Journal of the American Association of Nurse Practitioners最新文献

{"title":"The effects of health beliefs and acculturation on the acceptance of human papillomavirus vaccination among Asian Indian parents in the United States.","authors":"Daisy Mullassery,Barabara Posmontier","doi":"10.1097/jxx.0000000000001068","DOIUrl":"https://doi.org/10.1097/jxx.0000000000001068","url":null,"abstract":"BACKGROUNDThe available limited literature and Centers for Disease Control data suggest that human papillomavirus (HPV) vaccination acceptance is lower among Asian Indians than the general population in the United States.PURPOSEThe purpose of the study was to determine the effects of health beliefs, subjective norms, acculturation, and demographics on HPV vaccination acceptance among Asian Indian parents.METHODOLOGYUsing a comparative descriptive cross-sectional study design, immigrant and first-generation Asian Indian parents of 9- to 16-year-old children were recruited (N = 171). The survey comprised the Health Belief and Subjective Norms instrument and the Suinn-Lew Asian Self-Identity Acculturation Scale. The analysis included parametric and nonparametric tests.RESULTSParticipants who expressed higher levels of perceived barriers were less likely to accept HPV vaccination (odds ratio [OR] = 0.47, p = .016). Spousal opinion negatively correlated with HPV vaccination acceptance (OR = 0.57, p = .006). However, subjective norms positively predicted HPV vaccination acceptance (OR = 1.69, p = .039). Participants who perceived that friends and family approved of the vaccination also had significantly higher rates of vaccination acceptance (OR = 11.99, p = .001).CONCLUSIONSThe results revealed unique factors in the acceptance of HPV vaccination in Asian Indians that were not examined or understood before. The applied Health Beliefs and Subjective Norms theoretical framework suggested that perceived barriers, subjective norms, and the opinions of spouses, friends, and family predicted HPV vaccination acceptance.IMPLICATIONSEducational interventions targeting providers, spouses, family, and community members with influential effects on parents may positively affect HPV vaccination acceptance. Providers should note that this population welcomes the provider's recommendations.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To precept or not to precept: Perspectives from nurse practitioners.","authors":"Leonie DeClerk,Steven Chasteen,Cheryl Wells,Jonathan Baxter,Martha Rojo","doi":"10.1097/jxx.0000000000001071","DOIUrl":"https://doi.org/10.1097/jxx.0000000000001071","url":null,"abstract":"BACKGROUNDNurse practitioner (NP) preceptors are crucial to clinical education. Recent increases in the required direct patient care hours for NP students may worsen the current preceptor shortage. However, most studies of preceptorship only include NPs who are current preceptors and are therefore missing vital information from nonpreceptors. It is imperative to understand facilitators and barriers to preceptorship from the perspective of NPs who have stopped being or have never been preceptors.PURPOSEThe purpose of this study was to understand the factors influencing NPs' decisions whether to precept.METHODOLOGYThis was a descriptive, phenomenological study. Semistructured interviews were recorded in Zoom, transcribed verbatim, deidentified, and analyzed using thematic analysis.RESULTSSixty NPs participated in the study: 23 current preceptors, 22 previous preceptors, and 15 who had never been preceptors. Facilitators to preceptorship included institutional support of preceptorship, positive student characteristics, clear expectations from the educational facility, and incentives. Barriers to preceptorship included time constraints, specialty, negative student characteristics, no institutional support, and being uncomfortable in the clinical role.CONCLUSIONSPreceptors and nonpreceptors shared similar themes-positive student characteristics and clear expectations as facilitators to preceptorship, and time as a barrier. However, other themes were unique to one preceptorship group. This provides new evidence for practice and research.IMPLICATIONSNurse practitioner programs can facilitate preceptorship by ensuring that students are well prepared and providing clear expectations. Strategies should be developed to manage the time burden of preceptorship. In addition, support for preceptorship by health care organizations and systems should be studied.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of an online learning module to improve knowledge for prevention of back pain and injury in industrial workers.","authors":"Scarlet R Spain,Zheng Li,Raza Akbar","doi":"10.1097/jxx.0000000000001072","DOIUrl":"https://doi.org/10.1097/jxx.0000000000001072","url":null,"abstract":"Back pain is a significant public health problem that accounts for a high percentage of morbidity and disability worldwide. Low back pain is a frequent cause of missed workdays and job-specific disability and is associated with poor outcomes for employees and employers. An online learning module that focused on normal anatomy of the spine, common pathophysiologic diagnosis or findings that may contribute to back pain, and techniques for back pain reduction was created for employees at risk due to the nature of their labor-intensive jobs. This module also contained case studies and graphics that demonstrated ways to reduce risks or hazards by incorporating job-specific changes in the work environment. A mixed method statistical analysis of knowledge change was completed after participation in the online module. This demonstrated that participants had a marked increase in knowledge in all areas examined. In addition, participants perceived the module as beneficial for grasping anatomical concepts, understanding injury prevention and management strategies, valuing the shared information, leveraging visual aids, and applying practical examples per qualitative questions answered. Participants gained knowledge that can be used on the job to decrease risk of sustaining back pain or injury. The intervention approach enhances the understanding of back pain among industrial workers and holds profound implications for public health on a broader scale. Monitoring population health and preventing back pain and injury while at work is essential for safety and is also a core competency in public health.