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https://www.readbyqxmd.com/read/28445324/nurse-practitioner-physician-comanagement-of-primary-care-patients-the-promise-of-a-new-delivery-care-model-to-improve-quality-of-care
#1
Allison Andreno Norful, Kyleen Swords, Mickaela Marichal, Hwayoung Cho, Lusine Poghosyan
BACKGROUND: The U.S. primary care system is under tremendous strain to deliver care to an increased volume of patients with a concurrent primary care physician shortage. Nurse practitioner (NP)-physician comanagement of primary care patients has been proposed by some policy makers to help alleviate this strain. To date, no collective evidence demonstrates the effects of NP-physician comanagement in primary care. PURPOSE: This is the first review to synthesize all available studies that compare the effects of NP-physician comanagement to an individual physician managing primary care...
April 25, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28427444/interventions-to-reduce-wait-times-for-primary-care-appointments-a-systematic-review
#2
Dominique Ansell, James A G Crispo, Benjamin Simard, Lise M Bjerre
BACKGROUND: Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28413842/-i-do-not-have-time-is-there-a-handout-i-can-use-combining-physicians-needs-and-behavior-change-theory-to-put-physical-activity-evidence-into-practice
#3
R E Clark, C McArthur, A Papaioannou, A M Cheung, J Laprade, L Lee, R Jain, L M Giangregorio
Guidelines for physical activity exist and following them would improve health. Physicians can advise patients on physical activity. We found barriers related to physicians' knowledge, a lack of tools and of physician incentives, and competing demands for limited time with a patient. We discuss interventions that could reduce these barriers. INTRODUCTION: Uptake of physical activity (PA) guidelines would improve health and reduce mortality in older adults. However, physicians face barriers in guideline implementation, particularly when faced with needing to tailor recommendations in the presence of chronic disease...
April 17, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28392674/interventions-to-improve-the-response-of-professionals-to-children-exposed-to-domestic-violence-and-abuse-a-systematic-review
#4
William Turner, Marianne Hester, Jonathan Broad, Eszter Szilassy, Gene Feder, Jessica Drinkwater, Adam Firth, Nicky Stanley
Exposure of children to domestic violence and abuse (DVA) is a form of child maltreatment with short- and long-term behavioural and mental health impact. Health care professionals are generally uncertain about how to respond to domestic violence and are particularly unclear about best practice with regards to children's exposure and their role in a multiagency response. In this systematic review, we report educational and structural or whole-system interventions that aim to improve professionals' understanding of, and response to, DVA survivors and their children...
January 2017: Child Abuse Review
https://www.readbyqxmd.com/read/28364578/physician-associates-in-primary-health-care-in-england-a-challenge-to-professional-boundaries
#5
Vari M Drennan, Jonathon Gabe, Mary Halter, Simon de Lusignan, Ros Levenson
Like other health care systems, the National Health Service (NHS) in England has looked to new staffing configurations faced with medical staff shortages and rising costs. One solution has been to employ physician associates (PAs). PAs are trained in the medical model to assess, diagnose and commence treatment under the supervision of a physician. This paper explores the perceived effects on professional boundaries and relationships of introducing this completely new professional group. It draws on data from a study, completed in 2014, which examined the contribution of PAs working in general practice...
May 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28360245/listening-to-paediatric-primary-care-nurses-a-qualitative-study-of-the-potential-for-interprofessional-oral-health-practice-in-six-federally-qualified-health-centres-in-massachusetts-and-maryland
#6
Judith Bernstein, Christina Gebel, Clemencia Vargas, Paul Geltman, Ashley Walter, Raul Garcia, Norman Tinanoff
OBJECTIVES: To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. SAMPLE: Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28350364/are-brief-alcohol-interventions-adequately-embedded-in-uk-primary-care-a-qualitative-study-utilising-normalisation-process-theory
#7
Amy O'Donnell, Eileen Kaner
Despite substantial evidence for their effectiveness, the adoption of alcohol screening and brief interventions (ASBI) in routine primary care remains inconsistent. Financial incentive schemes were introduced in England between 2008 and 2015 to encourage their delivery. We used Normalisation Process Theory-informed interviews to understand the barriers and facilitators experienced by 14 general practitioners (GPs) as they implemented ASBI during this period. We found multiple factors shaped provision. GPs were broadly cognisant and supportive of preventative alcohol interventions (coherence) but this did not necessarily translate into personal investment in their delivery (cognitive participation)...
