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Nurse practitioner as primary care provider

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https://www.readbyqxmd.com/read/28721113/telehealth-and-ehealth-in-nurse-practitioner-training-current-perspectives
#1
REVIEW
Carolyn M Rutledge, Karen Kott, Patty A Schweickert, Rebecca Poston, Christianne Fowler, Tina S Haney
Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28720751/exploring-the-perspectives-of-clinical-professionals-and-support-staff-on-implementing-supported-self-management-for-asthma-in-uk-general-practice-an-imp-2-art-qualitative-study
#2
Susan Morrow, Luke Daines, Sharon Wiener-Ogilvie, Liz Steed, Lorna McKee, Ann-Louise Caress, Stephanie J C Taylor, Hilary Pinnock
Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices...
July 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28707827/cat-scratch-disease-u-s-clinicians-experience-and-knowledge
#3
C A Nelson, A R Moore, A E Perea, P S Mead
Cat scratch disease (CSD) is a zoonotic infection caused primarily by the bacterium Bartonella henselae. An estimated 12,000 outpatients and 500 inpatients are diagnosed with CSD annually, yet little is known regarding clinician experience with and treatment of CSD in the United States. Questions assessing clinical burden, treatment and prevention of CSD were posed to 3,011 primary care providers (family practitioners, internists, paediatricians and nurse practitioners) during 2014-2015 as part of the annual nationwide DocStyles survey...
July 14, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28701459/staff-perceptions-of-community-health-centre-team-function-in-ontario
#4
Jennifer Rayner, Laura Muldoon
OBJECTIVE: To examine perceptions of different staff groups about team functioning in mature, community-governed, interprofessional primary health care practices. DESIGN: Cross-sectional online survey. SETTING: The 75 community health centres (CHCs) in Ontario at the time of the study, which have cared for people with barriers to access to traditional health services in community-governed, interprofessional settings, providing medical, social, and community services since the 1970s...
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28697845/evaluation-of-veterans-affairs-primary-care-nurse-practitioner-residency-achievement-of-competencies
#5
Kathryn Wirtz Rugen, Mary A Dolansky, Maya Dulay, Samuel King, Nancy Harada
BACKGROUND: The Institute of Medicine has recommended the establishment of residency programs for advanced practice nursing graduates. Currently, the evidence about program effectiveness is limited. PURPOSE: To describe the nurse practitioner (NP) resident outcomes on seven competency domains established by the VA Centers of Excellence in Primary Care Education (VA CoEPCE). METHODS: We evaluated mean NP resident competency self-ratings and mean mentor ratings over the 12-month program across NP residency programs at five sites...
June 13, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28697296/hepatitis-b-testing-and-diagnosis-experiences-of-patients-and-primary-care-professionals-in-australia
#6
Jacqueline Richmond, Elizabeth Smith, Jack Wallace, Duane Duncan, Jayne Lucke
OBJECTIVE: A significant proportion of Australians with chronic hepatitis B (CHB) remains undiagnosed and unaware of their risk of liver disease and cancer. This study explored the hepatitis B testing and diagnostic experiences of people with CHB, general practitioners (GPs) and primary care nurses. METHODS: Semi-structured interviews were conducted with people who have CHB (n = 19), GPs (n = 14) and nurses (n = 5). RESULTS: The majority of patient participants with CHB were not provided with information prior to being tested, and were shocked to receive a diagnosis...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28694704/health-care-provider-experience-with-canagliflozin-in-real-world-clinical-practice-favorability-treatment-patterns-and-patient-outcomes
#7
Susan C Bolge, Natalia M Flores, Shu Huang, Jennifer Cai
PURPOSE: This study describes how health care providers approach canagliflozin for the treatment of patients with type 2 diabetes mellitus (T2DM) in the real world. PATIENTS AND METHODS: An Internet-based questionnaire was completed by 101 endocrinologists, 101 primary care physicians, and 100 nurse practitioners/physician assistants (NP/PAs). Health care providers were required to have experience prescribing or managing patients using canagliflozin to be included in the study...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28667826/effectiveness-of-intensive-practice-nurse-counselling-versus-brief-general-practitioner-advice-both-combined-with-varenicline-for-smoking-cessation-a-randomised-pragmatic-trial-in-primary-care
#8
Carolien van Rossem, Mark Spigt, Wolfgang Viechtbauer, A E M Lucas, Onno C P van Schayck, Daniel Kotz
AIMS: To study the effectiveness of intensive counselling by a practice nurse versus brief advice by a general practitioner, each combined with pharmacotherapy, for tobacco 6 months (primary outcome). Secondary outcomes included 12-month abstinence, medication adherence, and incremental costs per life year gained. DESIGN: A multi-site (N=10), two-group, parallel, pragmatic randomised controlled trial. SETTING: A network of primary healthcare centres in the Netherlands...
