Journal of the American Association of Nurse Practitioners最新文献

{"title":"Continuous glucose monitoring among nurse practitioners in primary care: Characteristics associated with prescribing and resources needed to support use.","authors":"","doi":"10.1097/JXX.0000000000001124","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001124","url":null,"abstract":"","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"37 4","pages":"217-218"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764225","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 model of care redesign within rheumatology: A mixed methods approach integrating nurse practitioners and physician assistants.","authors":"Lisa Carnago, Kristin Holbrook, David Leverenz, Allison Dimsdale","doi":"10.1097/JXX.0000000000001112","DOIUrl":"10.1097/JXX.0000000000001112","url":null,"abstract":"<p><strong>Background: </strong>Increasing patient demand and clinician burnout in rheumatology practices have highlighted the need for more efficient models of care (MOC). Interprofessional collaboration is essential for improving patient outcomes and clinician satisfaction.</p><p><strong>Local problem: </strong>Our current MOC lacks standardization and formal integration of Nurse Practitioners (NPs) and Physician Assistants (PAs), resulting in reduced clinician satisfaction and limited patient access. To optimize care quality, clinician satisfaction, and patient access, we sought to develop an interprofessional MOC tailored to an academic rheumatology practice.</p><p><strong>Methods: </strong>We used a mixed methods sequential-exploratory design within a quality improvement (QI) framework to create a blueprint for MOC redesign.</p><p><strong>Intervention: </strong>Intervention development proceeded in four phases: needs assessment, data collection, socializing key ideas, and team design and planning.</p><p><strong>Results: </strong>In the needs assessment phase, divisional leadership was interviewed to identify shared goals for an optimized MOC. Data collection included surveys distributed to 12 physicians and 8 NPs/PAs, addressing 11 key domains related to current and future MOC needs. In phase 3, we communicated key findings to divisional leadership, clinicians, and staff. Phase 4 involved iterative team building and MOC design. Survey results revealed low satisfaction with the current MOC and a strong preference for parallel practice, standardization, and formal NP/Physician Assistant integration. Several barriers to MOC implementation were also identified.</p><p><strong>Conclusion: </strong>Redesigning the MOC in rheumatology requires aligning clinician, leadership, and organizational priorities. A mixed methods QI approach effectively uncovers clinical needs and potential barriers, supporting the successful implementation of a new MOC.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"239-247"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066518","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":"Thriving in practice: A call for purpose, balance, and well-being.","authors":"Melissa R Troncoso","doi":"10.1097/JXX.0000000000001117","DOIUrl":"10.1097/JXX.0000000000001117","url":null,"abstract":"<p><strong>Abstract: </strong>Nurse practitioners (NPs) are uniquely positioned to model health and resilience by prioritizing their well-being, setting healthy boundaries, and fostering habits that support balance in everyday life. By shifting away from a culture of martyrdom and unhealthy self-sacrifice, NPs can lead by example, demonstrating the value of balanced and purposeful living. As a senior military leader, NP, and health and wellness coach, I offer my perspective on strategies for NPs to establish healthy boundaries, build and maintain healthy habits, and cultivate a fulfilling and healthy work environment.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"37 4","pages":"200-202"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764226","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":"Continuous glucose monitoring among nurse practitioners in primary care: Characteristics associated with prescribing and resources needed to support use.","authors":"Tristen L Hall, L Miriam Dickinson, Meredith K Warman, Tamara K Oser, Sean M Oser","doi":"10.1097/JXX.0000000000001060","DOIUrl":"10.1097/JXX.0000000000001060","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitoring (CGM) can improve health for people with diabetes but is limited in primary care (PC). Nurse Practitioners (NPs) in PC can improve diabetes management through CGM, but NPs' interest in CGM and support needed are unclear.</p><p><strong>Purpose: </strong>We describe behaviors and attitudes related to CGM for diabetes management among NPs in PC.</p><p><strong>Methodology: </strong>This cross-sectional web-based survey of NPs practicing in PC settings used descriptive statistics to describe CGM experience and identify resources to support prescribing. We used multivariable regression to explore characteristics predicting prescribing and confidence using CGM for diabetes.