioner Care Improves Renal Outcome in Patients with CKD

    PubMed Central

    van Zuilen, Arjan D.; van den Brand, Jan A.J.G.; Bots, Michiel L.; van Buren, Marjolijn; ten Dam, Marc A.G.J.; Kaasjager, Karin A.H.; Ligtenberg, Gerry; Sijpkens, Yvo W.J.; Sluiter, Henk E.; van de Ven, Peter J.G.; Vervoort, Gerald; Vleming, Louis-Jean; Blankestijn, Peter J.; Wetzels, Jack F.M.

    2014-01-01

    Treatment goals for patients with CKD are often unrealized for many reasons, but support by nurse practitioners may improve risk factor levels in these patients. Here, we analyzed renal endpoints of the Multifactorial Approach and Superior Treatment Efficacy in Renal Patients with the Aid of Nurse Practitioners (MASTERPLAN) study after extended follow-up to determine whether strict implementation of current CKD guidelines through the aid of nurse practitioners improves renal outcome. In total, 788 patients with moderate to severe CKD were randomized to receive nurse practitioner support added to physician care (intervention group) or physician care alone (control group). Median follow-up was 5.7 years. Renal outcome was a secondary endpoint of the MASTERPLAN study. We used a composite renal endpoint of death, ESRD, and 50% increase in serum creatinine. Event rates were compared with adjustment for baseline serum creatinine concentration and changes in estimated GFR were determined. During the randomized phase, there were small but significant differences between the groups in BP, proteinuria, LDL cholesterol, and use of aspirin, statins, active vitamin D, and antihypertensive medications, in favor of the intervention group. The intervention reduced the incidence of the composite renal endpoint by 20% (hazard ratio, 0.80; 95% confidence interval, 0.66 to 0.98; P=0.03). In the intervention group, the decrease in estimated GFR was 0.45 ml/min per 1.73 m2 per year less than in the control group (P=0.01). In conclusion, additional support by nurse practitioners attenuated the decline of kidney function and improved renal outcome in patients with CKD. PMID:24158983

  2. Continuity of care by cardiothoracic nurse practitioners: impact on outcome.

    PubMed

    Southey, Dawn; Mishra, Pankaj Kumar; Nevill, Alan; Aktuerk, Dincer; Luckraz, Heyman

    2014-10-01

    There have been recent reports on increased mortality in British National Health Service hospitals during weekends. This study aimed to assess the impact on patient care following the introduction of nurse practitioner cover for the cardiothoracic ward, including weekends. Prospectively collected and validated data of patients operated on from January 2005 to October 2011 were analyzed. The patients were grouped according to era: before (n = 2385) and after (n = 3910) the introduction of nurse practitioners in October 2007. There were no significant differences in preoperative patient characteristics such as age, logistic EuroSCORE, sex, smoking, and extracardiac vascular problems. There were more patients from an Asian background (p < 0.01), more with noninsulin-dependent diabetes (p < 0.01), and more requiring urgent cardiac surgery (p < 0.01) in the later era. Following the introduction of nurse practitioner grade, there was a decrease in the rate of cardiac intensive care unit readmission from 2.6% to 1.9% (p = 0.05) and length of hospital stay from 10 to 8 days (p < 0.01). There was a significant improvement in overall survival after cardiac surgery from 96.5% to 98.0% (p < 0.01). Logistic regression analysis confirmed that the presence of nurse practitioners on the ward was the strongest predictor of survival with an odds ratio of 1.9 (95% confidence interval: 1.23-3.01). The introduction of the nurse practitioner grade to provide continuity in patient care including at weekends has been confirmed to improve patient outcomes including survival after cardiac surgery. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. 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. © The Author(s) 2015.

  4. Nurse practitioner education: greater demand, reduced training opportunities.

    PubMed

    Forsberg, Ingrid; Swartwout, Kathryn; Murphy, Marcia; Danko, Katie; Delaney, Kathleen R

    2015-02-01

    To document the factors that are increasing the tension between nurse practitioner (NP) educational programs and the clinical training sites needed for NP students. Literature and the faculty experiences garnered over years of placing NP students for clinical training. Several conditions converge to create a situation where sites are increasingly reluctant to precept NP students. The underlying dynamics are diverse and include factors related to the electronic health record, productivity expectations, and the increasing demand for sites as a result of increasing NP enrollments and competing healthcare provider programs. The nursing community should approach this issue strategically and devise an action and policy agenda to support NP training, including federal monies to support NP training in a design that parallels the Graduate Medical Education; recognition of NPs as licensed professionals in advanced training; and identification of meaningful incentives for NP preceptors. ©2014 American Association of Nurse Practitioners.

  5. 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

  6. 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...

  7. 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)...

  8. 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)...

  9. 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)...

  10. 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…

  11. Implementation of the American Society of Clinical Oncology and Oncology Nursing Society chemotherapy safety standards.

    PubMed

    Vioral, Anna N; Kennihan, Heather K

    2012-12-01

    Chemotherapy involves an intricate, high-risk, multidisciplinary process of prescribing, dispensing, and administering complex multimedication regimens with narrow therapeutic indices. Chemotherapeutic agents also require safe-handling precautions for patients and healthcare providers. In addition, a number of chemotherapy and targeted therapies have expanded to nononcology populations. This complexity demands standardization of chemotherapy practice for all healthcare providers to ensure safe outcomes. This article describes one organization's multidisciplinary effort to standardize chemotherapy practice according to the American Society of Clinical Oncology and Oncology Nursing Society's 31 safety standards for chemotherapy administration. The article also describes how the organization integrated and developed standards of practice using interdisciplinary approaches. The educational processes used during implementation and the lessons learned are discussed to assist healthcare providers involved in standardizing chemotherapy administration. The article equips healthcare professionals with a multidisciplinary process for high-quality clinical standards of practice that may reduce errors and ensure safety.

  12. [The making and development of policy concerning nurse practitioners in Taiwan].

    PubMed

    Tsay, Shwu-Feng; Wang, Hsiu-Hung

    2007-12-01

    The purpose of this article is to guide nurses towards an understanding of current policy making and policy development concerning nurse practitioners. The article outlines the planned blueprints for the establishment of nurse practitioners through a systematic analysis of the developmental context surrounding nurse practitioners in Taiwan, and discusses Taiwan's current nurse practitioner policy from the perspective of participation and observation. It is hoped that an understanding of the processes by which policy is formed will provide nurses with the knowledge and skills to participate in policy-making and raise the influence of the professional commitment involved in nursing.

  13. Nurse Practitioners’ Experience With Herbal Therapy

    DTIC Science & Technology

    2000-05-01

    Nursing Services Approval Letter APPENDIX B: USUHS IRB Approval Letter APPENDIX C: Malcolm Grow IRB Approval Letter APPENDIX D: Research Study...schools are beginning to recognize the growing trend of patients resorting to complementary and non-traditional therapies, including the use of herbal...response to this growing trend has not been well documented. Because patients are at an increased risk for medication-herb interactions, adverse side

  14. [The relationships between the general practitioner and the oncological radiotherapist. A preliminary study by telephone interviews].

    PubMed

    Baio, A; Cavallini Francolini, D; Corbella, F; De Vecchi, P; Ragone, L; Tinelli, C; Franchini, P

    1999-11-01

    We addressed the issue of the relationship between the general practitioner (GP) and the radiotherapist to improve the quality of care of cancer patients. The study consisted in evaluating medical requests and phone interviews, with a questionnaire with yes/no and multiple choice answers to the following 5 questions: 1) Do you think a cancer diagnosis is always a hopeless death sentence? 2) Is it professionally rewarding to cure a cancer patient? 3) Are you satisfied with your relationship, as a general practitioner, with oncologic reference centers? 4) Is it more wearing for a general practitioner to manage a cancer than a noncancer patient? 5) Would you answer a questionnaire about the relationship between the general practitioner, the cancer patient and the oncologist? We evaluated 1590 medical requests and made 401 phone interviews; 255 colleagues (70%) answered the questionnaire. Medical requests were correctly and completely formulated by GPs in 45% of cases. A cancer diagnosis was not considered a hopeless death sentence in 90.9% of cases and 76% of GPs considered it professionally rewarding to cure a cancer patient. 75.6% of GPs considered it more wearing to manage a cancer than a noncancer patient, and female GPs felt this more strongly than their male counterparts. Irrespective of gender, GPs over 50 years of age tend to consider cancer a hopeless and fatal disease. The relationship with oncologic centers was considered satisfactory in 86.2% of cases. However, since cancer patients need greater medical care, GPs would like a closer cooperation with oncologists. The great interest GPs took in this study encourages further investigation through a more in depth questionnaire designed with the help of GPs themselves and interested statisticians.

  15. The complexities of defining nurse practitioner scope of practice in the Australian context.

    PubMed

    Scanlon, Andrew; Cashin, Andrew; Bryce, Julianne; Kelly, John G; Buckely, Tom

    2016-01-01

    To explore the legislative and regulatory constraints that defines nurse practitioner scope of practice within the Australian context. Nurse practitioners have been endorsed to practice in Australia for over 13 years. However, despite this lengthy period, there still remains confusion amongst newly endorsed nurse practitioners and their employers as to what determines the scope of their practice in Australia. A review of available policy and regulatory documents related to the Australian operational requirements for nurse practitioner scope of practice cited within or referred to by the Nursing and Midwifery Board of Australia. Data were collected over a 2-month period in 2013. This utilized the current standards, codes and guidelines cited by the Nursing and Midwifery Board of Australia related to scope of practice and nurse practitioner, as well as legislation and regulation referred to in relation to nurse practitioner practice. Information was also obtained through government health and professional organization websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant. Implications for nursing: Providing a means of interpreting the determinants of nurse practitioner scope of practice within Australia. The factors that determine nurse practitioner scope of practice, education, clinical experience, and competence leading to endorsement, are straightforward. However, the context of clinical practice, including jurisdictional restrictions, is major barriers to the expression of nurse practitioner scope of practice. These restrictions, although not insurmountable, continue to hinder nurse practitioners from practicing to their full scope of practice.

  16. 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…

  17. 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…

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

    PubMed

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

    2013-06-23

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

  19. Articulating nurse practitioner practice using King's theory of goal attainment.

    PubMed

    de Leon-Demare, Kathleen; MacDonald, Jane; Gregory, David M; Katz, Alan; Halas, Gayle

    2015-11-01

    To further understand the interactions between nurse practitioners (NPs) and patients, King's nursing theory of goal attainment was applied as the conceptual framework to describe the interactions between NPs and patients in the primary care setting. Six dyads of NPs and their patients were video- and audio-taped over three consecutive clinic visits. For the purposes of this arm of the study, the audio-taped interactions were transcribed and then coded using King's concepts in her theory of goal attainment. King's theory was applicable to describe NP practice. King's concepts and processes of nurse-patient interactions, such as disturbances, mutual goal setting, and transactions, were observed in NP-patient interactions. Disturbances during clinical encounters were essential in the progression toward goal attainment. Elements, such as social exchange, symptom reporting, role explanation, and information around clinical processes facilitated relationship building. NPs as practitioners need to be reflective of their own practice, embrace disturbances in the clinical encounter, and attend to these as opportunities for mutual goal setting. ©2015 American Association of Nurse Practitioners.

  20. Educating neonatal nurse practitioners in the 21st century.

    PubMed

    LeFlore, Judy; Thomas, Patricia E; Zielke, Marjorie A; Buus-Frank, Madge E; McFadden, Barbara E; Sansoucie, Debra A

    2011-01-01

    The purpose of this education project is to prepare neonatal nurse practitioners using a nonlinear (random exposure to information delivered in context rather than abstracting information as is done in a traditional lecture), asynchronous approach. The Internet-based 3-dimensional virtual "living world" classroom will have a living textbook and a virtual neonatal intensive care unit (NICU). Deploying the program within a virtual living world will enhance program accessibility and overcome the challenges of nurses returning to school. Greater accessibility can help to alleviate the shortage of neonatal providers, which are needed to meet the needs of the growing population.A Neonatal Curriculum Consortium comprising expert neonatal nurse practitioners and faculty are developing multimedia learning modules for core content defined by national organizations and certifying bodies. Our Internet-based, multisite, nonlinear, asynchronous universal neonatal curriculum has at its core a 3-dimensional virtual "living text book" for didactic instruction and a "living world" NICU for "deliberate practice." The NICU will feature an interactive virtual infant patient. Our "Virtual NICU" will assist students to transition from the classroom, to the simulation laboratory, and ultimately to the clinical area. Providing clinical learning experiences in the virtual NICU will enhance the students' opportunities to learn to care for the culturally diverse populations they will serve as neonatal nurse practitioners.

  1. Oral Health Education for Pediatric Nurse Practitioner Students

    PubMed Central

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

    2014-01-01

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

  2. 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.

  3. The nurse practitioner role in pain management in long-term care.

    PubMed

    Kaasalainen, Sharon; Martin-Misener, Ruth; Carter, Nancy; Dicenso, Alba; Donald, Faith; Baxter, Pamela

    2010-03-01

    This paper is a report of a study exploring the perceptions of long-term care team members and nurse managers about barriers and facilitators to optimal use of nurse practitioners to manage residents' pain in long-term care settings. Considering the high rates of pain in long-term care, research is needed to explore innovations in health-services delivery, including the emerging nurse practitioner role. For this study, an exploratory descriptive design was used to collect data in spring 2007 from five focus groups of nurses and 14 individual interviews with other healthcare team members and nurse managers. Data were analysed using thematic content analysis. Five pain management activities performed by nurse practitioners were identified, including assessing pain, prescribing pain medications, monitoring pain levels and side effects of pain medications, consulting and advocating for staff and patients, and leading and educating staff related to pain management. Factors that influenced the implementation of the nurse practitioner role included the availability of the nurse practitioner, scope of practice, role clarity, perceived added value of nurse practitioner role, terms of employment, nurse practitioner-physician relationship. Perceived outcomes of the nurse practitioner role were also described. The findings from this study contribute to our understanding of how the nurse practitioner role is perceived by other healthcare professionals, particularly in pain management. Stronger interprofessional collaborative relationships need to be facilitated within a model of care that includes a nurse practitioner, with the ultimate goal of improving pain management services in long-term care.

  4. Peer-supported storytelling for grieving pediatric oncology nurses.

    PubMed

    Macpherson, Catherine Fiona

    2008-01-01

    Telling stories about deceased patients to supportive peers is frequently mentioned as an activity used for meaning-making in anecdotal reports of clinical practice and the literature addressing nurses' experiences caring for dying children. This study examines peer-supported storytelling for grieving pediatric oncology nurses using a mixed methods single-group descriptive repeated measures design. Participants were 6 registered nurses from a tertiary care pediatric hospital inpatient oncology unit who self-identified as experiencing grief. Participants met in self-selected dyads for 2 storytelling sessions. Questionnaires were completed at baseline, midpoint, and study end. Sessions were audio-recorded. Participants reported (1) receiving and providing support during sessions; (2) that sessions had an impact on their grief; (3) that sessions had an impact on their meaning-making, and the explicit session focus on making sense of and identifying benefit in their experiences was particularly helpful. There was a significant positive correlation between participant report of number of special patient deaths during career and impact of sessions on grief.

  5. Investigating the Nursing Practitioners Perspectives about Undergraduate Nursing Internship and Apprenticeship Courses: Is Renewing Required?

    PubMed Central

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

    2013-01-01

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

  6. Evaluation of a compassion fatigue resiliency program for oncology nurses.

    PubMed

    Potter, Patricia; Deshields, Teresa; Berger, Julia Allen; Clarke, Marty; Olsen, Sarah; Chen, Ling

    2013-03-01

    To evaluate a resiliency program designed to educate oncology nurses about compassion fatigue. Descriptive pilot study. A National Cancer Institute-designated comprehensive cancer center in the midwestern United States. 13 oncology nurses employed in an outpatient infusion center. Nurses attended a five-week program involving five 90-minute sessions on compassion fatigue resiliency. A pre- and post-test design, using repeated measures, was conducted over six months. Scores on the Professional Quality of Life (ProQOL) IV, Maslach Burnout Inventory-Human Services Survey, Impact of Event Scale-Revised (IES-R), and the Nursing Job Satisfaction Scale. Long-term benefits were realized from the program. Secondary traumatization scores on the ProQOL IV declined immediately after the program, remained down at three months, and then dropped again at six months, with a statistically significant mean difference compared with baseline. The average IES-R total scores improved significantly overall and for each of the three postintervention time points. Participants evaluated the program positively with respect to their ability to apply and benefit from resiliency techniques. This is the first reported study to show benefits gained from a compassion fatigue intervention program. Participants received useful strategies for managing stress at work and home. Compassion fatigue is a prevalent condition among healthcare providers. Development of resiliency to compassion fatigue may improve decision making, clarity of communication, and patient and nurse satisfaction. Self-regulation offers an approach to reduce stress during a perceived threat. Working by intention reduces reactivity in the workplace and makes communication more intentional and, therefore, effective.

  7. 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.

  8. Resilience and burnout status among nurses working in oncology.

    PubMed

    Kutluturkan, Sevinc; Sozeri, Elif; Uysal, Nese; Bay, Figen

    2016-01-01

    This study aimed to identify the resilience and burnout status of nurses working in the field of oncology. This descriptive study was conducted with 140 oncology nurses. The data were collected using a socio-demographic attributes form, Resilience Scale for Adults, and the Maslach's Burnout Inventory. Percentage ratios, mean and median values, Kruskal-Wallis test, Mann-Whitney U test, correlation analysis, and multiple stepwise linear regression analysis were used to evaluate the data. The Maslach's Burnout Inventory total median score was 49.00. The emotional exhaustion median score was 24.00, the depersonalization median score was 9.00, and the personal accomplishment median score was 16.00. The Resilience Scale for Adults total median score was 134.00. The median resilience subscale scores, such as structural style, perception of future, family cohesion, self-perception, social competence, and social resources, were 16.00, 16.00, 24.00, 25, 23, and 31, respectively. A relationship existed between emotional exhaustion and perception of future; depersonalization and structured style and self-perception; and personal accomplishment and structured style, perception of future, and self-perception. Multiple stepwise linear regression analysis revealed a significant relationship between the number of years in the field and emotional exhaustion and depersonalization scores. Moreover, a significant relationship between structured style variables and personal accomplishment scores was observed. This study demonstrated the relationship between burnout and resilience situations among the oncology nurses. The results can be used to plan individual and organizational interventions to increase resilience and reduce the experience of burnout by developing measures such as improving communication skills, providing education on stress management and coping strategies, using social resources, and organizing programs that provide psychological support.

  9. A comparative study of physicians' and nurses' conceptions of the role of the nurse practitioner.

    PubMed Central

    Burkett, G L; Parken-Harris, M; Kuhn, J C; Escovitz, G H

    1978-01-01

    Attempts to define the role of the nurse practitioner as a new health care provider raise questions about the traditional health care division of labor. In order to determine nurses' and physicians' conceptions of the NP's role, parallel surveys were conducted among registered nurses and primary care physicians in southeastern Pennsylvania (including Philadelphia). Respondents (679 nurses and 597 physicians) indicated their opinions on the issue of autonomy for NPs and on the issue of specific tasks appropriate to the NP's role. There were significant differences between nurses and physicians with respect to both of the issues under consideration, but there were also important differences within each of these groups. Nurses were more likely to assert that an NP might practice independently, and also had a higher conception of the NP's capabilities. Physicians who were interested in employing a nurse practitioner had opinions which were closest to those of nurses. These findings suggest that conflict between nurses and physicians might be minimal as long as the nurse practitioner movement remains relatively small, but that there may be latent conflict inherent in any large scale attempt to change the health care division of labor at the present time. PMID:717617

  10. 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…

  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 certified nurse midwife services. 405.2414 Section 405.2414 Public Health CENTERS FOR MEDICARE & MEDICAID... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services § 405.2414...

  12. Attitudes toward nurse practitioner-led chronic disease management to improve outpatient quality of care.

    PubMed

    Sciamanna, Christopher N; Alvarez, Kristy; Miller, Judith; Gary, Tiffany; Bowen, Mary

    2006-01-01

    To understand the acceptability for a model of chronic disease management, in which primary care patients see nurse practitioners for structured visits using an evidence-based encounter form, the authors sent a mailed survey to primary care physicians and nurse practitioners. A total of 212 subjects completed the survey, for a total response rate of 53% (physicians, 44%; nurse practitioners, 61%). Most physicians (79.5%) reported that nurse practitioners saw patients in their practice. Most physicians (80.0%) and nurse practitioners (95.7%) believed that the proposed model of care would improve the control of chronic illnesses. In addition, most physicians (73.8%) and nurse practitioners (87.6%) believed that the model of care would be of interest to similar providers. Overall, the high level of support for the model and the presence of nurse practitioners in most physician offices suggests that future studies are warranted to understand how best to implement this.

  13. The future of nurse practitioner practice: a world of opportunity.

    PubMed

    Aleshire, Mollie E; Wheeler, Kathy; Prevost, Suzanne S

    2012-06-01

    Health care is transforming at a rapid pace. Nurses should be leading change and advancing health in this increasingly complex health system. The multiple systemic health care changes occurring secondary to the 2010 Patient Protection and Affordable Care Act make this an optimal time for full use of nurse practitioners (NPs). This article describes the evolution and future of the NP role, explores the practice in relation to regulation and policy; primary care; acute care; international, global, and cultural issues; and public image, and addresses how NPs must prepare for changing health care environments and consumer demands. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Exploring the Factors that Influence Nurse Practitioner Role Transition.

    PubMed

    Barnes, Hilary

    2015-02-01

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

  15. [Paediatric emergency: creation of an independent nurse practitioner consultation].

