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"Advanced Practice Provider"

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https://www.readbyqxmd.com/read/29781466/antiemetic-guidelines-using-education-to-improve-adherence-and-reduce-incidence-of-cinv-in-patients-receiving-highly-emetogenic-chemotherapy
#1
Corrine Mellin, Mallory Lexa, Ashley Leak Bryant, Susie Mason, Deborah K Mayer
BACKGROUND: With the development of increasingly effective antiemetic regimens, guideline adherence can prevent 70%-80% of chemotherapy-induced nausea and vomiting (CINV) in patients with cancer. OBJECTIVES: This quality improvement project aims to increase rates of adherence to national guidelines and, ultimately, decrease rates of CINV experienced by patients receiving highly emetogenic chemotherapy. METHODS: A retrospective chart analysis was performed...
June 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#2
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29759676/outcomes-associated-with-electrical-cardioversion-for-atrial-fibrillation-when-performed-autonomously-by-an-advanced-practice-provider
#3
Theresa A Strzelczyk, Rachel M Kaplan, Meena Medler, Bradley P Knight
OBJECTIVES: This study sought to determine the feasibility, safety, and efficacy of elective electrical cardioversion (CV) for atrial fibrillation (AF) when performed autonomously by a trained advanced practice provider (APP) using a guideline-directed protocol. BACKGROUND: APPs have emerged as an integral part of the cardiovascular team. METHODS: A licensed advanced practice nurse-clinical nurse specialist was trained and obtained credentials to perform CVs...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759257/developing-a-medical-scribe-program-at-an-academic-hospital-the-hennepin-county-medical-center-experience
#4
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29757817/brief-report-of-a-novel-advanced-practice-provider-led-course-for-ultrasound-novices
#5
Christan D Santos, Mariah Q Rose, Amanda D Tomlinson, Diane C McLaughlin
BACKGROUND AND PURPOSE: Formal training for ultrasound use is essential for critical care providers. Despite a national increase in the utilization of advanced practice providers in critical care, ultrasound education is not routinely provided in their training programs. This study describes and evaluates a 1-day advanced care provider (APP)-led course designed to provide fellow APPs with the skills to obtain and evaluate basic ultrasound images. METHODS: A 15-question pretest was administered via anonymous use of a clicker response system...
February 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29753519/state-of-the-national-emergency-department-workforce-who-provides-care-where
#6
M Kennedy Hall, Kevin Burns, Michael Carius, Mitchel Erickson, Jane Hall, Arjun Venkatesh
STUDY OBJECTIVE: We describe the current US emergency medicine workforce in terms of clinician type and examine rural and urban emergency medicine workforce differences. METHODS: Using the 2014 Medicare Public Use Files, we performed a cross-sectional study of all clinicians receiving reimbursement for evaluation and management (E/M) services (levels 1 to 5) to Medicare fee-for-service Part B beneficiaries in the emergency department. Providers were defined as emergency physicians, nonemergency physicians, or advanced practice providers, corresponding with the Medicare Public Use Files data set...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29708224/neurologic-provider-views-on-patient-reported-outcomes-including-depression-screening
#7
Irene L Katzan, Nicolas R Thompson, Cheryl Dunphy, John Urchek, Brittany Lapin
Background: We sought to assess neurologic provider satisfaction with the systematic electronic collection of patient-reported outcome measures (PROMs) for both disease-specific measures and depression screening (Patient Health Questionnaire [PHQ-9]). Methods: A web-based survey was sent to 299 staff physicians and advanced practice providers on the staff email list of a large group neurologic practice, of whom 206 used the PROM system. The survey consisted of 11 questions with Likert response options regarding perceived usefulness of PROM collection; usefulness of PROM data for clinical care, quality, and research activities according to provider age group and type; and perceived usefulness between disease-specific information and the PHQ-9 depression screen...
April 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29708218/stroke-code-simulation-benefits-advanced-practice-providers-similar-to-neurology-residents
#8
Muhib Khan, Grayson L Baird, Theresa Price, Tricia Tubergen, Omran Kaskar, Michelle De Jesus, Joseph Zachariah, Adam Oostema, Raymond Scurek, Robert R Coleman, Wendy Sherman, Cynthia Hingtgen, Tamer Abdelhak, Brien Smith, Brian Silver
Background: Advanced practice providers (APPs) are important members of stroke teams. Stroke code simulations offer valuable experience in the evaluation and treatment of stroke patients without compromising patient care. We hypothesized that simulation training would increase APP confidence, comfort level, and preparedness in leading a stroke code similar to neurology residents. Methods: This is a prospective quasi-experimental, pretest/posttest study. Nine APPs and 9 neurology residents participated in 3 standardized simulated cases to determine need for IV thrombolysis, thrombectomy, and blood pressure management for intracerebral hemorrhage...
