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Acute care nurse practitioner

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https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#1
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28040615/should-procedural-skills-be-a-part-of-the-acute-care-nurse-practitioner-curriculum
#2
Amita Avadhani
Invasive procedures are an integral component of the time sensitive management of the acute and critically ill patients. Acute Care Nurse Practitioner (ACNP) students aspiring to be employed in their roles in the acute care settings cannot be autonomous in their practices unless they have a minimum level of proficiency to perform life sustaining invasive procedures. Offering additional level of benefits of safety and quality in healthcare, simulation as a teaching method has grown in popularity among various levels of education among variety of disciplines...
March 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28012426/perceived-safety-and-efficacy-of-neuromuscular-blockers-for-acute-respiratory-distress-syndrome-among-medical-intensive-care-unit-practitioners-a-multicenter-survey
#3
Heather Torbic, Seth R Bauer, Heather A Personett, Amy L Dzierba, Joanna L Stollings, Lindsay P Ryder, Craig E Daniels, Sean M Caples, Erin N Frazee
PURPOSE: Neuromuscular blocking agents (NMBAs) are frequently used in patients with acute respiratory distress syndrome (ARDS). The purpose of this survey is to describe providers' knowledge and perceived efficacy and safety of NMBAs in patients with ARDS. MATERIALS AND METHODS: We performed a prospective, multicenter survey of medical intensive care unit intensivists, fellows, nurse practitioners (NPs), physician's assistants (PAs), and pharmacists at 5 tertiary care centers between July 2012 and May 2013...
December 7, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27973706/the-direct-observation-of-nurse-practitioner-care-study-an-overview-of-the-np-patient-visit
#4
Sharon M Weyer, Michelle L Cook, Lydia Riley
BACKGROUND AND PURPOSE: While there is a preponderance of studies that demonstrate the quality of nurse practitioner (NP) practice, little is known on the practice style of NPs. The Direct Observation of Nurse Practitioner Care study provided the first national direct observation and characterization of patient care delivered by primary care NPs. METHODS: The setting for this study was ambulatory care practices of NPs located throughout the United States. A nested sample was utilized, consisting of 22 NPs during visits with 245 patients...
December 14, 2016: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27926687/an-initiative-to-standardize-the-identification-of-and-acute-response-to-postoperative-lower-extremity-neurological-deficits-effects-on-provider-knowledge-confidence-and-communication-skills
#5
Peter B Derman, Sravisht Iyer, Matthew Garner, Steven Orr, Karla J Felix, Allison Goldberg, Titilayo Ologhobo, Minlun Wu, Laura Robbins, Charles Cornell
BACKGROUND: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. METHODS: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27919865/shared-decision-making-in-patients-with-low-risk-chest-pain-prospective-randomized-pragmatic-trial
#6
Erik P Hess, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M Montori
OBJECTIVE:  To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN:  Multicenter pragmatic parallel randomized controlled trial. SETTING:  Six emergency departments in the United States. PARTICIPANTS:  898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27918400/a-strategic-approach-for-developing-an-advanced-practice-workforce-from-postgraduate-transition-to-practice-fellowship-programs-and-beyond
#7
Dennis A Taylor, Britney S Broyhill, Allison M Burris, Mary Ann Wilcox
The healthcare provider landscape is rapidly changing. Given the imminent retirement of baby boomer physicians, implementation of the Affordable Care Act, and the increased utilization of health care services by an ever-aging population, the supply of providers cannot keep pace with the demand for services. This has led to an increased utilization of advanced clinical practitioners (ACPs). This article shows how one large highly-matrixed health care system approached identifying this workforce, and how thought leaders worked collaboratively with physicians, administrators, and ACPs to meet a growing demand for providers...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27894028/exploring-the-clinical-decision-making-used-by-experienced-cardiorespiratory-physiotherapists-a-mixed-method-qualitative-design-of-simulation-video-recording-and-think-aloud-techniques
#8
Debbie Thackray, Lisa Roberts
BACKGROUND: The ability of physiotherapists to make clinical decisions is a vital component of being an autonomous practitioner, yet this complex phenomenon has been under-researched in cardiorespiratory physiotherapy. The purpose of this study was to explore clinical decision-making (CDM) by experienced physiotherapists in a scenario of a simulated patient experiencing acute deterioration of their respiratory function. OBJECTIVES: The main objective of this observational study was to identify the actions, thoughts, and behaviours used by experienced cardiorespiratory physiotherapists in their clinical decision-making processes...
