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Advanced nursing practice

Tara Follett, Sara Calderon-Crossman, Denise Clarke, Marcia Ergezinger, Christene Evanochko, Krystal Johnson, Natalie Mercy, Barbara Taylor
BACKGROUND: A level 1 community hospital with a labor, delivery, recovery, and postpartum (LDRP) unit delivering over 2800 babies per year was operating without dedicated neonatal resuscitation and stabilization support. PURPOSE: With lack of funding and space to provide an onsite level 2 neonatal intensive care unit (NICU), a position was created to provide neonatal nurse practitioner (NNP) coverage to support the LDRP unit. METHOD: The article describes the innovative solution of having an NNP team rotate from a regional neonatal intensive care program to a busy community LDRP unit...
October 4, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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
Michelle M Byrne, Susan Welch
The Certified Nurse Educator (CNE) is the only credential recognizing the advanced practice role of the academic nurse educator. This article provides information regarding a CNE Certification Drive for faculty in one school of nursing. Descriptive findings include pass rates and content-specific averages. An analysis of the relationship between the variables is offered for role (faculty vs. recent graduate), years of teaching, and differences in test scores. Results indicate no significant relationship between role and test results, χ(1) = 1...
July 2016: Nursing Education Perspectives
David E Vance, Pariya L Fazeli, Shameka L Cody, Tyler R Bell, Caitlin Northcutt Pope
For centuries, since the advent of harnessing magnetic and electrical energies, humans have been applying such energies to various body parts, including the brain, with the goal of improving health. Advancements over the past two decades in the production and affordability of such devices that precisely deliver such energies have resulted in novel therapeutic uses. One technique in particular, transcranial Direct Current Stimulation (tDCS), uses electrodes placed on the scalp to deliver a low electrical current to various areas on the surface of the neocortex...
2016: Nursing: Research and Reviews
Gail Ewing, Clarissa Penfold, John Benson, Ravi Mahadeva, Sophie Howson, Julie Burkin, Sara Booth, Roberta Lovick, David Gilligan, Christopher Todd, Morag Farquhar
CONTEXT: Carers' needs in advanced disease, and specifically in relation to breathlessness, are well evidenced. Publications on educational interventions for carers of patients with advanced disease which focus on symptoms are scarce and absent for breathlessness. OBJECTIVES: To establish current education provided by clinicians for carers of patients with breathlessness in advanced disease, views about educating carers about breathlessness and relevant outcomes for a future randomised controlled trial (RCT) of an educational intervention for carers...
October 7, 2016: Journal of Pain and Symptom Management
Laura Petitta, Lixin Jiang, Charmine E J Härtel
The present study adds novel knowledge to the literature on emotional contagion (EC), discrete emotions, job burnout, and the management of healthcare professionals by simultaneously considering EC as both a job demand and a job resource with multiple social pathways. Integrating EC into the job demands-resource model, we develop and test a conceptual model wherein multiple stakeholder sources of emotional exchanges (i.e., leaders, colleagues, patients) play a differential role in predicting caregivers' absorption of positive (i...
October 10, 2016: Stress and Health: Journal of the International Society for the Investigation of Stress
Susan Gennaro
With more people having access to health care in the United States as a result of the Affordable Care Act, there is a greater need for nurses now than ever before. Generalist nurses will need to be educated, not just to care for people in hospitals, but also to promote health and help manage chronic conditions in a wide variety of health care settings. More advanced-practice nurses will be needed to provide primary care. Although the need for nurses educated at both the undergraduate and graduate levels in emerging health care systems is increasing, the number of nursing educators is decreasing...
October 2016: Nursing for Women's Health
Mary Raleigh, Helen Allan
AIM: To explore multiple perspectives on the use of physical assessment skills by Advanced Nurse Practitioners in the UK BACKGROUND: Physical assessment skills practices are embedded in advanced nursing practice roles in the UK. There is little evidence on how these skills are used by Advanced Nurse Practitioners' on the community. DESIGN: Case study METHODOLOGY AND METHODS: A qualitative interpretative single-embedded case study of 22 participants from South of England...
October 7, 2016: Journal of Clinical Nursing
M Charlesworth, M Mort, A F Smith
Previous studies of critical care admissions have largely compared patients that have been granted or declined admission. To better understand the decision process itself, our ethnographic approach combined observation of and interviews with critical care physicians in a large English hospital. We observed 30 critical care doctors managing 71 referrals and conducted ten interviews with senior decision-makers to explore the themes raised by our observations. We analysed data using the constant comparative method...
October 7, 2016: Anaesthesia
Angel K Chen, Josette Rivera, Nicole Rotter, Emily Green, Susan Kools
With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting...
