Journal of the American Association of Nurse Practitioners最新文献_第2页

Relationships among health promotion behaviors, patient engagement, and the nurse practitioner-patient partnership. 健康促进行为、患者参与与护医医患伙伴关系之关系。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2025-01-01 DOI: 10.1097/JXX.0000000000001107

引用次数: 0

Improving patient education in hospitalized patients with chronic obstructive pulmonary disease: A quality improvement initiative using LEAN methodology. 改善慢性阻塞性肺病住院患者的患者教育：采用精益方法的质量改进计划。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2025-01-01 DOI: 10.1097/JXX.0000000000001024

Jacquelyn M Stewart, Freny Shah, Jolly Thomas, Myrtle White

{"title":"Improving patient education in hospitalized patients with chronic obstructive pulmonary disease: A quality improvement initiative using LEAN methodology.","authors":"Jacquelyn M Stewart, Freny Shah, Jolly Thomas, Myrtle White","doi":"10.1097/JXX.0000000000001024","DOIUrl":"10.1097/JXX.0000000000001024","url":null,"abstract":"Background: Chronic obstructive pulmonary disease (COPD) is a costly chronic disease affecting more than 15 million Americans. The prevalence among US veterans is 3 times higher than the general population.Local problem: The Veteran Health Administration developed a standardized, evidence-based COPD educational tool called Green Light to Go (GLTG) designed to educate patients on managing their COPD symptoms at home. Despite the availability of this resource, inpatient education on COPD self-management practices is highly variable across different medical teams. This quality improvement (QI) initiative sought to standardize inpatient COPD patient education using the GLTG tool. This initiative also assessed whether patients receiving standardized patient education during their index hospitalization had lower COPD 30-day readmission rates.Method: The QI initiative followed the LEAN methodology and the A3 framework. The team performed rapid tests of change (plan-do-study-act cycles) to increase the percentage of veterans receiving COPD education.Interventions: The interventions implemented for this QI initiative focused on clinical, patient, and system improvements.Results: This initiative standardized COPD patient education and increased the percentage of veterans receiving (a) daily COPD education from 0% to 66%, (b) verbal COPD education on discharge from a baseline of 20% to 100%, (c) receipt of written educational material on discharge from 20% to 100%, and (d) the cohort all-cause 30-day readmission rate declined from 19.3% to 14.3%.Conclusions: Given the substantial economic burden of COPD readmissions on the health care system and patients, evidence-based educational interventions may potentially improve outcomes and reduce hospital readmissions in this veteran population.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"61-67"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898749","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}

引用次数: 0

Men, masculinities, and mental health: Key issues for nurse practitioners. 男性、男子气概和心理健康：护士从业人员的关键问题。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-19 DOI: 10.1097/JXX.0000000000001095

Rachel H Adler

引用次数: 0

The role of pharmacogenomic testing in optimizing depression treatment in medically underserved communities: Implications for nurse practitioner practice. 药物基因组学检测在优化医疗服务不足社区抑郁症治疗中的作用：对执业护士实践的影响。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-18 DOI: 10.1097/JXX.0000000000001108

Gryan Garcia

{"title":"The role of pharmacogenomic testing in optimizing depression treatment in medically underserved communities: Implications for nurse practitioner practice.","authors":"Gryan Garcia","doi":"10.1097/JXX.0000000000001108","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001108","url":null,"abstract":"Abstract: Depression is a leading cause of disability worldwide, with treatment-resistant depression (TRD) affecting approximately 30% of patients who do not respond to standard antidepressants. In underserved and uninsured communities, where Nurse Practitioners (NPs) often provide essential mental health care, the challenges of managing TRD are compounded by limited access to specialized services. Pharmacogenomic testing offers a promising approach to overcoming these barriers by providing personalized medication recommendations based on a patient's genetic profile. This brief report examines the medical records of 46 patients from underserved communities who underwent genetic testing for TRD. Of the patients reviewed, 31 achieved remission within 2 months of receiving genetically guided treatment, resulting in a remission rate of 67.39%. Patients with specific genetic markers, such as poor metabolizers for CYP2D6 or CYP2C19, experienced the most significant benefits. These findings suggest that pharmacogenomic testing can significantly improve treatment outcomes for TRD in underserved populations, enabling NPs to provide more personalized, effective care. Further research is necessary to explore the long-term benefits and cost-effectiveness of integrating pharmacogenomic testing into NP-led practices, particularly in resource-limited settings.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846944","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}

引用次数: 0

Improving the quality of self-collected swab specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in a clinical setting. 在临床环境中提高自采拭子标本检测沙眼衣原体和淋病奈瑟菌的质量。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-17 DOI: 10.1097/JXX.0000000000001102

Mia McDonald, Lauren Orser, Catherine Watson, Marie-Odile Grayson, Dominique Trudeau, Kim McMillan, Patrick O'Byrne