    PubMed

    Rey-Bellet Gasser, C; Gehri, M; Yersin, C

    2015-01-14

    Consultations in the Paediatric Emergency Department (PED) continue to climb regularly. Emergency Nurse Practitioner consultations have long been created in the English speaking countries. Since January 2013, an indepen- dent nurse consultation, under delegated medical responsibility, exists in the multidisciplinary PED of the Children's Hospital of Lausanne. The mean consultation time is the same as the medical consultation and the overall waiting time hasn't decreased yet. But a well definite working frame, a systematic approach, as well as the continual medical supervision possibility, make it a safe, efficient and appreciated consultation, by both patients and professionals.

  16. Differential Effectiveness of Coping in Managing Stress and Burnout in Oncology Nurses.

    ERIC Educational Resources Information Center

    Rounds, James B., Jr.; Zevon, Michael A.

    High levels of stress experienced by primary care oncology nursing staff, and the competency impairment which results from such stress, has become a matter of much concern in health care settings. This study was conducted to identify the coping strategies employed by oncology nurses, and to relate these strategies to differential indices of stress…

  17. A historical perspective of the women's health nurse practitioner.

    PubMed

    Kass-Wolff, Jane H; Lowe, Nancy K

    2009-09-01

    There are more than 12,000 women's health nurse practitioners (WHNPs) currently certified by the National Certification Corporation (NCC) and practicing in a wide range of roles. The purpose of this article is to describe the historical development of the WHNP specialty, and to review the evolution of the specialty from an initially very focused practice in the area of family planning into obstetric and gynecologic care to today's more diffuse role inclusive of primary care. Women's health nurse practitioners must broaden their educational background to include the lifespan of women, not just the reproductive years. With the inclusion of chronic disease management of the middle-aged and elderly woman, WHNPs will provide more comprehensive and integrative health care to women in all areas of the United States.

  18. Patient satisfaction with nurse practitioner service in a rural setting.

    PubMed

    Knudtson, N

    2000-10-01

    To determine the level of patient satisfaction with service provided by nurse practitioners (NP) to rural patients. Original research utilizing the Nurse Practitioner Satisfaction Instrument (NPSI), developed by the researcher and completed by a convenience sample of 93 rural patients. Overall there was a high level of patient satisfaction with NP service. Significant relationships (p < or = .05) were identified between patient satisfaction and the subject's age, educational level, familiarity with the NP seen, overall health, satisfaction with expectations of service being met, and likelihood to recommend the NP to others. These findings can be used to support the effectiveness of NP providers and the need for less restriction in reimbursement policies, which in turn, may improve access to care in rural and underserved areas.

  19. Autonomy of nurse practitioners in primary care: An integrative review.

    PubMed

    Choi, Min; De Gagne, Jennie C

    2016-03-01

    This integrative review of the existing literature was conducted to identify dimensions related to nurse practitioner (NP) autonomy and to recommend future areas of research related to the important topic of NP autonomy in this era of cost-conscious healthcare reform. Articles were identified from the following databases: CINAHL, MEDLINE, PubMed, Ovid, Scopus, Google Scholar, and EBSCO. Over 24 articles were found; 12 peer-reviewed articles met the inclusion criteria of research conducted with NPs, physicians, and patients. The results revealed three categories of association with regard to NP autonomy: job satisfaction, patient satisfaction, and physician-NP collaboration. This review was undertaken to advance understanding of autonomy among NPs and the dynamics involved in their delivery of care. Further research into the associations between NP autonomy and its dimensions are necessary to indicate a future direction to the NP role. ©2015 American Association of Nurse Practitioners.

  20. Preparation and Evolving Role of the Acute Care Nurse Practitioner.

    PubMed

    Hoffman, Leslie A; Guttendorf, Jane

    2017-08-18

    Acute care nurse practitioners (ACNPs) are increasingly being employed as members of critical care teams, an outcome driven by increasing demand for intensive care services, a mandated reduction in house officer hours, and evidence supporting the ability of ACNPs to provide high-quality care as collaborative members of critical care teams. Integration of adult ACNPs into critical care teams is most likely to be successful when practitioners have appropriate training, supervision, and mentoring to facilitate their ability to practice efficiently and effectively. Accomplishing this goal requires understanding the educational preparation and skill set potential hires bring to the position as well as the development of an orientation program designed to integrate the practitioner into the critical care team. Pediatric ACNPs are also commonly employed in critical care settings; however, this commentary focuses on the adult ACNP role. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  1. New tool for patient evaluation of nurse practitioner in primary care settings.

    PubMed

    Klemenc-Ketis, Zalika; Kravos, Andrej; Poplas-Susič, Tonka; Svab, Igor; Kersnik, Janko

    2014-05-01

    To validate a tool for patient evaluation of nurse practitioners. The roles of nurse practitioners in family practice settings are health promotion and routine follow-up of patients with chronic diseases. So far, several tools for patient evaluation of nurse practitioners have been developed. They revealed several dimensions of nurse practitioners' work and high levels of patient satisfaction with their work. The studies also reported conflicting data on the associations between demographic and other variables and the level of nurse practitioners' evaluation by patients. A cross-sectional study. This study was performed in a sample of seven model family medicine practices in Slovenia. We included 30 consecutive adult patients in each model family practice aiming at the final sample of 210 respondents. Patient evaluation of nurse practitioners was assessed using a Nurse Practitioner Evaluation Scale. The response rate was 80·9%. Mean total score on Nurse Practitioner Evaluation Scale was 87·9 ± 12·4 points. Cronbach's alpha of Nurse Practitioner Evaluation Scale was 0·941. Factor analyses revealed three factors: clinical approach factor, comprehensive approach factor and patient-centred approach factor. Nurse Practitioner Evaluation Scale proved to be a reliable tool for patient evaluations of nurse practitioners in primary care settings. Nurse Practitioner Evaluation Scale can be used in terms of a whole scale as well as in terms of three separate subscales. This newly developed tool can be used to monitor quality performance of nurse practitioners and to plan quality improvement actions in nurse practitioners' performance in primary care settings. © 2013 John Wiley & Sons Ltd.

  2. Nurse practitioner private practice: three legal pitfalls to avoid.

    PubMed

    Buppert, C

    1996-04-01

    Private practice is now a viable option for nurse practitioners. NPs who open their own practice will be wise if they anticipate, consider, and act to prevent certain potential legal problems. Awareness and avoidance of these problems--risk avoidance--is the legal equivalent of preventive medicine. This article gives NPs an attorney's perspective on setting up a practice and some of the legal pitfalls to avoid.

  3. 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.

  4. Reconceptualizing the core of nurse practitioner education and practice.

    PubMed

    Burman, Mary E; Hart, Ann Marie; Conley, Virginia; Brown, Julie; Sherard, Pat; Clarke, Pamela N

    2009-01-01

    The movement to the doctor of nursing practice (DNP) is progressing rapidly with new programs emerging and curricular documents being developed. We argue that the implementation of the DNP is a good move for nursing, provided that we use the opportunity to reconceptualize the core of advanced practice nursing, especially nurse practitioner (NP) practice. Theory and research articles from nursing focused on advanced practice nursing, NPs, and doctoral education. The foundation of NP education is currently based essentially on borrowed or shared content in assessment, pharmacology, and pathophysiology. We argue that the heart and soul of nursing is in health promotion, both in healthy persons and in those dealing with chronic illness. Current master's programs do not prepare NPs to assume high-level practice focused on health promotion and disease management using the latest theoretical developments in health behavior change, behavioral sciences, exercise physiology, nutrition, and medical anthropology. Although these are touched upon in most NP programs, they do not represent the core science of NP education and need to be a critical part of any DNP program. Ultimately, our vision is for NP care to be consistently "different," yet just as essential as physician care, leading to positive outcomes in health promotion and disease management.

  5. Financial savvy: the value of business acumen in oncology nursing.

    PubMed

    Rishel, Cindy J

    2014-05-01

    Have you given serious thought to your individual ability to affect the high cost of health care? If so, you may have determined that the opportunity to have any meaningful effect on cost of services for patients with cancer is limited. You may believe that budgets are the responsibility of nursing leadership. Indeed, the development of the unit or department budget is an activity that many of us have no direct (or even indirect) role in completing. Once the budget is finalized, we are frequently given directives to control our costs and improve the financial bottom line for our employers. One could argue that this is a particularly difficult missive for oncology nurses with the soaring costs of chemotherapy and biotherapy drugs, the expenses incurred to provide supportive care needed by patients with cancer, and the need to provide services to the increasing number of cancer survivors.

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

    PubMed Central

    Morgan, Walter A.; Sullivan, Nancy D.

    1980-01-01

    The primary health care needs of at least 26 rural California communities are being served by nurse practitioners (NP's) or physician's assistants (PA's). All of these have physician supervision and support. NP's and PA's have proved to be acceptable and effective. With 230 rural areas in California identified as having unmet health care needs, this type of service is likely to increase and should be supported. NP/PA clinics serve total populations or concentrate on Indians, Chicanos or the poor. Many barriers have been overcome, especially over the past four years, to allow these clinics to flourish and increase in number. The availability of nurse practitioners and physician's assistants has increased due to support to schools and to school policies. Clinic funding has greatly improved; federal funds for general rural clinics, Indians, migrants, family planning and maternalchild health have been greatly supplemented by California state funds. Beginning in 1978, rural NP and PA services can be reimbursed by Medicare and Medi-Cal (California's Medicaid program). Since 1975 state laws have defined PA and NP roles broadly, and these roles are more precisely defined at the local level. Although nurse practitioners and physician's assistants generally cannot prescribe or dispense drugs (a major problem in many clinics), demonstration legislation allows special pilot projects to do both. As remaining funding and legal problems are corrected, NP's and PA's will serve an even greater role in rural areas. PMID:6104383

  7. Collaborative arrangements for Australian nurse practitioners: a policy analysis.

    PubMed

    Cashin, Andrew

    2014-10-01

    In Australia in 2010, nurse practitioners (NPs) were granted legislated access to the Medical Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) as providers. These schemes are the federal schemes for third-party reimbursement for health care and medications. As a condition of access to the schemes, it was determined that collaborative arrangements needed to be in place as part of eligibility criteria for NPs. This article is the first published policy analysis of this determination. Published literature and available grey literature (including meeting minutes), and media content, was accessed and analyzed. The policy that was the National Health Collaborative arrangements for Nurse Practitioners Determination to amend the Australian National Health Act 1953 was a success. The policy led to NP access as providers to the MBS and PBS in Australia. Understanding the policy process as it relates to the determination of the need for collaborative arrangements demystifies the process and origins of the policy for NPs in Australia. Understanding the determination means NPs in Australia will not artificially reduce scope of practice based on recommendations from the medical lobby. Clear research direction is provided that may inform the next policy cycle. ©2014 American Association of Nurse Practitioners.

  8. [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. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Online tutors as a solution to the shortage of nurse practitioner educators.

    PubMed

    Bruce, T Joyce

    2007-01-01

    The shortage of nursing faculty in Canada, particularly those qualified to teach students in nurse practitioner programs, has contributed to the use of adjunct teachers and online methodologies. The author discusses 1 nurse practitioner online program's use of nurse practitioners who work in full-time clinical roles as tutors. Learning through experience, the author shares how the online tutor role was developed to assist those who are considering using tutors as a program delivery strategy.

  10. Validation of Nurse Practitioner Primary Care Organizational Climate Questionnaire: A New Tool to Study Nurse Practitioner Practice Settings.

    PubMed

    Poghosyan, Lusine; Chaplin, William F; Shaffer, Jonathan A

    2017-04-01

    Favorable organizational climate in primary care settings is necessary to expand the nurse practitioner (NP) workforce and promote their practice. Only one NP-specific tool, the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ), measures NP organizational climate. We confirmed NP-PCOCQ's factor structure and established its predictive validity. A crosssectional survey design was used to collect data from 314 NPs in Massachusetts in 2012. Confirmatory factor analysis and regression models were used. The 4-factor model characterized NP-PCOCQ. The NP-PCOCQ score predicted job satisfaction (beta = .36; p < .001) and intent to leave job (odds ratio = .28; p = .011). NP-PCOCQ can be used by researchers to produce new evidence and by administrators to assess organizational climate in their clinics. Further testing of NP-PCOCQ is needed.

  11. Humanbecoming theory in practice: a case for theory-guided nurse practitioner education.

    PubMed

    Karnick, Paula M

    2012-04-01

    The age-old battle of what to include in nursing education continues. Now this battle extends itself into nurse practitioner education with a slightly different twist. Abandoning nursing theory-guided education for the medical model leaves nurse practitioner education flat. In this author's academic experience, nursing theory was included in the curriculum. The exemplar presented is testament to the distinction and significance of including nursing theory-guided education. The unique difference between nurse practitioners and physicians is the use of theory in practice.

  12. Diet assessment methods: a guide for oncology nurses.

    PubMed

    Ralph, Jody L; Von Ah, Diane; Scheett, Angela J; Hoverson, Bonita S; Anderson, Cindy M

    2011-12-01

    Diet may play a significant role in cancer prevention, disease progression, and treatment tolerance. An in-depth search of the literature revealed limited information geared toward nurses about diet assessment methods used in research. The purpose of this review is to synthesize the evidence regarding diet assessment methods important in oncology studies. The method used varied based on the study size, duration, and research question. For example, studies focusing on mean nutrient intake of a group used a 24-hour dietary recall, estimated food diary or dietary record, or food frequency questionnaire. Studies investigating usual nutrient intake predominately used multiple 24-hour dietary recalls, dietary records, biomarkers, or food frequency questionnaires. Measuring dietary intake accurately in a cost-effective manner is a difficult task. Selection of the appropriate assessment tool is critical for the generation of quality data. Oncology nurses are increasing their involvement in nutrition research, and the findings from this review may promote a better understanding of the published and ongoing research in this important field of study.

  13. Communication skills, working environment and burnout among oncology nurses.

    PubMed

    Emold, Carol; Schneider, Noa; Meller, Isaac; Yagil, Yaron

    2011-09-01

    To examine the association between communication self-efficacy, working environment perceptions and burnout in an Israeli sample of oncology nurses. A non-randomized convenience sample of nurses (n=39) was recruited from six oncology units in a major tertiary medical center in Israel. Measurements included a socio-demographic survey, the Maslach Burnout Inventory, a communication skills self-efficacy inventory and the Working Environment Scale. Frequent experiences of emotional exhaustion were reported by >60% of participants, cynicism by 28%, and self-actualization by >80%. Several statistically significant associations were demonstrated between communication skills self-efficacy and burnout, as well as between cynicism and reported positive characteristics of the working environment. In our study, emotional exhaustion and self-actualization were found to be separate and distinct experiences that can occur simultaneously. Communication self-efficacy and a positive perception of the working environment appear to buffer the occurrence of emotional exhaustion and promote self-actualization. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Implementing two nurse practitioner models of service at an Australian male prison: A quality assurance study.

    PubMed

    Wong, Ides; Wright, Eryn; Santomauro, Damian; How, Raquel; Leary, Christopher; Harris, Meredith

    2017-06-21

    To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service. The study was guided by Donabedian's structure, processes and outcomes framework. Routinely collected information included surveys of staff attitudes to the implementation of the nurse practitioner models (n = 21 staff), consultation records describing clinical processes and time use (n = 289 consultations), and a patient satisfaction survey (n = 29 patients). Data were analysed descriptively and compared to external benchmarks where available. Over the two-month period, the nurse practitioners provided 289 consultations to 208 prisoners. The presenting problems treated indicated that most referrals were appropriate. A significant proportion of consultations involved medication review and management. Both nurse practitioners spent more than half of their time on individual patient-related care. Overall, multidisciplinary team staff agreed that the nurse practitioner services were necessary, safe, met patient need and reduced treatment delays. Findings suggest that the implementation of nurse practitioners into Australian correctional facilities is acceptable and feasible and has the potential to improve prisoners' access to health services. Structural factors (e.g., room availability and limited access to prisoners) may have reduced the efficiency of the nurse practitioners' clinical processes and service implementation. Results suggest that nurse practitioner models can be successfully integrated into a

  15. Prospective roles for Canadian oncology nurses in breast cancer rapid diagnostic clinics.

    PubMed

    Zanchetta, M S; Maheu, C; Baku, L; Wedderburn, P J S; Lemonde, M

    2015-01-01

    The introduction of rapid diagnostic clinics for breast cancer increases oncology nurses' (ONs) responsibility for patient education and coordination of multidisciplinary care. Developed as an outcome of the E-Mentorship Oncology Nursing Program, this paper proposes new roles for these nurses to respond effectively and competently to such diagnostic innovation. The Oslo Manual Conceptual Framework of Innovation inspired the idea of change in prospective ONs' roles, corroborated by the Canadian Association of Nurses in Oncology's Standards of Practice and Competencies. New roles for ONs that are informed by the domain of information dynamics and evidence-based care are proposed.

  16. Oncology Nurse Retreat: A Strength-Based Approach to Self-Care and Personal Resilience
.

    PubMed

    Kuglin Jones, Ann

    2017-04-01

    Oncology nurses are at high risk for burnout and compassion fatigue. Self-care is an essential element that oncology nurses should incorporate into their daily lives but, instead, is often deprioritized. As a result, nurses do not seek out educational opportunities that focus on self-care or personal growth. This article describes the curriculum that was developed for an oncology nurse retreat that promoted self-care and building personal resilience using tools that could be adapted for use with patients and families.
.

  17. Complementary and alternative medicine research initiatives in the Children's Oncology Group and the role of the pediatric oncology nurse.

    PubMed

    Hawks, Ria

    2006-01-01

    Complementary and alternative medicine (CAM) has emerged as a new area of investigation in cancer research and treatment. CAM modalities are widely used, but little is known about their efficacy. The Children's Oncology Group has made a major commitment to CAM research in childhood and adolescent cancer, beginning with studies of CAM in the area of supportive care. Pediatric oncology nurses, as implementing clinicians and collaborating researchers, are critical to the success of these studies.

  18. The use of a clinical resource nurse for newly graduated nurses in a pediatric oncology setting.

    PubMed

    MacKay, Lyndsay Jerusha; Bellamy-Stack, Catherine

    2010-01-01

    The pediatric oncology nursing unit at the Alberta Children's Hospital experienced a large influx of new staff nurses between May 2008 and November 2008. There were 16 in total, and only a few had previous experience, whereas the majority was newly graduated nurses. As a solution to the high numbers of new staff nurses, the role of a Resource Nurse was developed as a temporary position to assist new staff nurses with their patient assignment, prioritize their day, and deal with complex patient procedures/treatments. Also, the Resource Nurse assisted all staff on the unit in dealing with increased patient acuity, chemotherapy administration, acuity issues, family teaching, and complicated family situations. A total of 55 prebooked shifts were scheduled from November 2008 to January 2009. A questionnaire was handed out to the staff nurses as a means to determine the effectiveness of having a Resource Nurse work on the unit. Twenty-three nurses responded by filling out the confidential questionnaire. Overall, respondents reported that the Resource Nurse was beneficial to their practice on the unit.

  19. Two approaches to bridging the knowledge-practice gap in oncology nursing.

    PubMed

    Peek, Gloanna J

    2015-01-01

    The field of oncology nursing is continually changing. New drugs to aid in the fight against cancer are being developed, complementary therapies to ease symptoms are gaining prominence, and survivorship care is becoming a welcome yet challenging area of subspecialty. For oncology nurses to provide quality care and to develop improved care delivery systems, they must not only have access to the most current knowledge in the field, but also be equipped with the skills necessary to integrate that knowledge into practice for the benefit of patients and families (LoBiondo-Wood et al., 2014). The importance of nursing research and its relationship to the practice of oncology nursing cannot be minimized (Moore & Badger, 2014). Oncology nurse researchers advance knowledge and, consequently, improve the quality of care for patients with cancer and their families. For example, the Oncology Nursing Society (ONS) regularly surveys its membership to identify key areas of research focus that then guide the work of nurse investigators (LoBiondo-Wood et al., 2014; ONS Research Agenda Team, 2009). Unfortunately, the shortage of nurse scientists, particularly in oncology nursing, continues to increase as senior doctoral faculty reach retirement age and doctoral education program development remains stagnant (Glasgow & Dreher, 2010; LoBiondo-Wood et al., 2014). This shortage has and will continue to lead to gaps in the generation and implementation of new knowledge, negatively affecting the quality of patient care. As a result, an urgent need exists for innovative and quality doctoral educational programs to develop nurse scientists (Moore & Badger, 2014).

  20. Acute care nurse practitioners in transplantation: adding value to your program.

    PubMed

    Tedesco, Janel

    2011-12-01

    Nurse practitioners are nurses who are prepared at the graduate level. They exercise autonomy in clinical decision making, perform physical examinations and obtain health histories, diagnose and treat a variety of illnesses, provide education and counseling to patients, perform procedures, and ultimately provide cost-effective care. The role of the nurse practitioner evolved in the 1960s, when nurse practitioners filled a void in response to the nationwide shortage of physicians. Today, nurse practitioners specialize both by degree and by certification examination. There are several types of nurse practitioners, including acute care, adult, family practice, and pediatric. The incorporation of acute care nurse practitioners (ACNPs) in transplant programs is an emerging field and varies across the country from center to center. The goals of this article are to (1) identify implications for ACNPs in transplant, (2) discuss the value of using ACNPs in practice, and (3) explore billing and regulatory aspects of ACNPs in transplant programs.

