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Nurse practitioner as primary care provider

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https://www.readbyqxmd.com/read/28058748/effect-of-acupressure-on-pain-in-iranian-leukemia-patients-a-randomized-controlled-trial-study
#1
Hamid Sharif Nia, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh, Ken Kyid Yeoh, Amir Hossein Goudarzian, Mohammad Ali Soleimani, Saman Jamali
Nonpharmacological methods of pain relief such as acupressure are becoming increasingly popular worldwide. Practitioners often claim that such methods are highly effective and less invasive than analgesic drugs, but available empirical evidence is largely inconclusive. This study aimed to test the hypothesis that, postacupressure intervention, the amount of pain experienced by sampled leukemia patients, who received acupressure in addition to standard care, will reduce substantially compared to patients who received only routine treatment...
January 6, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28029709/increasing-role-of-nurse-practitioners-in-house-call-programs
#2
Nengliang Aaron Yao, Karen Rose, Virginia LeBaron, Fabian Camacho, Peter Boling
OBJECTIVES: Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work...
December 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28012799/clinic-personnel-facilitator-and-parent-perspectives-of-ehealth-familias-unidas-in-primary-care
#3
Lourdes Molleda, Monica Bahamon, Sara M St George, Tatiana Perrino, Yannine Estrada, Deborah Correa Herrera, Hilda Pantin, Guillermo Prado
INTRODUCTION: The purpose of this qualitative study was to understand the feasibility and acceptability of implementing eHealth Familias Unidas, an Internet-based, family-based, preventive intervention for Hispanic adolescents, in primary care. METHODS: Semistructured individual interviews with clinic personnel and facilitators (i.e., physicians, nurse practitioners, administrators, and mental health workers; n = 9) and one focus group with parents (n = 6) were audiorecorded, transcribed verbatim, and analyzed using a general inductive approach...
December 21, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28012426/perceived-safety-and-efficacy-of-neuromuscular-blockers-for-acute-respiratory-distress-syndrome-among-medical-intensive-care-unit-practitioners-a-multicenter-survey
#4
Heather Torbic, Seth R Bauer, Heather A Personett, Amy L Dzierba, Joanna L Stollings, Lindsay P Ryder, Craig E Daniels, Sean M Caples, Erin N Frazee
PURPOSE: Neuromuscular blocking agents (NMBAs) are frequently used in patients with acute respiratory distress syndrome (ARDS). The purpose of this survey is to describe providers' knowledge and perceived efficacy and safety of NMBAs in patients with ARDS. MATERIALS AND METHODS: We performed a prospective, multicenter survey of medical intensive care unit intensivists, fellows, nurse practitioners (NPs), physician's assistants (PAs), and pharmacists at 5 tertiary care centers between July 2012 and May 2013...
December 7, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28002227/using-reflective-practice-to-understand-lgbtq-client-needs
#5
Michele L Summers
Nurse practitioners as well as all nurses need to assess their values, be knowledgeable of Lesbian, Gay, Bisexual, Transgender, and Queer issues and current guidelines of care, and communicate with clients and their families in such a way as to create trusting and safe environments, free from barriers for quality healthcare. Nursing literature supports reflective practice as a means of reducing bias, as well as improving patient-provider trust and quality care. Understanding the primary care needs of specific populations is necessary to fulfill the nursing code of ethics...
December 19, 2016: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
https://www.readbyqxmd.com/read/27997577/spatial-accessibility-to-health-care-services-identifying-under-serviced-neighbourhoods-in-canadian-urban-areas
#6
Tayyab Ikram Shah, Scott Bell, Kathi Wilson
BACKGROUND: Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. METHODS: This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings...
2016: PloS One
https://www.readbyqxmd.com/read/27977851/implementation-of-treatment-guidelines-for-specialist-mental-health-care
#7
REVIEW
Irene Bighelli, Giovanni Ostuzzi, Francesca Girlanda, Andrea Cipriani, Thomas Becker, Markus Koesters, Corrado Barbui
BACKGROUND: A huge gap exists between the production of evidence and its uptake in clinical practice settings. To fill this gap, treatment guidelines, based on explicit assessments of the evidence base, are commonly used in several fields of psychiatry, including schizophrenia and related psychotic disorders. However, it remains unclear whether treatment guidelines have any material impact on provider performance and patient outcomes, and how implementation should be conducted to maximise benefit...
