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PubMed Journal Database | Journal of the American Association of Nurse Practitioners RSS

11:05 EST 9th December 2019 | BioPortfolio

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Showing PubMed Articles 1–25 of 191 from Journal of the American Association of Nurse Practitioners

Buprenorphine compared with methadone in opioid-dependent pregnant women: How does it affect neonatal abstinence syndrome?

The growing opioid epidemic in the United States has led to increasingly high rates of neonatal abstinence syndrome (NAS). Preliminary studies have shown that buprenorphine maintenance treatment (BMT) may lead to better outcomes for infants than methadone maintenance treatment (MMT).

Hypertonic saline versus mannitol for the treatment of increased intracranial pressure in traumatic brain injury.

Increased intracranial pressure (ICP) occurring after traumatic brain injury (TBI) is associated with increased morbidity and mortality. If appropriate treatments are not initiated, brain herniation can occur and lead to death. Previously, the Brain Trauma Foundation recommended mannitol as the first-choice hyperosmolar agent. However, in 2016, they retracted this recommendation, citing a lack of sufficient supporting evidence. Current research shows that hypertonic saline (HTS) also decreases ICP.

Development and testing of a module to promote generic oral contraceptive prescribing among nurse practitioners.

Although generic oral contraceptives (OCPs) can improve adherence and reduce health care expenditures, use of generic OCPs remains low, and the factors that affect generic prescribing are not well understood. We aimed to understand the barriers and facilitators of generic OCP prescribing and potential solutions to increase generic OCP prescribing, as well as pilot an educational module to address clinician misconceptions about generic OCPs. We developed focus group scripts using the 4D model of appreciative...

Relationship of pay-for-performance and provider pay.

Policymakers and health care leaders search for a payment model to balance the interests of providers, patients, and payers. This has shifted reimbursement from a fee-for-service (FFS) to pay-for-performance (P4P) model. The FFS model of reimbursement may lead to provider overuse. The P4P model incentivizes quality, not quantity, of care. However, the payer's reimbursement shift to P4P has not affected compensation of individual providers.

An innovative course to prepare advanced practice registered nurses to spearhead quality and safety initiatives for older adults.

Current trends dictate that advanced practice registered nurses (APRNs) must be competent to address quality/safety issues specific to older adults. A gap analysis and review of key competencies in an adult-gerontology APRN-Doctorate of Nursing Practice (DNP) curriculum prompted the design and evaluation of an innovative online course, Quality and Safety for the Aging Adult. Course objectives align with key competencies, including graduate-level Quality and Safety Education for Nurses (QSEN) and the DNP Ess...

Nurse practitioner interventions for smokers with chronic hepatitis C.

Smoking is a grossly overlooked risk factor for people with chronic hepatitis C with regard to disease progression. It is unclear whether current smoking cessation interventions are effective for this population.

Taking the leap from clinical practice to academic faculty: A beginner's guide.

Exploring new roles and responsibilities available to clinicians offers a path to renovate a nurse practitioner's career. The role of academician and nurse faculty broadens career horizons, presents a sense of autonomy, and offers unique opportunities to teach, participate in research, build leadership skills, and contribute to the health care delivery system at a higher level. Advance practice nurses often consider a shift to academia but are concerned about the unfamiliarity of the entire process. This ar...

Assessing and addressing practitioner burnout: Results from an advanced practice registered nurse health and well-being study.

Numerous nursing and physician studies have reported the effects of workload, environment, and life circumstances contributing to burnout. Effects may include job dissatisfaction, poor quality of life, and associated negative patient outcomes. Although assessing clinician burnout to determine effective interventions has become a topic of great importance, there are minimal studies specific to advanced practice registered nurses (APRNs).

Educational characteristics and content of postgraduate nurse practitioner residency/fellowship programs.

Nurse practitioner (NP) residency/fellowship programs are an emerging industry across the country.

Implementation of an educational program to improve precepting skills.

Educating health care providers is dependent on developing high-quality clinical preceptors, yet preceptors face widespread challenges to precepting, such as time constraints and lack of formal preceptor training.

Establishing nurse practitioner clinical practicums: Addressing fiscal realities.

As demand expands for nurse practitioner clinical practicum sites, the supply of preceptors is decreasing. The traditional model of in-kind clinical training is losing its foothold for a variety of reasons. A looming question is how quickly a "pay to precept" norm will grow and what will be the costs. The pay for precepting movement is discussed including current trends, costs, and emerging compensation models. To adapt to this trend, alternative ways of drawing the precepting value proposition are suggeste...

Nurse practitioners and barriers to diabetic foot treatment.

Even with full practice authority, nurse practitioners (NPs) face limitations in care and treatment options. An example of this is current federal law prohibiting NPs from ordering diabetic shoes.

Competency-based education in transitioning nurse practitioner students from education into practice.

