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Advanced Practice Registered Nurse

Doreen C Harper, Teena M McGuinness, Jean Johnson
BACKGROUND: 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...
August 31, 2016: Nursing Outlook
Deanna E Johnson
BACKGROUND: The skin of extremely preterm infants is underdeveloped and has poor barrier function. Skin maintenance interventions initiated in the neonatal intensive care unit (NICU) have immediate and lifelong implications when the potential for infection, allergen sensitization, and altered aesthetic outcomes are considered. In addition, the high-level medical needs of extremely preterm infants demand skin-level medical interventions that too often result in unintended skin harm. PURPOSE: We describe the use of a harm prevention, or consequence-centered, approach to skin care, which facilitates safer practice for extremely premature infants...
October 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Manuela Ferrari, Farah Ahmad, Yogendra Shakya, Cliff Ledwos, Kwame McKenzie
BACKGROUND: The worldwide rise in common mental disorders (CMDs) is posing challenges in the provision of and access to care, particularly for immigrant, refugee and racialized groups from low-income backgrounds. eHealth tools, such as the Interactive Computer-Assisted Client Assessment Survey (iCCAS) may reduce some barriers to access. iCCAS is a tablet-based, touch-screen self-assessment completed by clients while waiting to see their family physician (FP) or nurse practitioner (NP)...
2016: BMC Health Services Research
Melanie Birks, Jenny Davis, John Smithson, Robyn Cant
The nursing profession comprises Australia's largest regulated health workforce yet its practice boundaries are poorly understood. The ambiguity surrounding the practice scope of nurses limits the profession's ability to fully respond to Australia's current and emerging health system challenges. The aim of this review is to explore the concept of scope of practice of registered nurses (RN) in Australia, as reflected in contemporary literature. An integrative review of literature relating to the scope of practice of the Australian registered nurse published between 2007 and 2014 was conducted...
October 13, 2016: Contemporary Nurse
Hsien-Cheng Lin
Nursing information systems can enhance nursing practice and the efficiency and quality of administrative affairs within the nursing department and thus have been widely considered for implementation. Close alignment of human-computer interaction can advance optimal clinical performance with the use of information systems. However, a lack of introduction of the concept of alignment between users' perceptions and technological functionality has caused dissatisfaction, as shown in the existing literature. This study provides insight into the alignment between nurses' perceptions and how technological functionality affects their satisfaction with Nursing Information System use through a reductionist perspective of alignment...
September 9, 2016: Computers, Informatics, Nursing: CIN
Allison Magnuson, Beverly Canin, G J van Londen, Beatrice Edwards, Pamela Bakalarski, Ira Parker
A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum...
November 2016: Current Oncology Reports
Joanne Spetz, Nancy Dudley, Laura Trupin, Maggie Rogers, Diane E Meier, Tamara Dumanovsky
The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard...
September 1, 2016: Health Affairs
Barbara St Marie
Management of chronic pain is a challenge shared by healthcare providers in various clinical settings. The epidemic of opioid misuse has escalated this challenge. A gap exists in understanding barriers and facilitators to practices of advanced practice registered nurses (APRNs) caring for patients with chronic pain and substance use disorder (SUD). The purpose of this study was to examine the APRNs' experiences while caring for patients with coexisting SUD and chronic pain to help envision better ways to manage pain and direct educational initiatives...
October 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Elizabeth H Dobbins
A 2014 consensus report by the Institute of Medicine offers recommendations for healthcare providers to decrease unwanted care and improve the quality of life at the end of life. This article discusses the recommendations of interest to advanced practice registered nurses.
September 22, 2016: Nurse Practitioner
Jeremia S Sojane, Hester C Klopper, Siedine K Coetzee
BACKGROUND: The nurse leadership of a hospital is identified as the single most important aspect of the practice environment that impacts nurse outcomes. When nurses are satisfied with their jobs, they tend to remain with their employers and become more productive in their workplaces. OBJECTIVES: This study aimed to investigate the relationship between leadership, job satisfaction and intentions to leave among registered nurses (RNs) working in hospitals in the North West and Free State provinces of South Africa...
2016: Curationis
Kay Shannon, Barbara McKenzie-Green
BACKGROUND: Challenges facing healthcare assistants in aged residential care are a focus of global debate. These challenges involve remuneration, education, skill mix, work conditions and organisational structures. OBJECTIVES/AIMS: We enter the discussion by acknowledging current work, education and remuneration for healthcare assistants. We then consider the supervisory relationships between registered nurses (RNs), enrolled nurses (ENs) and healthcare assistants, educational levels for RNs, ENs and healthcare assistants, and the interplay between organisation and practice in aged residential care...