April 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29708093/addressing-religion-and-spirituality-in-the-intensive-care-unit-a-survey-of-clinicians
#9
Philip J Choi, Farr A Curlin, Christopher E Cox
OBJECTIVE: Studies have shown that when religious and spiritual concerns are addressed by the medical team, patients are more satisfied with their care and have lower healthcare costs. However, little is known about how intensive care unit (ICU) clinicians address these concerns. The objective of this study was to determine how ICU clinicians address the religious and spiritual needs of patients and families. METHOD: We performed a cross-sectional survey study of ICU physicians, nurses, and advance practice providers (APPs) to understand their attitudes and beliefs about addressing the religious and spiritual needs of ICU patients and families...
April 30, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29694293/development-of-a-pharmacoeconomic-model-to-demonstrate-the-effect-of-clinical-pharmacist-involvement-in-diabetes-management
#10
Heather Ourth, Jordan Nelson, Patrick Spoutz, Anthony P Morreale
BACKGROUND: A data collection tool was developed and nationally deployed to clinical pharmacists (CPs) working in advanced practice provider roles within the Department of Veterans Affairs to document interventions and associated clinical outcomes. Intervention and short-term clinical outcome data derived from the tool were used to populate a validated clinical outcomes modeling program to predict long-term clinical and economic effects. OBJECTIVE: To predict the long-term effect of CP-provided pharmacotherapy management on outcomes and costs for patients with type 2 diabetes...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29683377/feasibility-and-acceptability-of-a-best-supportive-care-checklist-among-clinicians
#11
Nathan A Boucher, Jonathan Nicolla, Adeboye Ogunseitan, Elizabeth R Kessler, Christine S Ritchie, Yousuf Y Zafar
CONTEXT: Best supportive care (BSC) is often not standardized across sites, consistent with best evidence, or sufficiently described. We developed a consensus-based checklist to document BSC delivery, including symptom management, decision making, and care planning. We hypothesized that BSC can be feasibly documented with this checklist consistent with consolidated standards of reporting trials. OBJECTIVE: To determine feasibility/acceptability of a BSC checklist among clinicians...
April 23, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29667200/treatment-in-a-preventive-cardiology-clinic-utilizing-advanced-practice-providers-apps-effectively-closes-atherosclerotic-cardiovascular-disease-ascvd-risk-management-gaps-amongst-a-primary-prevention-population-compared-with-a-propensity-matched-primary-care
#12
Emilio Fentanes, Anthony G Vande Hei, R Scott Holuby, Norma Suarez, Yousif Slim, Jennifer N Slim, Ahmad M Slim, Dustin Thomas
BACKGROUND: Advanced Practice Providers (APPs) can fill access to care gaps created by physician shortages and improve adherence/compliance with preventive atherosclerotic cardiovascular disease (ASCVD) interventions. METHODS: We retrospectively reviewed data on 595 patients enrolled in a preventive cardiology clinic (PCC) utilizing APPs compared with a propensity-matched cohort (PMC) of 595 patients enrolled in primary care clinics alone. PCC patients were risk stratified using Framingham risk scoring (FRS) and coronary artery calcium scoring (CACS) and treated based on published guideline-based algorithms...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29628333/multidisciplinary-difficult-airway-course-an-essential-educational-component-of-a-hospital-wide-difficult-airway-response-program
#13
W Robert Leeper, Elliott R Haut, Vinciya Pandian, Sajan Nakka, Jeffrey Dodd-O, Nasir Bhatti, Elizabeth A Hunt, Mustapha Saheed, Nicholas Dalesio, Adam Schiavi, Christina Miller, Thomas D Kirsch, Lauren Berkow
OBJECTIVE: A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). DESIGN: The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management...
April 5, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29621072/a-comprehensive-onboarding-and-orientation-plan-for-neurocritical-care-advanced-practice-providers
#14
Tamra M Langley, Jeremy Dority, Justin F Fraser, Kevin W Hatton
BACKGROUND: As the role of advanced practice providers (APPs) expands to include increasingly complex patient care within the intensive care unit, the educational needs of these providers must also be expanded. An onboarding process was designed for APPs in the neurocritical care service line. METHODS: Onboarding for new APPs revolved around 5 specific areas: candidate selection, proctor assignment, 3-phased orientation process, remediation, and mentorship. To ensure effective training for APPs, using the most time-conscious approach, the backbone of the process is a structured curriculum...
