Nurse practitioner productivity

BACKGROUND: Hospital strategies aimed at increasing quality of care and simultaneously reducing costs show potential to improve healthcare, but knowledge on real-world effectiveness is limited. In 2014, two Dutch hospitals introduced such quality-driven strategies. Our aim was to evaluate contexts, mechanisms, and outcomes of both strategies using multiple perspectives. METHODS: We conducted a mixed methods evaluation. Four streams of data were collected and analysed: (1) semi-structured interviewing of 62 stakeholders, such as medical doctors, nurses, managers, general practitioners (GPs), and consultants; (2) financial statements of both organisations and other hospitals in the Netherlands (counterfactual); (3) national database of quality indicators, and patient-reported experiences; and (4) existing material on strategy development and effects...

AIMS: This study offers an empirical exploration of self-assessed digital competencies of students, most of whom studied in nursing courses, using a discipline-based self-assessment survey tool. A range of digital competencies were explored: information and communication technology proficiency and productivity, information literacy, digital creation, digital research, digital communication, digital learning and development, digital innovation, digital identity management and digital well-being...

BACKGROUND: Nurses in tertiary hospitals are at high risk for depression. Understanding sleep quality and perceived stress may contribute to nurses' mental health and health-related nursing productivity. The aim of this study was to investigate the role of sleep quality and perceived stress on depressive symptoms among nurses in tertiary hospitals. METHODS: A total of 2,780 nurses (overall response rate = 91.1%) were recruited through a cross-sectional survey in 23 tertiary hospitals in China...

The World Health Organization (2019) has determined that patient safety is a global public health challenge. In UK clinical areas, policies and procedures are in place for the safe prescribing and delivery of blood and blood product transfusions, yet patient safety incidences continue. Undergraduate nurse education and training may provide the underlying knowledge to practitioners, while postgraduate standalone training sessions support skill development. However, over time, without regular experience, competence will diminish...

Telehealth is commonly used in nursing in recent years; however, there is a lack of information on hotspots and global trends over time. This study aimed to analyze the bibliometric patterns of telehealth research in nursing. This is a descriptive bibliometric study. Data were obtained from Web of Science Core Collection. CiteSpace version 6.1.R6 was used to perform analysis. The co-occurrence and co-citation analyses were conducted. A total of 1365 articles were analyzed. A total of 354 authors and 352 institutions from 68 countries have contributed telehealth research in nursing...

Background Economic evaluation has become an essential decision-making tool for health systems worldwide. This study was aimed at estimating the difference in the use of healthcare resources, days on sick leave, and costs between patients undergoing a standard-volume versus a low-volume ultrasound-guided interscalene brachial plexus block. Methods This is a post-hoc cost analysis of a double-blind, randomized, and controlled clinical trial. Forty-eight patients undergoing ultrasound-guided interscalene block received either 10 ml or 20 ml of levobupivacaine 0...

BACKGROUND: Persistent job-related stress can be harmful to physical and mental health and has a sizable financial burden on society. Face-to-face interventions are effective in reducing stress but have the disadvantage of high costs and time requirements. mHealth solutions may be an effective alternative to provide stress management interventions at work. Occupational health professionals need information on which mHealth apps are effective for employees to manage job-related stress...

Recent advances in molecular diagnostics have led to the characterization of an increasing number of actionable genomic alterations and immune-based signatures, which have facilitated the development of many highly effective cancer therapies. In addition to their prognostic value, some of these biomarkers have been shown to have predictive value and have had a significant impact on clinical decision-making. The presence of these therapeutic targets can thus aid health-care professionals to select the optimal therapies and avoid use of ineffective, potentially toxic ones...

A training program was developed to prepare registered nurses (RNs) at one cellular therapy centre to administer cryopreserved cells by intravenous (IV) push method. There are two main methods of infusion for dimethyl sulfoxide (DMSO) cryopreserved hematopoietic stem cell (HSC) products, gravity drip and IV push. Administering DMSO by either route can cause hypersensitivity reactions. Administration of HSCs by gravity drip is slower, resulting in fewer DMSO reactions. However, prolonged exposure of DMSO once the cells are thawed increases the risk of cellular damage...

OBJECTIVES: This study explored the experience of delivering care remotely among practitioners in a UK geriatric medicine clinic. METHODS: Nine semi-structured interviews were conducted with consultants (n = 5), nurses (n = 2), a speech and language and an occupational therapist, and thematically analysed. RESULTS: Four themes developed; Challenges of remote consultations; Perceived advantages of remote consultations; Disruption of involvement of family members; Impact on care staff...

