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Primary care nurse practitioner

Jane Desborough, Nasser Bagheri, Michelle Banfield, Jane Mills, Christine Phillips, Rosemary Korda
BACKGROUND: The numbers of nurses in general practice in Australia tripled between 2004 and 2012. However, evidence on whether nursing care in general practice improves patient outcomes is scarce. Although patient satisfaction and enablement have been examined extensively as outcomes of general practitioner care, there is little research into these outcomes from nursing care in general practice. The aim of this study was to examine the relationships between specific general practice characteristics and nurse consultation characteristics, and patient satisfaction and enablement METHODS: A mixed methods study examined a cross-section of patients from 21 general practices in the Australian Capital Territory...
October 17, 2016: International Journal of Nursing Studies
Madhav V Deo
A buzzword in Indian press and amongst the policy makers is that India is short of the WHO recommended doctor to population ratio of 1:1000. The recommendations were formulated to facilitate programs to achieve some of the health related UN-Millennium Development Goals (MDGs). Infections and malnutrition, which can be comfortably handled by a basic MBBS doctor, were the dominant health issues at the time of the formulation of the MDGs. However, all countries worldwide are going through health epidemiological transition and health impact of the non-communicable disorders (NCDs) can be no more ignored even by the low income nations...
October 2016: Journal of the Association of Physicians of India
Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
Oriol Yuguero, Josep Ramon Marsal, Montserrat Esquerda, Luis Vivanco, Jorge Soler-González
BACKGROUND: Burnout is a growing problem among healthcare professionals and may be mitigated and even prevented by measures designed to promote empathy and resilience. OBJECTIVES: We studied the association between burnout and empathy in primary care practitioners in Lleida, Spain and investigated possible differences according to age, sex, profession, and place of practice (urban versus rural). METHODS: All general practitioners (GPs) and family nurses in the health district of Lleida (population 366 000) were asked by email to anonymously complete the Maslach Burnout Inventory (MBI) and the Jefferson Scale of Physician Empathy (JSPE) between May and July 2014...
October 10, 2016: European Journal of General Practice
Nancy L Falk, Nancy Rudner, Deborah Chapa, Jessica Greene
BACKGROUND AND PURPOSE: Demand for primary care services is rising. Nurse practitioners (NPs) serve vital roles in meeting primary care demands. Workforce planning requires understanding NP retirement intentions. This study examines factors that relate to NPs, aged 55 years and older, and their intent to retire within 5 years. METHODS: We used the 2012 National Sample Survey of Nurse Practitioners to examine the relationship between NP demographic characteristics (gender, race/ethnicity, marital status, nursing degree), work environment characteristics (part-time vs...
October 7, 2016: Journal of the American Association of Nurse Practitioners
Sarah Tinkler, Rajiv Sharma, Sudeshna Pal, Raven Susu-Mago, Miron Stano
BACKGROUND AND PURPOSE: Access to primary care remains a problem for a substantial portion of the U.S. population, and is predicted to worsen due to an aging population and the increasing burden of chronic diseases. Better integration of nurse practitioners (NPs) into the primary care workforce is a possible solution. We examine offers of appointments with NPs if a requested primary care physician is unavailable. METHODS: Data are from a 2013 audit (simulated patient) study requesting appointment information from a national random sample of primary care physicians...
September 26, 2016: Journal of the American Association of Nurse Practitioners
Christine Petrin, Scott Kahan, M Turner, C Gallagher, W H Dietz
INTRODUCTION: Rates of obesity pharmacotherapy use, bariatric surgery and intensive behavioural counselling have been extremely low. OBJECTIVES: The primary objective of this study was to survey healthcare provider beliefs, practice and knowledge regarding obesity management. METHODS: Primary care physicians (PCPs), OB-GYN physicians and nurse practitioners (NPs) responded to a web-based survey related to drug therapy practice, bariatric surgery referral and reimbursement coding practice...
