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Role of Advanced practice nurse

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https://www.readbyqxmd.com/read/27918406/the-advanced-practice-clinical-nurse-specialist
#1
Ann M Mayo, Melinda Mercer Ray, Tracy B Chamblee, Linda D Urden, Rachel Moody
The clinical nurse specialist (CNS), one of the 4 advanced practice registered nurse (APRN) categories, has a unique role to play in contributing to high-quality patient care and system-level change across multiple health care settings. CNS practice requires advanced knowledge and skills, including specialty expertise, the ability to integrate new knowledge and innovation into the system of care, the ability to consult and collaborate with all health professions, and the mentoring of nursing staff to support and fully implement that new knowledge...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918404/entrepreneurship-assessing-the-readiness-of-the-new-jersey-apn-workforce
#2
Edna Cadmus, Mary L Johansen, Phyllis Arn Zimmer, David L Knowlton
There is an unprecedented opportunity to move advanced practice nurses (APNs) into primary care settings at a steady rate over the next 5 to 8 years. In addition, the opportunity for nurse-owned or nurse-led practices has never been greater. However, many APNs currently work in a structured environment where the employer focuses on the business aspects of the practice and the APN focuses primarily on clinical care. Often APNs are unaware of the entrepreneurial contribution they make to the practice. A Needs Assessment Survey was developed to better understand business and practice management knowledge and skills of APNs in New Jersey...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918402/leading-dnp-professionals-practice-competencies-for-organizational-excellence-and-advancement
#3
Kathy Malloch
The doctorate in nursing practice (DNP) role is quickly emerging across the United States in numerous practice settings, especially in hospitals, outpatient services, and academic institutions. There is now a need for guidelines to evaluate the enactment of the standards used to create DNP education and practice, competencies expected in practice, and the outcomes and value created by this role. This article presents a DNP Performance Demonstration and Impact template created on the basis of the AACN (American Association of Colleges of Nursing), NONPF (National Organization of Nurse Practitioner Faculties), and AONE (American Organization of Nurse Executives) standards to assist leaders in evaluating DNP performance from a standards-driven perspective...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918399/the-evolution-of-the-new-provider-team-driving-cultural-change-through-data
#4
Trish Anen, Debra McElroy
Nursing executives are continually challenged to address a rapidly evolving health care system. Every aspect of care delivery is being scrutinized, yet the constant requirement remains assurance of high-quality, highly reliable care that is cost-effective and easily accessible. The nursing workforce remains visible in traditional roles as well as in new and innovative capacities, whereas nurse executives experience expanded realms of focus and responsibility. As health systems continue to adapt to the changing environment, the ability to leverage the role and scope of the advanced practice registered nurse (APRN) as a health care provider is emerging as an essential business and care strategy...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27908942/the-need-for-an-effective-process-to-resolve-conflicts-over-medical-futility-a-case-study-and-analysis
#5
Jocelyn A Olmstead, Michael D Dahnke
The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is first determined by medicine, in order for the determination to meet legal criteria, it must be subject to review...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27898563/patient-characteristics-associated-with-primary-care-pa-and-aprn-roles
#6
Christine M Everett, Perri Morgan, George L Jackson
OBJECTIVES: Physician assistants (PAs) and advanced practice registered nurses (APRNs) can perform multiple roles on primary care teams, but limited research describes the patients they serve. We sought to identify patient characteristics associated with roles of primary care PAs and APRNs. METHODS: We analyzed adult respondents to the 2010 Health Tracking Household Survey with a primary care usual provider (physician, PA, or APRN). The dependent variable is the PA or APRN role...
December 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27888959/bearing-witness-the-lived-experience-of-sitting-with-patients
#7
Rebecca Schroeder
There is abundant literature focused on the practice of using hospital sitters as part of standard patient safety care. However, minimal attention has been paid to understanding the actual experiences of hospital workers as they sit with distressed and often agitated patients. With the overwhelming number of hospitalized patients who require sitters, attention must be paid to the healthcare workers' perspective. In this study a phenomenological approach was used to elicit the perceptions of these hospital sitters...
