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Nurse practitioner critical care

Kristen M Brown, Shawna S Mudd, Elizabeth A Hunt, Julianne S Perretta, Nicole A Shilkofski, J Wesley Diddle, Gregory Yurasek, Melania Bembea, Jordan Duval-Arnould, Kristen Nelson McMillan
OBJECTIVES: Assess the effect of a simulation "boot camp" on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training. DESIGN: Prospective pre/post interventional pilot study. SETTING: University simulation center. SUBJECTS: Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America...
March 10, 2018: Pediatric Critical Care Medicine
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
Walter A Boyle, David J Murray, Mary Beth Beyatte, Justin G Knittel, Paul W Kerby, Julie Woodhouse, John R Boulet
OBJECTIVES: Develop a standardized simulation method to assess clinical skills of ICU providers. DESIGN: Simulation assessment. SETTING: Simulation laboratory. SUBJECTS: Residents, Critical Care Medicine fellows, acute care nurse practitioner students. INTERVENTIONS: Performance scoring in scenarios from multiple Critical Care Medicine competency domains. MEASUREMENTS AND MAIN RESULTS: Three-hundred eighty-four performances by 48 participants were scored using checklists (% correct) and holistic "global" ratings (1 [unprepared] to 9 [expert])...
March 7, 2018: Critical Care Medicine
Michelle Boltz, Norma G Cuellar, Casey Cole, Brent Pistorese
Introduction Since 2010, more than 75 rural hospitals have closed in the USA and more than one-third are at risk of closure due to lower patient volumes, lower funding levels, decreased hospital revenue and lower physician employment pools. Telemedicine can provide new models of care delivery that maintain quality and reduce cost of healthcare in rural populations. The purpose of this project was to evaluate a cross-organizational pilot program by comparing a NP/telemedicine physician hospitalist programme with a traditional physician hospitalist model to assess effects on length of patient stay, mortality rates, readmission rate, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings of provider communication, and total hospital costs...
January 1, 2018: Journal of Telemedicine and Telecare
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
Molly Frances Battistelli, Sara Magnusson, M Antonia Biggs, Lori Freedman
CONTEXT: Access to abortion care in the United States varies according to multiple factors, including location, state regulation and provider availability. In 2013, California enacted a law that authorized nurse practitioners (NPs), certified nurse-midwives (CNMs) and physician assistants (PAs) to provide first-trimester aspiration abortions; little is known about organizations' experiences in implementing this policy change. METHODS: Beginning 10 and 24 months after implementation of the new law, semistructured interviews were conducted with 20 administrators whose five organizations trained and employed NPs, CNMs and PAs as providers of aspiration abortions...
February 14, 2018: Perspectives on Sexual and Reproductive Health
J P Cruz, F Alshammari, R F D Felicilda-Reynaldo
AIM: This study aimed to investigate the predictors of Saudi nursing students' attitudes towards the environment and sustainability in health care. BACKGROUND: With rising temperature and decreasing annual rainfall, Saudi Arabia is threatened by the harmful effects of climate change on its population. In response to these threats, the Ministry of Health adapted sustainable development and environmental preservation in their National E-Health strategy. INTRODUCTION: To implement these policies successfully, healthcare practitioners should be educated on how climate change could impact human health negatively...
February 9, 2018: International Nursing Review
Ali Asghar Shouryabi, Alireza Ghahrisarabi, Sima Zohari Anboohi, Malihe Nasiri, Maryam Rassouli
Background: Nursing competence is highly related to patient outcomes and patient safety issues, especially in intensive care units. Competence assessment tools are needed specifically for intensive care nursing. Objective: This study was performed to determine psychometric properties of the Intensive and Critical Care Nursing Competence Scale version-1 between Iranian Nurses. Methods: The present study was a methodological research in which 289 nurses of Intensive Care Units from nine hospitals in Shahid Beheshti University of Medical Sciences in Tehran were selected between 2015 and 2016...
November 2017: Electronic Physician
Bridget Laging, Amanda Kenny, Michael Bauer, Rhonda Nay
AIM: To explore the recognition and assessment of resident deterioration in the nursing home setting. BACKGROUND: There is a dearth of research exploring how nurses and personal-care-assistants manage a deteriorating nursing home resident. DESIGN: Critical ethnography. METHODS: Observation and semi-structured interviews with 66 participants (residents, family, nurses, personal-care-assistants and general practitioners) in two Australian nursing homes...
February 3, 2018: Journal of Clinical Nursing
Lisa Lestishock, Alison Moriarty Daley, Patience White
INTRODUCTION: This study examined the perspectives of pediatric nurse practitioners (PNPs) regarding the needs of adolescents, parents/caregivers, clinicians, and institutions in the health care transition (HCT) process for adolescents/young adults. METHODS: PNPs (N = 170) participated in a luncheon for those interested in transition at an annual conference. Small groups discussed and recorded their perspectives related to health care transition from adolescent to adult services...