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating genomics and precision health knowledge into practice: A guide for nurse practitioners.","authors":"Trina Walker, Anne L Ersig, Andrew A Dwyer, Rebecca Kronk, Cynthia T Snyder, Karen Whitt, Valerie Willis","doi":"10.1097/JXX.0000000000001050","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001050","url":null,"abstract":"<p><strong>Abstract: </strong>Nurse practitioners (NPs) are the fastest growing group of health care providers, with an increase of 8.5% over the past year and anticipated growth of more than 40% by 2031. Improving NPs' knowledge of how genes influence health enables them to assess, diagnose, and manage patients in all states of health in a safe, efficient, and competent manner. Nurse practitioners may also care for patients who obtain direct-to-consumer (DTC) genetic tests without provider oversight and share their results; improved knowledge of genetics can provide NPs with the information and resources needed to interpret and understand DTC test results. The literature indicates that NPs have limited understanding of basic genetic concepts and guidelines for prescribing drugs affected by genomic variability. As a result, NPs report low confidence in their ability to accurately interpret and apply genetic test results, which inhibits genomics-informed precision health care. This article provides resources and clinical recommendations for using the 2021 American Association of Colleges of Nursing Essentials and the American Nurses Association Essentials of Genomic Nursing to facilitate the integration of genomics into NP curricula and practice. These resources will help future and practicing NPs integrate genomics into practice and improve precision health care.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nurse practitioner-led deprescribing bundled intervention to reduce rates of polypharmacy in the post-acute care setting.","authors":"Polly B Boynton, Tracy Head","doi":"10.1097/JXX.0000000000001042","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001042","url":null,"abstract":"<p><strong>Background: </strong>In post-acute care (PAC) settings, residents face elevated risks of adverse drug reactions and emergency department visits because of polypharmacy. With over 90% of PAC residents nationally taking five or more medications, targeted deprescribing of inappropriate or unnecessary medications emerges as a critical strategy.</p><p><strong>Local problem: </strong>The project site faces high rates of polypharmacy with a root cause analysis revealing a deficiency in evidence-based practices (EBP) for deprescribing potentially inappropriate or unnecessary medications. To address this issue, a bundled deprescribing intervention was implemented as part of a quality improvement project aimed at reducing polypharmacy rates.</p><p><strong>Methods: </strong>This project, conducted at a PAC setting in the midwestern United States, used the RE-AIM Model. Data collection involved tracking prescribing rates before and after the intervention for residents admitted to the practice setting over a 5-month period.</p><p><strong>Intervention: </strong>A bundled EBP intervention comprising a deprescribing framework, pharmacist collaboration, and the utilization of an EBP guideline, established a systematic process guiding deprescribing efforts for each resident on admission to the PAC setting.</p><p><strong>Results: </strong>Fourty-nine patients received a deprescribing bundle, resulting in a 26.67% reduction in prescribed medications. On average, patients had 5.55 medications deprescribed, with reductions noted across 85 distinct therapeutic drug categories.</p><p><strong>Conclusion: </strong>Nurse practitioners play a pivotal role initiating successful deprescribing interventions within the PAC setting. Using a comprehensive approach, integrating pharmacist collaboration and EBP leads to reductions in prescribing rates among PAC residents. This model demonstrates potential for sustainable improvements in patient outcomes within the PAC environment.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of pediatric-focused advanced practice provider fellowship programs: An integrative review.","authors":"Rajashree Koppolu, Brigit Van Graafeiland, Bryan R Hansen","doi":"10.1097/JXX.0000000000001038","DOIUrl":"10.1097/JXX.0000000000001038","url":null,"abstract":"<p><strong>Background: </strong>An increased demand for pediatric-focused advanced practice providers (APPs) exists to address the health care needs of children with medical complexity. Postlicensure advanced practice fellowship programs have been developed to help improve novice provider transition to practice, reducing attrition.</p><p><strong>Objectives: </strong>The objectives of this integrative review are to (1) identify outcome measurements of pediatric-focused advanced practice fellowship programs and (2) evaluate the outcome measures to guide future implications for practice.</p><p><strong>Data sources: </strong>A systematic integrative literature review was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses. PubMed, CINAHL, Embase, and Google Scholar were searched in August and September 2022. Articles met inclusion criteria if they included new graduate APPs, reported the intervention of a pediatric fellowship program, and shared outcome measurements. Studies were excluded if they did not directly report on fellowship program outcome measures. Thirteen studies met inclusion criteria and were summarized and appraised for quality using the Johns Hopkins Evidence-Based Practice Model.