July 1, 2017: Addiction
https://www.readbyqxmd.com/read/28659157/supporting-medication-discontinuation-provider-preferences-for-interventions-to-facilitate-deprescribing
#9
Amy Linsky, Mark Meterko, Kelly Stolzmann, Steven R Simon
BACKGROUND: One approach to prevent adverse drug events is to discontinue ("deprescribe") medications that are outdated, not indicated, or of limited benefit relative to risk for a particular patient. However, there is little guidance to clinicians about how to integrate the process of deprescribing into the workflow of clinical practice. We sought to determine clinical prescribers' preferences for interventions that would improve their ability to appropriately and proactively discontinue medications...
June 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28655309/the-effectiveness-of-emergency-nurse-practitioner-service-in-the-management-of-patients-presenting-to-rural-hospitals-with-chest-pain-a-multisite-prospective-longitudinal-nested-cohort-study
#10
Tina E Roche, Glenn Gardner, Leanne Jack
BACKGROUND: Health reforms in service improvement have included the use of nurse practitioners. In rural emergency departments, nurse practitioners work to the full scope of their expanded role across all patient acuities including those presenting with undifferentiated chest pain. Currently, there is a paucity of evidence regarding the effectiveness of emergency nurse practitioner service in rural emergency departments. Inquiry into the safety and quality of the service, particularly regarding the management of complex conditions is a priority to ensure that this service improvement model meets health care needs of rural communities...
June 27, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28629510/screening-strategies-for-atrial-fibrillation-a-systematic-review-and-cost-effectiveness-analysis
#11
Nicky J Welton, Alexandra McAleenan, Howard Hz Thom, Philippa Davies, Will Hollingworth, Julian Pt Higgins, George Okoli, Jonathan Ac Sterne, Gene Feder, Diane Eaton, Aroon Hingorani, Christopher Fawsitt, Trudie Lobban, Peter Bryden, Alison Richards, Reecha Sofat
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. OBJECTIVES: To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28627110/patient-preferences-for-healthcare-delivery-through-community-pharmacy-settings-in-the-usa-a-discrete-choice-study
#12
M Feehan, M Walsh, J Godin, D Sundwall, M A Munger
WHAT IS KNOWN AND OBJECTIVE: In order to improve public health, it is necessary to facilitate patients' easy access to affordable high-quality primary health care, and one enhanced approach to do so may be to provide primary healthcare services in the community pharmacy setting. Discrete choice experiments to evaluate patient demand for services in pharmacy are relatively limited and have been hampered by a focus on only a few service alternatives, most focusing on changes in more traditional pharmacy services...
June 18, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28617196/factors-associated-with-having-a-physician-nurse-practitioner-or-physician-assistant-as-primary-care-provider-for-veterans-with-diabetes-mellitus
#13
Perri Morgan, Christine M Everett, Valerie A Smith, Sandra Woolson, David Edelman, Cristina C Hendrix, Theodore S Z Berkowitz, Brandolyn White, George L Jackson
Expanded use of nurse practitioners (NPs) and physician assistants (PAs) is a potential solution to workforce issues, but little is known about how NPs and PAs can best be used. Our study examines whether medical and social complexity of patients is associated with whether their primary care provider (PCP) type is a physician, NP, or PA. In this national retrospective cohort study, we use 2012-2013 national Veterans Administration (VA) electronic health record data from 374 223 veterans to examine whether PCP type is associated with patient, clinic, and state-level factors representing medical and social complexity, adjusting for all variables simultaneously using a generalized logit model...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28614974/electronic-consultation-system-demonstrates-educational-benefit-for-primary-care-providers
#14
Jonas Kwok, J Nwando Olayiwola, Margae Knox, Elizabeth J Murphy, Delphine S Tuot
Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28607235/meeting-the-current-and-future-health-care-needs-of-sri-lanka-s-ageing-population
#15
Dilhar Samaraweera, Shiromi Maduwage
Sri Lanka is one of the fastest-ageing countries in the world. This rapid demographic transition is expected to result in one quarter of the population being elderly by the year 2041. Profound challenges face the country as a result, especially with respect to planning adequate elderly-oriented services in the social-care and health-care sectors. In response to this need, many initiatives have been put in place to promote and protect the welfare of older people, and these rights have been inscribed in law. Within the health sector, despite the wealth of policies and initiatives in recent years, it is clear that the existing health infrastructure and systems still require strengthening, reorientation and coordination, to meet the needs of the growing population of elderly individuals...