September 28, 2016: Nurse Education in Practice
Katia Noyes, Janet Baack-Kukreja, Edward M Messing, Luke Schoeniger, Eva Galka, Wei Pan, Cai Xueya, Fergal J Fleming, John Rt Monson, Supriya G Mohile, Todd Francone
AIMS: To explore the feasibility of recruiting surgical oncology patients and implementing a surgical integrated discharge (SID) programme led by advanced practice providers (APP). BACKGROUND: Burden of illness and complexity of treatment regimen makes it challenging for surgical oncology patients to participate in research. Surgical oncology nurses may have the necessary expertise to overcome this problem. DESIGN: Controlled longitudinal prospective observational study...
July 2016: Nurs Open
Kate Beckett, Ellen M Henderson, Sarah Parry, Peter Stoddart, Margaret Fletcher
AIM: To assess Acute Pain Service and paediatric pain management efficacy in a UK specialist paediatric hospital to inform wider recommendations for future sustainability. BACKGROUND: UK paediatric acute pain services vary. Although comprehensive pain management guidelines exist, consensus on the best model of care is lacking. Worldwide, medical and pharmacological advances and rapid patient turnover have increased the challenges of managing hospitalized children's pain...
January 2016: Nurs Open
Lorelli Nowell
AIM: This paper presents a discussion of the role of the philosophy of pragmatism in the integrated knowledge translation approach to research. DESIGN: Critical inquiry is used to discuss bringing pragmatic philosophy and the integrated knowledge translation approach to research together to advance nursing knowledge. METHODS: This paper draws from the literature written on the philosophy of pragmatism and from the current literature on knowledge translation...
November 2015: Nurs Open
Li-Ling Lin, Chiu-Chu Lin
Diabetes is a huge problem that has been recognized as an important healthcare issue by most national governments. Diabetes affects patients not only in terms of physical health but also in terms of mental health. Furthermore, the medical costs that are associated with diabetes are considerable. Many countries have developed integrated care models for the treatment of diabetes and pay particular attention to assisting patients that require complicated care. Evidence from empirical studies shows that the integrated care of diabetes reduces complications, increases patients' health literacy, and decreases medical costs...
October 2016: Hu Li za Zhi the Journal of Nursing
Chia-Chan Kao, Yu-Hua Lin
At least half of patients with cancer experience emotional distress (e.g., posttraumatic stress symptoms). Most of the studies on the emotional distress of Taiwanese cancer patients have focused on issues of depression rather than on posttraumatic stress disorder. The scope of the present article covers the definitions of cancer-related posttraumatic stress disorder (CR-PTSD) and cancer-related posttraumatic stress symptoms (CR-PTSS), identifies the differences and similarities between professional interview and self-administered measurement tools and their applications; analyzes the prevalence of CR-PTSD and CR-PTSS; identifies the possible contributing sociodemographic (younger age, female, low education, low socio-economic status), clinical (advanced stage, undergoing chemotherapy, just completed the therapy), and psychosocial (negative psychological traits, poor social support, and insufficient coping strategies) of CR-PTSD and CR-PTSS; and aggregates the effects of cognitive and psychosocial interventions on CR-PTSD and CR-PTSS...
October 2016: Hu Li za Zhi the Journal of Nursing
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
PURPOSE: As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. METHODS: Process maps were created using medical record time stamps...
September 15, 2016: Journal of Pediatric Surgery
Susan B Williams, Michael D Dahnke
Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice...
October 2016: Critical Care Nurse
Debra Dunn
Body modification, also known as body art, has been a common cultural practice for thousands of years and includes body piercings, transdermal and subdermal implants, tattoos, scarification, body stretching and sculpting, dental grills, and nail art. Perioperative nurses must learn more about body art to provide nonjudgmental, nonprejudicial care and to ensure patient safety when they prepare patients for surgery. A welcoming environment engages patients and fosters communication so that patients are more likely to share hidden body art...
October 2016: AORN Journal
Ian N Olver, Jaklin A Eliott
Do-not-resuscitate (DNR) orders are necessary if resuscitation, the default option in hospitals, should be avoided because a patient is known to be dying and attempted resuscitation would be inappropriate. To avoid inappropriate resuscitation at night, if no DNR order has been recorded, after-hours medical staff are often asked to have a DNR discussion with patients whose condition is deteriorating, but with whom they are unfamiliar. Participants in two qualitative studies of cancer patients' views on how to present DNR discussions recognized that such patients are at different stages of understanding of their situation and may not be ready for a DNR discussion; therefore, a one-policy-fits-all approach was thought to be inappropriate...
2016: Cancers
Susan Williams
The development of advanced practice nursing roles in primary care is becoming popular in many countries and a recent study across 39 nations confirms this trend ( Maier and Aiken 2016 ).
September 30, 2016: Nursing Management (Harrow)
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