</p><p><strong>Conclusions: </strong>Four themes from the literature included the favorable impact of advanced practice fellowship programs on (a) job satisfaction, (b) retention, (c) clinical and professional performance, and (d) financial outcomes. Variable strategies were used to measure outcomes across programs.</p><p><strong>Implications for practice: </strong>Postlicensure pediatric-focused advanced practice fellowship programs seem to improve retention and job satisfaction, increase provider confidence, and bring a favorable return on investment for the organization. Future work should include investment in developing validated, standardized assessment tools to support future development of these programs in the pediatric population.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doctor of Nursing Practice-prepared academics: Promotion and tenure-eligible?","authors":"Judith A Berg, Rodney W Hicks","doi":"10.1097/JXX.0000000000001054","DOIUrl":"10.1097/JXX.0000000000001054","url":null,"abstract":"<p><strong>Abstract: </strong>Since the Doctor of Nursing Practice (DNP) was implemented, there has been ongoing discussion about whether or not DNP-prepared faculty are eligible for promotion and tenure. This column updates that discussion through input from two DNP-prepared faculty key informants.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Nurse Practitioner proficiency and confidence: An evaluation of postgraduate training in rural and medically underserved communities.","authors":"Christian Ketel, Natasha McClure, Tonya Elkins, April Kapu, Pam Jones","doi":"10.1097/JXX.0000000000001036","DOIUrl":"10.1097/JXX.0000000000001036","url":null,"abstract":"<p><strong>Background: </strong>Nurse practitioners (NPs) are critical in delivering primary health care, especially in underserved and rural areas. Transitioning from academic training to practical application poses challenges, highlighting the need for structured post-licensure training (PLT).</p><p><strong>Purpose: </strong>To address the knowledge gap regarding the impact of PLT programs on the clinical development, confidence, and care delivery of NPs using an innovative evaluative approach.</p><p><strong>Methodology: </strong>Using a mixed-methods approach, this study engaged 19 NP fellows in quantitative and qualitative evaluations. Assessments of clinical skills and feedback were collected using the REDCap platform, focusing on mentorship and the practical application of skills.</p><p><strong>Results: </strong>Quantitative analysis showed improvements in several domains: patient-centered care (median score increase from 8 to 10, p = .005), knowledge of evidence-based practice (median score from 8 to 9, p = .028), and health systems (median score from 8 to 9, p = .014). Qualitative feedback underscored the benefits of the program's structured support and practical learning experiences while revealing the need for improvements in mentor preparedness.</p><p><strong>Conclusions: </strong>The PLT program effectively advanced NP proficiency across various domains, particularly in patient-centered care and evidence-based practice. However, it also highlighted a crucial need for focused mentorship in developing leadership skills. The study's limited scope, dependence on self-reported measures, and specific statistical methods constrain the broader applicability of its findings. Future research should aim to validate these results across diverse settings and explore long-term outcomes.</p><p><strong>Implications: </strong>This study provides new perspectives on NP workforce development, emphasizing the importance of structured mentorship and training, especially in medically underserved communities.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guest Editorial: Annual Education Update.","authors":"Rodney W Hicks, Mary Ellen Roberts, Judith A Berg","doi":"10.1097/JXX.0000000000001063","DOIUrl":"10.1097/JXX.0000000000001063","url":null,"abstract":"","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national postgraduate nurse practitioner and physician assistant fellowship in cystic fibrosis: An innovative approach to the provider shortage in complex and rare disease.","authors":"Cynthia J Brady, Wendy S Looman, Jennifer L Hamilton, Jordan Dunitz, Taylor Gilard, Abraham I Sender, Cynthia George","doi":"10.1097/JXX.0000000000001021","DOIUrl":"10.1097/JXX.0000000000001021","url":null,"abstract":"<p><strong>Abstract: </strong>Cystic fibrosis (CF) is a complex life-limiting genetic condition that affects the respiratory, digestive, reproductive system, and sweat glands. Advances in treatment have led to improved survival and quality of life. Today, most persons with CF live to adulthood but require highly specialized care at accredited CF Care Centers. The growing and aging CF population combined with the provider workforce shortage have increased the demand for qualified CF providers. Nurse practitioners (NPs) and physician assistants (PAs) have been providing CF care for decades, but most learned on the job. The Leadership and Education for Advanced Practice Provider (LEAPP) fellowship in CF care aims to address the provider gap, ease transition to practice, and ensure access to specialized care. Unlike other institutional based joint NP/PA fellowships, LEAPP was designed to train providers at various locations across the national CF care center network. The program is innovative in several ways: (1) LEAPP employs a flipped classroom that pairs an online curriculum with case-based virtual discussion with content experts from the CF care network; (2) fellows receive mentored clinical training at their home CF center; (3) LEAPP partnered with a university-based team to ensure best practices and evaluation for adult learners; and (4) LEAPP promotes organizational enculturation through program components of professional mentoring, quality improvement, and leadership. This innovative approach may be suitable for other complex conditions that require highly specialized care, such as sickle cell disease, spina bifida, and solid organ transplant.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}