December 2016: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/27885343/qualitative-inquiry-into-challenges-experienced-by-registered-general-nurses-in-the-emergency-department-a-study-of-selected-hospitals-in-the-volta-region-of-ghana
#8
Confidence Alorse Atakro, Jerry Paul Ninnoni, Peter Adatara, Janet Gross, Michael Agbavor
Registered General Nurses (RGNs) play crucial roles in emergency departments (EDs). EDs in Ghana are primarily staffed by RGNs who have had no additional formal education in emergency care. Additionally, basic, master's, or doctoral level nursing education programs provide limited content on the complexities of emergency nursing. Nurses in EDs are affected by many challenges such as growing patient population, financial pressures, physical violence, verbal abuse, operational inefficiencies, overcrowding, and work overload...
2016: Emergency Medicine International
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#9
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27875451/developing-a-framework-to-help-bedside-nurses-bring-about-change
#10
Jordan S Porter, Kelley A Strout
: Nurses across all care settings and experience levels are being called upon to lead. In a 2011 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine examined the ways nurses could more fully apply their knowledge of direct patient care to address the increasing demands placed on the health care system since the passage of the Affordable Care Act. The report asked: "What roles can nursing assume to address the increasing demand for safe, high-quality, and effective health care services?"Multiple variables influence a nurse's ability to assume a leadership role, and multiple barriers to these roles continue to exist...
December 2016: American Journal of Nursing
https://www.readbyqxmd.com/read/27863592/nursing-interventions-in-stroke-care-delivery-an-evidence-based-clinical-review
#11
Dimitrios Theofanidis, Bernard Gibbon
INTRODUCTION: Generally, nursing interventions during the acute stages following a stroke aim at preventing secondary brain injury (intracranial hypertension), maintaining the airways (due to paralysis of the pharynx muscles), providing general body support (vital signs, fluid and electrolyte balance), and anticipating the occurrence of complications (atelectasis and pneumonia). AIM: This literature review is to prioritize nursing interventions for acute stroke and to update nursing roles and input considering recommended levels of evidence of care to date...
December 2016: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/27855673/gender-and-physician-specialization-and-practice-settings-in-ecuador-a-qualitative-study
#12
Rita Bedoya-Vaca, Kathryn P Derose, Natalia Romero-Sandoval
BACKGROUND: The increasing proportion of women in the medical profession is a worldwide phenomenon often called the "feminization of medicine." However, it is understudied in low and middle-income countries, particularly in Latin America. METHODS: Using a qualitative, descriptive design, we explored the influence of gender and other factors on physician career decision-making and experiences, including medical specialty and public vs. private practice, in Quito, Ecuador, through in-depth, semi-structured interviews (n = 31) in 2014...
November 17, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27830261/nursing-informatics-certification-worldwide-history-pathway-roles-and-motivation
#13
Mollie R Cummins, Adi V Gundlapalli, Aditya V Gundlapalli, Peter Murray, Hyeoun-Ae Park, Christoph U Lehmann
INTRODUCTION: Official recognition and certification for informatics professionals are essential aspects of workforce development. OBJECTIVE: To describe the history, pathways, and nuances of certification in nursing informatics across the globe; compare and contrast those with board certification in clinical informatics for physicians. METHODS: (1) A review of the representative literature on informatics certification and related competencies for nurses and physicians, and relevant websites for nursing informatics associations and societies worldwide; (2) similarities and differences between certification processes for nurses and physicians, and (3) perspectives on roles for nursing informatics professionals in healthcare Results: The literature search for 'nursing informatics certification' yielded few results in PubMed; Google Scholar yielded a large number of citations that extended to magazines and other non-peer reviewed sources...
November 10, 2016: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/27825345/reconfiguring-health-workforce-a-case-based-comparative-study-explaining-the-increasingly-diverse-professional-roles-in-europe
#14
Antoinette de Bont, Job van Exel, Silvia Coretti, Zeynep Güldem Ökem, Maarten Janssen, Kristin Lofthus Hope, Tomasz Ludwicki, Britta Zander, Marie Zvonickova, Christine Bond, Iris Wallenburg
BACKGROUND: Over the past decade the healthcare workforce has diversified in several directions with formalised roles for health care assistants, specialised roles for nurses and technicians, advanced roles for physician associates and nurse practitioners and new professions for new services, such as case managers. Hence the composition of health care teams has become increasingly diverse. The exact extent of this diversity is unknown across the different countries of Europe, as are the drivers of this change...
