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"Advanced Practice Provider"

Katia Noyes, Janet Baack-Kukreja, Edward M Messing, Luke Schoeniger, Eva Galka, Wei Pan, Cai Xueya, Fergal J Fleming, John Rt Monson, Supriya G Mohile, Todd Francone
AIMS: To explore the feasibility of recruiting surgical oncology patients and implementing a surgical integrated discharge (SID) programme led by advanced practice providers (APP). BACKGROUND: Burden of illness and complexity of treatment regimen makes it challenging for surgical oncology patients to participate in research. Surgical oncology nurses may have the necessary expertise to overcome this problem. DESIGN: Controlled longitudinal prospective observational study...
July 2016: Nurs Open
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
PURPOSE: As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. METHODS: Process maps were created using medical record time stamps...
September 15, 2016: Journal of Pediatric Surgery
April N Kapu, Carmel A McComiskey, Lacey Buckler, Jennifer Derkazarian, Tammy Goda, Maria A Lofgren, Colleen K McIlvennan, Julie Raaum, Patricia M Selig, Corinna Sicoutris, Barbara Todd, Vicki Turner, Elizabeth Card, Nancy Wells
OBJECTIVE: This study examines data collected from a survey of advanced practice providers' (APPs') perceptions of reasonable versus actual APP-to-patient ratios and other factors that affect workload burden in both inpatient and outpatient clinical settings. BACKGROUND: Advanced practice providers provide accessible, cost-effective, and quality care in a growing number of specialty practices across multiple patient care settings. They are caring for higher volumes of patients and assuming more responsibilities while continuing to navigate highly complex healthcare systems...
October 2016: Journal of Nursing Administration
Stephen Trevick, Minjee Kim, Andrew Naidech
The Neuro-ICU is a multidisciplinary location that presents peculiar challenges and opportunities for patients with life-threatening neurological disease. Communication skills are essential in supporting caregivers and other embedded providers (e.g., neurosurgeons, advanced practice providers, nurses, pharmacists), through leadership. Limitations to prognostication complicate how decisions are made on behalf of non-communicative patients. Cognitive dysfunction and durable reductions in health-related quality of life are difficult to predict, and the diagnosis of brain death may be challenging and confounded by medications and comorbidities...
November 2016: Current Neurology and Neuroscience Reports
Rachel Scherzer, Marie P Dennis, Beth Ann Swan, Mani S Kavuru, David A Oxman
OBJECTIVE: To compare usage patterns and outcomes of a nurse practitioner-staffed medical ICU and a resident-staffed physician medical ICU. DESIGN: Retrospective chart review of 1,157 medical ICU admissions from March 2012 to February 2013. SETTING: Large urban academic university hospital. SUBJECTS: One thousand one hundred fifty-seven consecutive medical ICU admissions including 221 nurse practitioner-staffed medical ICU admissions (19...
September 14, 2016: Critical Care Medicine
Timothy Kubal, Doug G Letson, Alberto A Chiappori, Gregory M Springett, Riti Shimkhada, Diana Tamondong Lachica, John W Peabody
OBJECTIVES: This study examined whether a measurement and feedback system led to improvements in adherence to clinical pathways. DESIGN: The M-QURE (Moffitt-Quality, Understanding, Research and Evidence) Initiative was introduced in 2012 to enhance and improve adherence to pathways at Moffitt Cancer Center (MCC) in three broad clinical areas: breast, lung and gastrointestinal (GI) cancers. M-QURE used simulated patient vignettes based on MCC's Clinical Pathways to benchmark clinician adherence and monitor change over three rounds of implementation...
September 13, 2016: BMJ Open
Nicholas G Wysham, May Hua, Catherine L Hough, Stephanie Gundel, Sharron L Docherty, Derek M Jones, Owen Reagan, Haley Goucher, Jessica Mcfarlin, Christopher E Cox
OBJECTIVE: Addressing the quality gap in ICU-based palliative care is limited by uncertainty about acceptable models of collaborative specialist and generalist care. Therefore, we characterized the attitudes of physicians and nurses about palliative care delivery in an ICU environment. DESIGN: Mixed-methods study. SETTING: Medical and surgical ICUs at three large academic hospitals. PARTICIPANTS: Three hundred three nurses, intensivists, and advanced practice providers...
September 9, 2016: Critical Care Medicine
Allison Magnuson, Beverly Canin, G J van Londen, Beatrice Edwards, Pamela Bakalarski, Ira Parker
A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum...
November 2016: Current Oncology Reports
Kathryn J Hammer, Eve M Segal, Laura Alwan, Shan Li, Amila M Patel, Melinda Tran, Helen M Marshall
PURPOSE: The use of a collaborative drug therapy agreement (CDTA) by oncology pharmacists in a comprehensive pain clinic is described. SUMMARY: Recognizing the complex clinical services required by patients with cancer, the Seattle Cancer Care Alliance began offering cancer pain management through a specialized pain service. Initially, the clinic was staffed by one attending physician; however, as the volume of patient referrals increased, the clinic expanded into an interprofessional team that includes physicians, advanced practice providers, nurses, and pharmacists...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
Heather Ourth, Julie Groppi, Anthony P Morreale, Kimberly Quicci-Roberts
PURPOSE: A comprehensive overview of clinical pharmacist prescribing authority and collaborative drug therapy management activities within the Veterans Health Administration (VHA) is presented. SUMMARY: In VHA terminology, "scope of practice" (SOP) denotes authorization to perform as an advanced practice provider, autonomously or collaboratively managing all facets of a patient's disease or condition; VHA clinical pharmacists with an SOP have prescribing authority...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
Andrew L Laccetti, Beibei Chen, Jennifer Cai, Samantha Gates, Yang Xie, Simon J Craddock Lee, David E Gerber
PURPOSE: Electronic portals provide patients with real-time access to personal health records. Use of this technology by individuals with cancer is particularly intensive. We therefore examined patterns of use of electronic portals by clinic staff at a National Cancer Institute-designated comprehensive cancer center. METHODS: We identified and characterized cancer center providers and clinic staff who performed electronic activities related to MyChart, the institution's personal health records portal, from 2009 to 2014...