OBJECTIVES: To navigate the field of digital cancer care and define and discuss key aspects and applications of big data analytics, artificial intelligence (AI), and data-driven interventions. DATA SOURCES: Peer-reviewed scientific publications and expert opinion. CONCLUSION: The digital transformation of cancer care, enabled by big data analytics, AI, and data-driven interventions, presents a significant opportunity to revolutionize the field...

BACKGROUND: With the COVID-19 pandemic, there was an increase and scaling up of provider-to-provider telemedicine programs that connect frontline health providers such as nurses and community health workers at primary care clinics with remote doctors at tertiary facilities to facilitate consultations for rural patients. Considering this new trend of increasing use of telemedicine, this study was conducted to generate evidence for patients, health providers, and policymakers to compare if provider-to-provider telemedicine-based care is equivalent to in-person care and is safe and acceptable in terms of diagnostic and treatment standards...

In many countries, policies have explicitly encouraged primary care teams and inter-professional cooperation and skill mix, as a way to improve both productive efficiency gains and quality improvement. France faces barriers to developing team working as well as new and more advanced roles for health care professionals including nurses. We aim to estimate the impact of a national pilot experiment of teamwork between general practitioners (GPs) and advance practitioners nurses (APN)-who substitute and complement GPs-on yearly quality of care process indicators for type two diabetes patients (T2DP)...

BACKGROUND: There is no consensus on the best intervention for topical management of bleeding in malignant wounds. Although surgical hemostatic dressings are recommended, the use of calcium alginate (CA) is frequent among practitioners. OBJECTIVE: The aim of this study was to evaluate the hemostatic efficacy of oxidized regenerated cellulose (ORC) and CA dressing in the management of bleeding from malignant wounds resulting from breast cancer. METHODS: This was a randomized open clinical trial...

Evidence suggests that blood transfusion errors tend to occur because of an external stimulus, limiting control for the professional administering it. Whether it be cognitive bias, human traits, organisational or human factors, errors should be prevented because they put the safety of the patient at risk from major morbidity and mortality. The authors explored the literature that looked at the blood transfusion errors that occur, suggesting interventions that may have a positive impact on patient safety. A review of the literature was undertaken using key words and limiters to focus the search...

GOALS: Despite the proliferation of over 45 000 smartphone mobile health applications (MHAs), as far as we know, there is no MHA for those living with rare diseases such as Bladder Exstrophy-Epispadias-Cloacal Exstrophy complex (BEEC). We hypothesized that an MHA could provide similar "on-demand" information and connectivity within health communities for patients with BEEC as they do for more common diseases. Thus, our primary goal was to create an MHA for patients and families affected by BEEC to provide them with important information about the condition and a format for them to connect with other affected patients and families...

BACKGROUND: Clinical trials (CTs) test new medical products for safety and effectiveness. Despite federal policy aimed at generating greater inclusivity of people of color (POC) in CTs, disparity in (CT) enrollment persists. Non-Hispanic White patients comprise the majority of CT participants while Black and Hispanic patient participation has declined over the past decade. The scope of Clinical Research Nurses (CRNs) includes recruitment of participants for CTs. The aim of this phenomenological study was to describe adult oncology CRNs' lived experiences of recruiting POC cancer patients to participate in CTs...

Pressure ulcer (PU) prevention is a high priority for health professionals in all settings. While PU incidence is expected to rise given the ageing population in the UK and Europe, PUs can occur in people of any age. It is therefore imperative that all practitioners know about the causes and consequences of PUs and be aware of up-to-date guidance on the prevention and management in patients who have developed a PU or who are at risk of developing a PU. Health professionals should also be aware of preventive equipment highlighted in national and local guidance, prevention strategies and protocols...

BACKGROUND: Many new graduate primary care physician assistants (PAs) and nurse practitioners (NPs) can experience stress and difficulty as they transition to practice. Feelings of anxiety and role ambiguity are common and can lead to costly turnover, impact care continuity, and place patients at risk for poor clinical outcomes. Onboarding, the process of helping new hires adjust to social and performance aspects of their new job and has the potential to ease transition to practice for PAs and NPs...

In recent years, chimeric antigen receptor (CAR) T-cell therapy has emerged as an effective and potentially paradigm-shifting therapy for patients with refractory lymphoma and myeloma. This novel therapy involves engineering T cells to recognize specific antigens on the surface of cancer cells. Several CAR T-cell products are approved by the US Food and Drug Administration as a result of numerous clinical trials. Due to the complexity of these studies and the high level of care required for CAR T-cell therapy patients, the role of the research advanced practice provider (APP) has become increasingly central to the success of CAR T-cell trials...