September 2016: Obesity Science & Practice
Lee A Lindquist, Rachel K Miller, Wayne S Saltsman, Jennifer Carnahan, Theresa A Rowe, Alicia I Arbaje, Nicole Werner, Kenneth Boockvar, Karl Steinberg, Shahla Baharlou
We assembled a cross-cutting team of experts representing primary care physicians (PCPs), home care physicians, physicians who see patients in skilled nursing facilities (SNF physicians), skilled nursing facility medical directors, human factors engineers, transitional care researchers, geriatricians, internists, family practitioners, and three major organizations: AMDA, SGIM, and AGS. This work was sponsored through a grant from the Association of Subspecialty Physicians (ASP). Members of the team mapped the process of discharging patients from a skilled nursing facility into the community and subsequent care of their outpatient PCP...
October 4, 2016: Journal of General Internal Medicine
Davorina Petek, Mitja Mlakar
BACKGROUND: A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone...
September 1, 2016: Zdravstveno Varstvo
Jane Winter, Sarah A McNaughton, Caryl A Nowson
Older people living in the community face unique nutritional issues that put them at risk of undernutrition, which is associated with increased morbidity and mortality. Primary healthcare staff such as general practitioners (GPs) and practice nurses (PNs) are well placed to identify nutritional problems early and intervene. The aim of this study was to understand the experiences and current practices in a sample of GPs and PNs with regards to nutritional care of elderly patients. An online survey of GPs and PNs working in regional Victoria was conducted...
October 4, 2016: Australian Journal of Primary Health
Javier Bartolomei, Rachel Baeriswyl-Cottin, David Framorando, Filip Kasina, Natacha Premand, Ariel Eytan, Yasser Khazaal
BACKGROUND: We aimed to assess the opinion of primary care workers, social workers, translators and mental health caregivers who work with asylum seekers about the latter's unmet needs and barriers to access to mental healthcare. METHODS: We used a Likert scale to assess the opinion of 135 primary care workers (general practitioners, nurses, social workers and translators) and mental health caregivers about the proportion of asylum seekers with psychiatric disorders, their priority needs and their main barriers to mental health services...
September 29, 2016: BMC Psychiatry
Kelsey Hegarty, Laura Tarzia, Leesa Hooker, Angela Taft
Experiences of domestic and sexual violence are common in patients attending primary care. Most often they are not identified due to barriers to asking by health practitioners and disclosure by patients. Women are more likely than men to experience such violence and present with mental and physical health symptoms to health practitioners. If identified through screening or case finding as experiencing violence they need to be supported to recover from these traumas. This paper draws on systematic reviews published in 2013-2015 and a further literature search undertaken to identify recent intervention studies relevant to recovery from domestic and sexual violence in primary care...
October 2016: International Review of Psychiatry
Fred C Eilrich
Revenues generated by physician assistants (PAs) and NPs in clinics and hospitals create employment opportunities and wages, salaries, and benefits for staff, which in turn are circulated throughout the local economy. An input-output model was used to estimate the direct and secondary effects of a rural primary care PA or NP on the community and surrounding area. This type of model explains how input/output from one sector of industry can be the output/input for another sector. Given two example scenarios, a rural PA or NP can have an employment effect of 4...
October 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Dana L Noffsinger, Susan R Johnson, Krista Wheeler, Junxin Shi, Huiyun Xiang, Jonathan I Groner
A pediatric nurse practitioner and an occupational therapist were impressed by the number and severity of treadmill-related hand burns encountered in their outpatient burn clinic. They observed that treadmill burns appeared to be deeper compared with other contact hand burns. Literature review revealed that research was inadequate in this area. A retrospective chart review was conducted, and a total of 384 patients were found to receive treatments at a regional level 1 pediatric burn center for treadmill and contact hand burns from 2010 to 2014...
