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Nurse practitioner productivity

Darlie Simerson
Despite the decline in traditional tobacco use among teens and young adults, the rapid increase in electronic cigarette (EC) use has filled the gap, raising concern that this will usher in a new generation of tobacco users. Although long-term effects have not been clearly established, EC use is not without risks or hazards that may be encountered by the advanced practice nurse in the emergency department (ED). The ED presents an opportune moment for health promotion and risk reduction education for patients and families, but there are also dangers to EC use that the practitioner should be aware of and prepared to manage...
January 2018: Advanced Emergency Nursing Journal
Adina S Gutstein, Tina Copple
BACKGROUND AND PURPOSE: Despite achievement of optimal low-density lipoprotein cholesterol (LDL-C) control with statin therapy, patients with elevated triglycerides (TGs) and residual cardiovascular risk are commonly encountered in clinical practice. METHODS: We present information from completed and ongoing clinical trials examining Rx omega-3s for TG-lowering and omega-3 dietary supplements to highlight important differences affecting patient management for nurse practitioners...
December 2017: Journal of the American Association of Nurse Practitioners
M D Stoneham, S Von Kier, L Harvey, M Murphy
OBJECTIVES: To investigate the impact of a dedicated cell salvage practitioner team on blood loss and allogeneic transfusion in abdominal aortic aneurysm (AAA) surgery. BACKGROUND: Cell salvage reduces allogeneic transfusion in AAA surgery, but is commonly performed by the anaesthetic nurse. At our hospital, a dedicated patient blood management practitioner is present for all elective open AAA repairs. METHODS/MATERIALS: Data were collected on 171 AAA patients operated on at the John Radcliffe Hospital, Oxford over a 3-year period, looking at the Patient Blood Management processes, including: blood loss, cell salvage, near-patient testing (thrombelastography) and transfusion rates of allogeneic blood products...
December 15, 2017: Transfusion Medicine
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
Trish A Gray, Jo C Dumville, Janice Christie, Nicky A Cullum
INTRODUCTION: People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services...
2017: PloS One
Annemarie Brown
Exudate has beneficial effects in normal wound healing but detrimental consequences for chronic wounds. Practitioners need to identify and treat its cause, and manage the exudate and prevent if from damaging periwound skin. Management involves dressings of the most appropriate absorbency and other products, and avoiding maceration of periwound skin; compression therapy is the gold standard treatment for treating oedema and venous leg ulceration. Nurses in acute settings may not have the skills to implement or maintain compression therapy; this article is intended for nurses who may have to manage these patients temporarily while they are admitted to secondary care and may not have the skills...
November 8, 2017: British Journal of Nursing: BJN
Cortnee Roman, Kara Menning
BACKGROUND AND PURPOSE: This review discusses the role of the nurse practitioner (NP) in evaluating the clinical effects, potential side effects, and monitoring requirements for treatment options in multiple sclerosis (MS) and provides guidance on how to help patients understand these issues. METHODS: A literature search was conducted on PubMed to identify publications on monitoring and disease management of MS patients. Additional resources included drug information web sites and package inserts...
October 2017: Journal of the American Association of Nurse Practitioners
Judy Haefner
The current article reviews selected complementary health approaches for the treatment of depressive symptoms. Complementary and integrative health (CIH) focuses on the whole person with the goal of optimal health-body, mind, and spirit. Patient use of integrative health practices and products is increasing; therefore, providers must understand these practices and products and be able to recommend or advise for or against their use based on research and guidelines. Difficulty with the current limitations of research on CIH practices is discussed, as these studies often may not have the same rigor or scientific weight as conventional treatment research...
December 1, 2017: Journal of Psychosocial Nursing and Mental Health Services
Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
November 2017: Journal of Pediatric Gastroenterology and Nutrition
Christi D DeLemos
In this month's Magnet® Perspectives column, the recipient of the 2016 Magnet Nurse of the Year® Award for New Knowledge, Innovations, and Improvements shares her journey to develop and disseminate a mobile application for nurses who care for neurological patients. "Neuroscience nurse" puts the latest, evidence-based information at the fingertips of nurses at the bedside in an effort to increase confidence when caring for patients with stroke, traumatic brain injury, and other neurological impairments.Nurse practitioner Christi DeLemos explains where she got the idea and how she went about implementing it...
September 2017: Journal of Nursing Administration
Subhash Tummala, Tarun Singhal, Vinit V Oommen, Gloria Kim, Fariha Khalid, Brian C Healy, Rohit Bakshi
Background: Monitoring patients with multiple sclerosis (MS) for “no evidence of disease activity” (NEDA) may help guide disease-modifying therapy (DMT) management decisions. Whereas surveillance brain magnetic resonance imaging (MRI) is common, the role of spinal cord monitoring for NEDA is unknown. Objective: To evaluate the role of brain and spinal cord 3T MRI in the 1-year evaluation of NEDA. Methods: Of 61 study patients (3 clinically isolated syndrome, 56 relapsing-remitting, 2 secondary progressive), 56 (91...