November 8, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27824800/transient-ischemic-attack-and-cognitive-impairment-a-review
#15
Christine A Ganzer, Andrea Barnes, Constance Uphold, Alan R Jacobs
Transient ischemic attack (TIA) is a neurologic deficit resulting from focal ischemia in the brain, spinal cord, or retina. Historically, the definition included symptom resolution within 24 hours. However, recent studies investigating cognition after TIA suggest that deficits in executive function persist at 7 days post-TIA, although few studies have examined these effects long term. Recent advances in neuroimaging techniques provide emerging evidence of permanent microvascular tissue damage in the brain, suggesting that the effects of TIA may persist beyond resolution of focal symptoms...
December 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/27804187/partners-in-research-building-academic-practice-partnerships-to-educate-and-mentor-advanced-practice-nurses
#16
Patricia Harbman, Denise Bryant-Lukosius, Ruth Martin-Misener, Nancy Carter, Christine L Covell, Faith Donald, Sharyn Gibbins, Kelley Kilpatrick, James McKinlay, Krista Rawson, Diana Sherifali, Joan Tranmer, Ruta Valaitis
RATIONALE: Clinical practice is the primary focus of advanced practice nursing (APN) roles. However, with unprecedented needs for health care reform and quality improvement (QI), health care administrators are seeking new ways to utilize all dimensions of APN expertise, especially related to research and evidence-based practice. International studies reveal research as the most underdeveloped and underutilized aspect of these roles. AIMS: To improve patient care by strengthening the capacity of advanced practice nurses to integrate research and evidence-based practice activities into their day-to-day practice...
November 1, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27792068/does-persistent-pain-following-a-motor-vehicle-crash-impact-functional-status-in-older-adults
#17
Matthew E Proud, Patricia Kunz Howard
Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Persistent Pain Among Older Adults Discharged Home From the Emergency Department After Motor Vehicle Crash: A Prospective Cohort Study." This longitudinal inquiry enrolled 161 patients 65 years or older seeking care in an emergency department (ED) following a motor vehicle crash. Interviews were conducted at the initial ED visit and at 6 weeks, 6 months, and 1 year. Variables of interest were persistent pain, depressive symptoms, and interference with activities of daily living, with an end goal of impact on functionality...
October 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/27783745/developing-the-advanced-practice-nurse-in-catalonia
#18
Montserrat Comellas-Oliva
The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice...
September 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27769020/between-two-roles-experiences-of-newly-trained-nurse-practitioners-in-surgical-care-in-sweden-a-qualitative-study-using-repeated-interviews
#19
Eva Jangland, Pia Yngman Uhlin, Erebouni Arakelian
The position of Nurse Practitioner is a new role in Nordic countries. The transition from a registered nurse to the Nurse Practitioner role has been reported to be a personal challenge. This study, guided by the Nordic theoretical model for use in the education of advanced practice nurses, represents a unique opportunity to describe this transition for newly graduated Nurse Practitioners in an interprofessional surgical care team in Sweden. The aim was to explore how the first Nurse Practitioners in surgical care experienced the transition into a new role and what competences they used in the team...
November 2016: Nurse Education in Practice
https://www.readbyqxmd.com/read/27767363/the-role-of-advanced-practice-registered-nurses-in-the-completion-of-physician-orders-for-life-sustaining-treatment
#20
Sophia A Hayes, Dana Zive, Betty Ferrell, Susan W Tolle
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm records advance care planning for patients with advanced illness or frailty as actionable medical records. The National POLST Paradigm Task Force recommends that physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) be permitted to execute POLST forms. OBJECTIVE: To investigate the percentage of Oregon POLST forms signed by APRNs, and examine the obstacles faced by states attempting to allow APRNs to sign POLST forms...
October 21, 2016: Journal of Palliative Medicine
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