{"title":"Improving the quality of self-collected swab specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in a clinical setting.","authors":"Mia McDonald, Lauren Orser, Catherine Watson, Marie-Odile Grayson, Dominique Trudeau, Kim McMillan, Patrick O'Byrne","doi":"10.1097/JXX.0000000000001102","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001102","url":null,"abstract":"Background: The practice of patient self-collected swab specimens for Neisseria gonorrhoeae and Chlamydia trachomatis is supported in the literature.Local problem: Health care providers observed that patients sometimes performed their self-swabs incorrectly resulting in cancelled or invalid specimens.Methods: The clinic's outdated visual aids were replaced with new visual aids. The goal was to improve health care provider proficiency in providing the health teaching and to reduce the clinic's number of cancelled or invalid swab specimens. Staff evaluated the visual aids using an online pretest and post-test survey. The percentage of invalid swabs was calculated before and after project implementation.Intervention: The posters were designed and printed. In-person teaching on the project and using the new visual aids was provided.Results: There was no change in the reported proficiency of staff in providing health teaching for self-collected swab specimens. There was a reduction in staff observed self-swabbing errors. Three percent of rectal swabs were reported as invalid in the 2 weeks before project implementation, and 1.4% of rectal swabs were invalid in the 2 weeks after.Conclusions: Providing patient health teaching using verbal instructions combined with visual diagrams can improve patients' ability to retain health information.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837121","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}

引用次数: 0

Neonatal Eating Assessment Tool-Mixed Breastfeeding and Bottle-feeding: Reference values and factors associated with problematic feeding symptoms in healthy, full-term infants. 新生儿进食评估工具--混合母乳喂养和奶瓶喂养：参考值以及与健康足月婴儿喂养问题症状相关的因素。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-17 DOI: 10.1097/JXX.0000000000001104

Britt Frisk Pados, Jamarii Johnson, Madeline Nelson

{"title":"Neonatal Eating Assessment Tool-Mixed Breastfeeding and Bottle-feeding: Reference values and factors associated with problematic feeding symptoms in healthy, full-term infants.","authors":"Britt Frisk Pados, Jamarii Johnson, Madeline Nelson","doi":"10.1097/JXX.0000000000001104","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001104","url":null,"abstract":"Background: The Neonatal Eating Assessment Tool-Mixed Breastfeeding and Bottle-feeding (NeoEAT-Mixed Feeding) is a parent-report assessment of symptoms of problematic feeding in infants who are feeding by both breast and bottle.Purpose: To establish reference values for the NeoEAT-Mixed Feeding and evaluate factors that contribute to symptoms of problematic feeding in healthy, full-term infants.Methodology: Parents of 409 infants less than 7 months old completed an online survey. Median and percentile scores are presented for infants aged 0-2, 2-4, 4-6, and 6-7 months old.Results: Neonatal Eating Assessment Tool-Mixed Feeding total score and scores for the Gastrointestinal Tract Function and Energy & Physiologic Stability subscales decreased with increasing infant age. Infant Regulation and Feeding Flexibility subscale scores remained stable over time, whereas Sensory Responsiveness subscale scores increased with increasing infant age. Infants with more gastrointestinal and gastroesophageal symptoms had higher NeoEAT-Mixed Feeding total scores.Conclusions: In healthy, full-term infants, symptoms of problematic feeding generally improve over the first 7 months, with the exception of symptoms related to sensory responsiveness. Gastrointestinal and gastroesophageal reflux symptoms are related to symptoms of problematic feeding.Implications: The reported reference values may be used to identify infants in need of further assessment, referral, and intervention. In healthy, full-term infants with concurrent gastrointestinal symptoms and problematic feeding, interventions targeted at gastrointestinal symptoms may help to improve symptoms of problematic feeding as well.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837142","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}

引用次数: 0

Assessment of adherence to American Diabetes Association guidelines and evaluation of social determinants of health and interventions in patients with type 2 diabetes mellitus in a nurse practitioner-owned clinic. 对美国糖尿病协会指南的依从性评估，以及对2型糖尿病患者健康的社会决定因素和干预措施的评估。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-12 DOI: 10.1097/JXX.0000000000001084

Rachel G Murumba, Rachel O Naman, Christine A Tuohy, Patricia A White, Wendy Wright