  1. The Latin American Center for Pediatric Oncology Nursing Education: development, implementation, and accomplishments.

    PubMed

    Day, Sara W; Segovia, Lorena; Viveros, Paola; Alqudimat, Mohammad R; Rivera, Gaston K

    2013-01-01

    Pediatric oncology nurses in low- and middle-income countries have limited access to specialized education and clinical training. This is a major impediment for treating children with cancer and contributes to the disparity in survival rates between high- and low-income countries. The International Outreach Nursing Program at St Jude Children's Research Hospital established full-time nurse educator positions at partner sites throughout Latin America. Experienced nurses were hired as educators; however, they had no formal pediatric oncology education, limited teaching experience, and no mentors as this was a new nursing role in low- and middle-income countries. Our objective was to create a regional education center to prepare nurse educators to succeed in this pioneering role. The Latin American Center for Pediatric Oncology Nursing Education was created at Calvo Mackenna Hospital in Santiago, Chile, to provide education, resources, and support to educators. Education resources, including a comprehensive orientation program and courses in chemotherapy and central venous line care, were developed. A 4-week on-site comprehensive educator course and an organized support system were implemented. Education, resources, and support have been provided to 13 nurse educators representing 7 Latin American countries. The educators have provided pediatric oncology education to more than 1000 nurses. The center promotes excellence in pediatric oncology nursing by preparing and supporting educators, who in turn educate the entire nursing staff at partner sites. Nurse educators equipped with knowledge and skills can improve the quality of care and ultimately survival of patients throughout Latin America.

  2. An exploration of the correlates of nurse practitioners' clinical decision-making abilities.

    PubMed

    Chen, Shiah-Lian; Hsu, Hsiu-Ying; Chang, Chin-Fu; Lin, Esther Ching-Lan

    2016-04-01

    This study investigated nurse practitioners' clinical decision-making abilities and the factors that affect these abilities. Nurse practitioners play an important role in clinical care decision-making; however, studies exploring the factors that affect their decision-making abilities are lacking. A cross-sectional descriptive survey was employed. A purposive sample of 197 nurse practitioners was recruited from a medical centre in central Taiwan. Structured questionnaires consisting of the Knowledge Readiness Scale, the Critical Thinking Disposition Inventory and the Clinical Decision-Making Model Inventory were used to collect data. The intuitive-analytical type was the most commonly used decision-making model, and the intuitive type was the least frequently used model. The decision-making model used was significantly related to the nurse practitioners' work unit. Significant differences were noted between the nurse practitioners' clinical decision-making models and their critical thinking dispositions (openness and empathy). The nurse practitioners' years of work experience, work unit, professional knowledge and critical thinking disposition (openness and empathy as well as holistic and reflective dispositions) predicted the nurse practitioners' analytical decision-making scores. Age, years of nurse practitioner work experience, work unit and critical thinking disposition (holistic and reflective) predicted the nurse practitioners' intuitive decision-making scores. This study contributes to the topic of clinical decision-making by describing various types of nurse practitioner decision-making. The factors associated with analytic and intuitive decision-making scores were identified. These findings might be beneficial when planning continuing education programmes to enhance the clinical decision-making abilities of nurse practitioners. The study results showed that nurse practitioners demonstrated various clinical decision-making types across different work units

  3. 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.

  4. Nurse practitioner practice and deployment: electronic mail Delphi study.

    PubMed

    Marsden, Janet; Dolan, Brian; Holt, Lynda

    2003-09-01

    The nature of modern government and needs of policy-makers demand accurate information that is delivered quickly. This study was part of a larger project for the Department of Health relating to nurse practitioner (NP) education and practice in UK. The aim of the study was to identify the principal factors that help or hinder the development of NP roles in the National Health Service. In order to facilitate a rapid response, a Delphi study was undertaken using electronic mail (e-mail) and was completed within 4 weeks. Key stakeholders in NP practice, education and research and (non-governmental) policy-making were invited to participate. Key themes relating to the deployment and practice of NPs were generated. These were refined and collated by the research team and then rated by the respondents. This approach generated valuable expert consensus data around NP deployment and practice. Nurse practitioners' practice is recognized as an integral part of health care that needs to be recognized by regulatory bodies to promote understanding of their potential at local levels. Nurse practitioners need freedom to innovate, adequate support and appropriate education to allow true autonomy. Limited prescribing and local restrictions on requesting investigations hinder practice. Although this was a small-scale study, the expert panel was wide-ranging and achieved substantial consensus. The organisational and cultural changes that are required to foster the development of practice and deployment of NPs have yet to be instigated, according to the comments of the key stakeholders in this study. There appears to be a clear message that the government needs to take a more interventionist role in supporting nursing developments, rather than leaving this to local arrangements.

  5. The core role of the nurse practitioner: practice, professionalism and clinical leadership.

    PubMed

    Carryer, Jenny; Gardner, Glenn; Dunn, Sandra; Gardner, Anne

    2007-10-01

    To draw on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. Enacted legislation provides for mutual recognition of qualifications, including nursing, between New Zealand and Australia. As the nurse practitioner role is relatively new in both countries, there is no consistency in role expectation and hence mutual recognition has not yet been applied to nurse practitioners. A study jointly commissioned by both countries' Regulatory Boards developed information on the core role of the nurse practitioner, to develop shared competency and educational standards. Reporting on this study's process and outcomes provides insights that are relevant both locally and internationally. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner program curricula and interviews with 15 nurse practitioners from the two countries. Data were analysed according to the appropriate standard for each data type and included both deductive and inductive methods. The data were aggregated thematically according to patterns within and across the interview and material data. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care. A clearly articulated and research informed description of the core role of the nurse practitioner provides the basis for development of educational and practice competency standards. These research findings provide

  6. The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

    PubMed

    Taylor, Anita; Staruchowicz, Lynda

    2012-01-01

    This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much

  7. 42 CFR 405.2415 - Services and supplies incident to 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 Services and supplies incident to nurse... 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...

  8. 42 CFR 405.2415 - Services and supplies incident to 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 Services and supplies incident to nurse... 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...

  9. 42 CFR 405.2415 - Services and supplies incident to 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 Services and supplies incident to nurse... 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...

  10. Effect of the clinical support nurse role on work-related stress for nurses on an inpatient pediatric oncology unit.

    PubMed

    Chang, Ann; Kicis, Jennifer; Sangha, Gurjit

    2007-01-01

    High patient acuity, heavy workload, and patient deaths can all contribute to work-related stress for pediatric oncology nurses. A new leadership role, the clinical support nurse (CSN), was recently initiated on the oncology unit of a large Canadian pediatric hospital to support frontline staff and reduce some of the stresses related to clinical activity. The CSN assists nurses with complex patient care procedures, provides hands-on education at the bedside, and supports staff in managing challenging family situations. This study explores the effect of the CSN role on the nurses' work-related stress using the Stressor Scale for Pediatric Oncology Nurses. A total of 58 nurses participated in this study for a response rate of 86%. The results show that the intensity of work-related stress experienced by nurses in this study is significantly less (P < .001) on shifts staffed with a CSN compared with shifts without a CSN.

  11. Exercise in cancer care in Ireland: a survey of oncology nurses and physiotherapists.

    PubMed

    O'Hanlon, E; Kennedy, N

    2014-09-01

    Little is known about the extent of exercise prescription within cancer care. This cross-sectional survey aims to identify Irish oncology nurses and physiotherapists' current knowledge and practice in prescribing exercise for cancer care and barriers to such prescription. An online survey was distributed to the Chartered Physiotherapists in Oncology and Palliative Care (n = 35) and the Irish Association for Nurses in Oncology (n = 170). The response rate was 74% (26/35) for physiotherapists and 34% (58/170) for oncology nurses. Three quarters of physiotherapists recommended/prescribed exercise with 81% or more of cancer patients in the past 6 months, with the exercises prescribed largely in line with current guidelines. Patients' family/friends advising rest was the most commonly reported exercise barrier by physiotherapists [89% (17/19)], with a lack of exercise guidelines for cancer patients being most problematic for oncology nurses [93% (50/54)]. Only 33% (18/54) of oncology nurses felt they had sufficient knowledge regarding exercise in cancer care. In conclusion, exercise prescription by physiotherapists largely corresponds with current guidelines. A minority of nurses felt they had sufficient knowledge of exercise for this population. Further formal postgraduate educational opportunities are needed for oncology nurses and physiotherapists in this area.

  12. Clinical residency training: Is it essential to the Doctor of Nursing Practice for nurse practitioner preparation?

    PubMed

    Harper, Doreen C; McGuinness, Teena M; Johnson, Jean

    The Doctor of Nursing Practice (DNP) degree positions nurse practitioners (NPs) and other advanced practice registered nurses, with clinical competencies similar to other disciplines requiring doctoral education (medicine, physical therapy, psychology, and pharmacy). In addition, all these disciplines also offer residencies. However, nursing is the only discipline that does not require a doctoral degree and/or have a systematic approach to residency training for advanced practice roles. The authors posit that there are critical policy issues to resolve within the nursing profession to clarify the role that clinical residencies should play in transition to DNP practice specifically related to NPs. The purpose of this article was to (a) describe the context of NP residency models within NP curricula that strengthen the DNP Essentials with an emphasis on Essential VIII and a focus on distinctive clinical specialization, (b) describe the history and policy implications of NP residency programs as well as existing programs that assist transition to practice, and (c) recommend policies for consideration related to DNP NP residencies. Literature on nurse practitioner residencies was reviewed. While nurse practitioner residencies continue to grow, research is needed regarding outcomes of job satisfaction, clinical competencies, and patient satisfaction. The first year of practice for nurse practitioners is a critical period of professional development. It is important to further clarify the need, direction, and program standards. Academically affiliated residencies will facilitate the development and standardization of curricula and competencies to enhance clinical rigor. The partnership between academic units and clinical agencies will pool resources and strengthen nursing in both settings. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The primary healthcare nurse practitioner in Ontario: a workforce study.

    PubMed

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

    2009-01-01

    The role of the primary healthcare nurse practitioner (NP-PHC) has a long history in Ontario. In this paper, we describe the evolution of the role with a focus on geographic distribution, a profile of client populations and the services provided by NP-PHCs. Comparisons will be made to findings from previous studies and reports on the NP-PHC role in Ontario. In 2004 and 2005, two-thirds of the nurse practitioners registered with the College of Nurses of Ontario responded to a descriptive self-reporting survey. The data collected revealed that NP-PHCs work throughout the healthcare system, including with underserviced and marginalized populations, in community health centres and in outpatient areas within acute care hospitals. They provide the entire spectrum of primary healthcare services. Barriers to fully enacting the role are related to restrictive legislation that limits NP prescribing and diagnosing, and the ability to work to full scope of practice in hospitals (for example, in emergency departments). Targeted funding has promoted the role throughout the province. However, inadequate and insecure pilot funding continues to be a concern. Findings from this study indicate that policy decisions to support the NP role in rural and remote areas have resulted in expansion of the role across the province. Yet, NPs perceive that legislation has lagged and inhibits their ability to meet patient and health systems needs.

  14. Nurse practitioner-led transitional care interventions: An integrative review.

    PubMed

    Mora, Kathlyen; Dorrejo, Xiomara M; Carreon, Kimberly Mae; Butt, Sadia

    2017-08-28

    Chronically ill patients 65 and above have an increased risk of preventable readmission within 30 days of discharge from the hospital. The Transitional Care Model (TCM) introduced by Naylor and colleagues was implemented to improve the transition between hospital and home while decreasing readmissions. This article examines whether nurse practitioner (NP)- led TCM interventions as compared to standard care decrease hospital readmission rates in older adults. A literature review was conducted from June 2016 to March 2017 using Cochrane Library, PubMed, Cumulative Index to Nursing and Health Literature (CINAHL) PLUS, Joanna Briggs Institute, and ProQuest Central to seek out the highest level of evidence. Search results were refined to focus on randomized control trials (RTCs) containing NP-led TCM interventions with older adults. Synthesis of three RTCs, one meta-analysis, and four nonrandomized studies reviewed TCM interventions that included these interventions: follow-up phone calls post discharge, home visits, and handoff of information to the patient's primary care provider. These interventions, although not exclusively led by NPs, decreased hospital readmission rates. NP-led TCM interventions have the potential to decrease readmissions, but the level of evidence is insufficiently high to allow for generalizability, warranting further study. ©2017 American Association of Nurse Practitioners.

  15. Essential nurse practitioner business knowledge: An interprofessional perspective.

    PubMed

    LaFevers, David; Ward-Smith, Peggy; Wright, Wendy

    2015-04-01

    To describe business practice knowledge from the perspectives of nurse practitioners (NPs) who are practicing clinicians, academic instructors, and clinic managers. Using the eight domains of business practice attitudes identified by the Medical Group Management Associations Body of Knowledge (MGMA), which are supported by the American Association of Colleges of Nursing (AACN), a study-specific survey was developed. Data, which describe the knowledge and attitudes with respect to business practices, were obtained from 370 participants. Regardless of their job classification, these participants described (1) quality management, (2) risk management, and (3) patient care systems as critical business practice knowledge. Consensus was also achieved when ranking the content for business practice knowledge: (1) patient care systems, (2) business operation, and (3) financial management. These data identify gaps in business practice knowledge and content that should be included in educational programs. Business practice knowledge is essential for a successful clinical practice and should be a professional practice skill for the NP. ©2015 American Association of Nurse Practitioners.

  16. Attitudes of paediatric intensive care nurses to development of a nurse practitioner role for critical care transport.

    PubMed

    Davies, Joanna; Bickell, Fiona; Tibby, Shane M

    2011-02-01

    This paper is a report of a descriptive study of the attitudes and opinions of nurses before and after the introduction of independent Retrieval Nurse Practitioners into a critical care transport service for children. Little is known about nurses' attitudes to advanced practice roles, particularly when these function as part of a team in a high-risk, remote setting (distant to the base hospital). Increasing knowledge in this area may give insight into ways of improving team working and enhancing quality of patient care. A qualitative questionnaire was sent to nurses pre- (June 2006) and post- (July 2007) retrieval nurse practitioner introduction. Questionnaires were analysed using an adapted phenomenological method. The response rates were 62% (2006) and 48% (2007). The main themes that emerged included fear, communication, trust, team working, role conflict, role division and role boundaries. In the first survey, most nurses anticipated difficulties during retrieval with retrieval nurse practitioners and felt anxious about the prospect of being part of a team with an independent retrieval nurse practitioner. However, by the second survey (after retrieval nurse practitioner introduction), the majority reported confidence in the retrieval nurse practitioners' knowledge and skills. This advanced practice development has been a challenge for the nurses and the retrieval nurse practitioners, but initial anxieties and fears of a host of anticipated problems have been largely dispelled as enhanced communication and team working were reported. © 2010 Blackwell Publishing Ltd.

  17. Nurse practitioner perceptions of the impact of physician oversight on quality and safety of nurse practitioner practice.

    PubMed

    Lowery, Bobby; Scott, Elaine; Swanson, Mel

    2016-08-01

    Nurse practitioner (NP) regulation and physician oversight (PO) of NP practice are inextricably intertwined. A flexible, well-prepared workforce is needed to meet consumer healthcare needs. All outcome studies have revealed that NPs provide safe, effective, quality care with outcomes equal to or better than that of physicians or physician assistants. Variability in state regulation of NP practice limits the full deployment of these proven healthcare providers, threatens the quality and safety of NP-delivered care, and limits consumer choice in healthcare access. The purpose of this study was to document NP perceptions of the impact of PO on the safety and quality of NP practice. A total of 1139 NP respondents completed an exploratory survey, Impact of Regulatory Requirements for Physician Oversight on Nurse Practitioner Practice. Participants were asked their perceptions of the impact of PO on patient care and NP practice. Descriptive statistics on the state of residence regulatory requirements and personal demographics were also collected. NP perceptions of the impact of PO on the safety and quality of NP practice were predicted by NP experience and state regulatory environment ranking. The results of this study have implications for educators, policy makers, and nursing advocacy groups seeking to increase access to care in U.S. Study participants perceived that requirements for PO impacted their practice and may jeopardize patient safety. An understanding of the impact of influences on regulatory processes is critical to ensuring full deployment of NPs as interprofessional leaders to meet current and future healthcare access. ©2015 American Association of Nurse Practitioners.

  18. Overcoming barriers to the employment and utilization of the nurse practitioner.

    PubMed

    Sullivan, J A; Dachelet, C Z; Sultz, H A; Henry, M; Carrol, H D

    1978-11-01

    A national longitudinal cohort study of nurse practitioners and their employers conducted during 1973--1976 provided data on barriers to the development of the nurse practitioner role in primary care. Nearly 90 per cent of the 500 primary care nurse practitioners responding and 75 per cent of the 407 employers responding reported encountering one or more barriers to the role development of the nurse practitioner in their practice setting. Nurse practitioners identified an average of 2.2 barriers and employers identified an average of 1.6 barriers each. Specific barriers identified by 20 per cent or more of the nurse practitioners and employers were legal restrictions, limitations of space and facilities, and resistance from other providers. The data and other evidence suggest that these barriers are not insurmountable and that progress is being made in overcoming these obstacles.

  19. Overcoming barriers to the employment and utilization of the nurse practitioner.

    PubMed Central

    Sullivan, J A; Dachelet, C Z; Sultz, H A; Henry, M; Carrol, H D

    1978-01-01

    A national longitudinal cohort study of nurse practitioners and their employers conducted during 1973--1976 provided data on barriers to the development of the nurse practitioner role in primary care. Nearly 90 per cent of the 500 primary care nurse practitioners responding and 75 per cent of the 407 employers responding reported encountering one or more barriers to the role development of the nurse practitioner in their practice setting. Nurse practitioners identified an average of 2.2 barriers and employers identified an average of 1.6 barriers each. Specific barriers identified by 20 per cent or more of the nurse practitioners and employers were legal restrictions, limitations of space and facilities, and resistance from other providers. The data and other evidence suggest that these barriers are not insurmountable and that progress is being made in overcoming these obstacles. PMID:717618

  20. Role and quality of nurse practitioner practice: a policy issue.

    PubMed

    Mullinix, Connie; Bucholtz, Dawn P

    2009-01-01

    Nurse practitioners (NPs) are at a crucial period in the development of their profession. The increasing demand for primary care practitioners is changing the environment in which they practice. As they face both increased opportunity and continuing opposition to independent practice, NPs must define their role in healthcare delivery and establish their capabilities. The debate around what is and is not an appropriate role for the NP often focuses on quality of care; however, the real issues may be turf and economic defensiveness in an increasingly competitive market. This article discusses the challenges NPs face in establishing the quality of care they provide, and it reviews the literature on the subject, identifying its strengths and weaknesses and recommending policy changes.

  1. Understanding the Challenges of Providing Holistic Oncology Nursing Care in Nigeria

    PubMed Central

    Nwozichi, Chinomso Ugochukwu; Ojewole, Foluso; Oluwatosin, Abimbola O.

    2017-01-01

    This article describes the current state of cancer nursing and the various challenges that hinder the provision of effective nursing care to cancer patients in Nigeria. The major issue identified was the lack of specialized oncology nursing education which should actually form a basis for nurses to practice in the oncology setting. Other issues include poor facilities for oncology nursing care, lack of specific cancer centers resulting in the management of cancer patients in non-specialist wards. It is therefore recommended that solidified structure be put in place in order to establish and strengthen the nursing curriculum which has a strong potential for improving the knowledge and skills of nurses to care for people living with cancer in Nigeria. PMID:28217725

  2. Cost-effectiveness of nurse practitioners in primary and specialised ambulatory care: systematic review

    PubMed Central

    Martin-Misener, Ruth; Harbman, Patricia; Donald, Faith; Reid, Kim; Kilpatrick, Kelley; Carter, Nancy; Bryant-Lukosius, Denise; Kaasalainen, Sharon; Marshall, Deborah A; Charbonneau-Smith, Renee; DiCenso, Alba

    2015-01-01

    Objective To determine the cost-effectiveness of nurse practitioners delivering primary and specialised ambulatory care. Design A systematic review of randomised controlled trials reported since 1980. Data sources 10 electronic bibliographic databases, handsearches, contact with authors, bibliographies and websites. Included studies Randomised controlled trials that evaluated nurse practitioners in alternative and complementary ambulatory care roles and reported health system outcomes. Results 11 trials were included. In four trials of alternative provider ambulatory primary care roles, nurse practitioners were equivalent to physicians in all but seven patient outcomes favouring nurse practitioner care and in all but four health system outcomes, one favouring nurse practitioner care and three favouring physician care. In a meta-analysis of two studies (2689 patients) with minimal heterogeneity and high-quality evidence, nurse practitioner care resulted in lower mean health services costs per consultation (mean difference: −€6.41; 95% CI −€9.28 to −€3.55; p<0.0001) (2006 euros). In two trials of alternative provider specialised ambulatory care roles, nurse practitioners were equivalent to physicians in all but three patient outcomes and one health system outcome favouring nurse practitioner care. In five trials of complementary provider specialised ambulatory care roles, 16 patient/provider outcomes favouring nurse practitioner plus usual care, and 16 were equivalent. Two health system outcomes favoured nurse practitioner plus usual care, four favoured usual care and 14 were equivalent. Four studies of complementary specialised ambulatory care compared costs, but only one assessed costs and outcomes jointly. Conclusions Nurse practitioners in alternative provider ambulatory primary care roles have equivalent or better patient outcomes than comparators and are potentially cost-saving. Evidence for their cost-effectiveness in alternative provider

  3. How do nurse practitioners in acute care affect perceptions of team effectiveness?

    PubMed

    Kilpatrick, Kelley

    2013-09-01

    To describe how acute care nurse practitioners affect perceptions of team effectiveness. Acute care nurse practitioners provide safe and effective care to patients. There is limited evidence of the effects of acute care nurse practitioner roles on healthcare teams, and many of the findings are contradictory. Research is lacking to describe how nurse practitioners affect perceptions of team effectiveness. A descriptive multiple-case study undertaken in two university-affiliated teaching hospitals in Canada. Data were collected from March-May 2009. Data sources included interviews (n = 59), time and motion study, non-participant observations, documents and field notes. Interviews were conducted individually or in groups using a semi-structured interview guide. Data were analysed within and across the cases to identify similarities and differences in perceptions of team effectiveness. Team members believed the nurse practitioners improved the team's effectiveness. They identified six team processes they believed were improved by the addition of the nurse practitioners to the teams. The processes included decision-making, communication, cohesion, care coordination, problem-solving and focus on patients and families. The study contributes to our understanding of how nurse practitioners affect perceptions of team effectiveness. Improved team communication and care coordination were believed to be particularly important. Nurse practitioner can facilitate patient- and family-centred care in healthcare teams. Nurse practitioners improve perceptions of team effectiveness. Further work is needed in different contexts and with patients and families to determine their perceptions of team effectiveness. The nurse practitioner role was believed to be particularly important to improve team communication and care coordination. This constitutes an added value of acute care nurse practitioners roles in healthcare teams. Nurse practitioner roles contribute to patient-centred care

  4. Clinical Trials and the Role of the Oncology Clinical Trials Nurse.

    PubMed

    Ness, Elizabeth A; Royce, Cheryl

    2017-03-01

    Clinical trials are paramount to improving human health. New trial designs and informed consent issues are emerging as a result of genomic profiling and the development of molecularly targeted agents. Many groups and individuals are responsible for ensuring the protection of research participants and the quality of the data produced. The specialty role of the clinical trials nurse (CTN) is critical to clinical trials. Oncology CTNs have competencies that can help guide their practice; however, not all oncology clinical trials are supervised by a nurse. Using the process of engagement, one organization has restructured oncology CTNs under a nurse-supervised model.