Competency-based education (CBE) provides a framework for nursing programs including those educating nurse practitioners (NPs). The basic assumption of CBE is that the student will demonstrate acquisition of the identified essential knowledge, skills, and attitudes expected for the designated educational process before leaving the learning environment. The work done to date in developing competencies and progression indicators provides the critical basis to move toward a common language and clear expectatio...

Nurse practitioners leading the way: An exploratory qualitative study on the added value of nurse practitioners in outpatient care in the Netherlands.

Many Dutch nurse practitioners (NPs) work together with physicians and specialized nurses (SNs) in outpatient clinics, although the latter have questioned the added value of NPs in the outpatient clinic. Clarification of the distinction between and the added value of both nursing professions in relation to each other could lead to optimal use of the unique competencies of each type of nurse.

Preparing students to be ready for practice: An innovative approach to teaching advanced physical assessment skills online.

Distance graduate nursing education has been expanding. Although many didactic courses are taught through an online platform, there are often challenges to providing skill-based courses, such as advanced physical assessment, through an online format. To prepare and assess advanced practice nursing students on their clinical knowledge and physical assessment skills, an online course was developed using multisource feedback and videography. Students used videography to record themselves as they conducted phys...

Enhancing the nurse practitioner curriculum to improve telehealth competency.

Telehealth improves access to health care and has seen rapid expansion in recent years. Nurse practitioner (NP) students are expected to be able to use telehealth to provide health care on graduation; however, many programs of study do not include telehealth in the academic preparation of students. As a result, students feel unprepared to use telehealth to provide care to patients. To meet this need, a land-grant institution developed evidence-based competencies and curriculum to educate NP students in the ...

Evidence-based interventions cause multifold increase of influenza immunization rates in a free clinic.

Every year in the United States, influenza-related infection causes thousands of deaths, the complications of which require millions of dollars in hospital-related care. The influenza vaccine is proven to effectively reduce incidence of infection and complications from influenza viruses.

A whole-food plant-based experiential education program for health care providers results in personal and professional changes.

Diet-related diseases are the primary contributor to morbidity and mortality. The risk for these diseases can be reduced with a whole-food plant-based (WFPB) diet, but most people are never counseled on this dietary pattern. An experiential education program was designed and conducted in which sample of 30 nurse practitioners, registered nurses, and physicians learned about and followed a WFPB diet for 3 weeks. The objective was for the health care providers to increase their knowledge and acceptance of WFP...

Meeting preceptor expectations to facilitate optimal nurse practitioner student clinical rotations.

Preceptors are essential to nurse practitioner (NP) students' transition from being a student to competent entry-level NP graduate. The literature is replete with data pertaining to the benefits of and barriers to preceptors engaging in the clinical education of NP students, and little has changed in the last two decades in this regard. Therefore, faculty solicited preceptor input to enhance curriculum revision and clinical training preparation. This qualitative inquiry project derived data from interviews ...

Facilitating faculty knowledge of DNP quality improvement projects: Key elements to promote strong practice partnerships.

Enrollment in Doctor of Nursing Practice (DNP) programs is growing rapidly. This poses a challenge to faculty because there is a gap in knowledge about evidence-based practice and quality improvement DNP projects. Challenged by the growing unavailability of preceptors and mentors in the practice setting, solutions are needed to help students meet the essentials of the degree and competencies for practice. Faculty knowledge of key DNP quality improvement project elements, measuring, monitoring, and sustainin...

Authors, topics, and readers.

Genomics and breast cancer screening.

Many women fear the risk of developing breast cancer, and some women have increased fear because of their family history. Thankfully, the study of genetics has brought forth tools to better identify women at risk. An understanding of genetics and cancer has led to genetic testing protocols which enable at-risk women to take preventative action through medication, surgery, and intensive screenings. These protocols not only have the potential to prevent cancer but also lead to early detection. Appropriate scr...

Nutrition knowledge, attitudes, and self-regulation as predictors of overweight and obesity.

Promoting treatment for hepatitis C in people who inject drugs: A review of the barriers and opportunities.

People who inject drugs (PWIDs) comprise a significant amount of the population who are also positive for hepatitis C virus (HCV) around the world. Even though there is evidence that patients who currently inject drugs do not display altered treatment adherence or medication effectiveness, health care providers are still hesitant to treat this patient population based on perceived threats and barriers.

Avoiding missed opportunities to screen for HIV.

HIV transmission is ongoing, primarily among men who have sex with men, injection drug users, and persons from HIV endemic regions. One prevention strategy has been prompt HIV diagnosis. Undermining these efforts is that some persons are diagnosed with HIV late in their infection because practitioners missed the diagnosis. In this article, the authors review the epidemiology and pathophysiology of HIV/AIDS, and provide a recommended clinical approach: (1) continue to screen persons who belong to the groups ...


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