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"Advanced Practice Provider"

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
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
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...
March 7, 2018: Critical Care Medicine
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 United States continues to increase and remains a major public health concern. Opioid-related deaths parallel prescribing trends and post-operative opioids are a significant source of opioids in the community. Our objective was to identify opioid prescribing and use patterns after surgery to inform evidenced-based practices. STUDY DESIGN: Data from a 340-bed academic medical institution and its affiliated outpatient surgical facility included: 1) retrospective medical record data, 2) prospective telephone questionnaire and medical record data...
February 27, 2018: Journal of the American College of Surgeons
Sean S Michael, Kavita M Babu, Christopher Androski, Martin A Reznek
OBJECTIVE: Little is known about accuracy of provider self-perception of opioid prescribing. We hypothesized that an intervention asking emergency department (ED) providers to self-identify their opioid prescribing practices compared to group norms-and subsequently providing them with their actual prescribing data-would alter future prescribing compared to controls. METHODS: This was a prospective, multi-center randomized trial in which all attending physicians, residents, and advanced practice providers at four EDs were randomly assigned to either no intervention or a brief data-driven intervention during which providers were: (1) asked to self-identify and explicitly report to research staff their perceived opioid prescribing in comparison to their peers, and then (2) given their actual data with peer group norms for comparison...
March 2, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Travis F D Souza, Steven G Hoshal, Ridwaan Albeiruti, Mario P Zambito, Giuseppe M Zambito, Faizan M Khan, Bennett P Samuel, Teri L Crumb, Surender Rajasekaran, Joseph J Vettukattil
BACKGROUND: To develop an understanding of current practices in the management of transient secondary hypothyroidism in pediatric postoperative cardiopulmonary bypass (CPB) patients. METHODS: Electronic survey comprising a 10-item questionnaire was sent to sixty-four high volume pediatric heart centers in the United States and United Kingdom. Survey participants included cardiologist, intensivists, cardiothoracic surgeons, and advanced practice providers. A retrospective chart review was also performed at a large regional referral center in the Midwest on subjects 0-18 years old who underwent CPB from 2005-2015...
February 26, 2018: Current Cardiology Reviews
Moneeb Akhtar, Paul G Van Heukelom, Azeemuddin Ahmed, Rachel D Tranter, Erinn White, Nathaniel Shekem, David Walz, Catherine Fairfield, J Priyanka Vakkalanka, Nicholas M Mohr
BACKGROUND: Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. MATERIALS AND METHODS: This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED...
February 22, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Lara C Pullen
No abstract text is available yet for this article.
March 2018: American Journal of Transplantation
Gabrielle B Rocque, Courtney P Williams, Karina I Halilova, Uma Borate, Bradford E Jackson, Emily S Van Laar, Maria Pisu, Thomas W Butler, Randall S Davis, Amitkumar Mehta, Sara J Knight, Monika M Safford
New treatments for chronic lymphocytic leukemia (CLL) with excellent response rates and varying toxicity profiles have emerged in recent years, creating an opportunity for a patient's personal preferences to contribute to treatment decisions. We conducted a prospective, quasi-experimental pre- and post-evaluation of a multilevel educational program and its impact on knowledge of CLL and shared decision-making (SDM). We educated patients, lay navigators, nurses/advanced practice providers (APPs), and physicians...
January 30, 2018: Translational Behavioral Medicine
David S Wang
No abstract text is available yet for this article.
February 2018: Journal of Urology
Monica Slinkard Philipp, Jody Stonehocker
Team-based care in the outpatient women's health setting has the potential to help alleviate the demand for women's health care providers and to deliver improved quality of care to the growing population of US women. Although teamwork is necessary in the current health care system, most of the current obstetrics and gynecology and advanced practice provider (APP) workforce were not trained for collaborative practice. Core competencies for building an effective outpatient women's health care team are explained and current evidence regarding the specific role of APPs in women's health care is reviewed...
March 2018: Clinical Obstetrics and Gynecology
Ramona A Benkert, Ann Clifton
With the resurgence of tuberculosis (TB), it is imperative that healthcare providers have the necessary skills to manage the specialized issues of prevention, recognition, and treatment of TB. The case study in this article illustrates these skills for NPs and other advanced practice providers.
February 16, 2018: Nurse Practitioner
Nisha Narula, Bradford J Kim, Catherine H Davis, Whitney L Dewhurst, Leigh A Samp, Thomas A Aloia
BACKGROUND: After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. METHODS: Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge...
January 9, 2018: Surgery
Jennifer E Flythe, Julia H Narendra, Adeline Dorough, Jonathan Oberlander, Antoinette Ordish, Caroline Wilkie, Laura M Dember
BACKGROUND: Most prospective studies involving individuals receiving maintenance dialysis have been small, and many have had poor clinical translatability. Research relevance can be enhanced through stakeholder engagement. However, little is known about dialysis clinic stakeholders' perceptions of research participation and facilitation. The objective of this study was to characterize the perspectives of dialysis clinic stakeholders (patients, clinic personnel, and medical providers) on: (1) research participation by patients and (2) research facilitation by clinic personnel and medical providers...