{"title":"Assessment of adherence to American Diabetes Association guidelines and evaluation of social determinants of health and interventions in patients with type 2 diabetes mellitus in a nurse practitioner-owned clinic.","authors":"Rachel G Murumba, Rachel O Naman, Christine A Tuohy, Patricia A White, Wendy Wright","doi":"10.1097/JXX.0000000000001084","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001084","url":null,"abstract":"Background: This was an ongoing quality-improvement (QI) project that aimed to assess the quality of nurse practitioner (NP)-driven diabetes care based on the 2023 American Diabetes Association (ADA) Standards of Care (SOC) at a NP-owned primary care practice. In addition, a more recent focus was the assessment of and intervention on social determinants of health (SDOH). Nationally, 47.4% of people with diabetes mellitus (DM) have an HbA1C of >7.0%. Adherence to ADA SOC for DM management minimizes the risk of diabetes-associated complications.Local problem: At a NP-owned clinic, within one year, the average A1Cs improved in all patients except those with positive SDOH despite receiving similar care. SDOH predicts DM prevalence and severity of progression, yet screening is not consistently performed or documented.Methods: An ongoing retrospective chart review since 2013 has assessed adherence to ADA SOC among adult patients with type 2 DM at an NP-owned practice. Multiple Plan-Do-Study-Act (PDSA) cycles have resulted in new recommendations that have promoted adherence to diabetes metrics and improvement in overall mean A1C.Interventions: The current PDSA cycle emphasizes the creation and implementation of evidence-based interventions to assist NPs in addressing social needs at a NP-owned practice.Results: Recent data collection has included frequency of SDOH screening, identifying social needs, gaps in SDOH documentation, and has found overall higher A1Cs in patients with positive screens.Conclusions: Project intervention of social workers collaboration with NPs resulted in improvement in addressing social needs in patients with type 2 diabetes mellitus.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812953","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}

引用次数: 0

Medication reconciliation in the outpatient primary care setting: Barriers and opportunities. 在门诊初级保健设置药物和解：障碍和机会。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-11 DOI: 10.1097/JXX.0000000000001101

Susan P Schriefer, Marcy Ainslie

引用次数: 0

Optimizing nurse practitioner productivity within the Veterans Health Administration. 在退伍军人健康管理优化护士执业生产力。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-03 DOI: 10.1097/JXX.0000000000001092

Michelle Peacock, Diane Rybacki, Brooke Dixon, Aaron Haslam, Kathryn Wirtz Rugen, Penny Kaye Jensen, Maria Colandrea

{"title":"Optimizing nurse practitioner productivity within the Veterans Health Administration.","authors":"Michelle Peacock, Diane Rybacki, Brooke Dixon, Aaron Haslam, Kathryn Wirtz Rugen, Penny Kaye Jensen, Maria Colandrea","doi":"10.1097/JXX.0000000000001092","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001092","url":null,"abstract":"Background: Nurse practitioners (NPs) provide high-quality, comprehensive health care at Veterans Health Administration (VHA) medical centers in various practice settings. Accurately determining the productivity of NPs is essential to understanding their overall contribution to veteran care. There is a lack of understanding of the contributors to the variability among VHA medical centers regarding their processes for capturing these data. Using benchmark data from the VHA Support Service Center Capital Assets application, this quality improvement (QI) initiative implemented a series of plan-do-study-act (PDSA) cycles to determine whether increased education regarding billing and coding, along with person classification and labor mapping accuracy, could increase NP productivity.Local problem: The problem identified through an analysis of NP productivity revealed variability across multiple VHA facilities.Methods: The PDSA method was employed in this QI project. The QI team compared the total workload relative value units (wRVU) for NPs in each participating facility pre and post a three-phase intervention.Interventions: Nurse practitioners' person classification and labor mapping accuracy was evaluated at each site. An educational program regarding billing and coding was developed and delivered to the NP frontline staff. The QI team compared the total wRVUs for the NPs at each facility pre- and postintervention.Results: An increase in the wRVUs was observed following the intervention across six facilities. Five of the seven facilities displayed stability in relative value unit improvement postintervention.Conclusion: Educating frontline NPs on billing, coding, person classification, and labor mapping can improve NP productivity.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769935","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}

引用次数: 0

Evidence-based simulation: Fostering competency through structured and multisource feedback. 循证模拟：通过结构化和多源反馈培养能力。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-12-01 DOI: 10.1097/JXX.0000000000001004

Leah Burt, Sarah Fitz, Bob Kiser

{"title":"Evidence-based simulation: Fostering competency through structured and multisource feedback.","authors":"Leah Burt, Sarah Fitz, Bob Kiser","doi":"10.1097/JXX.0000000000001004","DOIUrl":"10.1097/JXX.0000000000001004","url":null,"abstract":"Abstract: Preclinical simulation is an evidence-based method for nurse practitioner (NP) students to improve clinical communication and disease management competency. During simulation, students may receive feedback from multiple sources, including standardized patients (SPs), faculty, peers, and themselves. Although evidence supports simulation with multisource feedback, its impact on clinical knowledge and communication has yet to be evaluated among NP students. We designed, implemented, and evaluated a preclinical simulation program with structured multisource feedback integrated into a disease management course within a Doctor of Nursing Practice curriculum. Differences in communication self-efficacy and disease management knowledge before and after participation, as well as perceptions of learning and importance of varying feedback sources, were evaluated using a single group pre-post mixed-methods design. On average, clinical communication self-efficacy was significantly higher, and disease management knowledge scores were significantly higher after participation. Learners rated feedback sources as important or very important and described varying feedback sources as complementary. Feedback from SPs, peers, learners themselves, and faculty was complementary and important to learning. This preclinical simulation program with purposeful integration of multisource feedback provides an evidence-based foundation for scaffolding multidomain competency development into curriculums to meet updated standards of advanced nursing education.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"696-703"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912873","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}

引用次数: 0