September 2016: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28606909/-treated-as-a-number-not-treated-as-a-person-a-qualitative-exploration-of-the-perceived-barriers-to-effective-pain-management-of-patients-with-chronic-pain
#16
Muhammad Abdul Hadi, David Phillip Alldred, Michelle Briggs, Kathryn Marczewski, S José Closs
OBJECTIVES: To identify barriers to effective pain management encountered by patients with chronic pain within the UK's National Health Service (NHS). DESIGN: Secondary analysis of face-to-face, semistructured qualitative interviews using thematic analysis. SETTING: A community-based chronic pain clinic jointly managed by a nurse and pharmacist located in the North of England. PARTICIPANTS: Nineteen adult (>18 years) patients with chronic pain discharged from a pain clinic, with the ability to understand and speak the English language...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28602803/patient-preference-in-primary-care-provider-type
#17
Brandi Leach, Margaret Gradison, Perri Morgan, Christine Everett, Michael J Dill, Justine Strand de Oliveira
BACKGROUND: Given the growing roles of nurse practitioners (NPs) and physician assistants (PAs), patients are increasingly able to choose their primary care provider type. Studies examining patient preferences among provider types are limited and ours is the first to examine reasons for patients' provider type preferences. METHODS: Using data from the 2014 Association of American Medical Colleges' (AAMC) Consumer Survey of Health Care Access, we used qualitative analysis to identify themes in open text responses of reasons for respondents' provider type preference (N = 4220)...
June 9, 2017: Healthcare
https://www.readbyqxmd.com/read/28577459/nurse-practitioners-as-primary-care-providers-with-their-own-patient-panels-and-organizational-structures-a-cross-sectional-study
#18
Lusine Poghosyan, Jianfang Liu, Allison A Norful
BACKGROUND: Health care systems globally are facing challenges of meeting the growing demand for primary care services due to a shortage of primary care physicians. Policy makers and administrators are searching for solutions to increase the primary care capacity. The effective utilization of nurse practitioners (NPs) has been proposed as a solution. However, organizations utilize NPs in variable capacities. In some settings, NPs serve as primary care providers delivering ongoing continuous care to their patients, referred to as patient panels, whereas in other settings they deliver episodic care...
May 25, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28576661/knowledge-and-practice-related-to-gestational-diabetes-among-primary-health-care-providers-in-morocco-potential-for-a-defragmentation-of-care
#19
Bettina Utz, Bouchra Assarag, Amina Essolbi, Amina Barkat, Alexandre Delamou, Vincent De Brouwere
INTRODUCTION: The objective of this study was to assess knowledge and practices of general practitioners, nurses and midwives working at primary health care facilities in Morocco regarding screening and management of gestational diabetes (GDM). METHODS: Structured interviews with 100 doctors, midwives and nurses at 44 randomly selected public health care centers were conducted in Marrakech and Al Haouz. All data were descriptively analyzed. Ethical approval for the study was granted by the institutional review boards in Belgium and Morocco...
May 30, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28545538/providing-online-weight-management-in-primary-care-a-mixed-methods-process-evaluation-of-healthcare-practitioners-experiences-of-using-and-supporting-patients-using-power
#20
Emily Smith, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, Lucy Yardley
BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+...
May 25, 2017: Implementation Science: IS
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