March 28, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28339494/facility-type-and-primary-care-performance-in-sub-district-health-promotion-hospitals-in-northern-thailand
#8
Nithra Kitreerawutiwong, Sue Jordan, David Hughes
BACKGROUND: Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28331972/safe-sleeping-positions-practice-and-policy-for-babies-with-cleft-palate
#9
Karen Davies, Iain A Bruce, Patricia Bannister, Peter Callery
Guidance recommends 'back to sleep' positioning for infants from birth in order to reduce the risk of sudden infant death. Exceptions have been made for babies with severe respiratory difficulties where lateral positioning may be recommended, although uncertainty exists for other conditions affecting the upper airway structures, such as cleft palate. This paper presents research of (i) current advice on sleep positioning provided to parents of infants with cleft palate in the UK; and (ii) decision making by clinical nurse specialists when advising parents of infants with cleft palate...
March 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28294293/current-barriers-and-potential-strategies-to-increase-the-use-of-long-acting-reversible-contraception-larc-to-reduce-the-rate-of-unintended-pregnancies-in-australia-an-expert-roundtable-discussion
#10
Danielle Mazza, Deborah Bateson, Meredith Frearson, Philip Goldstone, Gab Kovacs, Rod Baber
BACKGROUND: Australia's abortion rates are among the highest in the developed world. Efficacy of the most commonly used form of contraception (oral contraceptives and condoms) relies on regular user compliance. Long-acting reversible contraception (LARC) virtually eradicates contraceptive failure as it is not user-dependent; however, its uptake has been low. AIM: To provide an overview of barriers to LARC use in Australia and potential strategies to overcome these barriers...
March 10, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28290256/preparing-the-sexual-health-workforce-to-deliver-integrated-services-is-education-the-answer-a-qualitative-study-exploring-the-impact-of-sexual-health-education-on-developing-integrated-policy-and-practice
#11
Judy Brook, Debra Salmon, Rachael-Anne Knight
Aim This study aimed to explore the ability of sexual health nurses working in the South West of England, to implement new learning within existing sexual health service delivery models. Drawing on Lipsky's account of street-level bureaucracy to conceptualise policy implementation, the impact of workforce learning on the development of integrated services across this region of the United Kingdom was assessed. BACKGROUND: In order to achieve the United Nations' goal of universal access to sexual health, it is essential for reproductive and sexual health, including HIV provision, to integrate into a single service...
March 14, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28287020/exploring-informal-workplace-learning-in-primary-healthcare-for-continuous-professional-development
#12
Viktoria Joynes, Micky Kerr, Tamsin Treasure-Jones
BACKGROUND AND OBJECTIVES: All health and social care professionals learn on the job through both formal and informal learning processes, which contributes to continuous professional development (CPD). This study explored workplace learning in General Practices, specifically looking at the role of informal learning and the workplace practices that appear to support or restrict that learning, as well as how technology was integrated into these learning processes. METHODS: Three focus groups with general practitioners, practice nurses, managerial and administrative staff were conducted followed by twelve individual semi-structured interviews with participants drawn from the focus groups...
