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https://www.readbyqxmd.com/read/29475093/nurse-practitioner-independence-health-care-utilization-and-health-outcomes
#1
Jeffrey Traczynski, Victoria Udalova
Many states allow nurse practitioners (NPs) to practice and prescribe drugs without physician oversight, increasing the number of autonomous primary care providers. We estimate the causal impact of NP independence on population health care utilization rates and health outcomes, exploiting variation in the timing of state law passage. We find that NP independence increases the frequency of routine checkups, improves care quality, and decreases emergency room use by patients with ambulatory care sensitive conditions...
January 17, 2018: Journal of Health Economics
https://www.readbyqxmd.com/read/29472515/development-of-a-standardized-approach-for-managing-opioids-in-adults-with-chronic-noncancer-pain
#2
Jessica M Downes, Donald G Klepser, Jennifer Foster, Maggie Nelson
PURPOSE: The implementation of a chronic pain protocol (CPP) and its effects on the management of long-term opioid therapy are described. SUMMARY: The CPP used at a federally qualified health center and primary care clinic was updated in 2015 and included a prescribing ceiling in morphine equivalent dose (MED) per day and standardized the prescribing of chronic opioids. Intermittent urine drug screening performed at least once annually was added as a requirement of the pain management contract between the provider and the patient...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29472277/documenting-stage-1-and-2-meaningful-use-criteria-a-comparison-of-clinical-pharmacists-with-other-healthcare-providers
#3
Osamah M Alfayez, Sandra Leal, Terri Warholak
PURPOSE: Documentation of Stage 1 and Stage 2 Meaningful Use (MU) criteria for patients with type 2 diabetes mellitus between clinical pharmacists and other healthcare providers was compared. METHODS: Patients seen at 8 clinics in a federally qualified health center who had type 2 diabetes mellitus and were seen by clinical pharmacists or other healthcare providers were randomly selected for inclusion in this retrospective study. Approximately half of the encounters were evaluated for Stage 1 MU compliance (encounters from October through December 2014), and half were evaluated for Stage 2 MU compliance (encounters from January through March 2015)...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29471839/controlled-education-of-patients-after-stroke-ceops-nurse-led-multimodal-and-long-term-interventional-program-involving-a-patient-s-caregiver-to-optimize-secondary-prevention-of-stroke-study-protocol-for-a-randomized-controlled-trial
#4
Anne-Marie Mendyk, Alain Duhamel, Yannick Bejot, Didier Leys, Laurent Derex, Olivier Dereeper, Olivier Detante, Pierre-Yves Garcia, Olivier Godefroy, Francisco Macian Montoro, Jean-Philippe Neau, Sébastien Richard, Thierry Rosolacci, Igor Sibon, Denis Sablot, Serge Timsit, Mathieu Zuber, Charlotte Cordonnier, Régis Bordet
BACKGROUND: Setting up a follow-up secondary prevention program after stroke is difficult due to motor and cognitive impairment, but necessary to prevent recurrence and improve patients' quality of life. To involve a referent nurse and a caregiver from the patient's social circle in nurse-led multimodal and long-term management of risk factors after stroke could be an advantage due to their easier access to the patient and family. The aim of this study is to compare the benefit of optimized follow up by nursing personnel from the vascular neurology department including therapeutic follow up, and an interventional program directed to the patient and a caregiving member of their social circle, as compared with typical follow up in order to develop a specific follow-up program of secondary prevention of stroke...
February 22, 2018: Trials
https://www.readbyqxmd.com/read/29469712/future-growth-of-physicians-and-non-physician-providers-within-the-u-s-dermatology-workforce
#5
Michael R Sargen, Lucy Shi, Roderick S Hooker, Suephy C Chen
Trends in the training, supply, availability, career decisions, and retirement of US dermatology physicians are not well delineated. The current study evaluates whether growth in the dermatology workforce will keep pace with population expansion in the United States. A dermatologist supply model was projected to 2030 drawing on data from the American Academy of Dermatology, American Medical Association, Bureau of Labor Statistics, American Association of Medical Colleges, and other associations. The clinically active dermatologist workforce in 2015 was 36 per capita (1,000,000); entry following postgraduate training was age 30 with career separation at age 65 on average...
September 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29468777/caring-for-crying-babies-a-mixed-methods-study-to-understand-factors-influencing-nurses-and-doctors-management-of-infant-colic
#6
James McGann, Jaqueline Manohar, Harriet Hiscock, Denise O'Connor, Jan Hodgson, Franz Babl, Valerie Sung
AIM: The aim of this study was to determine the barriers and enablers influencing the uptake of two recommendations from a tertiary paediatric hospital's clinical practice guidelines by maternal and child health nurses (MCHNs) and emergency department (ED) doctors: (i) explaining normal crying; and (ii) avoiding attributing crying to gastro-oesophageal reflux (GOR) and limiting anti-reflux medication use. METHODS: The study was designed as 1-h focus group discussions, guided by the Theoretical Domains Framework, and a short questionnaire, with a purposive sample of MCHNs and ED doctors in Victoria, Australia in (March to September) 2015...