  5. A comparison of burnout among oncology nurses working in adult and pediatric inpatient and outpatient settings.

    PubMed

    Davis, Shoni; Lind, Bonnie K; Sorensen, Celeste

    2013-07-01

    To investigate differences in burnout among oncology nurses by type of work setting, coping strategies, and job satisfaction. Descriptive. A metropolitan cancer center. A convenience sample of 74 oncology nurses. Participants completed a demographic data form, the Nursing Satisfaction and Retention Survey, and the Maslach Burnout Inventory. Burnout, coping strategies, job satisfaction, and oncology work setting (inpatient versus outpatient and adult versus pediatric). The participants most often used spirituality and coworker support to cope. Emotional exhaustion was lowest for youngest nurses and highest for outpatient RNs. Personal accomplishment was highest in adult settings. Job satisfaction correlated inversely with emotional exhaustion and the desire to leave oncology nursing. The findings support that the social context within the work environment may impact emotional exhaustion and depersonalization, and that demographics may be more significant in determining burnout than setting. The findings raise questions of whether demographics or setting plays a bigger role in burnout and supports organizational strategies that enhance coworker camaraderie, encourage nurses to discuss high-stress situations, and share ways to manage their emotions in oncology settings. Spirituality and coworker relationships were positive coping strategies among oncology nurses to prevent emotional exhaustion. Nurses who rely on supportive social networks as a coping mechanism have lower levels of depersonalization. Age was inversely related to emotional exhaustion.

  6. Psychological interventions helping pediatric oncology patients cope with medical procedures: a nurse-centered approach.

    PubMed

    Weinstein, Aurélie G; Henrich, Christopher C

    2013-12-01

    This study explored whether psychological interventions are currently used by pediatric oncology nurses to help children cope with their treatment and, if so, which interventions were considered by oncology nurses to be the most effective. A web-based survey was developed to assess pediatric oncology nurses' impressions of psychological care for pediatric patients during their medical treatment. A sample of 88 pediatric oncologic nurses from twelve leading pediatric oncology departments in the US participated in the survey. The closed questions were analyzed through quantitative methods with statistics. The open questions were examined through qualitative methods with report narratives and discourse analysis. Pediatric oncology nurses identified three psychological interventions to reduce suffering: educating children by explaining the procedure; providing emotional support to children by listening, answering children's worries, or holding their hands; and distracting children through passive and active forms. The survey further showed that nurses spent on average 3 h per day providing emotional support, would be willing to be trained in additional interventions (93%), and could devote at least 10 min per treatment to provide support (77%). This work demonstrates the central role nurses play as emotional support caregivers. Since nurses would be willing to provide emotional support during treatments, training may be an approach to incorporate the use of psychological interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. The application of qualitative research findings to oncology nursing practice.

    PubMed

    Cuthbert, Colleen Ann; Moules, Nancy

    2014-11-01

    The Oncology Nursing Society (ONS) has established an ambitious research agenda and professional priorities based on a survey by LoBiondo-Wood et al. (2014). With the overall goal to "improve cancer care and the lives of individuals with cancer" (Moore & Badger, 2014, p. 93) through research activities, translating those research findings to direct clinical practice can be overwhelming. As clinicians, understanding how to critique research for quality prior to incorporating research findings into practice is important. The ultimate goal in this critique is to ensure that decisions made about patient care are based on strong evidence. However, the process for appraisal of qualitative research can be ambiguous and often contradictory as a result of the elusive aspect of quality in qualitative research methods (Seale, 1999). In addition, with more than 100 tools available to evaluate qualitative research studies (Higgins & Green, 2011), a lack of consensus exists on how to critically appraise research findings.

  8. Predicting the future of the adult nurse practitioner.

    PubMed

    Glynn, P M

    1998-05-01

    In the late 1980s, the future of the adult nurse practitioner (ANP) was less than certain. This study, conducted in 1987, explored the opinions of ANPs, physicians, and healthcare administrators regarding the future of the ANP in 1995. A sociological framework was used to identify factors potentially affecting the ANPs future and to assess the ANP's functionality vis-à-vis the healthcare delivery system. Findings are discussed within the context of the healthcare delivery system as it emerged by 1995, and recommendations are made for ensuring the future viability of the ANP role.

  9. Truth-telling to patients' terminal illness: what makes oncology nurses act individually?

    PubMed

    Huang, Shu-He; Tang, Fu-In; Liu, Chang-Yi; Chen, Mei-Bih; Liang, Te-Hsin; Sheu, Shuh-Jen

    2014-10-01

    Nurses encounter the challenge of truth-telling to patients' terminal illness (TTPTI) in their daily care activities, particularly for nurses working in the pervasive culture of family protectiveness and medical paternalism. This study aims to investigate oncology nurses' major responses to handling this issue and to explore what factors might explain oncology nurses' various actions. A pilot quantitative study was designed to describe full-time nurses' (n = 70) truth-telling experiences at an oncology centre in Taipei. The potential influencing factors of nurses' demographic data, clinical characteristics, and truth-telling attitudes were also explored. Most nurses expressed that truth-telling was a physician's responsibility. Nevertheless, 70.6% of nurses responded that they had performed truth-telling, and 20 nurses (29.4%) reported no experience. The reasons for inaction were "Truth-telling is not my duty", "Families required me to conceal the truth", and "Truth-telling is difficult for me". Based on a stepwise regression analysis, nurses' truth-telling acts can be predicted based on less perceived difficulty of talking about "Do not resuscitate" with patients, a higher perceived authorisation from the unit, and more oncology work experience (adjusted R² = 24.1%). Oncology care experience, perceived comfort in communication with terminal patients, and unit authorisation are important factors for cultivating nurses' professional accountability in truth-telling. Nursing leaders and educators should consider reducing nursing barriers for truth-telling, improving oncology nurses' professional accountability, and facilitating better quality care environments for terminal patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Oncology Nursing Society year 2004 research priorities survey.

    PubMed

    Berger, Ann M; Berry, Donna L; Christopher, Kimberly A; Greene, Amanda L; Maliski, Sally; Swenson, Karen K; Mallory, Gail; Hoyt, Dan R

    2005-03-05

    To determine the Oncology Nursing Society (ONS) research priorities for 2005-2008 for oncology nursing across the entire scope of cancer care, including prevention, detection, treatment, survivorship, and palliative care. Descriptive, cross-sectional survey. Stratified into two groups: random sample of general membership (N = 2,205; responses = 287, or 13%) and all ONS active members in the United States with doctoral degrees (N = 627, responses = 144, or 23%); overall response rate was 15%. The 2000 survey was revised and updated. Postcards were mailed to the original sample (N = 1,605) prior to the launch of the online survey, inviting participation via an online or paper-and-pencil survey. An e-mail announcement of the survey was launched one week later, followed by reminders the following week. Because of low response rates, a second sample (N = 600) was selected and contacted. 117 topic questions divided into seven categories. Several items were new or reworded. The top 20 research priorities included 12 of the top 20 items found in the 2000 survey; 8 topics were new to the top 20. Priority topics were distributed across six of seven categories. When general membership results were compared to the doctoral sample, 10 topics were among the top 20 for both groups. Nine topics were top priorities in the 2000 (researcher) and 2004 (doctorally prepared) surveys. Response rates to the electronic survey were lower than for previous paper-and-pencil surveys, but an adequate response was obtained. Rank order of mean importance ratings was determined by narrow differences in scores. The general membership and doctorally prepared samples showed similarities as well as differences in results. The 2004 survey results will inform the 2005 research agenda and assist the ONS Foundation and other funding organizations in distributing research funds.

  11. State regulatory board structure, regulations, and nurse practitioner availability.

    PubMed

    Wilken, M

    1995-10-01

    State boards of nursing (BON) and medicine (BOM) promulgate regulations that affect nurse practitioners (NPs). Certain characteristics of board structure have an impact on two potential barriers to NP practice: the absence of direct third-party reimbursement and authority to prescribe. The percentage of consumers on BONs and BOMs increases the likelihood of direct third-party reimbursement for NPs. The presence of an NP committee providing input to a board increases the likelihood of authority to prescribe for NPs. The availability of NPs is enhanced by the presence of NP educational programs in the state, the level of effort by the state related to NP recruitment and retention, and the presence of direct third-party reimbursement.

  12. Relationship between pediatric oncology nurses' management of patients' symptoms and job satisfaction.

    PubMed

    Rheingans, Jennifer I

    2008-01-01

    The purpose of this article is to describe the results of a study examining the relationship between nurses' management of pediatric oncology patients' symptoms and job satisfaction. Surveys were mailed to a national sample of pediatric oncology nurses to assess the presence of symptoms in their patients, the nurses' distress from the patients' symptoms, the interventions used to manage the symptoms, the perceived effectiveness of the interventions, and the nurses' job satisfaction. Based on the stress response sequence model, study hypotheses proposed that nurses' symptom management affects nurses' distress and, in turn, job satisfaction. Hierarchical regression analyses were used to evaluate the hypotheses and study model. Results demonstrated that both the number of nursing interventions and the perceived effectiveness of nursing interventions were significant as mediators in predicting nurses' distress. The overall study model contributed significantly in predicting overall job satisfaction.

  13. For Elderly Needing Home Medical Care, Are Nurse Practitioners the Answer?

    MedlinePlus

    ... of Virginia Medical School's department of public health sciences. Nurse practitioners are nurses with advanced training. In some states, they can prescribe medicine and practice without direct supervision of a doctor the study authors noted. ...

  14. Reliability and validity of the Nurse Practitioners' Roles and Competencies Scale.

    PubMed

    Lin, Li-Chun; Lee, Sheuan; Ueng, Steve Wen-Neng; Tang, Woung-Ru

    2016-01-01

    The objective of this study was to test the reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale. The role of nurse practitioners has attracted international attention. The advanced nursing role played by nurse practitioners varies with national conditions and medical environments. To date, no suitable measurement tool has been available for assessing the roles and competencies of nurse practitioners in Asian countries. Secondary analysis of data from three studies related to nurse practitioners' role competencies. We analysed data from 563 valid questionnaires completed in three studies to identify the factor structure of the Nurse Practitioners' Roles and Competencies Scale. To this end, we performed exploratory factor analysis using principal component analysis extraction with varimax orthogonal rotation. The internal consistency reliabilities of the overall scale and its subscales were examined using Cronbach's alpha coefficient. The scale had six factors: professionalism, direct care, clinical research, practical guidance, medical assistance, as well as leadership and reform. These factors explained 67·5% of the total variance in nurse practitioners' role competencies. Cronbach's alpha coefficient for the overall scale was 0·98, and those of its subscales ranged from 0·83-0·97. The internal consistency reliability and construct validity of the Nurse Practitioners' Roles and Competencies Scale were good. The high internal consistency reliabilities suggest item redundancy, which should be minimised by using item response theory to enhance the applicability of this questionnaire for future academic and clinical studies. The Nurse Practitioners' Roles and Competencies Scale can be used as a tool for assessing the roles and competencies of nurse practitioners in Taiwan. Our findings can also serve as a reference for other Asian countries to develop the nurse practitioner role. © 2015 John Wiley & Sons Ltd.

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

    ERIC Educational Resources Information Center

    Hasselblad, Judith

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

  16. Determined persistence: achieving and sustaining job satisfaction among nurse practitioners.

    PubMed

    Shea, Mary L

    2015-01-01

    Job satisfaction of nurse practitioners (NPs) has been studied using quantitative methods. A grounded theory approach was used in this study to understand the contextual nature of the NPs' description of job satisfaction from a personal perspective. A grounded theory approach as described by Glaser and Strauss was used in this study. The study took place in a rural northeastern state. The researcher conducted face-to-face interviews using open-ended questions with 15 participants. Constant comparative method was utilized to analyze data culminating in a basic social process. The participants described holistic care as the foundation of their work and their relationship with patients as determining factors of job satisfaction. When NPs felt as though patient care was compromised, they became dissatisfied. NPs were highly satisfied when providing holistic care and within an environment that respected their professional values. In order to maintain accessibility to high-quality health care, it is imperative to understand the factors that contribute to job satisfaction of NPs. As the healthcare system evolves, healthcare policymakers and healthcare organizations must develop strategies to ensure job satisfaction among NPs. ©2014 American Association of Nurse Practitioners.

  17. Methamphetamine use among suburban women: implications for nurse practitioners.

    PubMed

    Bairan, Annette; Boeri, Miriam; Morian, Janice

    2014-11-01

    The purpose of this article is to provide nurse practitioners (NPs) with more effective strategies to diagnose methamphetamine (MA) use and assess healthcare needs of MA-using women. The researchers collected data from 65 suburban women who were MA users living in the suburbs of a large southeastern city in the United States. We conducted in-depth interviews and focus groups examining their life history, drug history, risk behaviors, and access to health care. The qualitative findings are examined here. Three main themes emerged from the data: (a) gendered stigmatization of MA use; (b) MA-related health risk behaviors; and (c) barriers to health and social services, which resulted in a domino effect that led to further life and health complications. When these factors are not effectively addressed, the result is more serious health problems for the women and their children. This article offers awareness and assessment tools to provide NPs adequate knowledge about the factors associated with MA use in order to treat patients holistically. NPs are strategically positioned to effectively assess, diagnose, treat, and provide linkage to health and social services, especially for suburban females who are a hidden population of drug users. ©2014 American Association of Nurse Practitioners.

  18. Nurse moral distress and cancer pain management: an ethnography of oncology nurses in India.

    PubMed

    LeBaron, Virginia; Beck, Susan L; Black, Fraser; Palat, Gayatri

    2014-01-01

    The majority of cancer patients in low- and middle-income countries (LMICs) present with late-stage, incurable disease, and basic tools to alleviate patient suffering-such as morphine-are often absent. Oncology nurses must cope with many challenges and may experience moral distress (MD), yet little research has examined this experience in LMICs. This ethnographic study explored the experience of MD with oncology nurses (n = 37) and other providers (n = 22) in India and its potential relationship to opioid availability. Data (semistructured interviews and field observations) were collected at a 300-bed government cancer hospital in urban South India over 9 months. Dedoose v.4.5.91 supported analysis of transcripts using a coding schema that mapped to an Integrated Model of Nurse Moral Distress and concepts that emerged from field notes. Primary themes included "We feel bad," "We are alone and afraid," "We are helpless," and "We leave it." A weak link between MD and opioid availability was found. Participants described significant work-related distress, but the moral dimension to this distress was less clear as some key aspects of the Integrated Model of Nurse Moral Distress were not supported. The concept of MD may have limited applicability in settings where alternative courses of action are unknown, or not feasible, and where differing social and cultural norms influence moral sensitivity. Improving job-related conditions is prerequisite to creating an environment where MD can manifest. Educational initiatives in LMICs must account for the role of the oncology nurse and their contextual moral and professional obligations.

  19. Ethical conflict associated with managed care: views of nurse practitioners.

    PubMed

    Ulrich, Connie M; Soeken, Karen L; Miller, Nancy

    2003-01-01

    Ethical conflict of nurse practitioners (NPs) practicing within a managed care environment has not been systematically examined, yet like physician practitioners, NPs are confronted with daily ethical conflicts. To determine perceptions toward ethical conflict in practice espoused by NPs affiliated with managed care systems and to identify the relationship between selected individual, organizational, and societal/market contextual factors and ethical conflict in practice. Descriptive, cross-sectional, correlational survey of a stratified random sample of 700 NPs licensed and certified to practice in the state of Maryland, conducted from November 2000 to January 2001. A majority of respondents reported being moderately to extremely concerned with managed care. Eighty percent of the sample perceived that it was sometimes necessary to bend managed care guidelines with 61% agreeing that the practitioner must weigh the patient's interest against managed care organizations' interests. The NPs in a staff/group model health maintenance organization (a) were less ethically concerned (p <.001); (b) perceived the ethical environment more positively (p <.001); and (c) had lower ethical conflict scores (p <.001) than NPs in other types of practice settings. Results from this study indicate that NPs are experiencing ethical conflict associated with practicing within a managed care environment; however, NPs in a staff/group model health maintenance organization report these concerns less. Ethical support through intervening strategies (i.e., ethics education and interdisciplinary ethics support systems) may help mitigate the conflict associated with this system of care.

  20. 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

  1. Is it economically viable to employ the nurse practitioner in general practice?

    PubMed

    Dierick-van Daele, Angelique T M; Steuten, Lotte M G; Romeijn, Arla; Derckx, Emmy W C C; Vrijhoef, Hubertus J M

    2011-02-01

    This article provides insight into the potential economic viability of nurse practitioner employment in Dutch general practices. General practitioners face the challenging task of finding the most efficient and effective mix of professionals in general practice to accommodate future care demands within scarce health care budgets. To enable informed decision-making about skill mix issues, economic information is needed. Discursive paper. A descriptive and explorative design was chosen to study the economic viability of nurse practitioner employment in general practice. The conditions under which the nurse practitioner is able to earn back his/her own cost of employment were identified. Preferences and expectations of general practitioners and health insurers about nurse practitioner reimbursement were made transparent. Although general practitioners and health insurers acknowledge the importance of the nurse practitioner in accommodating primary care demands, they have polarised views about reimbursement. The employment of nurse practitioners is seldom economically viable in current practices. It requires a reallocation of (80% of) the general practitioner's freed up time towards practice growth (12% number of patients). The economic viability of the nurse practitioner has proven difficult to achieve in every day health care practice. This study provided insight into the complex interaction of the (cost) parameters that result in economic viability and feeds a further discussion about the content of the nurse practitioner role in general practice based on optimal quality of care vs. efficiency. Effective and efficient health care can only be provided if the actual care needs of a population provide the basis for deciding which mix of professionals is best equipped to deal with the changing and increasing demand of care. A macro-level intervention is needed to help a broad-scale introduction of the nurse practitioner in general practice. © 2011 Blackwell Publishing

  2. 2013 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards Including Standards for the Safe Administration and Management of Oral Chemotherapy

    PubMed Central

    Neuss, Michael N.; Polovich, Martha; McNiff, Kristen; Esper, Peg; Gilmore, Terry R.; LeFebvre, Kristine B.; Schulmeister, Lisa; Jacobson, Joseph O.

    2013-01-01

    In 2009, ASCO and the Oncology Nursing Society (ONS) published standards for the safe use of parenteral chemotherapy in the outpatient setting, including issues of practitioner orders, preparation, and administration of medication. In 2011, these were updated to include inpatient facilities. In December 2011, a multistakeholder workgroup met to address the issues associated with orally administered antineoplastics, under the leadership of ASCO and ONS. The workgroup participants developed recommended standards, which were presented for public comment. Public comments informed final edits, and the final standards were reviewed and approved by the ASCO and ONS Boards of Directors. Significant newly identified recommendations include those associated with drug prescription and the necessity of ascertaining that prescriptions are filled. In addition, the importance of patient and family education regarding administration schedules, exception procedures, disposal of unused oral medication, and aspects of continuity of care across settings were identified. This article presents the newly developed standards. PMID:23914148

  3. Knowledge, Perceived Ability and Practice Behaviors Regarding Oral Health among Pediatric Hematology and Oncology Nurses.

    PubMed

    Perry, Antiana D; Iida, Hiroko; Patton, Lauren L; Wilder, Rebecca S

    2015-08-01

    Oral complications are common in children undergoing head and neck radiation and chemotherapy. The purpose of this study is to examine the knowledge, perceived ability and practice behaviors of pediatric oncology and hematology nurses in assisting with the various oral health care needs of pediatric oncology patients and to identify pediatric oncology nurses' previous training/education, practice types and other demographic characteristics that are related to their oral health competencies. A survey of a convenience sample of Pediatric Oncology and Hematology Nurses was conducted during the Association of Pediatric Oncology and Hematology Nurses' (APHON) 36(th) Annual Conference and Exhibit. Descriptive analysis and the exploratory factor analyses were performed using SAS version 9.2 (SAS Institute, Inc., Cary, NC). Among the 300 surveys that were distributed, 235 surveys were completed (78% response rate) by pediatric oncology or hematology nurses who provide direct patient care in the U.S. Approximately 75% reported receiving less than 3 hours of oral health related education/training. Sixty percent did not have a clinical requirement regarding the assessment of the teeth and gums during their nursing school education. Bivariate analyses indicated that nurses who had clinical requirements regarding oral health assessment during nursing education/training presented greater overall oral health competencies including having greater confidence in examining oral complications than those who did not. Pediatric oncology nurses' knowledge, perceived ability and practice in assisting patient's oral hygiene care, preventing and managing oral complications vary by topic and might reflect their educational preparedness. This study may provide valuable information pertaining to the need and opportunity for interprofessional oral health care education and collaboration with nursing and dental professionals, in order to increase access to comprehensive oral care for pediatric

  4. 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.