</p><p><strong>Results: </strong>Nurse practitioners in hospital-owned settings were twice as likely to have prescribed CGM (odds ratio [OR] = 2.320, 95% CI [1.097, 4.903]; p = .002) than private practice; those in academic medical centers were less likely (OR = 0.098, 95% CI [0.012, 0.799]; p = .002). Past prescribing was associated with favorability toward future prescribing (coef. = 0.7284, SE = 0.1255, p < .001) and confidence using CGM to manage diabetes (type 1: coef. = 3.57, SE = 0.51, p < .001; type 2: coef. = 3.49, SE = 0.51, p < .001). Resources to prescribe CGM included consultation with an endocrinologist (62%), educational website (61%), and endocrinological e-consultations (59%).</p><p><strong>Conclusions: </strong>Nurse practitioners are open to prescribing CGM and can improve diabetes management and health outcomes for PC patients.</p><p><strong>Implications: </strong>Research should explore mechanisms behind associations with CGM experience and attitudes. Efforts to advance CGM should include educational websites and endocrinology consultations for NPs in PC.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"207-216"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voices from the frontline: Perspectives from certified nurse practitioners, clinical nurse specialists and physician assistants at an Academic Medical Center.","authors":"Katherine N Dickerman, Cara A Chao, Nicole M Rondinelli, Hareklia L Brackett, Martina M Schulte, Kasey R Bowden, Marisha A Burden, Hillary J Chrastil, Katherine T Morrison, Kristin M Jensen, Stacey A Seggelke","doi":"10.1097/JXX.0000000000001111","DOIUrl":"10.1097/JXX.0000000000001111","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has exacerbated already existing stressors within health care. In August 2020, a campus-wide COVID-19 well-being survey indicated high levels of burnout, stress, and mental health concerns among certified nurse practitioners (CNPs), clinical nurse specialists (CNSs), and physician assistants (PAs) within our Department of Medicine.</p><p><strong>Purpose: </strong>In response to this survey, an interdisciplinary task force was formed by CNPs, CNSs, and PAs across departmental specialty divisions to conduct focus groups to gain a deeper understanding of workplace experience both prepandemic and during the COVID-19 pandemic.</p><p><strong>Methodology: </strong>As part of a quality-improvement project, 14 focus groups involving 34 CNPs, CNSs, and PAs within our department were conducted to better understand their experiences before and during the COVID-19 pandemic. A rapid qualitative analysis was used to identify themes and subthemes. In this article, we explore these themes and review potential solutions solicited from the focus groups.</p><p><strong>Results: </strong>The following themes were identified: (1) the importance of being valued; (2) the need for career development opportunities; and (3) the significance of professional fulfillment.</p><p><strong>Conclusions: </strong>Each of these themes existed before, but was exacerbated by, the ongoing COVID-19 pandemic. The manifestation of these stressors is unique to the CNPs, CNSs, and PAs experience, although the larger themes may overlap with physician colleagues.</p><p><strong>Implications: </strong>To improve the professional experience and well-being of CNPs, CNSs, and PAs at our institution, it will be critical for leadership to acknowledge these differences and develop specific initiatives to address these concerns.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"219-228"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066520","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":"2024 preceptor appreciation.","authors":"M Elayne DeSimone","doi":"10.1097/JXX.0000000000001125","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001125","url":null,"abstract":"","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"37 4","pages":"197-199"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764224","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 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":"10.1097/JXX.0000000000001108","url":null,"abstract":"<p><strong>Abstract: </strong>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.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"203-206"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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}