March 12, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28252511/nurse-practitioner-prescriptive-authority-for-buprenorphine-from-data-2000-to-cara-2016
#13
Katherine S Fornili, Susanne A Fogger
The aim of this Policy Watch column is to provide an update on a much anticipated legislation, enacted in 2016, which enabled office-based opioid treatment (OBOT) with buprenorphine prescribing for the treatment of opioid addiction by nurse practitioners (as well as physician assistants). First, an overview of the Drug Addiction Treatment Act of 2000, which only permitted OBOT prescribing by physicians, will be described. It will be followed by a summary of the Recovery Enhancement for Addiction Treatment Act of 2015-2016...
January 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/28213902/professional-identity-of-korean-nurse-practitioners-in-the-united-states
#14
Kumsook Seo, Miyoung Kim
BACKGROUND: Despite nurse practitioners' (NPs) professional identity having important implications for the confirmation of nursing practice characteristics, few studies have examined the professional identity of NPs overlaid with the immigrant experience. PURPOSE: The aim of this study was to explore the career characteristics of Korean nurse immigrants who became NPs in the United States. METHODS: Seven Korean NPs in the United States underwent in-depth interviews from August 2013 to May 2015...
February 17, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28192033/seven-foundational-principles-of-population-health-policy
#15
Dru Bhattacharya, Jay Bhatt
In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels...
February 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28181218/collaborative-hiv-care-in-primary-health-care-nurses-views
#16
R N Ngunyulu, M D Peu, F M Mulaudzi, M L S Mataboge, S S Phiri
BACKGROUND: Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. AIM: To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. METHOD: A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria...
February 9, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28173766/factors-influencing-decision-of-general-practitioners-and-managers-to-train-and-employ-a-nurse-practitioner-or-physician-assistant-in-primary-care-a-qualitative-study
#17
Mieke van der Biezen, Emmy Derckx, Michel Wensing, Miranda Laurant
BACKGROUND: Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28162784/considering-disparities-how-do-nurse-practitioner-regulatory-policies-access-to-care-and-health-outcomes-vary-across-four-states
#18
Andréa Sonenberg, Hillary J Knepper
Health disparities persist among morbidity and mortality rates in the United States. Contributing significantly to these disparities are the ability to pay for health care (largely, access to health insurance) and access to, and capacity of, the primary care health workforce. This article examines key determinants of health (DOH) including demographics, public and regulatory policies, health workforce capacity, and primary health outcomes of four states of the United States. The context of this study is the potential association among health care disparities and myriad DOH, among them, the restrictive nurse practitioner (NP) scope of practice (SOP) regulatory environment, which are documented to influence access to care and health outcomes...
November 1, 2016: Nursing Outlook
https://www.readbyqxmd.com/read/28155298/use-of-physical-restraint-in-hospital-patients-a-descriptive-study-in-a-tertiary-hospital-in-south-africa
#19
Sebastiana Z Kalula, Sabela G Petros
BACKGROUND: The use of physical restraint in patient management is a common and emotive issue, and has legal and ethical dimensions. OBJECTIVE: To document the prevalence of physical restraint use, patient characteristics associated with physical restraint use, and nurses' and doctors' knowledge and perceptions towards the practice. METHODS: A cross-sectional study of 572 patients, of whom 132 were physically restrained, was conducted in acute wards of a tertiary hospital...
November 10, 2016: Curationis
https://www.readbyqxmd.com/read/28127773/does-the-regulatory-environment-affect-nurse-practitioners-patterns-of-practice-or-quality-of-care-in-health-centers
#20
Ellen T Kurtzman, Burt S Barnow, Jean E Johnson, Samuel J Simmens, Donna Lind Infeld, Fitzhugh Mullan
OBJECTIVE: To examine the impact of state-granted nurse practitioner (NP) independence on patient-level quality, service utilization, and referrals. DATA SOURCES/STUDY SETTING: The National Ambulatory Medical Care Survey's community health center (HC) subsample (2006-2011). Primary analyses included approximately 6,500 patient visits to 350 NPs in 220 HCs. STUDY DESIGN: Propensity score matching and multivariate regression analysis were used to estimate the impact of state-granted NP independence on each outcome, separately...
February 2017: Health Services Research
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