February 2017: Nurse Education Today
https://www.readbyqxmd.com/read/27876403/characterizing-the-high-risk-homebound-patients-in-need-of-nurse-practitioner-co-management
#9
Masha G Jones, Katherine A Ornstein, David M Skovran, Theresa A Soriano, Linda V DeCherrie
By providing more frequent provider visits, prompt responses to acute issues, and care coordination, nurse practitioner (NP) co-management has been beneficial for the care of chronically ill older adults. This paper describes the homebound patients with high symptom burden and healthcare utilization who were referred to an NP co-management intervention and outlines key features of the intervention. We compared demographic, clinical, and healthcare utilization data of patients referred for NP co-management within a large home-based primary care (HBPC) program (n = 87) to patients in the HBPC program not referred for co-management (n = 1027)...
November 19, 2016: Geriatric Nursing
https://www.readbyqxmd.com/read/27852879/examining-the-sources-of-occupational-stress-in-an-emergency-department
#10
S Basu, C Yap, S Mason
BACKGROUND: Previous work has established that health care staff, in particular emergency department (ED) personnel, experience significant occupational stress but the underlying stressors have not been well quantified. Such data inform interventions that can reduce cases of occupational mental illness, burnout, staff turnover and early retirement associated with cumulative stress. AIMS: To develop, implement and evaluate a questionnaire examining the origins of occupational stress in the ED...
December 2016: Occupational Medicine
https://www.readbyqxmd.com/read/27850790/1153-impact-on-quality-and-continuity-by-adding-acute-care-nurse-practitioners-to-a-level-i-trauma-icu
#11
William Cameron, Caroline Banes
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27846030/efficacy-of-monitoring-devices-in-support-of-prevention-of-pressure-injuries-systematic-review-and-meta-analysis
#12
Gurjot S Walia, Alison L Wong, Andrea Y Lo, Gina A Mackert, Hannah M Carl, Rachel A Pedreira, Ricardo Bello, Carla S Aquino, William V Padula, Justin M Sacks
GENERAL PURPOSE: To present a systematic review of the literature assessing the efficacy of monitoring devices for reducing the risk of developing pressure injuries. 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:1...
December 2016: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/27803809/experiences-of-hand-hygiene-among-acute-care-nurses-an-interpretative-phenomenological-analysis
#13
Sheryl L Chatfield, Rachael Nolan, Hannah Crawford, Jeffrey S Hallam
OBJECTIVE: Occurrences of healthcare-associated infections are associated with substantial direct and indirect costs. Improvement in hand hygiene among acute care nurses has potential to reduce incidence of healthcare-associated infections. Findings from reviews of intervention research have not conclusively identified components that are more or less efficient or effective. Much prior qualitative research has focused on descriptive analysis of policies and practices rather than providing interpretive explorations of how individuals' perceptions of hygiene might drive practices...
2016: SAGE Open Medicine
https://www.readbyqxmd.com/read/27792075/reducing-inappropriate-antibiotic-prescribing-for-adults-with-acute-bronchitis-in-an-urgent-care-setting-a-quality-improvement-initiative
#14
Tamara L Link, Mary L Townsend, Eugene Leung, Sekhar Kommu, Rhonda Y Vega, Cristina C Hendrix
Acute bronchitis is a predominantly viral illness and, according to clinical practice guidelines, should not be treated with antibiotics. Despite clear guidelines, acute bronchitis continues to be the most common acute respiratory illness for which antibiotics are incorrectly prescribed. Although the national benchmark for antibiotic prescribing for adults with acute bronchitis is 0%, a preliminary record review before implementing the intervention at the project setting showed that 96% (N = 30) of adults with acute bronchitis in this setting were prescribed an antibiotic...
