Journal of the American Academy of Nurse Practitioners

PURPOSE: To highlight the unique pathophysiology and clinical presentation of ischemic heart disease in women. The article will emphasize the atypical clinical manifestations, reinforce the pitfalls of standard testing, and provide new insights into novel risk factors as well as diagnostic tools to enable earlier detection of disease. DATA SOURCES: An extensive review of the literature was conducted using Pub Med and CINAHL databases. The reference lists of applicable published reports were also reviewed...

PURPOSE: To provide an overview of normal and abnormal temper tantrum behavior as well as give recommendations nurse practitioners (NPs) can use in counseling families. DATA SOURCES: Articles were identified from the following databases: CINAHL, HEALTH SOURCE: Nursing/Academic edition, Medline, Social Work Abstracts, Social Science Abstracts, Psych INFO, Psychology and Behavioral Science Collection. Textbook references were also identified using Stat!Ref. CONCLUSIONS: Temper tantrums are one of the most common behavior problems in children...

No abstract text is available yet for this article.

PURPOSE: 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 RESOURCES: Data collection consisted of face to face or telephone interviews with 24 experienced NP faculty members teaching in 22 NP programs across the country...

PURPOSE: The purpose of this study was to analyze the national practice of fulfilling 500 clinical hours as a requirement for graduation from nurse practitioner (NP) programs at the master's level and to compare this standard to a comprehensive approach of evaluating attainment of clinical competencies. DATA SOURCES: The National Organization of NP Faculties (NONPF) and specialty accreditation bodies publications were used for references to clinical hour and core competency requirements for graduation from NP programs...

PURPOSE: This article describes the development and implementation of integrated use of personal handheld devices (personal digital assistants, PDAs) and high-fidelity simulation in an advanced health assessment course in a graduate family nurse practitioner (NP) program. A teaching tool was developed that can be utilized as a template for clinical case scenarios blending these separate technologies. DATA SOURCES: Review of the evidence-based literature, including peer-reviewed articles and reviews...

PURPOSE: The purpose of this article is to describe how one university in northern British Columbia (BC) dealt with the issues of nurse practitioner (NP) program administration in light of its geographic context. DATA SOURCES: Reflections of the management team during the first 2 years of implementation of the faculty-driven approach. CONCLUSIONS: Our experience reflects family NP (FNP) faculty shortages internationally, the challenge of attracting qualified candidates to centers outside the urban mainstream in today's competitive academic job market, as well as the need to develop NP faculty capacity in BC, Canada...

PURPOSE: To present an example of an innovative educational strategy using a theoretical framework for the design and evaluation of a virtual world simulation for family nurse practitioner (FNP) students. DATA SOURCES: The example arises from a primary care pediatric clinic developed for FNP students in Second Life(®) to supplement experiences in clinical practice sites. The simulation uses a case-based interactive format. The educational strategy is based on constructivist learning theory and experiential learning principles...

PURPOSE: To review use of simulation in the education of advanced practice nurses and to describe an innovative simulation program for family nurse practitioner (NP) students. DATA SOURCES: The literature was reviewed using MEDLINE and CINAHL searches for descriptions of simulation programs for advanced practice nursing (APN) students. A description of a simulation program in a family NP program was provided. CONCLUSIONS: The literature on the use of simulation in primary care APN programs is scant, but simulation seems to represent an active learning strategy that would be of benefit to primary care APN students in increasing knowledge and confidence about the management of clinical situations...

No abstract text is available yet for this article.

PURPOSE: The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. DATA SOURCES: Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. CONCLUSIONS: The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid...

PURPOSE: Lichen Sclerosis (LS) is an often unrecognized and misdiagnosed chronic inflammatory skin condition of the anogenital area that affects quality of life, bringing severe discomfort and distress to affected men, women, and children. The purpose of this qualitative study is to explore the lived experiences of women with LS. DATA SOURCES: Content analysis was conducted of data obtained from three public online forums/blogs used by women with LS. A total of 527 postings/entries were analyzed for patterns and themes by four researchers...

PURPOSE: Strict adherence to HIV medications is critical to ensure long-term disease control, and adherence interventions that are possible in a clinic setting with limited resources are needed. DATA SOURCES: This randomized controlled pilot study tested an adherence intervention guided by the Information-Motivation-Behavioral Skills (IMB) model. The intervention included HIV education, a peer video, motivational interviewing, and attention to behavioral skills including communication with providers and adherence-enhancing devices...

PURPOSE: This review focuses on the health benefits of viscous versus nonviscous soluble fibers, why symptoms can occur with increased fiber consumption, and how to avoid symptoms to improve adherence with a high-fiber diet. DATA SOURCES: Review of scientific literature as well as evidence-based guidelines and resources. CONCLUSIONS: While it is generally known that "fiber is good for you," it is less well known that specific health benefits are associated with specific fiber characteristics...

PURPOSE: To propose a set of core competencies for the cardiac surgery nurse practitioner (CSNP). DATA SOURCES: Research, review articles, standards of practice, hospital practice guidelines. CONCLUSION: Although there have been preliminary studies that demonstrate the effectiveness and cost savings associated with the use of a CSNP, specific competencies have yet to be defined. The CSNP provides direct patient care and functions simultaneously as part of an interdisciplinary team...

PURPOSE: The purpose of this project was to determine if customization of the electronic medical record (EMR) using evidence-based practice guidelines developed by the National Association of Pediatric Nurse Practitioners and the Expert Panel recommendations for the prevention, screening, and treatment of childhood and adolescent overweight and obesity would improve the rate of screening and diagnosis of obesity in children, 7 to 18 years of age. DATA RESOURCES: A retrospective review of encounters before and after implementation of customized EMR was conducted in a community health center...

PURPOSE: To present an evidence-based review of the data for and against the use of the intrauterine device (IUD) in adolescent females and to provide guidelines for selection of appropriate candidates. DATA SOURCES: Clinical research, expert opinions, and systematic reviews of IUD use in adolescents. CONCLUSIONS: The use of the IUD in adolescents has been questioned in the past as a result of concerns surrounding increased risks for pelvic inflammatory disease and infertility in adolescents...

PURPOSE: This study identified the perceived user barriers to documentation of nursing practice utilizing standardized nursing language (SNL) in the electronic health record (EHR) by ambulatory care nurse practitioners (NPs). DATA SOURCES: A researcher-developed survey was sent to a randomized sample of ambulatory care NPs in the United States who belonged to the American Academy of Nurse Practitioners (n= 1997). CONCLUSIONS: Surveyed ambulatory care NPs placed a higher value on documenting medical care versus nursing care...

PURPOSE: The purpose of this study was to use an ecological lens to explore gender differences in risky sexual behavior among urban adolescents exposed to violence. DATA SOURCES: This was a secondary analysis of data from a larger behavioral intervention trial that targeted drinking behaviors among adolescents. Data from a total of 2,560 male and female urban adolescents between the ages of 14 and 21 were analyzed for personal, interpersonal, and community exposure to violence and risky sexual behavior...

PURPOSE: To document unique ways Nurse Practitioners (NPs) contribute to the delivery of culturally competent healthcare to diverse and underserved patient populations in urban primary care practices. DATA SOURCES: Data are from a multi-year, multi-site study and includes 50 intensive interviews with healthcare professionals and repeated observations at three urban primary health clinics in a Northeastern U.S. city. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Different healthcare professionals reported common perspectives on cultural competence dealing with distinctive patient communities, including altruistic motivations, advocacy, and addressing root causes while treating diverse patients...