  5. Job satisfaction and perceived autonomy for nurse practitioners working in nurse-managed health centers.

    PubMed

    Pron, Ann Linguiti

    2013-04-01

    More primary care providers are needed to deliver health care to Americans living in poverty and those soon to be insured under the Affordable Care Act. Nurse practitioners (NPs) in nurse-managed health centers (NMHCs) are poised to meet this need. This research study examined the characteristics of NPs working in NMHCs and measured job satisfaction and perceived level of autonomy. No studies about job satisfaction or autonomy for NPs working in NMHCs had been previously reported. This descriptive, quantitative study surveyed primary care NPs working in NMHCs that are part of the National Nursing Centers Consortium (NNCC). NP e-mail addresses were obtained from NNCC center directors. Of 198 NPs invited to the electronic survey, 99 completed the Misener Nurse Practitioner Job Satisfaction Scale, demographic questionnaire, questions about perceived autonomy, and whether they would recommend working in an NMHC. Participants came from 16 states and 46 NMHCs. NPs working in NMHCs have job satisfaction, perceive their role as autonomous, and are satisfied with the autonomy they have. NMHCs can provide access to primary health care for many Americans. More NPs may choose employment in NMHCs for job satisfaction and autonomy. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  6. Oncology Nursing Minimum Data Set (ONMDS): can we hypothesize a set of prevalent Nursing Sensitive Outcomes (NSO) in cancer patients?

    PubMed

    Milani, A; Mauri, S; Gandini, S; Magon, G

    2013-01-01

    The nursing minimum data set (NMDS) was created in 1977 in the United States to collect uniform standardised data that could be comparable among different nursing areas or patients. So far, in the literature, an NMDS in an oncology setting has not yet been described. Considering an oncology nursing minimum data set (ONMDS), which data could be chosen to define this tool regarding cancer patient care? At the European Institute of Oncology (IEO), 20 experienced oncology nurses representing surgical, medical, and critical areas participated in a nursing record working group. All nurses followed an educational course on NMDS, and they shared clinical experiences to find which data common among different areas could be useful to care. To identify these data, nurses considered three issues: what is nursing care for nurses in the IEO? What is the nurses' responsibility in the IEO? What is the organisational nursing model in the IEO? Nurses in the IEO are autonomous in decision making and recognised by patients and by a multi-professional team; the organisational nursing model is primary nursing with patient-centred care. Nursing data must therefore show the quality and results of this care. With this in mind, the working group decided to orient the ONMDS toward nursing-sensitive outcomes (NSOs), meeting also with psychologists, physiotherapists, and dieticians. Nurses analysed Oncology Nursing Society outcomes, and through focus groups, experiential meetings, role playing, and case studies, they integrated them with other NSOs. The ONMDS is composed of 49 NSOs recognised as the most common and frequent oncologic outcomes regardless of the treatment that the patient undergoes. These outcomes were clustered into 15 categories. The categories are: gastrointestinal outcomes, genitourinary outcomes, respiratory outcomes, skin outcomes, fluid and electrolyte balance outcomes, neurological outcomes, security, functional status, vascular access outcomes, nutritional status, pain

  7. Development and testing of an instrument to measure holistic nursing values in nurse practitioner care.

    PubMed

    Kinchen, Elizabeth

    2015-01-01

    As primary care delivery evolves in the United States with nurse practitioners (NPs) as key providers, exploring the patient's perception of the nature and quality of NPs' care is of critical importance to healthcare consumers, providers, educators, policy makers, and underwriters. The aim of this study was to describe the development and testing of the Nurse Practitioner Holistic Caring Instrument, a new, investigator-developed measure of the preservation of holistic nursing values in NP care. Results suggest that NPs provide patient-centered, comprehensive, and clinically competent care, rendering them ideally suited to leading primary health care delivery. However, further testing in more diverse populations and settings is needed to strengthen preliminary findings.

  8. Understanding acute care nurse practitioner communication and decision-making in healthcare teams.

    PubMed

    Kilpatrick, Kelley

    2013-01-01

    This paper aims to describe communication and decision-making in healthcare teams following the introduction of an acute care nurse practitioner role. Healthcare teams need to establish clear processes for communication and decision-making about patient care to be effective. Little is known about how acute care nurse practitioners affect these team processes. Observational/descriptive study. Structured non-participant observations of acute care nurse practitioners and healthcare team members during routine patient care activities were completed to identify the verbal and non-verbal behaviours. Data were collected in two hospitals in one Canadian province from March-May 2009 for a total of 17 hours and 23 minutes. Descriptive statistics were generated. Differences in communication and decision-making were noted between the cases. The acute care nurse practitioners in Case 1 spoke most frequently with physicians when making patient care decisions while the acute care nurse practitioners in Case 2 spoke most frequently with the nurses. The acute care nurse practitioners needed to validate all patient care decisions if prescriptive authority had not been transferred to them. Much of the potential of acute care nurse practitioner roles rests on the ability to enact the full scope of their role. Acute care nurse practitioner scope of practice depends on the legislation, the transfer of decision-making authority in the organisation, and the messages received form the medical and nursing leadership group. This appears to be the first in-depth description of communication and decision-making in healthcare teams following the introduction of acute care nurse practitioners and furthers our understanding of how system-level imperatives filter down to healthcare teams. The transfer of prescriptive authority to acute care nurse practitioners affected communication and decision-making and changed the way routine activities were conducted. © 2012 Blackwell Publishing Ltd.

  9. Out of necessity: oncology nurses' experiences integrating the internet into practice.

    PubMed

    Dickerson, Suzanne S; Boehmke, Marcia; Ogle, Carolann; Brown, Jean K

    2005-03-05

    To understand the experiences of oncology nurses who use the Internet in their practice when their patients use the Internet for cancer care. Heideggerian hermeneutics branch of phenomenology. Oncology nurses were interviewed at their practice settings (n = 13), the researcher's office (n = 5), or their homes (n = 2). 20 nurses recruited from local and national Oncology Nursing Society meetings. Their practice sites were cancer centers, hospitals, clinics, veterans centers, communities, and Internet companies. Data were collected by informal interviews that provided the narrative stories for hermeneutic analysis. Internet use for cancer care, nurse-patient relationships, and Internet use for nursing practice. Five related themes emerged: (a) varying degrees of Internet integration in the practice environment, (b) changing schools of thought, (c) developing Internet use for professional practice, (d) redefining relationships, and (e) new nursing skills. The two constitutive patterns are (a) integrating Internet into practice out of necessity and (b) reflecting historical changes in practice patterns influenced by technology. Nurses who use the Internet are developing new practice patterns that incorporate technology and foster nurse-patient partnerships. Practice environments either foster or hinder technology use. Nurse computer competency is essential. Findings reflect the influence of adapting technology on practice. Internet use is a catalyst for redefining nurse-patient relationships into partnerships. The movement suggests a need for nurse Internet competencies, environmental support, and consideration for patient access (digital divide). Evaluation of content in nursing curricula and of patient competencies is advised. Further research on patient experiences is recommended.

  10. Nurse-driven protocols for febrile pediatric oncology patients.

    PubMed

    Dobrasz, Gina; Hatfield, Marianne; Jones, Laura Masak; Berdis, Jennifer Joan; Miller, Erin Elizabeth; Entrekin, Melanie Smith

    2013-05-01

    Infection is a frequent complication experienced by many children with cancer, with potentially life-threatening consequences that may result in hospitalization, prolonged length of stay, and increased mortality. The need for prompt assessment and early intervention for infection is widely recognized by ED staff as best practice; however, the average length of time to antibiotic administration varies widely in published studies. An interdisciplinary quality improvement initiative including physician, nursing, and pharmacy leaders was created to streamline the identification and treatment for this high-risk population. Based on published evidence for best practice and national recognition of the need for rapid treatment, the goal was set for administration of antibiotic therapy to less than 60 minutes after ED arrival. This project was conducted at 2 emergency departments in a pediatric health care system with 520 beds and a level I and level II trauma designation. Approximately 154,000 patients are seen annually. In the emergency departments, 271 staff members, including registered nurses, paramedics, and patient care technicians, required education about using the newly designed process. Records from all patients with fever and a known history of pediatric cancer who presented to the emergency departments were included in the retrospective review, including patients with solid tumors, acute lymphoblastic leukemia, acute myeloid leukemia, and chronic myelogenous leukemia. Exclusion criteria included patients in known remission, those with prior antibiotic therapy at another facility, congenital neutropenia, or parental concern or objection to treatment. A retrospective medical record review of febrile oncology patients treated from September 2008 until May 2012 was conducted to evaluate the impact of this evidence-based practice change to streamline the "door to drug" process. The average length of time until antibiotic administration, nurses' compliance initiating

  11. A literature review of the Dutch debate on the nurse practitioner role: efficiency vs. professional development.

    PubMed

    ter Maten-Speksnijder, A; Grypdonck, M; Pool, A; Meurs, P; van Staa, A L

    2014-03-01

    To explore the debate on the development of the nurse practitioner profession in the Netherlands. In the Netherlands, the positives and negatives of nurse practitioners working in the medical domain have been debated since the role was introduced in 1997. The outcome of the debate is crucial for nurse practitioners' professional development and society's justification of their tasks. Review of 14 policy documents, 35 opinion papers from nurses, 363 opinion articles from physicians and 24 Dutch research papers concerning nurse practitioners from 1995 to 2012. Two discourses were revealed: one related to efficiency and one to the development of the profession. In both, the nurse practitioner role was presented as a solution for healthcare and workforce problems, while arguments differed. The efficiency discourse seemed most influential. Opinions of nurse practitioners were underrepresented; taking up new responsibilities was driven by the wish to improve patient care. While most physicians were willing to delegate tasks to nurse practitioners, they wished to retain final responsibility for medical care. All available publications were extensively studied, which could not include unpublished policy documents from the government or influential parties. This may have led to some selectivity. The case of the Netherlands shows that nurses in developing their advanced role are facing barriers, similar to those in other countries. The dominance of efficiency arguments combined with protection of medical autonomy undermines the development towards nursing care that really benefits patients. Nurse practitioners should strive to obtain positions in which they are allowed to make their own decisions and wise use of healthcare resources for the good of patients and society. Nurse practitioners should aim to become members of influential healthcare Boards in their countries, in which they can raise their voices and be involved in policy making. © 2013 International Council of

  12. Oncology Nursing Minimum Data Set (ONMDS): can we hypothesize a set of prevalent Nursing Sensitive Outcomes (NSO) in cancer patients?

    PubMed Central

    Milani, A; Mauri, S; Gandini, S; Magon, G

    2013-01-01

    Background The nursing minimum data set (NMDS) was created in 1977 in the United States to collect uniform standardised data that could be comparable among different nursing areas or patients. So far, in the literature, an NMDS in an oncology setting has not yet been described. Considering an oncology nursing minimum data set (ONMDS), which data could be chosen to define this tool regarding cancer patient care? Material and methods At the European Institute of Oncology (IEO), 20 experienced oncology nurses representing surgical, medical, and critical areas participated in a nursing record working group. All nurses followed an educational course on NMDS, and they shared clinical experiences to find which data common among different areas could be useful to care. To identify these data, nurses considered three issues: what is nursing care for nurses in the IEO? What is the nurses’ responsibility in the IEO? What is the organisational nursing model in the IEO? Nurses in the IEO are autonomous in decision making and recognised by patients and by a multi-professional team; the organisational nursing model is primary nursing with patient-centred care. Nursing data must therefore show the quality and results of this care. With this in mind, the working group decided to orient the ONMDS toward nursing-sensitive outcomes (NSOs), meeting also with psychologists, physiotherapists, and dieticians. Nurses analysed Oncology Nursing Society outcomes, and through focus groups, experiential meetings, role playing, and case studies, they integrated them with other NSOs. Results The ONMDS is composed of 49 NSOs recognised as the most common and frequent oncologic outcomes regardless of the treatment that the patient undergoes. These outcomes were clustered into 15 categories. The categories are: gastrointestinal outcomes, genitourinary outcomes, respiratory outcomes, skin outcomes, fluid and electrolyte balance outcomes, neurological outcomes, security, functional status, vascular

  13. 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. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  14. The acute care nurse practitioner role in Canada.

    PubMed

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

    2010-12-01

    The acute care nurse practitioner (ACNP) role was developed in Canada in the late 1980s to offset rapidly increasing physician workloads in acute care settings and to address the lack of continuity of care for seriously ill patients and increased complexity of care delivery. These challenges provided an opportunity to develop an advanced practice nursing role to care for critically ill patients with the intent of improving continuity of care and patient outcomes. For this paper, we drew on the ACNP-related findings of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing. The synthesis revealed that ACNPs are working in a range of clinical settings. While ACNPs are trained at the master's level, there is a gap in specialty education for ACNPs. Important barriers to the full integration of ACNP roles into the Canadian healthcare system include lack of full utilization of role components, limitations to scope of practice, inconsistent team acceptance and funding issues. Facilitators to ACNP role implementation include clear communication about the role, with messages tailored to the specific information needs of various stakeholder groups; supportive leadership of healthcare managers; and stable and predictable funding. The status of ACNP roles continues to evolve across Canada. Ongoing leadership and continuing research are required to enhance the integration of these roles into our healthcare system.

  15. 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.

  16. Physical activity prescriptions in healthy populations: resources for Canadian nurse practitioners.

    PubMed

    Turin, Rochelle

    2015-02-15

    Canadian nurse practitioners' use of physical activity prescriptions is examined. Nurse practitioners use unstructured counseling techniques; have more opportunities with older adults; experience barriers; and want more education. Barriers are lack of time, lack of knowledge, and patient disinterest. Canadian resources are suggested to support physical activity prescriptions.

  17. 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. © 2013 Wiley Publishing Asia Pty Ltd.

  18. 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... 130—Confidential Physician or Nurse Practitioner Affidavit ER31MY00.002 ER31MY00.003...

  19. 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...

  20. 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...

  1. 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... 130—Confidential Physician or Nurse Practitioner Affidavit ER31MY00.002 ER31MY00.003...

  2. 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...

  3. Nurse practitioner knowledge of child sexual abuse in children with cognitive disabilities.

    PubMed

    Koetting, Cathy; Fitzpatrick, Joyce J; Lewin, Linda; Kilanowski, Jill

    2012-06-01

    The purpose of this study was to describe the knowledge level of nurse practitioners regarding symptoms of child sexual abuse in children with cognitive disabilities. A total sample of 43 nurse practitioners from two professional nurse practitioner organizations was surveyed to assess child sexual abuse symptoms identification in intellectually disabled children using a revised edition of the Child Sexual Abuse Knowledge Survey. Data collected showed nurse practitioners have deficits in identifying various parts of prepubescent female genitalia. The majority of nurse practitioners did not check genitalia in regular physical exams, did not feel competent to perform this type of evaluation, and were not aware of their professional organizations' position regarding checking for child sexual abuse. When assessing a child with an intellectual disability, nurse practitioners must accurately assess physical symptoms and behaviors that could have resulted from sexual abuse. Examining children for sexual abuse is a required duty of the nurse practitioner as evidenced by the position statements of the various professional organizations and nurse practitioners must be aware of their required scope of practice.

  4. Physician assistants and nurse practitioners: rural-urban settings and reimbursement for services.

    PubMed

    Anderson, D M; Hampton, M B

    1999-01-01

    Evidence based on productivity measures, salaries and costs of medical education indicates that physician assistants and nurse practitioners are cost-effective. Managed care suggests that health maintenance organizations (HMOs) would seek to utilize these professionals. Moreover, underserved rural areas would utilize physician assistants and nurse practitioners to provide access. This study examined the role of payment sources in the utilization of physician assistants and nurse practitioners using the 1994 National Hospital Ambulatory Medical Care Survey (NHAMCS) conducted by the National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Rural vs. urban results were compared. The study found that significant rural-urban differences exist in the relationships between payment sources and the utilization of physician assistants and nurse practitioners. The study also found that payment source affects varied for physicians, physician assistants and nurse practitioners who saw outpatients in hospital settings. Surprisingly, prepaid and HMO types of reimbursements are shown to have no relationship with physician assistant and nurse practitioner utilization, and this finding is the same for both rural and urban patient visits. After controlling for other influences, the study shows that physicians, physician assistants and nurse practitioners are each as likely as the other to be present at a rural managed care visit. However, physicians are much more likely than physician assistants and nurse practitioners to be present at an urban managed care visit.

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

    PubMed

    Kilpatrick, Kelley

    2008-06-01

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

  6. Reducing Readmissions After Stroke With a Structured Nurse Practitioner/Registered Nurse Transitional Stroke Program.

    PubMed

    Condon, Christina; Lycan, Sarah; Duncan, Pamela; Bushnell, Cheryl

    2016-06-01

    Our aim was to determine whether a standardized Transitional Stroke Clinic (TSC) led by nurse practitioners could reduce 30-day and 90-day readmissions for stroke or transient ischemic attack patients discharged home. Phase I consisted of nurse practitioners calling only high-risk patients discharged home within 7 days and performing an office visit within 2 to 4 weeks of discharge. Phase II consisted of all patients discharged home receiving both a 2-day follow-up phone call by a registered nurse and a follow-up visit with a nurse practitioner within 7 to 14 days. Differences in process metrics and readmissions across the 2 phases and overall were assessed. Increasing complexity with multiple chronic conditions (diabetes mellitus, coronary artery disease, and congestive heart failure) was represented in a continuous variable from 0 to 3. Multivariable logistic regression models for 30-day and 90-day readmissions were performed with adjustment for National Institutes of Health Stroke Scale (NIHSS) and previous hospitalizations. From October 2012 through September 2015, 510 patients were enrolled. From phase I to II, a higher proportion of follow-up calls were made and days from discharge to TSC decreased. Patients readmitted within 30 days were less likely to show for TSC visits (60.85% versus 76.3%; P=0.021). Multivariable modeling showed that TSC visit was associated with a 48% reduction in 30-day readmission (odds ratio, 0.518; 95% confidence interval, 0.272-0.986), whereas multiple chronic conditions and previous stroke/transient ischemic attack increased the risk. TSC visit did not impact 90-day readmissions. Evaluation in a nurse practitioner-led structured clinic is a model that may reduce readmissions at 30 days for stroke patients discharged home. © 2016 American Heart Association, Inc.

  7. Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

    PubMed Central

    2013-01-01

    Background This integrative review synthesises research studies that have investigated the perceptions of nurse practitioners and medical practitioners working in primary health care. The aggregation of evidence on barriers and facilitators to working collaboratively and experiences about the processes of collaboration is of value to understand success factors and factors that impede collaborative working relationships. Methods An integrative review, which used systematic review processes, was undertaken to summarise qualitative and quantitative studies published between 1990 and 2012. Databases searched were the Cochrane Library, the Joanna Briggs Institute Library, PubMed, Medline, CINAHL, Informit and ProQuest. Studies that met the inclusion criteria were assessed for quality. Study findings were extracted relating to a) barriers and facilitators to collaborative working and b) views and experiences about the process of collaboration. The findings were narratively synthesised, supported by tabulation. Results 27 studies conducted in seven different countries met the inclusion criteria. Content analysis identified a number of barriers and facilitators of collaboration between nurse practitioners and medical practitioners. By means of data comparison five themes were developed in relation to perceptions and understanding of collaboration. Nurse practitioners and medical practitioners have differing views on the essentials of collaboration and on supervision and autonomous nurse practitioner practice. Medical practitioners who have a working experience with NPs express more positive attitudes towards collaboration. Both professional groups report concerns and negative experiences with collaborative practice but also value certain advantages of collaboration. Conclusions The review shows that working in collaboration is a slow progression. Exposure to working together helps to overcome professional hurdles, dispel concerns and provide clarity around roles and the

  8. Nurse Practitioner Autonomy and Satisfaction in Rural Settings.

    PubMed

    Spetz, Joanne; Skillman, Susan M; Andrilla, C Holly A

    2016-01-29

    Rural primary care shortages may be alleviated if more nurse practitioners (NPs) practiced there. This study compares urban and rural primary care NPs (classified by practice location in urban, large rural, small rural, or isolated small rural areas) using descriptive analysis of the 2012 National Sample Survey of NPs. A higher share of rural NPs worked in states without physician oversight requirements, had a DEA (drug enforcement administration) number, hospital admitting privileges, and billed using their own provider identifier. Rural NPs more often reported they were fully using their NP skills, practicing to the fullest extent of the legal scope of practice, satisfied with their work, and planning to stay in their jobs. We found lower per capita NP supply in rural areas, but the proportion in primary care increased with rurality. To meet rural primary care needs, states should support rural NP practice, in concert with support for rural physician practice.

  9. 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.

  10. Interpersonal styles of nurse practitioner students during simulated patient encounters.

    PubMed

    Miller, A M; Wilbur, J; Dedhiya, S; Talashek, M L; Mrtek, R

    1998-05-01

    Evaluation methods are needed to assess nurse practitioners' (NPs') interpersonal skills and provide students with systematic, qualitative feedback. The purpose of this study was to identify characteristics and styles of students' interpersonal behavior from patients' perspectives during simulated encounters. The 29-item Clinical Encounter Q-Set for NPs was generated pertaining to patients' perceptions of their interactions with NP students. Using Q-methodology, simulated patients (SPs) sorted the items immediately after each of their encounters with 45 NP students. Items were rank-ordered along a continuum, ranging from "most like my feelings regarding the encounter" to "least like my feelings." Three interpersonal styles were identified. "Nonjudgmental professionalism" characterized student behavior during the simulation portraying a patient with a sexually transmitted disease. "Competence/confidence" and "empathy/respect" were predominant styles exhibited during the hypertension simulation. The potential value of this method for teaching and evaluation is discussed.