December 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27977293/development-of-a-sleep-telementorship-program-for-rural-department-of-veterans-affairs-primary-care-providers-sleep-va-echo
#8
Elizabeth C Parsons, Elizabeth A Mattox, Lauren A Beste, David H Au, Bessie A Young, Michael F Chang, Brian N Palen
RATIONALE: Primary care providers (PCPs) frequently encounter sleep complaints, especially in regions with limited specialty care access. OBJECTIVES: The US Department of Veterans Affairs Extension for Community Healthcare Outcomes (VA-ECHO) program (based on Project ECHO) has successfully provided rural PCP education in subspecialty areas, including hepatitis C. We describe the feasibility of an ECHO program for sleep medicine. METHODS: ECHO creates a virtual learning community through video-teleconferencing, combining didactics with individualized clinical case review...
December 15, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27968830/availability-and-use-of-primary-care-facilities-in-china-a-nationwide-representative-survey
#9
William C W Wong, Sunfang Jiang, Jason Ong, Minghui Peng, Eric Wan, Zhanshu Zhu, Cindy L K Lam, Michael Kidd, Martin Roland
BACKGROUND: China introduced a national policy to develop primary care in 2009, with 8669 community health centres (CHCs) established by 2014, employing more than 300 000 staff. However, against a background of the "barefoot doctor" legacy in rural China, mistrust of doctors, and over-reliance on specialist care, these facilities have been underused. This study aimed to evaluate the current quality of CHCs in China, including the organisation and infrastructure, as well as the use and training of the health-care professionals within primary care...
October 2016: Lancet
https://www.readbyqxmd.com/read/27939622/a-systematic-review-and-evidence-synthesis-of-qualitative-studies-to-identify-primary-care-clinicians-barriers-and-enablers-to-the-management-of-osteoarthritis
#10
REVIEW
T Egerton, L E Diamond, R Buchbinder, K L Bennell, S C Slade
OBJECTIVE: Primary care management of osteoarthritis (OA) is variable and often inconsistent with clinical practice guidelines (CPGs). This study aimed to identify and synthesize available qualitative evidence on primary care clinicians' views on providing recommended management of OA. DESIGN: Eligibility criteria included full reports published in peer-reviewed journals, with data collected directly from primary care clinicians using qualitative methods for collection and analysis...
December 7, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/27918408/full-practice-authority-for-nurse-practitioners
#11
Deborah Dillon, Faye Gary
Implementation of the Affordable Care Act (2010) enabled more than 30 million people to have new access to primary care services. On the basis of current utilization patterns, demand for primary care providers is expected to grow more rapidly than physician supply. This imbalance is expected to worsen, as the aging population requires more health care resources. In addition, more patients are requiring critical care services and physician numbers are not keeping with this growing need. Restrictions on resident physician practice hours have impacted inpatient care as well...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27911972/integrating-behavioral-health-into-pediatric-primary-care-implications-for-provider-time-and-cost
#12
Natasha Gouge, Jodi Polaha, Rachel Rogers, Amy Harden
OBJECTIVES: Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27893509/educating-providers-in-return-to-play-suggested-guidelines-postconcussion
#13
Angela Macci Bires, Amanda L Leonard, Brandon Thurber
As the awareness of concussions increases, it is imperative to be able to evaluate, diagnose, and treat concussed individuals properly to prevent further complications or death. The primary purpose of this study was to compare a provider's current awareness and comfort level as it relates to the return-to-play guidelines for concussions. A secondary aim was to evaluate current protocols that are in use and determine whether they coincide with the suggested guidelines. An educational intervention was implemented to assess the knowledge and confidence of health care providers...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27887032/provider-perception-of-pharmacy-services-in-the-patient-centered-medical-home
#14
Nicole P Albanese, Alyssa M Pignato, Scott V Monte
BACKGROUND: Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. OBJECTIVE: To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. METHODS: A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group...