May 2017: International Journal of MS Care
Zanyiwe Vuso, Sindiwe James
AIM: To explore the perceptions of midwifery educators regarding effects of limited standardisation of midwifery clinical education and practice on clinical preparedness of midwifery students. BACKGROUND: Investigation of levels of clinical competency of students is a critical need in the current era. Such competency levels are especially important in midwifery practice in South Africa as there is a significant increase of maternal deaths and litigations in the country...
August 2017: Nurse Education Today
Tracie White, Justin Kokiousis, Stephanie Ensminger, Maria Shirey
In the United States, providing health care to critically ill patients is a challenge. An increase in patients older than 65 years, a decrease in critical care physicians, and a decrease in work hours for residents cause intensivist staffing issues. In this article, use of nurse practictioners to fill the intensive care unit intensivist staffing gap is assessed and evidence-based recommendations are identified to better incorporate nurse practitioners as part of intensive care unit intensivist staffing. The literature reveals that when nurse practitioners are part of a staffing model, outcomes are either positively impacted or no different from physician outcomes...
2017: AACN Advanced Critical Care
Jane E Frawley, Dennis Anheyer, Sandy Davidson, Debra Jackson
AIM: This study was conducted to evaluate the use of complementary and alternative medicine (CAM) among Australian children within the previous 12 months. METHODS: Parents with children up to the age of 18 years were recruited from online parenting groups. Questions addressed demographic factors, socio-economic status, conventional health service use, including vaccination status and use of CAM. RESULTS: A total of 149 parents responded to the study of which 73...
May 5, 2017: Journal of Paediatrics and Child Health
Kate Sitnikova, Stephanie S Leone, Lyonne N L Zonneveld, Harm W J van Marwijk, Judith E Bosmans, Johannes C van der Wouden, Henriëtte E van der Horst
BACKGROUND: Up to a third of patients presenting medically unexplained physical symptoms in primary care may have a somatoform disorder, of which undifferentiated somatoform disorder (USD) is the most common type. Psychological interventions can reduce symptoms associated with USD and improve functioning. Previous research has either been conducted in secondary care or interventions have been provided by general practitioners (GPs) or psychologists in primary care. As efficiency and cost-effectiveness are imperative in primary care, it is important to investigate whether nurse-led interventions are effective as well...
May 3, 2017: Trials
Emma Gregg
Aim The aim of this literature review was to explore the development of the role of specialist ophthalmic nurses in delivering ranibizumab intravitreal injections to patients with wet age-related macular degeneration (AMD), and to evaluate their contribution to reducing capacity pressures in medical retina services, while maintaining safe and effective standards of care. Method A systematic literature search was undertaken to identify relevant articles published between January 2000 and June 2015. A search of electronic databases was undertaken, and selected relevant journals were searched manually...
April 12, 2017: Nursing Standard
Loyd V Allen
Pharmaceutics is relevant far beyond the pharmaceutical industry, compounding, and the laboratory. Pharmaceutics can be used to solve many clinical problems in medication therapy. A pharmacists' knowledge of the physicochemical aspects of drugs and drug products should help the patient, physician, and healthcare professionals resolve issues in the increasingly complex world of modern medicine. Pharmacy is unique as it contains a knowledge base significantly different from that of physicians, nurses, and other health-related practitioners...
September 2016: International Journal of Pharmaceutical Compounding
Astrid Berland, Signe Berit Bentsen
AIMS AND OBJECTIVES: To explore registered nurses' experiences of medication errors and patient safety in home care. BACKGROUND: The focus of care for older patients has shifted from institutional care towards a model of home care. Medication errors are common in this situation and can result in patient morbidity and mortality. DESIGN: An exploratory qualitative design with focus group interviews was used. METHODS: Four focus group interviews were conducted with 20 registered nurses in home care...
November 2017: Journal of Clinical Nursing
Susan M Burke
No abstract text is available yet for this article.
March 2017: Journal of Pediatric Nursing
Mary G Lynch, April Maa, William Delaune, Joel Chasan, Glenn C Cockerham
OBJECTIVES: Eye care in the Veterans Affairs Health Care System is challenged with increasing demand and higher prevalence of patients with complex ocular conditions. Understanding factors that impact eye care productivity and access is necessary for appropriate allocation of resources. The purpose of this study was to determine the impact of various eye clinic personnel on eye care provider productivity and patient access. METHODS: Utilizing data from the Veterans Health Administration National Data Warehouse, workload and level of staffing were analyzed...
January 2017: Military Medicine
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