February 22, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29468005/assessment-of-trained-hand-hygiene-observers-using-parallel-observations
#7
Humberto Guanche Garcell, Ariadna Villanueva Arias, Isme Borroto Garcés, Alexis Cardoso Gil, Pedro Rivero Companioni, Katiana Figueredo Arias, Osiris I Escobar More, Norgely Rivero Rodríguez, Francisco Gutierrez García
Objectives: To validate hand hygiene (HH) observers following training and determine the concordance between the observers and the Kappa index. Methods: This study was conducted during June 2017. HH observers from 15 hospital units received eight-hours training including a two-hour workshop conducted by the infection control practitioner and hospital epidemiologist. After its completion, parallel observations were conducted by trained nurses from each respective unit for a maximum of 20 minutes per session at any time or day...
January 2018: Oman Medical Journal
https://www.readbyqxmd.com/read/29467136/attitudes-and-perceptions-of-health-professionals-towards-management-of-hypothyroidism-in-general-practice-a-qualitative-interview-study
#8
Rosie Dew, Kathryn King, Onyebuchi E Okosieme, Simon H Pearce, Gemma Donovan, Peter N Taylor, Janis Hickey, Colin M Dayan, Graham Leese, Salman Razvi, Scott Wilkes
OBJECTIVE: To explore the attitudes and perceptions of health professionals towards management of hypothyroidism that contributes to the suboptimal treatment of hypothyroidism in general practice. DESIGN: A qualitative interview study using semistructured interviews. PARTICIPANTS: Sixteen participants were interviewed between March and August 2016 comprising nine general practitioners (GPs), four pharmacists, two practice nurses and one nurse practitioner...
February 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29466968/palliative-care-specialists-perceptions-concerning-referral-of-haematology-patients-to-their-services-findings-from-a-qualitative-study
#9
Dorothy McCaughan, Eve Roman, Alexandra G Smith, Anne C Garry, Miriam J Johnson, Russell D Patmore, Martin R Howard, Debra A Howell
BACKGROUND: Haematological malignancies (leukaemias, lymphomas and myeloma) are complex cancers that are relatively common, affect all ages and have divergent outcomes. Although the symptom burden of these diseases is comparable to other cancers, patients do not access specialist palliative care (SPC) services as often as those with other cancers. To determine the reasons for this, we asked SPC practitioners about their perspectives regarding the barriers and facilitators influencing haematology patient referrals...
February 21, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29465664/knowledge-practices-and-barriers-to-hiv-pre-exposure-prophylaxis-prep-prescribing-among-washington-state-medical-providers
#10
Brian R Wood, Vanessa M McMahan, Kelly Naismith, Jonathan B Stockton, Lori A Delaney, Joanne D Stekler
BACKGROUND: We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. METHODS: In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. RESULTS: Of 735 eligible providers, 64...
January 4, 2018: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/29465476/idiopathic-pulmonary-fibrosis-a-guide-for-nurse-practitioners
#11
Michelle Vega-Olivo, Gerard J Criner
Idiopathic pulmonary fibrosis (IPF) is a rare disease characterized by decline in lung function, dyspnea, and cough. The clinical course of IPF is variable and unpredictable. Early referral to specialists is key to ensure timely and accurate diagnosis. Two antifibrotic drugs (nintedanib and pirfenidone) have been approved for the treatment of IPF.
February 19, 2018: Nurse Practitioner
https://www.readbyqxmd.com/read/29465446/current-practices-and-attitudes-regarding-use-of-inhaled-nitric-oxide-in-the-nicu-results-from-a-survey-of-members-of-the-national-association-of-neonatal-nurse-practitioners
#12
Allyson Kayton, Paula Timoney, Lyn Vargo, Jose A Perez
BACKGROUND: Excessive supplemental oxygen exposure in the neonatal intensive care unit (NICU) can be associated with oxygen-related toxicities, which can lead to negative clinical consequences. Use of inhaled nitric oxide (iNO) can be a successful strategy for avoiding hyperoxia in the NICU. iNO selectively produces pulmonary vasodilation and has been shown to improve oxygenation parameters across the spectrum of disease severity, from mild to very severe, in neonates with hypoxic respiratory failure associated with persistent pulmonary hypertension of the newborn...
February 20, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29465212/exploring-emergency-nurse-practitioners-perceptions-of-their-role
#13
Sue Bagley
Since the 1980s, the emergency nurse practitioner (ENP) role has evolved as increasing socioeconomic pressures and changing government policy have led to new working practices in emergency departments. Similarly, a lack of consensus regarding educational support for ENPs and the regulation of ENP training, mean that variations remain in the scope of practice, role description and academic requirements for ENPs. AIM: To explore ENPs' perceptions of their changing role, including their educational requirements and whether their training needs are being met...