April 2016: Contemporary Nurse
Peter Lewis, Ryan J Gaffney, Nathan J Wilson
AIMS AND OBJECTIVES: The aim of this narrative review was to describe how nurses experience caring for people with ID in an acute care setting. BACKGROUND: Recent advances in the care of people with ID in hospital are primarily based upon the experiences of people with ID and their caregivers. Little is known about the experiences of registered nurses caring for people with ID, yet the experiences of nurses in delivering care largely determine the quality of care experienced by people with ID and their caregivers...
August 17, 2016: Journal of Clinical Nursing
Tessa van der Maaden, Henrica C W de Vet, Wilco P Achterberg, Froukje Boersma, Jos M G A Schols, David R Mehr, Francisca Galindo-Garre, Cees M P M Hertogh, Raymond T C M Koopmans, Jenny T van der Steen
BACKGROUND: Pneumonia in people with dementia has been associated with severe discomfort. We sought to assess the effectiveness of a practice guideline for optimal symptom relief for nursing home residents with dementia and pneumonia. METHODS: A single-blind, multicenter, cluster randomized controlled trial was conducted in 32 Dutch nursing homes. Outcomes were assessed on the patient level. The main outcome measures were discomfort and symptoms: discomfort (DS-DAT: Discomfort Scale-Dementia of Alzheimer Type), (lack of) comfort (EOLD-CAD: End Of Life in Dementia-Comfort Assessment in Dying), pain (PAINAD: Pain Assessment in Advanced Dementia), and respiratory distress (RDOS: Respiratory Distress Observation Scale)...
2016: BMC Medicine
J Margo Brooks Carthon, Kelly Wiltse Nicely, Danielle Altares Sarik, Julie Fairman
BACKGROUND: Current regulatory impediments prohibit advanced practice registered nurses from practicing to their full capacity. PURPOSE: To examine the process of successful removal of scope of practice barriers in Pennsylvania under the Rx4PA legislation introduced in 2007. METHOD: We used qualitative research techniques, including purposeful sampling of participants. Twelve stakeholder informed interviews were conducted between October 2013 and May 2014...
May 2016: Policy, Politics & Nursing Practice
Amanda Locke, Norifumi Kamo
Access to mental health providers has become an increasingly common challenge for many patients with depression and anxiety disorders. Primary care providers often manage this gap in care and currently provide solo care without the assistance of other team members. In order to provide quality care that aligns with best practice, we developed a depression and anxiety disorder treatment pathway utilizing a multidisciplinary team based on each members' individual skill set, or skill-task alignment. The main change to treatment implemented by the pathway was the addition of a clinical pharmacist in the management of patient care...
2016: BMJ Quality Improvement Reports
Emilia Fan, Joel J Rhee
Nurses are well positioned to initiate and conduct advance-care planning (ACP) conversations; however, there has been limited research on practice nurses performing this role in Australia. The aim of the present study was to understand the beliefs, attitudes, perceptions, confidence, training and educational needs of New South Wales practice nurses with regards to involvement in ACP. A cross-sectional online survey was conducted in August to October 2014. Nurses were recruited through nursing organisations and Medicare Locals...
August 5, 2016: Australian Journal of Primary Health
Dian Dowling Evans, Glenn Clinton Shedd
The Research to Practice column is intended to improve the research critique skills of the advanced practice registered nurse and emergency nurse (RN) and to assist with the translation of research into practice. For each column, a topic and a research study are selected. The stage is set with a case presentation. The research article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. In the current column, we examine the findings of from their article, titled "Two Days of Dexamethasone Versus 5 Days of Prednisone in the Treatment of Acute Asthma: A Randomized Controlled Trial...
July 2016: Advanced Emergency Nursing Journal
Joshua Hofmeyer, Jonathon P Leider, Jennifer Satorius, Erin Tanenbaum, David Basel, Alana Knudson
INTRODUCTION: Public and private entities in the United States spend billions of dollars each year on potentially avoidable hospitalizations. This is a common occurrence in long-term care (LTC) facilities, especially in rural jurisdictions. This article details the creation of a telemedicine approach to assess residents from rural LTC facilities for potential transfer to hospitals. METHODS: An electronic LTC (eLTC) pilot was conducted in 20 pilot LTC facilities from 2012-2015...
July 28, 2016: Journal of the American Medical Directors Association
Judy L LeFlore, Patricia E Thomas
Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas...
July 2016: Journal of Perinatal & Neonatal Nursing
Laura Distelhorst, Amy Bieda, Marguerite DiMarco, Susan Tullai-McGuinness
: Chemical flame retardants are routinely applied to children's products and are harmful to their health. Pediatric nurses are in a key position to provide education to caregivers on methods to decrease their children's exposure to these harmful chemicals. However, a critical barrier is the absence of any program to educate nurses about chemical flame retardants. In order to overcome this barrier, we must first assess their knowledge. This article provides key highlights every pediatric nurse should know about chemical flame retardants and reports the results of a knowledge assessment study...
July 14, 2016: Journal of Pediatric Nursing
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