November 24, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27875994/do-primary-care-professionals-agree-about-progress-with-implementation-of-primary-care-teams-results-from-a-cross-sectional-study
#15
E Tierney, M O'Sullivan, L Hickey, A Hannigan, C May, W Cullen, N Kennedy, L Kineen, A MacFarlane
BACKGROUND: Primary care is the cornerstone of healthcare reform with policies across jurisdictions promoting interdisciplinary team working. The effective implementation of such health policies requires understanding the perspectives of all actors. However, there is a lack of research about health professionals' views of this process. This study compares Primary Healthcare Professionals' perceptions of the effectiveness of the Primary Care Strategy and Primary Care Team (PCT) implementation in Ireland...
November 22, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27825340/patient-and-provider-acceptance-of-telecoaching-in-type-2-diabetes-a-mixed-method-study-embedded-in-a-randomised-clinical-trial
#16
I Odnoletkova, H Buysse, F Nobels, G Goderis, B Aertgeerts, L Annemans, D Ramaekers
BACKGROUND: Despite advances in diagnosis and treatment of type 2 diabetes, suboptimal metabolic control persists. Patient education in diabetes has been proved to enhance self-efficacy and guideline-driven treatment, however many people with type 2 diabetes do not have access to or do not participate in self-management support programmes. Tele-education and telecoaching have the potential to improve accessibility and efficiency of care, but there is a slow uptake in Europe. Patient and provider acceptance in a local context is an important pre-condition for implementation...
November 9, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27798780/knowing-your-limits-a-qualitative-study-of-physician-and-nurse-practitioner-perspectives-on-np-independence-in-primary-care
#17
Elena Kraus, James M DuBois
BACKGROUND: The shortage of primary care providers and the provisions of the Affordable Care Act (ACA) have spurred discussion about expanding the number, scope of practice (SOP), and independence of primary care nurse practitioners (NPs). Such discussions in the media and among professional organizations may insinuate that changes to the laws governing NP practice will engender acrimony between practicing physicians and NPs. However, we lack empirical, descriptive data on how practicing professionals view NP independence in primary care...
October 31, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27797634/observation-of-interprofessional-collaboration-in-primary-care-practice-a-multiple-case-study
#18
Susan Pullon, Sonya Morgan, Lindsay Macdonald, Eileen McKinlay, Ben Gray
Interprofessional collaboration (IPC) is known to improve and enhance care for people with complex healthcare and social care needs and is ideally anchored in primary care. Such care is complex, challenging, and often poorly undertaken. In countries such as Canada, the United Kingdom, the Netherlands, Australia, and New Zealand, primary care is provided predominantly via general practices, where groups of general practitioners and nurses typically work. Using a case study design, direct observations were made of interprofessional activity in three diverse general practices in New Zealand to determine how collaboration is achieved and maintained...
November 2016: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27785364/barriers-to-weight-loss-among-community-health-center-patients-qualitative-insights-from-primary-care-providers
#19
Rebecca C Woodruff, Gillian L Schauer, Ann R Addison, Ajay Gehlot, Michelle C Kegler
BACKGROUND: Community Health Centers (CHCs) are important settings for obesity prevention and control. However, few studies have explored the barriers that CHC clinicians perceive their patients face in maintaining a healthy weight. METHODS: Semi-structured in-depth interviews were conducted with thirty physicians, physician assistants, and nurse practitioners recruited from four Community Health Centers (CHCs), located in a rural, southwestern region of the state of Georgia, US...
2016: BMC Obesity
https://www.readbyqxmd.com/read/27785047/managing-the-pediatric-patient-with-celiac-disease-a-multidisciplinary-approach
#20
REVIEW
Daniela Migliarese Isaac, Jessica Wu, Diana R Mager, Justine M Turner
Celiac disease (CD) is an autoimmune reaction to gluten, leading to intestinal inflammation, villous atrophy, and malabsorption. It is the most common autoimmune gastrointestinal disorder, with an increasing prevalence. A life-long gluten-free diet (GFD) is an effective treatment to alleviate symptoms, normalize autoantibodies, and heal the intestinal mucosa in patients with CD. Poorly controlled CD poses a significant concern for ongoing malabsorption, growth restriction, and the long-term concern of intestinal lymphoma...
2016: Journal of Multidisciplinary Healthcare
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