  11. 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.

  12. Physician assistant and nurse practitioner utilization in academic medical centers.

    PubMed

    Moote, Marc; Krsek, Cathleen; Kleinpell, Ruth; Todd, Barbara

    2011-01-01

    The purpose of this study was to collect information on the utilization of physician assistants (PAs) and nurse practitioners (NPs) in academic health centers. Data were gathered from a national sample of University HealthSystem Consortium member academic medical centers (AMCs). PAs and NPs have been integrated into most services of respondent AMCs, where they are positively rated for the value they bring to these organizations. The primary reason cited by most AMCs for employing PAs and NPs was Accreditation Council for Graduate Medical Education resident duty hour restrictions (26.9%). Secondary reasons for employing PAs and NPs include increasing patient throughput (88%), increasing patient access (77%), improving patient safety/quality (77%), reducing length of stay (73%), and improving continuity of care (73%). However, 69% of AMCs report they have not successfully documented the financial impact of PA/NP practice or outcomes associated with individual PA or NP care.

  13. Nurse practitioners on the cutting edge of leadership.

    PubMed

    Kodiath, M F

    1995-01-01

    For the past 10 to 15 years nurse practitioners (NPs) have been pioneers in the development of their roles within the health care system. My journey over the past 8 years has been to develop an interdependent role as the co-founder of a chronic pain rehabilitation program. Now, I believe, it is no longer sufficient to be an effective pioneer. The pioneer stage is over. We need to stop practicing from an industrial paradigm that views leadership as great men and great women who have certain preferred traits influencing followers to do what leaders want (Rost, 1994). NPs need interdependent team-based practices with the patient as a team member. We need to experience influential relationships between leaders and collaborators intending real change for mutual purposes.

  14. 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.

  15. Simulation Design: Engaging Large Groups of Nurse Practitioner Students.

    PubMed

    Garnett, Susan; Weiss, Josie A; Winland-Brown, Jill E

    2015-09-01

    Little has been written about using human patient simulation to teach primary care management to large groups of nurse practitioner (NP) students. This article describes an innovative design for simulated clinical experiences based on a game show format. This large-group design was conceived as a way to overcome several challenges, particularly limited faculty resources, to integrating simulation into NP education. Progressive variations evolved from this foundation, including the use of observer-participant groups; initial and follow-up visits on the same simulated patient; and mentor-mentee collaborations. Student comments, while consistently positive about the simulated clinical experiences, have been used to guide revisions to strengthen the simulation program. The innovative large-group design enabled faculty to use simulation to enhance students' skills in primary care management. Faculties with similar challenges might find these strategies useful to replicate or adapt. Copyright 2015, SLACK Incorporated.

  16. Nurse practitioner workforce: a substantial supply of primary care providers.

    PubMed

    Poghosyan, Lusine; Lucero, Robert; Rauch, Lindsay; Berkowitz, Bobbie

    2012-01-01

    For about 5 decades, nurse practitioners (NPs) have been utilized to deliver primary care, traditionally in underserved areas or to vulnerable populations. However, over the years, this workforce has experienced a steady growth and has expanded its reach to provide primary care in diverse settings. An additional 32 million patients will have access to primary care with full implementation of the Patient Protection and Affordable Care Act. It is unlikely that the scarce supply of primary care physicians will be able to properly meet the demand and the health care needs of the nation. NPs face challenges but practice, policy, and research recommendations for better utilizing NPs in primary care can mediate the workforce shortages and meet the demand for care.

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

    PubMed

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

    2015-01-01

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

  18. Nurse practitioners and physician assistants in the intensive care unit: an evidence-based review.

    PubMed

    Kleinpell, Ruth M; Ely, E Wesley; Grabenkort, Robert

    2008-10-01

    Advanced practitioners including nurse practitioners and physician assistants are contributing to care for critically ill patients in the intensive care unit through their participation on the multidisciplinary team and in collaborative physician practice roles. However, the impact of nurse practitioners and physician assistants in the intensive care unit setting is not well known. To identify published literature on the role of nurse practitioners and physician assistants in acute and critical care settings; to review the literature using nonquantitative methods and provide a summary of the results to date incorporating studies assessing the impact and outcomes of nurse practitioner and physician assistant providers in the intensive care unit; and to identify implications for critical care practice. We conducted a systematic search of the English-language literature of publications on nurse practitioners and physician assistants utilizing Ovid MEDLINE, PubMed, and the Cumulative Index of Nursing and Allied Health Literature databases from 1996 through August 2007. None. Over 145 articles were reviewed on the role of the nurse practitioner and physician assistant in acute and critical care settings. A total of 31 research studies focused on the role and impact of these practitioners in the care of acute and critically ill patients. Of those, 20 were focused on nurse practitioner care, six focused on both nurse practitioner and physician assistant care, and five were focused on physician assistant care in acute and critical care settings. Fourteen focused on intensive care unit care, and 17 focused on acute care including emergency room, trauma, and management of patients with specific acute care conditions such as stroke, pneumonia, and congestive heart failure. Most studies used retrospective or prospective study designs and nonprobability sampling techniques. Only two randomized control trials were identified. The majority examined the impact of care on patient

  19. Psychological empowerment and structural empowerment among nurse practitioners.

    PubMed

    Stewart, Julie G; McNulty, Rita; Griffin, Mary T Quinn; Fitzpatrick, Joyce J

    2010-01-01

    Empowering workplaces provide practitioners with access to information, support, resources, and opportunities to learn and grow. Empowerment is also a psychological process, which occurs when one has a sense of motivation in relation to the workplace environment. There is no previous research on the relationship of psychological empowerment and structural empowerment in nurse practitioner (NP) practice. Structural empowerment was measured using the conditions of work effectiveness questionnaire-II (CWEQ-II), and psychological empowerment was measured using Spreitzer's psychological empowerment scale. The sample consisted of 74 NPs in the state of Connecticut. The correlational scores for the instruments were derived with n = 72 as two subjects had extreme scores on multiple variables and were excluded. There were significant correlations between psychological and structural empowerment for total scores, and within 10 of these tools' subscales. The NPs who participated in this study scored high on perceptions of structural empowerment and psychological empowerment. The results of the psychological empowerment instrument indicated that the NPs value their work and find meaning in what they do. The relationships between psychological empowerment and structural empowerment have been linked to work effectiveness, quality patient care, cost-effectiveness, and retention. Study results support an implication that it is of critical importance for the organization or practice setting to facilitate both psychological and structural empowerment to the NP to ensure successful practice.

  20. [Patient-centered care. Improvement of communication between university medical centers and general practitioners for patients in neuro-oncology].

    PubMed

    Renovanz, M; Keric, N; Richter, C; Gutenberg, A; Giese, A

    2015-12-01

    Communication between university medical centers and general practitioners (GP) is becoming increasingly more important in supportive patient care. A survey among GPs was performed with the primary objective to assess their opinion on current workflow and communication between GPs and the university medical center. The GPs were asked to score (grades 1-6) their opinion on the current interdisciplinary workflow in the care of patients with brain tumors, thereby rating communication between a university medical center in general and the neuro-oncology outpatient center in particular. Questionnaires were sent to1000 GPs and the response rate was 15 %. The mean scored evaluation of the university medical center in general was 2.62 and of the neuro-oncological outpatient clinic 2.28 (range 1-6). The most often mentioned issues to be improved were easier/early telephone information (44 %) and a constantly available contact person (49 %). Interestingly, > 60 % of the GPs indicated they would support web-based tumor boards for interdisciplinary and palliative neuro-oncological care. As interdisciplinary care for neuro-oncology patients is an essential part of therapy, improvement of communication between GPs and university medical centers is indispensable. Integrating currently available electronic platforms under data protection aspects into neuro-oncological palliative care could be an interesting tool in order to establish healthcare networks and could find acceptance with GPs.

  1. A sustainable model for pediatric oncology nursing education in low-income countries.

    PubMed

    Day, Sara W; Garcia, Jose; Antillon, Federico; Wilimas, Judith A; McKeon, Leslie M; Carty, Rita M; de Alarcon, Pedro; Pui, Ching-Hon; Ribeiro, Raul C; Howard, Scott C

    2012-02-01

    Effectiveness of a nurse educator in the pediatric oncology unit in Guatemala was assessed by measuring completion of an education course, chemotherapy and central line competency, continuing education, and cost. All newly hired nurses completed the education course. Of the nurses employed, 86% participated in the chemotherapy course, and 93% achieved competency; 57% participated in the central line course, and 79% achieved competency. The nurses completed a mean of 26 hours continuing education yearly. The annual direct cost of the educator ($244/nurse) was markedly less than other models. This is an effective and sustainable means to educate nurses in low-income countries. Copyright © 2011 Wiley Periodicals, Inc.

  2. 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…

  3. Burnout among physicians and nurses working in oncology.

    PubMed

    Caruso, Anita; Vigna, Cristina; Bigazzi, Valentina; Sperduti, Isabella; Bongiorno, Laura; Allocca, Amalia

    2012-01-01

    The phenomenon of Burnout is an important occupational problem which affects those working in the "helping professions" to a greater degree since they have continuous and constant contact with suffering patients. We aimed to assess the Burnout level and its correlation with organizational stressors. The aim was achieved through administration of a questionnaire, the organizational check-up survey (OCS) among 80 physicians and 102 nurses working in a cancer institute. The results showed significant levels of Burnout (Exhaustion and Cynicism) associated with perceived discrepancy between the worker's values and those promoted by the hospital management, mainly among longer serving staff work overload reported by staff working in the intensive care and medical oncology departments; lack of recognition reported by permanent staff and also those who had no contact with the patients. The study confirmed the multiple factors involved in the phenomenon of Burnout and the usefulness of the OCS tool for the diagnosis and management of Burnout via appropriate intervention programmes. Furthermore, it also seemed to confirm the need to pay particular attention to the wellbeing of health professionals working in care and treatment of cancer patients via individual measures associated with other organizational measures.

  4. 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.

  5. Paediatric nurse practitioner managed cardiology clinics: patient satisfaction and appointment access.

    PubMed

    Evangelista, Juli-Anne K; Connor, Jean Anne; Pintz, Christine; Saia, Teresa; O'Connell, Cheryl; Fulton, David R; Hickey, Patricia

    2012-10-01

    This article summarizes a comparative study of patient/family satisfaction and appointment wait times in physician managed vs. paediatric nurse practitioner managed cardiology clinics. Appointment wait times exceeded 40 days in the outpatient cardiology department at a children's hospital. To address the gap in available appointments, paediatric nurse practitioner managed cardiology clinics were implemented. A sample of 128 patients who presented concurrently in physician or paediatric nurse practitioner managed cardiology clinics from December 2009 through February 2010 was recruited for participation. The hospital's ambulatory patient satisfaction survey was utilized to measure level of patient satisfaction with care. Survey responses were evaluated using Fisher's exact test. Appointment wait times were compared pre and post implementation of paediatric nurse practitioner managed clinics. Sixty-five physician families and 63 paediatric nurse practitioner families completed the satisfaction survey. There was no statistically significant difference in patient satisfaction between clinic types. Appointment wait time decreased from 46 to 43 days, which was not statistically significant. Paediatric nurse practitioner clinics included a statistically higher percentage total of urgent appointments compared to that in physician clinics. Paediatric nurse practitioner managed cardiology clinics are a strategic solution for improving patient access and facilitating high quality patient care while earning high levels of patient satisfaction. This healthcare delivery model illustrates the potential for expanded utilization of advanced practice nurses. © 2012 Blackwell Publishing Ltd.

  6. Measuring job satisfaction of advanced nurse practitioners and advanced midwife practitioners in the Republic of Ireland: a survey.

    PubMed

    O'Keeffe, Anne Paula; Corry, Margarita; Moser, Debra K

    2015-01-01

    To describe the level of job satisfaction of advanced nurse practitioners (ANP) and advanced midwife practitioners in the Republic of Ireland (RoI). Job satisfaction is related to productivity, performance, turnover and health, and thus is a challenge for nursing and healthcare organisations. Job satisfaction data were collected from 47 ANPs using the Misener Nurse Practitioner Job Satisfaction Scale. High levels of global job satisfaction were reported. All ANPs reported satisfaction with autonomy, sense of accomplishment, challenge, social interaction and status in the organisation. Lower levels of job satisfaction were attributed to the amount of involvement in research (55%), opportunities to receive compensation for services provided outside normal working hours (55%), the amount (44%) and the quality of administrative support (51%), and the opportunity to negotiate bonuses and resources in return for productivity (36%). Advanced nurse practitioners in RoI have high levels of job satisfaction with areas relating to clinical practice but are dissatisfied with areas that lead to empowerment within organisations. Efforts to improve the negotiating and leadership skills of ANPs may improve job satisfaction. Enhancing inter-professional collegial relationships and improving managerial recognition of the role within nursing are key areas to be targeted to promote job satisfaction of ANPs. © 2013 John Wiley & Sons Ltd.

  7. Clarifying, affirming, and preserving the nurse in nurse practitioner education and practice.

    PubMed

    Brykczynski, Karen

    2012-09-01

    This work responds to the need for maintaining an ethic of care in the face of increased demands for cost effectiveness and efficiency. Findings are presented from a qualitative study describing how nurse practitioner (NP) faculty teach NP students about holistic nursing dimensions of NP practice. Data collection consisted of face to face or telephone interviews with 24 experienced NP faculty members teaching in 22 NP programs across the country. Data were analyzed using the interpretive phenomenological approach. Aspects of scientific merit were addressed through reviewing transcripts for accuracy, consensual validation sessions, and member checking. The most common approaches used for teaching holistic nursing dimensions of NP practice were role modeling and sharing narratives of actual cases. Other approaches included: incorporation of holistic complementary diagnoses along with medical diagnoses into assessments, use of case scenarios and standardized patients, a rite of passage ceremony, and an entire narrative curriculum. NP faculty advocate incorporating a holistic mind-body-spirit perspective into assessment and intervention and broadening the diagnostic process to include complementary components of nursing and medicine. Findings have implications for teaching/learning, curriculum planning, and evaluation as NP programs transition from the master's to the doctoral level. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  8. Training and Education in Practice Nursing: The Perspectives of the Practice Nurse, Employing General Practitioner and Family Health Service Authority.

    ERIC Educational Resources Information Center

    Atkin, Karl; Lunt, Neil

    1995-01-01

    Interviews with 56 practice nurses, 29 general practitioners (GPs), 23 health administrators, and 1 government official revealed that nurses use a variety of education and training opportunities; GPs largely let nurses take responsibility for their continuing education. The informal nature of training opportunities and lack of funding were…

  9. Oncology nurses' obstacles and supportive behaviors in end-of-life care: providing vital family care.

    PubMed

    Beckstrand, Renea L; Collette, Joan; Callister, Lynn; Luthy, Karlen E

    2012-09-01

    To determine the impact of obstacles and supportive behaviors in end-of-life (EOL) care as perceived by hospital-based oncology nurses. A 69-item mailed survey. National random sample. 1,005 nurse members of the Oncology Nursing Society who had provided EOL care for patients with cancer. Three mailings yielded 380 usable responses from 912 eligible respondents, resulting in a 42% return rate. Size and frequency of EOL care obstacles and supportive behaviors for patients with cancer in a hospital setting. Results of this research demonstrate the need for more EOL education and help in forming teams of nurses, social and palliative care workers, and physicians to support high-quality care. Another finding was the need for other nurses at a facility to give the nurse caring for the dying patient more time to support the patient and family. Dealing with the family is vital in providing optimal EOL care to patients dying from cancer. By carefully listening to the experience, concerns, and recommendations of hospital-based oncology nurses, compassionate EOL care can be provided to these patients and their families. Oncology nurses are dedicated to providing the best EOL care to their patients and patients' families. This study helped to identify research-based obstacles and supportive behaviors regarding the provision of high-quality EOL care.

  10. Consumer perspectives on nurse practitioners and independent practice.

    PubMed

    Brown, Deonne J

    2007-10-01

    The purposes of this study were to report the results of a survey for determining the feasibility and sustainability of independently managed nurse practitioner (NP) practices, to identify the characteristics of consumers who would likely choose an independent NP practice, to assess consumer needs, and to define a target market for competitively positioning NPs. An anonymous electronic survey of 1000 employees (response rate = 21%) at a large nonprofit organization in King County, Washington. This organization employs persons in a wide range of socioeconomic and vocational situations. Descriptive statistics and chi-square analyses were applied to determine associations between demographic characteristics and having used an NP or having the intent to use an independent NP practice. Most respondents knew about NPs, and the majority had seen an NP for their care. Most were satisfied or very satisfied with NP care. A much larger percentage (90%) than previous studies knew about NPs; 58% had seen an NP for their care, making NPs the most used practitioner alternative to physicians. Evidence suggests that NP users are more likely to be female and younger. Eighty-two percent of NP users were satisfied or very satisfied with the care they had received compared to a 70% satisfaction rate for current providers. Women, relatively younger respondents, those who had seen a physician assistant or NP, and those who considered NPs to provide quality and more personalized care were significantly more likely to indicate that they would choose an independent NP practice in their community. Based on a standard marketing formula, 30% of the sample in this study would be expected to change their health care to such a practice. This is the first descriptive study to suggest widespread acceptance of NPs as independent practitioners. Compared to a 1985 study of Seattle residents, consumers are far more likely to know about NPs. Consumer studies such as this one identify the characteristics

  11. Oncology nurses' communication challenges with patients and families: A qualitative study.

    PubMed

    Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A; Parker, Patricia A; Bylund, Carma L

    2016-01-01

    The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions.

  12. Knowing the nurse practitioner: dominant discourses shaping our horizons.

    PubMed

    Rashotte, Judy

    2005-01-01

    The purpose of this paper is to examine the various discourses, particularly the dominant instrumental and economic discourses that have brought the phenomena of the nurse practitioner (NP) into being. It is proposed that NPs have been constituted as an object of nature and therefore understood metaphorically as a tool or instrument within the health care system to be used efficiently and effectively. Heidegger's philosophical analysis of the question concerning technology is used to argue that our current ways of knowing the NP through these discourses, with their emphasis on calculative logic, have resulted from our modern view of the essence of technology. It is also argued that there is now a need to shape our horizons concerning the NP in new and different ways. There is a need to engage in dialogical forms of research in order to evoke the richness and depth of what it means to be an NP, that is, to reveal the other modes of expression by which we define ourselves, understand others and nursing.

  13. Pediatric nurse practitioner practice patterns and compensation in Ohio.

    PubMed

    Schaffner, Barbara; Vogt, Marjorie

    2004-01-01

    The purpose of the study was to describe practice patterns and compensation patterns of Pediatric Nurse Practitioners (PNPs) in Ohio. A survey, including open-ended and forced choice questions, was sent to all members of Ohio's chapter of NAPNAP. The resultant sample included 200 female PNPs. Over half had practiced as NPs between 5-29 years, holding at least a Master's degree. Fifty percent worked full-time in a variety of practice settings; 71% held prescriptive privileges. Most saw patients with a physician on-site and billed for services with the physician's name; few had "on call" responsibilities. The majority spent most of their clinical time with acute visits and providing preventative services. Only 29% had a contract with a collaborating physician and the components of the contract varied greatly. Compensation for services mimicked national rates, annual salaries from $35,000-$90,000/year and hourly rates $19-$40/hour. Salary bonuses were reported by 23%. Two-thirds of the PNPs received benefits. Practice patterns of the Ohio PNPs were found to be consistent with the practice patterns of advanced practice nurses nationally. Most PNPs remain largely uninformed about reimbursement issues. Negotiation of employment contracts with potential employers will be enhanced by demonstration of the positive impact of the NP on the number and type of patients seen, reimbursement possibilities, and quality of care. Future studies need to focus on quantifying the value of the NP.

  14. Building leadership capacity in advanced nurse practitioners - the role of organisational management.

    PubMed

    Elliott, Naomi

    2017-01-01

    To highlight the organisation-level management's role in building leadership capacity in advanced nurse practitioners and the need for appropriate supports to increase their becoming leaders. Little is published about the role of organisation-level management in building leadership capacity and in developing the next generation of nurse leaders. In times of economic constraint, organisations need to focus their efforts on targeted leadership initiatives. Advanced nurse practitioners are ideally positioned to act as leaders both within and beyond the health care organisation. From the available research evidence, several support structures and mechanisms are identified as enablers for advanced nurse practitioners to enact their leadership role. Health care organisations need to include building leadership capacity as a priority in their strategic plan and take action to build-up the level of advanced nurse practitioner leadership. Nurse executives have a vital role in influencing the organisation's strategic plan and making a business case for prioritising leadership capacity building within advanced nurse practitioners. A challenge for nurse executives faced with competing service and leadership development demands, involves strategic decision-making regarding whether the advanced nurse practitioner's role is limited to service delivery or its potential in leading health care reforms is realised. © 2016 John Wiley & Sons Ltd.

  15. Demystifying the role of nurse practitioners in hospice: nurse practitioners as an integral part of the hospice plan of care.

    PubMed

    Kennedy, Jennifer

    2012-01-01

    Beginning January 1, 2011, as a result of the Patient Protection and Affordable Care Act healthcare-reform law that was signed in March 2010, Medicare requires that all patients entering their third or later hospice benefit period must have a face-to-face encounter with a hospice physician or nurse practitioner (NP) to validate hospice eligibility. Medicare has allowed NPs to function as a patient's hospice attending physician since 2003, but they may not certify or recertify a patient's terminal illness or function in the role of the hospice physician in the hospice interdisciplinary team. The allowance of Medicare for the NP to complete the hospice face-to-face encounter allows a greater role for a NP in the realm of hospice care.