February 21, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29465090/-level-of-knowledge-of-quality-commitment-campaign-qcc-and-of-do-not-do-recommendations-amongst-gps-pediatricians-and-nurses-primary-care
#14
J J Mira, I Carrillo, P Pérez-Pérez, G Olivera, C Silvestre, C Nebot, J González de Dios, J Aranaz-Andrés
BACKGROUND: To evaluate if the Quality Commitment Campaign (QCC) was sufficiently known among primary care professionals (PC), and second, to evaluate the knowledge about certain recommendations of what should not be done in PC. METHODS: A observational study was conducted. General practitioners (GP), pediatricians (PED) and nursing (NUR) participated. A direct question was asked about whether QCC was known and a set of dichotomous questions based on the "do not do" recommendations to assess their knowledge...
February 21, 2018: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29462004/how-surrogate-decision-makers-for-patients-with-chronic-critical-illness-perceive-and-carry-out-their-role
#15
Lingsheng Li, Judith E Nelson, Laura C Hanson, Christopher E Cox, Shannon S Carson, Emily J Chai, Kristine L Keller, James A Tulsky, Marion Danis
OBJECTIVES: Family members commonly make medical decision for patients with chronic critical illness. This study examines how family members approach this decision-making role in real time. DESIGN: Qualitative analysis of interviews with family members in the intervention arm of a randomized controlled communication trial. SETTINGS: Medical ICUs at four U.S. hospitals. PARTICIPANTS: Family members of patients with chronic critical illness (adults mechanically ventilated for ≥ 7 d and expected to remain ventilated and survive for ≥ 72 hr) who participated in the active arm of a communication intervention study...
February 16, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29461383/evaluating-nurse-practitioners-perceived-knowledge-competence-and-comfort-level-in-caring-for-the-sexually-abused-child
#16
Janice Ceccucci
OBJECTIVE: The purpose of this project was to evaluate nurse practitioners' (NPs') current approach and self-reported competence in the care of the sexually abused child in the primary care setting. METHODS: A 50-question survey was distributed to 5,734 NPs who were members of a state nursing organization and nursing alumni. Inclusion criteria included NPs caring for pediatric patients in a primary care setting in New York State. RESULTS: A total of N = 325 responses were obtained, and 110 participants met the inclusion criteria...
January 2018: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/29458392/recruitment-of-older-adults-to-three-preventative-lifestyle-improvement-studies
#17
Robin Chatters, Louise Newbould, Kirsty Sprange, Daniel Hind, Gail Mountain, Katy Shortland, Lauren Powell, Rebecca Gossage-Worrall, Tim Chater, Anju Keetharuth, Ellen Lee, Bob Woods
BACKGROUND: Recruiting isolated older adults to clinical trials is complex, time-consuming and difficult. Previous studies have suggested querying existing databases to identify appropriate potential participants. We aim to compare recruitment techniques (general practitioner (GP) mail-outs, community engagement and clinician referrals) used in three randomised controlled trial (RCT) studies assessing the feasibility or effectiveness of two preventative interventions in isolated older adults (the Lifestyle Matters and Putting Life In Years interventions)...
February 20, 2018: Trials
https://www.readbyqxmd.com/read/29457946/the-provision-of-ambulatory-systemic-anti-cancer-therapy
#18
Susan Cooper, Kate de Lord
This article reflects on the changing nature of the provision of care and delivery of ambulatory systemic anti-cancer therapy (SACT) services. It reviews the national guidance and looks at ambulatory SACT in terms of patients being treated closer to home, i.e. ambulatory care in its truest sense. It considers the impact on quality of life for patients receiving treatments at a place of their choice. It explores the role of the nurse as an advanced practitioner while also examining the safety and delivery of complex regimens ensuring robust pathways are in place to deliver care in a safe and standardised way...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29457869/assessment-of-the-spectrum-of-hepatic-encephalopathy-a-multi-center-study
#19
Bradley Reuter, Kara Walter, Julien Bissonnette, Michael D Leise, Jennifer Lai, Puneeta Tandon, Patrick S Kamath, Scott W Biggins, Christopher F Rose, James B Wade, Jasmohan S Bajaj
Hepatic encephalopathy (HE) is a major cause of morbidity in cirrhosis. However its severity assessment is often subjective, which needs to be studied systematically. AIM: To determine how accurately trainee and non-trainee practitioners grade and manage HE patients throughout its severity. METHODS: We performed a survey study using standardized simulated patient videos at 4 US and 3 Canadian centers. Participants were trainees (gastroenterology/hepatology fellows) and non-trainees (faculty, nurse practitioners, physician assistants)...
February 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29457258/quality-of-prescribing-by-physicians-nurse-practitioners-and-physician-assistants-in-the-united-states
#20
Shiyin Jiao, Irene B Murimi, Randall S Stafford, Ramin Mojtabai, G Caleb Alexander
OBJECTIVE: Nurse practitioners (NPs) and physician assistants (PAs) have increasingly broad prescribing authority in the United States, yet little is known regarding how the quality of their prescribing practices compares to that of physicians. The objective of this study was to compare the quality of prescribing practices of physicians and non-physician providers. METHODS: A serial cross-sectional analysis of the 2006-2012 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) was performed...
February 19, 2018: Pharmacotherapy
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