December 19, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Matthew J Trombley, Andrea Hassol, Jennifer T Lloyd, Timothy G Buchman, Allison F Marier, Alan White, Erin Colligan
OBJECTIVE: To estimate the effect of implementing a tele-ICU and a critical care residency training program for advanced practice providers on service utilization and total Medicare episode spending. DATA SOURCES/STUDY SETTINGS: Medicare claims data for fee-for-service beneficiaries at 12 large, inpatient hospitals in the Atlanta Hospital Referral Region. STUDY DESIGN: Difference-in-differences design where changes in spending and utilization for Medicare beneficiaries eligible for treatment in participating ICUs was compared to changes in a comparison group of clinically similar beneficiaries treated at similar hospitals' ICUs in the same hospital referral region...
December 27, 2017: Health Services Research
Prasanna Ananth, Clement Ma, Hasan Al-Sayegh, Leah Kroon, Victoria Klein, Claire Wharton, Elise Hallez, Ilana Braun, Kelly Michelson, Abby R Rosenberg, Wendy London, Joanne Wolfe
BACKGROUND: Although medical marijuana (MM) may have utility in the supportive care of children with serious illness, it remains controversial. We investigated interdisciplinary provider perspectives on legal MM use in children with cancer. METHODS: We sent a 32-item, cross-sectional survey to 654 pediatric oncology providers in Illinois, Massachusetts, and Washington characterizing MM practices, knowledge, attitudes, and barriers. Forty-eight percent responded; 44% (n = 288) were included in analyses...
December 12, 2017: Pediatrics
Ravinder Kang, Jesse A Columbo, Samuel T Kunkel, Ryland S Stucke, Matthew J Sabatino, Austin Tang, Philip P Goodney, Kari M Rosenkranz
BACKGROUND: To ensure that residents are appropriately trained in the era of the 80-hour work-week, training programs have restructured resident duties and hired advanced practice providers (APPs). However, the effect of APPs on surgical training remains unknown. STUDY DESIGN: We created a survey using a modified Delphi technique to examine the interaction between residents and APPs across practice settings (inpatient, outpatient, and operating room). We identified the following domains: administrative tasks, clinical experience, operative experience, and overall impressions...
December 7, 2017: Journal of the American College of Surgeons
Joyce L Neumann, Lih-Wen Mau, Sanya Virani, Ellen M Denzen, Deborah A Boyle, Nancy J Boyle, Jane Dabney, Alexandra De KeselLofthus, Marion Kalbacker, Tippu Khan, Navneet S Majhail, Elizabeth A Murphy, Pamela Paplham, Leslie Parran, Miguel-Angel Perales, Todd H Rockwood, Kim Schmit-Pokorny, Tait D Shanafelt, Elaine Stenstrup, William A Wood, Linda J Burns
A projected shortage of hematopoietic cell transplantation (HCT) health professionals was identified as a major issue during the National Marrow Donor Program/Be The Match System Capacity Initiative. Work-related distress and work-life balance were noted to be potential barriers to recruitment/retention. This study examined these barriers and their association with career satisfaction across HCT disciplines. A cross-sectional, 90-item, web-based survey was administered to advanced practice providers, nurses, physicians, pharmacists, and social workers in 2015...
December 2, 2017: Biology of Blood and Marrow Transplantation
Sarah K Schmidt, Lina Brou, Sara J Deakyne, Rakesh D Mistry, Halden F Scott
OBJECTIVES: Intubation in critically ill pediatric patients is associated with approximately 20% rate of adverse events, but rates in the high-risk condition of sepsis are unknown. Our objectives were to describe the frequency and characteristics of tracheal intubation adverse events in pediatric sepsis. DESIGN: Retrospective cohort study of a sepsis registry. SETTING: Two tertiary care academic emergency departments and four affiliated urgent cares within a single children's hospital health system...
February 2018: Pediatric Critical Care Medicine
Poonam Sharma, Megan Brooks, Pahresah Roomiany, Lalit Verma, Lisa Criscione-Schreiber
PURPOSE: The number of physician assistants (PAs) practicing hospital medicine is rapidly expanding. Little research has been done to determine which inpatient medicine rotation experiences are most helpful to prepare PA students for a career in inpatient medicine. We aimed to determine those skills that practicing hospitalists believe are most critical for PA students to master and to describe hospitalists' current understanding of PA training. We also sought to evaluate the current performance of our own inpatient medicine rotation for PA students...
December 2017: Journal of Physician Assistant Education
Mary E McBride, Dorothy M Beke, James D Fortenberry, Annette Imprescia, Louise Callow, Lindsey Justice, Ronald A Bronicki
Pediatric cardiac critical care is a new and emerging field. There is no standardization to the current education provided, and high-quality patient outcomes require such standardization. For physicians, this includes fellowship training, specific competencies, and a certification process. For advanced practice providers, a standardized curriculum as well as a certification process is needed. There is evidence that supports a finding that critical care nursing experience may have a positive impact on outcomes from pediatric cardiac surgery...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
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