  16. Assessment of the interest of the geriatric oncology consultation among French general practitioners.

    PubMed

    Charbonnier, Claire; Marilier, Sophie; Dabakuyo, Sandrine; Cueff, Adèle; Quipourt, Valérie; Manckoundia, Patrick

    2016-01-01

    We assessed the interest of the geriatric oncology (GO) consultation (GOC) among general practitioners (GPs). We conducted a survey among GPs whose patients had had a GOC in 2012. A questionnaire was sent to GPs. The 1st part collected GPs' characteristics including medical education in geriatrics and GO, and knowledge of GOC. The following parts concerned the GOC and included the cancer type, GOC report and care plan. One-hundred twenty-six questionnaires corresponding to 94 GPs were collected. Concerning the GPs' characteristics, age range 50-59 (44.7%), men (62.8%) and urban practice (79.8%) were the most represented, 80.8% had no expertise in geriatrics, 60.6% knew of the existence of GOCs, and 14.9% had received medical education in GO. The most frequent cancer location was gynecological (40.7%) (82.6% were breast cancers). Of the GPs, 69.8% had received a GOC report and 92% were (very) satisfied with the delivery time. A care plan was proposed after the GOC in 83% of cases. It was satisfactory in 96.4% of cases, and applied by 74.7% of GPs. Sixteen percent of GPs were called by the GO team. The less the GP was satisfied with the GOC, the more he or she wanted phone contact (p=0.02); 94% of GPs considered the GOC (very) satisfactory. Sixty-seven percent of GPs wanted to be trained in GO. Very few GPs had been trained in geriatrics and/or GO. They were mostly satisfied with GOC and expressed a wish to be trained in GO. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Open arms, conflicted hearts: nurse-practitioner's attitudes towards working with lesbian, gay and bisexual patients.

    PubMed

    Dorsen, Caroline; Van Devanter, Nancy

    2016-12-01

    To explore nurse-practitioner's attitudes towards working with lesbian, gay and bisexual patients. Literature suggests that lesbians, gay men and bisexuals have significant health disparities compared to heterosexuals. Although the reasons are multifactorial, research suggests that attitudes of healthcare providers (HCPs) may be a contributing factor in both accessing and receiving care. There is currently no literature exploring the attitudes of the approximately 300,000 nurse-practitioners in the United States. Thus, nurse-practitioners strengths and challenges in providing care to sexual minorities are unknown. As part of a larger study, Corbin & Strauss' grounded theory methodology was used to explore the attitudes towards lesbian, gay and bisexual patients among primary care nurse-practitioners in NYC. Data were collected via individual semi-structured interviews with nurse-practitioners currently in practice in primary or outpatient care in NYC (n = 19). Data were evaluated using the three-step constant comparison method. Nurse-practitioners in this study had varied, often overlapping and sometimes conflicting, attitudes about working with lesbian, gay and bisexual patients. The main theme identified was 'open arms, conflicted hearts' with three major subthemes - feeling at home, struggling to maintain professionalism and finding comfort under the umbrella of diversity. Nurse-practitioner participants in this study had varied attitudes about working with lesbian, gay and bisexual patients, ranging from open, confident and comfortable to ambivalent, cautious and unsure about working with lesbian, gay and bisexual patients generally and specifically regarding the health needs of this population. This study highlights the inadequate didactic and clinical preparation most nurse-practitioners feel they have to care for lesbian, gay and bisexual patients. There is a need for increased education for registered nurses and nurse-practitioners regarding lesbian, gay

  18. Cancer patients' expressions of emotional cues and concerns and oncology nurses' responses, in an online patient-nurse communication service.

    PubMed

    Grimsbø, Gro Hjelmeland; Ruland, Cornelia M; Finset, Arnstein

    2012-07-01

    To (1) investigate emotional cues and concerns (C&C) of cancer patients expressed in e-mail communication with oncology nurses in an online patient-nurse communication service (OPNC), and (2) explore how nurses responded to patients' C&C. 283 e-messages sent from 38 breast and 22 prostate cancer patients and 286 e-responses from five oncology nurses were coded with the Verona Coding Definitions of Emotional Sequences. We identified 102 cues and 33 concerns expressed in patients' messages. Cues indicating expression of uncertainty or hope, occurred most frequently (in 38.5% of messages), followed by concerns (in 24.4% of messages). Nurses responded to 85.2% of patients' C&Cs; more than half of patients' C&Cs were met with a mixture of information giving and empathic responses. Patients with breast and prostate cancer express many C&C in e-mail communications with oncology nurses, who demonstrated satisfactory sensitivity to patients' emotions in their responses to patients. Offering e-communication with oncology nurses to cancer patients is a promising and feasible supplement to usual care to address and relieve patients' concerns and emotional distress during illness and recovery. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. Oncology Nursing Certification: Relation to Nurses' Knowledge and Attitudes About Pain, Patient-Reported Pain Care Quality, and Pain Outcomes.

    PubMed

    Beck, Susan L; Brant, Jeannine M; Donohue, Rebecca; Smith, Ellen M Lavoie; Towsley, Gail; Berry, Patricia H; Guo, Jia-Wen; Al-Qaaydeh, Sharifa; Pett, Marjorie A; Donaldson, Gary

    2016-01-01

    To (a) compare pain knowledge and attitudes between nurses with oncology certified nurse (OCN®) status, non-OCN®-certified nurses, and nurses ineligible for certification and (b) examine the relationships among OCN® status, nurses' knowledge and attitudes about pain, patient-reported quality of nursing pain care, and pain outcomes. 
. Prospective, correlational survey design. Patients were nested within nurses. 
. Six inpatient oncology units in three hospitals. 91 nurses in three states (28 OCN®-certified nurses, 37 noncertified nurses, and 26 not eligible for certification). Certification status was validated for 105 nurses who were matched with a sample of 320 patients. 
. Nurses completed a survey, and matched adult patients who were experiencing pain rated their pain care quality and pain experience during the past shift. 
. Demographic characteristics, certification status, and responses to the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), Pain Care Quality Survey-Nursing, and modified Brief Pain Inventory (Short Form). 
. OCN®-certified nurses scored significantly higher on the NKASRP (82% correct) compared to non-OCN® eligible nurses (76%) and non-OCN® ineligible nurses (74%) (p < 0.001). Only 43% overall achieved a benchmark of 80% correct. No statistically significant relationships existed between (a) certification status and pain care quality or pain outcomes or (b) NKASRP and care quality or outcomes (p > 0.05).
. OCN®-certified nurses' knowledge and attitudes related to pain management were superior to noncertified nurses. Neither knowledge and attitudes nor OCN® status were associated with pain care quality or pain outcomes. 
. Knowledge is necessary but insufficient to improve patient outcomes; providing optimal pain care requires action. Sustained efforts to improve cancer pain management are indicated.

  20. Acquiring Competence in Oncology Nursing Skills Through the Use of Film: A Study Protocol.

    PubMed

    Raga-Chardi, Rosa; Iglesias-Parra, Maria R; García-Mayor, Silvia; Kaknani, Shakira; García-Guerrero, Alfonso; Morales-Asencio, Jose M

    2016-01-01

    To determine the influence of movies as a teaching resource with nursing students to improve their ability to cope with challenging scenarios in oncology nursing, as well as their competence to identify nursing diagnoses in these patients. Cluster, randomized controlled trial with nursing students at the University of Málaga (Spain). Accuracy of nursing diagnoses, perceived stressors, death anxiety, empathy, level of decision making, and cognitive closure. This study will provide information about the efficacy of movies to improve the competence in nursing students for the care of oncology patients, as well as their diagnostic reasoning. If significant modifications are obtained, this approach can be an important resource applicable to other contexts of patient care. © 2014 NANDA International, Inc.

  1. Preparing Nursing Students for Interprofessional Practice: The Interdisciplinary Curriculum for Oncology Palliative Care Education

    PubMed Central

    Hermann, Carla P.; Head, Barbara A.; Black, Karen; Singleton, Karen

    2015-01-01

    Interprofessional educational experiences for baccalaureate nursing students are essential to prepare them for interprofessional communication, collaboration, and team work. Nurse educators are ideally positioned to develop and lead such initiatives. The purpose of this article is to describe the development and implementation of an interprofessional education (IPE) project involving students in nursing, medicine, social work, and chaplaincy. The Interdisciplinary Curriculum for Oncology Palliative Care Education (iCOPE) project uses team based palliative oncology education as the framework for teaching students interprofessional practice skills. The need for IPE is apparent, but there are very few comprehensive, successful projects for nurse educators to use as models. This article describes the development of the curriculum by the interprofessional faculty team. Issues encountered by nursing faculty members as they implemented the IPE experience are discussed. Solutions developed to address the issues as well as ongoing challenges are presented. This project can serve as a model of a successful IPE initiative involving nursing students. PMID:26802593

  2. Central venous access devices: an investigation of oncology nurses' troubleshooting techniques.

    PubMed

    Mason, Tina M; Ferrall, Sheila M; Boyington, Alice R; Reich, Richard R

    2014-08-01

    Experienced oncology nurses use different troubleshooting techniques for clearing occluded central venous access devices (CVADs) with varying degrees of success. The purpose of this study was to explore troubleshooting techniques used for clearing occluded CVADs by experienced oncology RNs and identify the perceived effectiveness of each technique. An invitation for a web-based survey was sent to select RN members of the Oncology Nursing Society. All nurses (N = 224) reported asking patients to raise and/or move their arm. Most nurses asked patients to lie down, cough, and take deep breaths. Respondents considered instilling a thrombolytic agent to be the most effective technique. No associations were found between techniques and respondents' years in oncology nursing, work setting, certification, or academic degree. The findings contribute to knowledge about care of patients with occluded devices and will help formulate direction for additional investigation of CVADs. Establishing the appropriateness of practice-related troubleshooting techniques may eliminate unnecessary steps and save nursing time. Educating nurses on the topic will also help reduce techniques that are not expected to yield results or are contraindicated.

  3. 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.

  4. Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India

    PubMed Central

    LeBaron, Virginia T; Palat, Gayatri; Sinha, Sudha; Chinta, Sanjeeva Kumari; Jamima, Beaulah John Battula; Pilla, Usha Lakshmi; Podduturi, Nireekshana; Shapuram, Yadamma; Vennela, Padma; Rapelli, Vineela; Lalani, Zahra; Beck, Susan L

    2017-01-01

    Context: Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. Aim: The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. Methods: Qualitative ethnography. Setting: The study was conducted at a government cancer hospital in urban South India. Sample: Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study. Data Collection: Data were collected over 9 months (September 2011– June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews. Analysis: Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns. Results: Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training. Conclusions: Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice. PMID:28503040

  5. Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India.

    PubMed

    LeBaron, Virginia T; Palat, Gayatri; Sinha, Sudha; Chinta, Sanjeeva Kumari; Jamima, Beaulah John Battula; Pilla, Usha Lakshmi; Podduturi, Nireekshana; Shapuram, Yadamma; Vennela, Padma; Rapelli, Vineela; Lalani, Zahra; Beck, Susan L

    2017-01-01

    Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. Qualitative ethnography. The study was conducted at a government cancer hospital in urban South India. Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study. Data were collected over 9 months (September 2011- June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews. Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns. Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training. Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.

  6. Boundary work and the introduction of acute care nurse practitioners in healthcare teams.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise; Doran, Diane

    2012-07-01

    This article is a report of a study of boundary work following the introduction of an acute care nurse practitioner role in healthcare teams. Acute care nurse practitioners enacting their roles in healthcare teams have faced a number of challenges including a mix of positive and negative views of the acute care nurse practitioner role from healthcare team members and acute care nurse practitioner roles crossing the boundaries between the medical and nursing professions. Understanding the process by which the boundaries between professions changed following the introduction of an acute care nurse practitioner role was important since this could affect scope of practice and the team's ability to give patient care. The study was conducted in two university-affiliated teaching hospitals in Canada. A descriptive multiple case study design was used. Data were collected from March to May 2009. Participants (N = 59) described boundary work as a process that included: (1) creating space; (2) loss of a valued function; (3) trust; (4) interpersonal dynamics; and (5) time. The development of trust among team members was essential. The co-location of team members working on common projects, and medical and nursing leadership facilitated boundary work. The micro-level processes of boundary work in healthcare teams have important implications for the development of full scope of practice for acute care nurse practitioners, effective inter-professional teamwork and the integration of new roles in healthcare systems. Future research needs to be undertaken in different contexts, and with patients and families. © 2011 Blackwell Publishing Ltd.

  7. Gerontological nurse practitioners (GNPs) for the first time in Israel: Physicians' and nurses' attitudes.

    PubMed

    Yafa, Haron; Dorit, Rubinstein; Shoshana, Riba

    2016-08-01

    Nurse practitioners (NPs) have recently been partially introduced by the Israel Ministry of Health. This study examines the attitudes among gerontological physicians and nurses toward the scope of practice and effects on healthcare quality of the new role of gerontological NPs (GNPs). A descriptive survey methodology, with a cross-sectional design, was used. According to about 50% of the respondents, GNPs would be expected to have various positive effects on health care, such as reducing the number of referrals to emergency care, as well as readmissions. Despite the overall positive attitude to the GNPs' role, nurses and physicians perceived its scope of practice somewhat differently. Implementing the NP role involves multiple challenges and provides insights into this complex new function. Especially in these early stages, identified intentions for the NP role and value of the role by healthcare teams are expected to be useful to policy makers for planning effective utilization of NPs in healthcare workforce. This role is also a new role in other countries, so these findings should be relevant beyond Israel. ©2016 American Association of Nurse Practitioners.

  8. Managing distress in oncology patients: description of an innovative online educational program for nurses.

    PubMed

    Pasacreta, Jeannie V; Kenefick, Amy L; McCorkle, Ruth

    2008-01-01

    The American Psychosocial Oncology Society and the Individual Cancer Assistance Network have launched the online continuing education accredited program "ICAN: Distress Management for Oncology Nursing" to address the ability of oncology nurses to assess, treat, and refer patients with a range of psychosocial problems. An important goal of the program is to reduce traditional barriers to psychosocial oncology education by providing the oncology nursing community with easy access to information from experts in the field. There are 4 Internet webcasts: Nurse's Role in Recognizing Distress in Patients and Caregivers; Assessment Recommendations; Treatment Strategies; and Principles and Guidelines for Psychotherapy and Referral. The program examines the prevalence and dimensions of patient distress and offers instruction on how to effectively integrate screening tools, such as the Distress Thermometer and Problem Check List, into clinical practice. It provides details on relevant interventions and referral algorithms based on the National Comprehensive Cancer Network Guidelines for Distress Management. It explores the devastating impact of psychological distress on quality of life, and the unique position of nurses in busy inpatient settings, outpatient clinics, and offices to detect, intervene, and refer to appropriate services. Providing information over the Internet addresses common barriers to learning, including schedule and time constraints.

  9. Knowledge Level on Administration of Chemotherapy through Peripheral and Central Venous Catheter among Oncology Nurses

    PubMed Central

    Kapucu, Sevgisun; Özkaraman, Ayşe Özaydın; Uysal, Neşe; Bagcivan, Gulcan; Şeref, Ferhan Çetin; Elöz, Aygül

    2017-01-01

    Objective: The aim of this study is to determine the knowledge levels of oncology nurses about peripheral and central venous catheter during their chemotherapy administration. Methods: Data collection of this descriptive study was started on April 15, 2015–July 15, 2015. The data presented in this summary belong to 165 nurses. Data were collected with data collection form including questions related to sociodemographic qualifications and knowledge levels of nurses. Data collection forms were E-mailed to the members of Turkish Oncology Nursing Society. Data presented with numbers, percentages, and mean ± standard deviation. Results: The mean age of nurses was 33.60 ± 7.34 years and mean duration for oncology nursing experience was 2.65 ± 0.91 years. Nurses had correct information about the importance of selecting peripheral venous catheter and choosing the placement area for chemotherapy administration (63.6%), control of catheter before the administration (93.9%), influence of chemotherapeutic agent on length of catheter (40.6%), and management of extravasation (75.7%). Nurses also had correct information about the first use of port catheter (67.3%) and checking the catheter whether it is working properly or not (75.8%). Conclusions: In General, nurses’ level of knowledge related to catheter is 50% and higher. It is recommended to increase the knowledge of nurses about evidence-based information for catheter care as a step to safe chemotherapy practice. PMID:28217732

  10. Creating a Healthy Practice Environment: A Call to Action for Oncology Nurses.

    PubMed

    Lacovara, Jane E

    2015-09-01

    When nurse researcher Marlene Kramer published Reality Shock: Why Nurses Leave Nursing in 1974, her seminal work launched a national discussion related to the distress felt by many baccalaureate-prepared novice nurses about leaving the academic setting and transitioning to the clinical setting. In particular, Kramer (1974) highlighted conflict between the values these new nurses had been taught in school and the reality of practicing as a professional nurse in a clinical setting. For example, in an educational setting, nursing students may focus on one or two patients at a time, whereas in the clinical setting, nurses must practice simultaneously with multiple patients with varied and numerous health deficits. This conflict is felt acutely by novice and experienced oncology nurses who are tasked with providing quality physical care, as well as emotional care and support to patients with cancer and their families
.

  11. The nurse practitioner and policy in end-of-life care.

    PubMed

    DuBois, Janet C; Reed, Pamela G

    2014-01-01

    The focus of this column is the interface between policy and end-of-life care, particularly as provided by advanced nurse practitioners. The complexities of end-of-life along with barriers in practice can diminish quality of life for patients and their families. Changes in policy are needed to enable nurse practitioners their full scope of practice in a way that benefits patients and families at end-of-life. Three areas particularly relevant to policy for nursing practitioners and end-of-life care are addressed: scope of practice, reimbursement, and prescribing practices. Other recommendations for policy and end-of-life care are discussed.

  12. Steering a course towards advanced nurse practitioner: a critical care perspective.

    PubMed

    Fleming, Elizabeth; Carberry, Martin

    2011-01-01

    This article is a report of a study of the experiences of expert critical care nurses in their transition to the role of advanced nurse practitioner within an intensive care unit (ICU) setting. The advanced nurse practitioner role was developed to support the ICU team and to undertake many of the roles traditionally associated with junior medical staff in this specialized area. The impetus for this study therefore was generated from the need to explore the role development experiences of trainee advanced nurse practitioners to inform future developments and practice. This study used grounded theory methodology to conduct and analyse data from 25 participants. The data were collected between March 2010 and August 2010, using interview format. Data collection and analysis was conducted simultaneously using methods associated with grounded theory, theoretical sampling and the constant comparative method. 'Staying the course to advanced nursing practice' emerged as the core category, with four related major categories and substantive codes. In conjunction, the substantive theory explaining the essential processes involved comprised of three inextricably linked processes: situational, development and conceptual meaning. The developed conceptual model captures the unique experiences of expert critical care nurses during their transition to confident and competent advanced nurse practitioners. This study provides an account of the role transition from expert critical care nurse to advanced nurse practitioner, specifically the synthesis of expert nursing practice with traditional medical values. The conceptual model has the potential to be utilized as a framework for others embarking upon similar projects, informing advanced nurse practitioner roles within and out with critical care settings. © 2011 The Authors. Nursing in Critical Care © 2011 British Association of Critical Care Nurses.

  13. Journey to Becoming a Neonatal Nurse Practitioner: Making the Decision to Enter Graduate School.

    PubMed

    Brand, M Colleen; Cesario, Sandra K; Symes, Lene; Montgomery, Diane

    2016-04-01

    Neonatal nurse practitioners (NNPs) play an important role in caring for premature and ill infants. Currently, there is a shortage of NNPs to fill open positions. Understanding how nurses decide to become NNPs will help practicing nurse practitioners, managers, and faculty encourage and support nurses in considering the NNP role as a career choice. To describe how nurses decide to enter graduate school to become nurse practitioners. A qualitative study using semistructured interviews to explore how 11 neonatal intensive care unit nurses decided to enter graduate school to become NNPs. Key elements of specialization, discovery, career decision, and readiness were identified. Conditions leading to choosing the NNP role include working in a neonatal intensive care unit and deciding to stay in the neonatal area, discovering the NNP role, deciding to become an NNP, and readiness to enter graduate school. Important aspects of readiness are developing professional self-confidence and managing home, work, and financial obligations and selecting the NNP program. Neonatal nurse practitioners are both positive role models and mentors to nurses considering the role. Unit managers are obligated to provide nurses with opportunities to obtain leadership skills. Faculty of NNP programs must be aware of the impact NNP students and graduates have on choices of career and schools. Exploring the decision to become an NNP in more geographically diverse populations will enhance understanding how neonatal intensive care unit nurses decide to become NNPs.

  14. Third-party reimbursement for nurse practitioners' services on trauma teams: working through a maze of issues.

    PubMed

    Buppert, Carolyn

    2005-01-01

    Third-party payers reimburse for physician services performed by nurse practitioners, if the services are within the scope of practice of a nurse practitioner and the payers' rules are followed. However, some hospitals and trauma services have been reluctant to bill the services of nurse practitioners they employ or to hire nurse practitioners, because the rules are complex, vary from payer to payer, can be difficult to find, and because operations are not always set up so that nurse practitioners' services are bundled in ways which conform to the rules. Medicare has developed detailed rules on billing nurse practitioners' services, but neither Medicaid nor commercial payers necessarily follow Medicare's rules. The situation is further complicated by wide variations in state law governing nurse practitioner scope of practice and requirements for physician collaboration. Despite all of these variables, it may be worth the time and effort to sort out the requirements for utilizing nurse practitioners and billing for their services, considering the limitations on residents' hours, the data on quality of nurse practitioners' clinical services and the potential for generating revenue. This article describes the legal and business issues, provides the general rules for billing nurse practitioners' services, and provides a plan for obtaining third-party payment for nurse practitioners' services on trauma teams.