April 4, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29605347/diagnosis-and-management-of-pediatric-sinusitis-a-survey-of-primary-care-otolaryngology-and-urgent-care-providers
#15
Laurie Newton, Amanda Kotowski, Melissa Grinker, Robert Chun
OBJECTIVES: The aims of this project were two-fold: 1) To assess pediatric primary care (PCP), pediatric otolaryngology (ENT) and pediatric urgent care (UC) providers' perception of their adherence to the 2013 American Academy of Pediatrics (AAP) established guidelines for the diagnosis and management of acute bacterial rhinosinusitis (ABRS) in children 1-18 years old and 2) to assess the same providers' practice patterns in the diagnosis and management of pediatric chronic rhinosinusitis (PCRS)...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29572814/a-person-centered-approach-to-poststroke-care-the-comprehensive-post-acute-stroke-services-model
#16
Cheryl D Bushnell, Pamela W Duncan, Sarah L Lycan, Christina N Condon, Amy M Pastva, Barbara J Lutz, Jacqueline R Halladay, Doyle M Cummings, Martinson K Arnan, Sara B Jones, Mysha E Sissine, Sylvia W Coleman, Anna M Johnson, Sabina B Gesell, Laurie H Mettam, Janet K Freburger, Blair Barton-Percival, Karen M Taylor, Janet Prvu-Bettger, Gladys Lundy-Lamm, Wayne D Rosamond
Many individuals who have had a stroke leave the hospital without postacute care services in place. Despite high risks of complications and readmission, there is no standard in the United States for postacute stroke care after discharge home. We describe the rationale and methods for the development of the COMprehensive Post-Acute Stroke Services (COMPASS) care model and the structure and quality metrics used for implementation. COMPASS, an innovative, comprehensive extension of the TRAnsition Coaching for Stroke (TRACS) program, is a clinician-led quality improvement model providing early supported discharge and transitional care for individuals who have had a stroke and have been discharged home...
March 23, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29561192/provider-practice-habits-and-barriers-to-care-in-obesity-management-in-a-large-multicenter-health-system
#17
Rebecca Simon, Sharon W Lahiri
OBJECTIVE: To identify provider recommendations and barriers in obesity management in a multicenter academic health system with extensive weight-loss management resources. METHODS: A 26-question online survey was sent to attending physicians, trainees, and advanced practice providers in primary care specialties (internal medicine, family medicine, women's health) and endocrinology. RESULTS: The survey response rate was 26% (111/430). Of respondents, 50% were internal medicine, 24% family medicine, 16% women's health, and 9% endocrinology...
March 21, 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29521734/aneurysmal-subarachnoid-hemorrhage-mortality-after-implementation-of-nocturnist-advanced-practice-provider-coverage
#18
Diane C McLaughlin, Margaret M Margretta, William D Freeman
INTRODUCTION: We hypothesized that a nocturnist advanced practice provider (APP) model compared with overnight neurocritical care coverage with general critical care physicians and neurology residents would provide similar patient outcomes, as measured by patient mortality. METHODS: This study is a retrospective review of healthcare outcomes of aneurysmal subarachnoid hemorrhage (aSAH) patients from 2013 and 2016, after implementation of specialty-trained neurocritical care nocturnist APPs...
April 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29521716/interprofessional-care-and-teamwork-in-the-icu
#19
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz, Kathleen Turner, Jayne McCullough, Jennifer Schwarz, Kathleen D Liu, Wendy Anderson, Raman Khanna, Priyanka Agarwal, Heidi Engel, Brian Daniel, Kelly Timothy, Amie Lencioni, Robert Newton, Trese Biagini, Megan Rathfon, Charlotte Garwood, Jenica Cimino, Min Zhu, Michael Blum, Alvin Rajkomar, Chetna Pathak
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
June 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29499361/post-discharge-opioid-prescribing-and-use-after-common-surgical-procedure
#20
Mayo H Fujii, Ashley C Hodges, Ruby L Russell, Kristin Roensch, Bruce Beynnon, Thomas P Ahern, Peter Holoch, Jesse S Moore, S Elizabeth Ames, Charles D MacLean
BACKGROUND: The number of deaths from prescription opioids in the US continues to increase and remains a major public health concern. Opioid-related deaths parallel prescribing trends, and postoperative opioids are a significant source of opioids in the community. Our objective was to identify opioid prescribing and use patterns after surgery to inform evidence-based practices. STUDY DESIGN: Data from a 340-bed academic medical institution and its affiliated outpatient surgical facility included retrospective medical record data and prospective telephone questionnaire and medical record data...
February 28, 2018: Journal of the American College of Surgeons
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