September 20, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Nancy Carter, Esther Sangster-Gormley, Jenny Ploeg, Ruth Martin-Misener, Faith Donald, Abigail Wickson-Griffiths, Sharon Kaasalainen, Carrie McAiney, Kevin Brazil, Alan Taniguchi, Lori Schindel Martin
The aim of this paper is to explore the role and activities of nurse practitioners (NPs) working in long-term care (LTC) to understand concepts of access to primary care for residents. Utilizing the "FIT" framework developed by Penchanksy and Thomas, we used a directed content analysis method to analyze data from a pan-Canadian study of NPs in LTC. Individual and focus group interviews were conducted at four sites in western, central and eastern regions of Canada with 143 participants, including NPs, RNs, regulated and unregulated nursing staff, allied health professionals, physicians, administrators and directors and residents and family members...
2016: Nursing Leadership
Valerie Wing Yu Wong, Daniel Yee Tak Fong, Kris Yuet Wan Lok, Janet Yuen Ha Wong, Chu Sing, Alice Yin-Yin Choi, Carol Yuet Sheung Yuen, Marie Tarrant
BACKGROUND: Although pregnant women are the highest priority group for seasonal influenza vaccination, maternal influenza vaccination rates remain suboptimal. The purpose of this study was to evaluate the effect of a brief education intervention on maternal influenza vaccine uptake. METHODS: During the 2013-14 and 2014-15 influenza seasons, we recruited 321 pregnant women from the antenatal clinics of 4 out of 8 public hospitals in Hong Kong with obstetric services...
October 17, 2016: Vaccine
Antje Lindenmeyer, Sabi Redwood, Laura Griffith, Zaheera Teladia, Jenny Phillimore
OBJECTIVES: The main objectives of the study were to explore the experiences of primary care professionals providing care to recent migrants in a superdiverse city and to elicit barriers and facilitators to meeting migrants' care needs. This paper focuses on a strong emergent theme: participants' descriptions and understandings of creating a fit between patients and practices. DESIGN: An exploratory, qualitative study based on the thematic analysis of semistructured interviews...
2016: BMJ Open
Leonardo Méndez Boo, Ermengol Coma, Manuel Medina, Eduardo Hermosilla, Manuel Iglesias, Carmen Olmos, Sebastian Calero Muñoz, Johanna Caro Mendivelso
BACKGROUND: To determine the effectiveness of reminders compared to no reminders in improving adherence to multiple clinical recommendations measured as the resolution of the clinical condition that motivated the reminder, in a primary care setting with a well-established feedback system. METHODS/DESIGN: A 12-month, cluster-randomized, controlled clinical trial was designed (randomized by primary care team) to evaluate the impact of computerized reminders. All study participants will continue to receive the usual feedback from the electronic health records system...
2016: SpringerPlus
Bertrand Fougère, Stéphane Oustric, Julien Delrieu, Bruno Chicoulaa, Emile Escourrou, Yves Rolland, Fati Nourhashémi, Bruno Vellas
BACKGROUND: Aging can be affected by frailty and chronic diseases causing physical, cognitive, sensory, and functional decline evolving gradually to disability. The assessment of older patients is carried out in some geriatric day hospitals (GDHFs). However, it seems difficult to assess all patients in these GDHFs. In this context, a care model, which uses a specialist nurse trained in primary care and geriatric assessment, has been developed. In this article, we describe the organization, details of the evaluation, and provide the main characteristics of the first 200 patients assessed over a 6-month period...
September 16, 2016: Journal of the American Medical Directors Association
A J Benham, Kathleen A Geier, Susan Salmond
BACKGROUND: Musculoskeletal disorders affect a third of the U.S. population and are among the most prevalent, costly, and debilitating medical conditions. Basic familiarity with musculoskeletal conditions is essential for all primary care providers, including nurse practitioners (NPs). PURPOSE: The purpose of this study was: (1) to estimate the quantity of musculoskeletal education provided in NP programs; (2) to evaluate NPs' perceptions of their own confidence in providing musculoskeletal care versus other areas of primary care; and (3) to determine how well NPs score on a test of basic musculoskeletal knowledge...
September 2016: Orthopaedic Nursing
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