  15. Strategic modeling of the pediatric nurse practitioner workforce.

    PubMed

    Schell, Greggory J; Lavieri, Mariel S; Li, Xiang; Toriello, Alejandro; Martyn, Kristy K; Freed, Gary L

    2015-02-01

    To assess the current pediatric nurse practitioner (PNP) workforce and to investigate the impact of potential policy changes to address forecasted shortages. We modeled the admission of students into nursing bachelor's programs and followed them through advanced clinical programs. Prediction models were combined with optimal decision-making to determine best-case scenario admission levels. We computed 2 measures: (1) the absolute shortage and (2) the expected number of years until the PNP workforce will be able to fully satisfy PNP demand (ie, self-sufficiency). There is a forecasted shortage of PNPs in the workforce over the next 13 years. Under the best-case scenario, it would take at least 13 years for the workforce to fully satisfy demand. Our analysis of potential policy changes revealed that increasing the specialization rate for PNPs by 4% would decrease the number of years required until there are enough PNPs from 13 years to 5 years. Increasing the certification examination passing rate to 96% from the current average of 86.9% would lead to self-sufficiency in 11 years. In addition, increasing the annual growth rate of master's programs to 36% from the current maximum of 10.7% would result in self-sufficiency in 5 years. Current forecasts of demand for PNPs indicate that the current workforce will be incapable of satisfying the growing demand. Policy changes can result in a reduction in the expected shortage and potentially improve access to care for pediatric patients. Copyright © 2015 by the American Academy of Pediatrics.

  16. Knowledge and attitudes about cancer pain management: a national survey of Italian oncology nurses.

    PubMed

    Bernardi, Matteo; Catania, Gianluca; Lambert, Annie; Tridello, Gloria; Luzzani, Massimo

    2007-07-01

    The purpose of this study was to obtain information about the knowledge and attitudes of Italian oncology nurses concerning cancer pain management and to determine the predictors of nurses' pain management knowledge. The study was a nationwide descriptive survey and included 287 nurses in Italy from 21 oncology wards in the north, center and south of Italy. The Nurses' Knowledge and Attitudes Survey (Italian version) and a background information form were used to collect the data. Knowledge and attitudes regarding cancer pain were the main research variables. Among the 39 pain knowledge questions assessed, the mean number of correctly answered question was 21.4 (SD=5.5), with a range of 6-35. The correct answer rate for the entire scale, on average, was 55% (SD=25.9). Further analysis of items showed that more than 50% of oncology nurses underestimated the patients' pain and they did not treat it in the correct way; they also had an incorrect self-evaluation about their pain management knowledge. Results from stepwise regression showed that nurses with higher mean correct answer scores had attended more courses about pain education. There are still significant knowledge deficits and erroneous beliefs that may hamper treatment of oncology patients in pain. The results of this study could be useful to institutions involved in patient care and teaching of pain management.

  17. In their own words: oncology nurses respond to patient requests for assisted suicide and euthanasia.

    PubMed

    Matzo, M L; Schwarz, J K

    2001-05-01

    Little is currently known about the context, nature, or frequency of nurses' responses to patient requests for help in dying. Only two empirical studies have surveyed American nurses about their actual responses to such requests. In one of those studies, 441 New England oncology nurses described how often patients ask them for help in ending their lives and also indicated how often they participated in assisted suicide and patient-requested euthanasia. One hundred and ten of those 441 nurses wrote comments on their returned questionnaires. This article describes the content analysis of those comments. Those oncology nurses who wrote have much to say about caring for patients at the end of life. Copyright 2001 by W.B. Saunders Company

  18. Nurse practitioner and physician assistant interest in prescribing buprenorphine.

    PubMed

    Roose, Robert J; Kunins, Hillary V; Sohler, Nancy L; Elam, Rashiah T; Cunningham, Chinazo O

    2008-06-01

    Office-based buprenorphine places health care providers in a unique position to combine HIV and drug treatment in the primary care setting. However, federal legislation restricts nurse practitioners (NPs) and physician assistants (PAs) from prescribing buprenorphine, which may limit its potential for uptake and inhibit the role of these nonphysician providers in delivering drug addiction treatment to patients with HIV. This study aimed to examine the level of interest in prescribing buprenorphine among nonphysician providers. We anonymously surveyed providers attending HIV educational conferences in six large U.S. cities about their interest in prescribing buprenorphine. Overall, 48.6% (n = 92) of nonphysician providers were interested in prescribing buprenorphine. Compared to infectious disease specialists, nonphysician providers (adjusted odds ratio [AOR] = 2.89, 95% confidence interval [CI] = 1.22-6.83) and generalist physicians (AOR = 2.04, 95% CI = 1.09-3.84) were significantly more likely to be interested in prescribing buprenorphine. NPs and PAs are interested in prescribing buprenorphine. To improve uptake of buprenorphine in HIV settings, the implications of permitting nonphysician providers to prescribe buprenorphine should be further explored.

  19. Treating vasomotor symptoms of menopause: the nurse practitioner's perspective.

    PubMed

    Alexander, Ivy M; Moore, Anne

    2007-03-01

    This article reviews the pathophysiology of vasomotor symptoms (VMS) of menopause and current management options. Current scientific literature. In most menopausal women, loss of ovarian function results in VMS, including hot flashes, night sweats, and mood and sleep disturbances. Hormone therapy (HT) has been the mainstay of VMS treatment for many years, but safety concerns raised by publication of the Women's Health Initiative (WHI) results have dramatically reduced the use of this treatment. Since the WHI published its findings, attention has focused on other novel treatments for menopausal symptoms, including low-dose oral or transdermal HT and agents such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, gabapentin, and clonidine. Many women also use complementary and alternative medications to manage VMS, but little evidence from controlled clinical trials supports their efficacy. The increasing number of alternative treatments for VMS requires improvement in patient-provider communication about treatment risks and benefits, individualization of treatment to meet patient needs and attitudes, and careful follow-up to ensure adherence to potentially effective therapy. Nurse practitioners play a leading role in patient evaluation, discussions, and management to help women achieve control over bothersome VMS that dramatically impact their quality of life.

  20. Clients' understanding of the role of nurse practitioners.

    PubMed

    Allnutt, Jane; Allnutt, Nissa; McMaster, Rose; O'Connell, Jane; Middleton, Sandy; Hillege, Sharon; Della, Phillip R; Gardner, Glenn E; Gardner, Anne

    2010-03-01

    Nurse practitioners (NPs) have an emerging role in the Australian health care system. However, there remains a dearth of data about public understanding of the NP role. The aim of this study was to evaluate clients' understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales were invited to recruit five consecutive clients to complete the self-administered survey. Thirty-two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two-thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP-related outcomes as 'excellent' or 'very good': education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (P = 0.005), and where applicable would to prefer to see an NP rather than a doctor (P = 0.022). Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction, more awareness of the scope of the NP role is required.

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

    PubMed Central

    Bairan, Annette; Boeri, Miriam; Morian, Janice

    2012-01-01

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

  2. Strategic modeling of the neonatal nurse practitioner workforce.

    PubMed

    Schell, Greggory J; Lavieri, Mariel S; Jankovic, Filip; Li, Xiang; Toriello, Alejandro; Martyn, Kristy K; Freed, Gary L

    2016-01-01

    Neonatal nurse practitioners (NNPs) play a vital role in the medical care of newborns and infants. There is expected to be a shortage of NNPs in the near future. To assess the present NNP workforce and study the impact of potential policy changes to alleviate forecasted shortages. We modeled the education and workforce system for NNPs. Forecasting models were combined with optimal decision-making to derive best-case scenario admission levels for graduate and undergraduate programs. Under the best-case scenario for the current system, the shortage of NNPs is expected to last 10 years. We analyzed the impact of improving the certification examination passing rate, increasing the annual growth rate of master's programs, and reducing the workforce annual attrition rate. We found that policy changes may reduce the forecasted shortage to 4 years. Present forecasts of demand for NNPs indicate that the existing workforce and education system will be unable to satisfy the growing demand. Policy changes may reduce the expected shortage and potentially improve access to care for newborns and infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The transition of nurse practitioners to changes in prescriptive authority.

    PubMed

    Kaplan, Louise; Brown, Marie-Annette

    2007-01-01

    To understand nurse practitioners' (NPs) decisions about whether to obtain prescriptive authority for controlled substances, to describe NPs' experiences with providing or prescribing controlled substances, and to describe the relationship between perceived autonomy and prescriptive authority for controlled substances. Twelve focus groups were conducted with approximately 100 NPs who attended continuing education conferences. Discussions were audiotaped and transcribed verbatim. Grounded theory approaches were used for data collection and analysis. A core category of Letting go and taking hold characterized Washington State NPs' experience of the transition to prescribing schedule II-IV medications. Three dimensions of the NPs' transition were Resisting change, Ambivalent about change, and Embracing change. The core category, Letting go and taking hold, indicated how transition to a new scope of practice extended beyond successful passage of legislation, the importance of examining the nature of professional transition that accompanies successful legislative change, and role development as an ongoing process throughout one's career in response to changes in scope of practice. NPs need preparation for a new scope of practice long before legislation actually passes. Revealing and examining this process can facilitate the goal of achieving fully autonomous NP practice.

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

    PubMed Central

    Morgan, Walter A.

    1980-01-01

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

  5. The rural nurse practitioner: a challenge and a response.

    PubMed Central

    Sullivan, J A; Dachelet, C Z; Sultz, H A; Henry, M

    1978-01-01

    From a cohort of 525 employed nurse practitioners (NPs) who graduated between May 1975 and June 1976, 85 (16 per cent) reported practicing in rural areas. While 91 per cent of the rural NPs chose the short-term certificate programs rather than the master's degree for their NP preparation, 47 per cent had already earned a baccalaureate or master's degree prior to NP training. Family NPs comprised the most frequent specialty area chosen, followed by pediatric and adult specialties. Of the 85, 99 per cent were actually providing a broad array of primary care services to clients over a wide age range. Physicians were periodically available on site in about 80 per cent of the practices, by telephone in 97 per cent of the practices, and in 60 per cent of the practices provided additional consulation by record review. Major motivations of the NPs for entering rural practice were to participate in a creative approach to health care delivery (50 per cent of the practice setting were less than five years old), and for the opportunity for role autonomy. Over 95 per cent of these NPs and employers were satisfied with the NP role. PMID:717607

  6. Pediatric nurse practitioners: roles and scope of practice.

    PubMed

    Freed, Gary L; Dunham, Kelly M; Lamarand, Kara E; Loveland-Cherry, Carol; Martyn, Kristy K

    2010-11-01

    There are ∼ 13,000 pediatric nurse practitioners (PNPs) in the United States. PNPs have been suggested as professionals who could provide care to the growing cadre of children with chronic illnesses and expand the pool of subspecialty care providers. Little is known about current roles of PNPs in primary or subspecialty care. To gain a better understanding of the roles, focus of practice, professional setting, and professional responsibilities of PNPs. We conducted a mail survey of a random national sample of 1200 PNPs stratified according to states that license NPs to practice independently. χ(2) statistics were used to assess responses from PNPs in states that allow independent practice versus those that do not and on PNPs in primary versus specialty care. The overall response rate was 82.4%. Ninety-six percent (n = 636) of the PNPs were female. More than half of all the respondents (59% [n = 391]) worked in primary care, and almost two-thirds (64% [n = 394]) did not provide care in inpatient settings. Only 11% of the PNPs in states that allow independent practice, practiced independently. The majority of PNPs currently work in primary care, and most do not have any inpatient roles. It does not seem that independent PNP practices are responsible for a significant portion of pediatric visits. For those who posit that PNPs will help alleviate the currently perceived shortage of pediatric subspecialists, our findings indicate that it likely will not occur without a significant change in the PNP workforce distribution.

  7. Canada's First Nurse Practitioner-Led Clinic: A Case Study in Healthcare Innovation.

    PubMed

    Heale, Roberta; Butcher, Marilyn

    2010-09-01

    Canada's first nurse practitioner-led clinic opened in 2007 after a period of intense lobbying. The development of this clinic has received a great deal of attention in the nursing world and among the general public, but the factors that enabled it have not been examined. The antecedents outlined in healthcare innovation concept analysis - including leadership, financial considerations, idea generation, teamwork, culture and demand - provide a framework for examination of the campaign for the nurse practitioner-led clinic. This review demonstrates the complex interplay of factors that drive healthcare innovation and expands understanding of the leadership and change competencies of the advanced practice nurse.

  8. 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.

  9. The importance of communication in pediatric oncology palliative care: focus on Humanistic Nursing Theory.

    PubMed

    França, Jael Rúbia Figueiredo de Sá; da Costa, Solange Fátima Geraldo; Lopes, Maria Emilia Limeira; da Nóbrega, Maria Miriam Lima; de França, Inacia Sátiro Xavier

    2013-01-01

    to investigate and analyze communication in palliative care contexts from the perspective of nurses, based on Humanistic Nursing Theory. this is a field study with a qualitative approach, in which ten nurses working in the pediatric oncology unit of a Brazilian public hospital participated. Semi-structured interviews were used to collect data. The testimonies were qualitatively analyzed using Humanistic Nursing Theory and based on the five phases of Nursing Phenomenology. two thematic categories emerged from the analysis of the study's empirical material: "strategy to humanize nursing care, with an emphasis on relieving the child's suffering" and "strategy to strengthen ties of trust established between nurse and child." communication is an efficacious element in the care provided to the child with cancer and is extremely important to promoting palliative care when it is based on Humanistic Nursing Theory.

  10. Striving for good nursing care: nurses' experiences of do not resuscitate orders within oncology and hematology care.

    PubMed

    Pettersson, Mona; Hedström, Mariann; Höglund, Anna T

    2014-12-01

    Within oncology and hematology care, patients are sometimes considered to have such a poor prognosis that they can receive a do not resuscitate order from the physician responsible, stipulating that neither basic nor advanced coronary pulmonary rescue be performed in the event of a cardiac arrest. Studies on do not resuscitate decisions within oncology and hematology units, focusing on the specific role of the nurse in relation to these decisions, are scarce. The aim of this study was to investigate hematology and oncology nurses' experiences and perceptions of do not resuscitate orders, in order to achieve a deeper understanding of the nurses' specific role in these decisions. A qualitative, descriptive methodology with individual semi-structured interviews was used. A total of 15 nurses from eight hematology/oncology wards in four hospitals in Sweden were interviewed individually. In accordance with national regulations, an ethical review was not required for this study. The research followed international guidelines for empirical research, as outlined in the Helsinki Declaration. The nurses strived for good nursing care through balancing harms and goods and observing integrity and quality of life as important values. Experienced hindrances for good care were unclear and poorly documented decisions, uninformed patients and relatives, and disagreements among the caregivers and family. The nurses expressed a need for an ongoing discussion on do not resuscitate decisions, including all concerned parties. In order to provide good nursing care, nurses need clear and well-documented do not resuscitate orders, and patients and relatives need to be well informed and included in the decisions. To increase the understanding for each other's opinions within the medical team, regular ethical discussions are required. © The Author(s) 2014.

  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. 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)

  13. Best practice in nurse-led chemotherapy review: a position statement from the United Kingdom Oncology Nursing Society

    PubMed Central

    Lennan, E; Vidall, C; Roe, H; Jones, P; Smith, J; Farrell, C

    2012-01-01

    This position statement has been formulated by nurses from the United Kingdom Oncology Nursing Society (UKONS) to provide guidance on the provision of nurse-led chemotherapy review clinics for adult patients. For the purposes of this statement, a nurse-led chemotherapy clinic is defined as one that conducts formal review (in a consultation room) before the decision to proceed and prescribe the next cycle of chemotherapy. This statement does not address the toxicity checks that take place immediately prior to the administration of chemotherapy, although many of the same principles will apply to both settings. PMID:22879834

  14. National nursing registration in Australia: a way forward for nurse practitioner endorsement.

    PubMed

    Driscoll, Andrea; Harvey, Clare; Green, Anna; Weatherby, Robert P; Liew, Danny; Prentice, David; Lord, Julie; Lee, Geraldine; Crellin, Dianne; Dobroff, Naomi; Heland, Melodie

    2012-03-01

    The move to national registration of health professionals and the creation of the Nursing and Midwifery Board of Australia (NMBA) provides both challenges and opportunities for the regulation of nurse practitioners (NPs) in Australia. National and state health policy documents, accessible on the Internet, concerning the regulation and endorsement processes for NPs in Australia were examined. The similarities between two of the previous jurisdictional NP endorsement processes in New South Wales and Victoria provide a common ground on which to build a robust national system. However, there are also key differences between these two states. These differences were mainly in the evidence required to assess competency of NP applicants and the authority to prescribe medications. All Victorian NP applicants were required to complete an approved medication subject at a master's level. A consistent endorsement process that delivers NPs of the highest standard and allows for efficient use of their skills and expertise is vital. This needs to be performed with the aim of providing high-quality care in a regulatory environment that protects the public and clearly articulates the level of competence expected of all NPs. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  15. Bridging the gap: interprofessional collaboration between nurse practitioner and clinical nurse specialist.

    PubMed

    McNamara, Shannon; Lepage, Karine; Boileau, Johanne

    2011-01-01

    The purpose of this article was to describe the collaborative model established between the specialized nurse practitioner (SNP) and the clinical nurse specialist (CNS), within the cardiac surgery population. The literature has shown a trend that SNPs and CNSs work in parallel or even in competition. Little has been written about a collaborative model and the advantages to working together toward a mutual goal. It was felt that a collaborative model between advance practice nurses could demonstrate the advantages of using their unique perspectives to achieve improvement in the quality of care given to the patients. The Structuration Model of Interprofessional Collaboration was used as a guide to our interventions and elaboration of our project. The team set out to establish, promote, and nurture a collaborative approach to care for the cardiac surgery population from admission to 3 months after discharge. A collaborative relationship was achieved between the SNP and the CNS, to the benefit of the patient population. Collaboration between these 2 advanced practice nurses is realistic and attainable. The advantages to this relationship outweigh the negative feelings harbored toward each professional title. By working in collaboration instead of in parallel, resources are pooled together to achieve greater services and care for the patients. A change in attitude between professionals has a positive impact on working relationships, partnerships, and communication. Ultimately, it is an advantage for the advanced practice nurse, the multidisciplinary team, and the patient.

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

    PubMed

    Chikotas, Noreen Elaine

    2008-01-01

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

  17. Relation of Compassionate Competence to Burnout, Job Stress, Turnover Intention, Job Satisfaction and Organizational Commitment for Oncology Nurses in Korea.

    PubMed

    Park, Sun-A; Ahn, Seung-Hee

    2015-01-01

    Nursing focuses on the development of an empathic relationship between the nurse and the patients. Compassionate competence, in particular, is a very important trait for oncology nurses. The current study sought to determine the degree of compassionate competence in oncology nurses, as well as to determine the relationships between compassionate competence, burnout, job stress, turnover intention, degrees of job satisfaction, and organizational commitment in oncology nurses. A descriptive correlational study evaluating the relationships between compassionate competence, burnout, job stress, turnover intention, degrees of job satisfaction, and organizational commitment in 419 oncology nurses was conducted between January 30 and February 20, 2015. The average score of compassionate competence for oncology nurses in the current study was higher than for clinical nurses. The correlational analysis between compassionate competence and organizational commitment, burnout, job stress, turnover intention, and degree of job satisfaction revealed a high correlation between compassionate competence and positive job satisfaction and organizational commitment. Compassionate competence was higher in oncology nurses than in nurses investigated in previous studies and positively correlated with work experience. Job satisfaction and organizational commitment in nurses may be improved through compassionate competence enhancement programs that employ a variety of experiences.

  18. A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service.

    PubMed

    Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard

    2014-09-01

    To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Pragmatic randomized controlled trial at one site with 260 participants. This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce. Trial registration details: Australian and New Zealand Clinical Trials Registry dated 18th August 2013, ACTRN12613000933752. © 2014 John Wiley & Sons Ltd.

  19. Oncology nurses' practices of assisted suicide and patient-requested euthanasia.

    PubMed

    Matzo, M L; Emanual, E J

    1997-01-01

    To provide reliable and valid empirical data related to New England Oncology Nursing Society (ONS) members' self-reported practices of assisted suicide and patient-requested euthanasia. Analysis focused on the nurses' practices, a comparison of their practices to a similar sample of oncology physicians, and their use of the healthcare team. Quantitative survey. New England region of the United States. 600 ONS members surveyed by mail, 441 of whom responded (74% return rate). Only nurses who worked at least 20 hours per week, were ONS members for at least one year, and worked with adult patients with cancer were included. Replication and extension of a survey of oncology physicians. Frequency of requests for and responses to patient requests for assisted suicide and euthanasia and the use of the healthcare team in response to these requests. More physicians than nurses assisted their patients' suicides (11% versus 1%). However, nurses were more likely than physicians to have performed patient-requested euthanasia (4% versus 1%). Nurses frequently consulted with others--particularly physicians--about patient requests for assistance with death but rarely with one another including nursing supervisors. The relative number of healthcare professionals (physicians or nurses) who admit to hastening a patient's death is small. Nurses in this study received fewer requests to perform euthanasia than physicians, but they performed patient-requested euthanasia four times more frequently than physicians. Professional affiliation appears to be one factor in determining whether or not a patient's request for assistance with death will be granted. IMPLICATIONS FOR NURSING PRACTICES: The policy debate about professional roles in actions that end the lives of patients must be extended beyond physicians to include nurses. Nurses must take an active role in the discussion and definition of acceptable practice at the end of life.

  20. Job Satisfaction Among Family Nurse Practitioners in the United States Air Force

    DTIC Science & Technology

    1999-05-01

    Practitioners (FNPs) are being utilized within the Air Force. Nurse Practitioners provide patient education, acute care , and prevention services at...lower cost due to the lower cost of training and lower salaries than physicians, without jeopardizing care . Creating an optimal working relationship, can...contains questions related to seven categories: personal, workload, training, standards of care , pay, prospects, and professional support satisfaction. A