October 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/27792072/unique-educational-needs-of-emergency-nurse-practitioners
#15
Vicki A Keough, Dina Tell, Colleen Andreoni, Paula Tanabe
The purpose of this study is to identify the unique educational needs of emergency nurse practitioners (ENPs). A survey from 167 nurse practitioners (NPs) practicing in the emergency department (ED) settings was analyzed. A variety of certified NPs practice in EDs: family NPs (30%), adult NPs (18%), acute care NPs (40%), and some with 2 or more certifications (12%). NPs come with a variety of basic educational preparations. The top educational needs specific to ENP preparation identified were managing critically ill patients, pharmacology, interpretation of laboratory tests, electrocardiograms, radiographs, and computed tomographic scans, suturing superficial lacerations, and mentoring by MDs and NPs...
October 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/27755226/discharge-of-non-acute-coronary-syndrome-chest-pain-patients-from-emergency-care-to-an-advanced-nurse-practitioner-led-chest-pain-clinic-a-cross-sectional-study-of-referral-source-and-final-diagnosis
#16
Shirley J Ingram, Gabrielle McKee, Mary B Quirke, Niamh Kelly, Ashling Moloney
BACKGROUND: Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). METHODS: The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge...
October 14, 2016: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27749686/implementation-of-the-neonatal-nurse-practitioner-role-in-a-community-hospital-s-labor-delivery-and-level-1-postpartum-unit
#17
Tara Follett, Sara Calderon-Crossman, Denise Clarke, Marcia Ergezinger, Christene Evanochko, Krystal Johnson, Natalie Mercy, Barbara Taylor
BACKGROUND: A level 1 community hospital with a labor, delivery, recovery, and postpartum (LDRP) unit delivering over 2800 babies per year was operating without dedicated neonatal resuscitation and stabilization support. PURPOSE: With lack of funding and space to provide an onsite level 2 neonatal intensive care unit (NICU), a position was created to provide neonatal nurse practitioner (NNP) coverage to support the LDRP unit. METHOD: The article describes the innovative solution of having an NNP team rotate from a regional neonatal intensive care program to a busy community LDRP unit...
October 4, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27706840/models-of-partnership-within-family-centred-care-in-the-acute-paediatric-setting-a-discussion-paper
#18
Christine Dennis, Pamela Baxter, Jenny Ploeg, Susan Blatz
AIMS: A discussion of partnership in the context of family-centred care in the acute paediatric setting, through a critical analysis of partnership models. BACKGROUND: Paediatric healthcare practitioners understand the importance of family-centred care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family-centred care, yet less is known about strategies to fully engage or support parents in these partnerships...
October 5, 2016: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/27692506/development-of-the-24-7-nurse-practitioner-model-on-the-inpatient-pediatric-general-surgery-service-at-a-large-tertiary-care-children-s-hospital-and-associated-outcomes
#19
Marketa Rejtar, Lee Ranstrom, Christina Allcox
Nurse practitioners (NPs) have been providing high-quality and safe patient care for a few decades, and evidence showing the extent of their impact is emerging. This article describes the implementation of a 24/7 NP patient care model on an inpatient pediatric general surgery service in a tertiary free-standing Children's Hospital in the Northeastern United States. The literature shows that there is limited evidence regarding NP models of care and their effect on patient outcomes. In response to policy changes leading to reduction of resident work hours and a more acute and complex inpatient pediatric general surgery patient population, our existing NP model evolved into a 24/7 NP Model in June 2011...
January 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/27666307/what-are-the-barriers-to-initiating-end-of-life-conversations-with-patients-in-the-last-year-of-life
#20
REVIEW
Alice Travers, Vanessa Taylor
INTRODUCTION: Improving end of life care is a national imperative. Unsatisfactory care persists particularly in acute hospitals, with shortcomings, variability in communication and advance care planning identified as fundamental issues. This review explored the literature to identify what is known about the barriers to initiating end-of-life conversations with patients from the perspective of doctors and nurses in the acute hospital setting. METHOD: Six electronic databases were searched for potentially relevant records published between 2008 and 2015...
September 2, 2016: International Journal of Palliative Nursing
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