January 12, 2018: Journal of Pediatric Health Care
Sam Porter, Tracey McConnell, Mike Clarke, Jenny Kirkwood, Naomi Hughes, Lisa Graham-Wisener, Joan Regan, Miriam McKeown, Kerry McGrillen, Joanne Reid
BACKGROUND: Music therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK). METHODS: Using a realistic evaluation approach, we conducted a qualitative study using a variety of approaches...
December 8, 2017: BMC Palliative Care
Adam J Singer, Susan Wilson
Nonvitamin K antagonist oral anticoagulants have advantages compared with warfarin, but both types of anticoagulants come with uncertainty about how best to manage life-threatening bleeding events, urgent surgeries, and invasive procedures. Nurse practitioners and physician assistants may need to manage such emergency situations in the critical care setting. Achieving hemostasis quickly is key, and efforts to do so have relied mainly on blood products. Targeted reversal agents are in clinical development and one, idarucizumab, which reverses dabigatran anticoagulation, has been approved...
2017: AACN Advanced Critical Care
Yolanda Keys, Jaynelle F Stichler
Intensive care units (ICUs) exist to serve as a safe place for critically ill patients to receive care from skilled practitioners. In this qualitative study, ICU nurses shared their perspectives on elements that promote safety and security on their units. After obtaining institutional review board approval, participants participated in telephone interviews with a nurse researcher who has experience as a bedside ICU nurse. Five categories and 14 themes were identified and then confirmed using member checking...
January 2018: Critical Care Nursing Quarterly
Javier J Lasa, Parag Jain, Tia T Raymond, Charles G Minard, Alexis Topjian, Vinay Nadkarni, Michael Gaies, Melania Bembea, Paul A Checchia, Lara S Shekerdemian, Ravi Thiagarajan
OBJECTIVES: Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. DESIGN: A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation...
February 2018: Pediatric Critical Care Medicine
Rachael Ryan, Christine O'Farrelly, Paul Ramchandani
This paper reviews parenting programmes and their effectiveness with families of young children and highlights additional resources for primary care practitioners. Typically, 30% of GP consultations concern child behaviour problems and established behaviour problems can have lasting effects on children's life chances. These problems can be identified in infancy and toddlerhood.Parenting is a key risk factor in their development and maintenance, yet is also amenable to change. In this paper we consider six parenting programmes that are widely evaluated and/or available in the U...
November 2017: London Journal of Primary Care
Himani Pandya, Wiedaad Slemming, Haroon Saloojee
The Integrated Management of Childhood Illness (IMCI) strategy has been adopted by 102 countries including South Africa, as the preferred primary health care (PHC) delivery strategy for sick children under 5 years. Despite substantial investment to support IMCI in South Africa, its delivery remains sub-optimal, with varied implementation in different settings. There is scarce research globally, and in the local context, examining the effects of health system characteristics on IMCI implementation. This study explored key determinants of IMCI delivery in a South African province, with a specific focus on health system building blocks using a health system dynamics framework...
November 17, 2017: Health Policy and Planning
Shirlee M Drayton-Brooks, Paula A Gray, Nichole P Turner, Jamesetta A Newland
Building clinical education training capacity in nurse practitioner programs is critical to build the primary care workforce and to address the access to care problem in the country. Challenges related to obtaining clinical sites and qualified preceptors are well reported, but few practical solutions are presented. Clinical sites and qualified preceptors willing to serve can be found, but nurse practitioner faculty must remove obstacles and strengthen resources by discovering untapped capacity. Nurse practitioner faculty can design, implement, and test innovative clinical models to maximize clinical training capacity...
November 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
Jorun E Thoma, Marion A Waite
AIMS AND OBJECTIVES: Purpose of this study was to gain knowledge of Nurse Case Managers' (NCM) experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role. Further to learn about patients' assignment to the management of the NCMs. Explicitly, to explore critical incidences of interactions between NCM, patients and health care practitioner in discharge planning to understand the factor that contributes to effective collaboration...
November 17, 2017: Journal of Clinical Nursing
Eran Shavit, Afsaneh Alavi, R Gary Sibbald
GENERAL PURPOSE: To provide information about pyoderma gangrenosum (PG), including pathophysiology, diagnostic criteria, and treatment. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to: ABSTRACT: Pyoderma gangrenosum (PG) is an uncommon cutaneous disease, presenting with recurrent painful ulcerations most commonly on the lower extremities...
December 2017: Advances in Skin & Wound Care
Michelle Pardee, Elizabeth Kuzma, Chin Hwa Gina Y Dahlem, Nicole Boucher, Cynthia S Darling-Fisher
BACKGROUND AND PURPOSE: Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed...
November 15, 2017: Journal of the American Association of Nurse Practitioners
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