September 6, 2016: Journal of Oncology Practice
Amanda B Levin, Tessie W October
No abstract text is available yet for this article.
September 2016: Pediatric Critical Care Medicine
Camille Haycock, Michelle L Edwards, Christopher S Stanley
The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule that details a consolidated pay-for-performance provider payment system within the Medicare Access and CHIP Reauthorization Act. This proposed rule establishes policy for the new provider Merit-Based Incentive System and Alternative Payment Models. While the rule is extremely complex, and not yet finalized, there are significant implications for nursing and advanced practice providers. This proposed rule intends to drastically change the current provider payment system and reward providers who demonstrate better quality outcomes at a lower cost...
October 2016: Nursing Administration Quarterly
Cory M Resnick, Kimberly M Daniels, Susan J Flath-Sporn, Michael Doyle, Ronald Heald, Bonnie L Padwa
PURPOSE: To determine the effects on time, cost, and complication rates of integrating advanced practice providers (APPs) into the procedural components of an outpatient oral and maxillofacial surgery practice. MATERIALS AND METHODS: This is a prospective cohort study of patients from the Department of Plastic and Oral Surgery at Boston Children's Hospital who underwent removal of 4 impacted third molars with intravenous sedation in our outpatient facility. Patients were separated into the "no APP group" and APP group...
July 22, 2016: Journal of Oral and Maxillofacial Surgery
Joshua Hofmeyer, Jonathon P Leider, Jennifer Satorius, Erin Tanenbaum, David Basel, Alana Knudson
INTRODUCTION: Public and private entities in the United States spend billions of dollars each year on potentially avoidable hospitalizations. This is a common occurrence in long-term care (LTC) facilities, especially in rural jurisdictions. This article details the creation of a telemedicine approach to assess residents from rural LTC facilities for potential transfer to hospitals. METHODS: An electronic LTC (eLTC) pilot was conducted in 20 pilot LTC facilities from 2012-2015...
July 28, 2016: Journal of the American Medical Directors Association
Cortney B Foster, Shari Simone, Dayanand Bagdure, Nan A Garber, Adnan Bhutta
OBJECTIVES: The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members...
September 2016: Pediatric Critical Care Medicine
Krista Estes, Eric Gilliam, Sarah Knapfel, Chanmi Lee, Diane Skiba
The use of eHealth has grown in recent years and is projected to continue to increase exponentially. In order to empower and prepare advanced practice providers to integrate eHealth into their clinical practice, curricular changes need to occur. The iTEAM grant provides a unique opportunity to prepare advanced practice disciplines to provide collaborative care using eHealth. Through the integration of a simulated telehealth using a standardized patient, Doctor of Pharmacy and Advanced Practice Registered Nursing students learned how to apply health information technology and coordinate care in an interprofessional manner...
2016: Studies in Health Technology and Informatics
Charles S Day, Scott D Boden, Patrick T Knott, Nancy C O'Rourke, Brian W Yang
Growth estimates and demographic shifts of the population of the United States foreshadow a future heightened demand for musculoskeletal care. Although many articles have discussed this growing demand on the musculoskeletal workforce, few address the inevitable need for more musculoskeletal care providers. As we are unable to increase the number of orthopaedic surgeons because of restrictions on graduate medical education slots, physician assistants (PAs) and nurse practitioners (NPs) represent one potential solution to the impending musculoskeletal care supply shortage...
June 1, 2016: Journal of Bone and Joint Surgery. American Volume
Kevin R Betts, Amie C O'Donoghue, Kathryn J Aikin, Bridget J Kelly, Vanessa Boudewyns
BACKGROUND AND PURPOSE: Professional online communities allow healthcare providers to exchange ideas with their colleagues about best practices for patient care. Research on this topic has focused almost exclusively on primary care physicians and specialists, to the exclusion of advanced practice providers such as nurse practitioners and physician assistants. We expand this literature by examining membership and participation on these websites among each of these provider groups. METHODS: Participants (N = 2008; approximately 500 per provider group) responded to an Internet-based survey in which they were asked if they use professional online communities to dialogue with colleagues and if so, what their motivation is for doing so...
May 23, 2016: Journal of the American Association of Nurse Practitioners
Rae Brana Reynolds, Kimberly McCoy
Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs), generally referred to as Advanced Practice Providers (APPs), are fundamental to interdisciplinary oncology care. As the projected demand for oncology services is anticipated to outpace the supply of oncologists, APPs will become increasingly vital in the delivery of oncology care and services. The training, education, and scope of practice for APPs gives the interdisciplinary care team professionals that deliver high-quality clinical services and provide valuable contributions and leadership to health care quality improvement initiatives...
June 2016: Chinese Clinical Oncology
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