{"title":"Recognizing and responding to human trafficking in clinical care environments: A pediatric primary care case study.","authors":"Jessica L Peck, Kelcey Y King, Katherine P Hettenhaus, Kelley B Rigby, Tami McMichael","doi":"10.1097/JXX.0000000000001110","DOIUrl":"10.1097/JXX.0000000000001110","url":null,"abstract":"<p><strong>Abstract: </strong>Human trafficking is a proliferating abuse within the United States in which persons who are victimized frequently interface with clinical environments across the care continuum with a variety of presentations for health needs. However, in the absence of uniform standards for evidence-based training among the health professions, recognition and response in these scenarios remains low. This case study presents a young adolescent female accessing primary care with a chief complaint of commercial sexual exploitation. The Core Competencies for Human Trafficking Response in Health Systems is used as a guiding lens for practical applications in clinical practice in provision of pediatric primary care. Health care providers in a direct service role should be prepared to respond with evidence-based, trauma-informed, culturally responsive procedures and protocols used within their scope of practice.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"229-238"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399465","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":"Improving the evaluation of novice advanced practice nurse transition.","authors":"Donna R Wyly","doi":"10.1097/JXX.0000000000001070","DOIUrl":"10.1097/JXX.0000000000001070","url":null,"abstract":"<p><strong>Background: </strong>Novice advanced practice registered nurses (RNs) experience decreased self-confidence, anxiety, and identity confusion in their first year of practice, which leads to poor job satisfaction and turnover. Advanced practice RN fellowship programs, developed to bridge the gap from the RN to the advanced practice role, lack standardized measures for program evaluation.</p><p><strong>Local problem: </strong>A large Midwestern pediatric hospital's advanced practice nurse fellowship program lacks a structured program evaluation.</p><p><strong>Methods: </strong>A quasi-experimental evidence-based improvement project was implemented to evaluate fellowship program outcomes for novice nurse practitioner transition and retention.</p><p><strong>Interventions: </strong>All novice advanced practice RNs (APRNs) were enrolled in the site's 12-month APRN fellowship program. The transition experiences of enrollees who completed the fellowship program were assessed using the novice nurse practitioner role transition scale. In addition, role transition scores were compared for two subgroups: fellows in acute care and fellows in primary care roles. Fellowship participant retention 1 year after hire was measured.</p><p><strong>Results: </strong>Postintervention data showed that most fellowship graduates had a positive transition experience as evidenced by at least a 4.33/6.0 mean total novice nurse practitioner role transition score. There was not a statistically significant difference between the transition scores of the acute care fellows and primary care fellows.</p><p><strong>Conclusions: </strong>The APRN fellowship program was effective in promoting a successful role transition from RN to novice APRN. Similar APRN fellowship programs may benefit from using this tool for program evaluation.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"248-255"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349034","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":"Characteristics and outcomes of medication-assisted treatment care models for pregnant women with opioid use disorder: A scoping review.","authors":"Kyeung Mi Oh, K Pierre Eklou, Krista Beran, Nora H Elnahas, Rebecca Bates, Patagonita Kitsantas","doi":"10.1097/JXX.0000000000001123","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001123","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women and their unborn children are often overlooked in the opioid crisis, despite increased rates of both maternal complications and neonatal opioid withdrawal syndrome. Although medications for opioid use disorder (MOUD) are considered the gold standard for pregnant women, many either do not have access to or are not offered MOUD as an option.</p><p><strong>Objectives: </strong>To describe the characteristics of MOUD care models and assess the effectiveness of MOUD Care Models on initiation, adherence, and engagement in treatment for pregnant women with OUD.</p><p><strong>Data sources: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol directed the process of this scoping review. A search for English, peer-reviewed, quantitative studies, published between 2012 and 2023 was conducted in eight scholarly databases. The Joanna Briggs Critical Appraisal tools were used to assess study quality.</p><p><strong>Conclusions: </strong>The integrated care models included medication management, psychotherapy support, behavioral health care, and medical care management, with added focus on prenatal and postpartum care. Synthesis revealed that treatment engagement, medication adherence, breastfeeding rates, and postdelivery MOUD referrals were higher in integrated care models compared with nonintegrated care models. Pregnant women with OUD in integrated care models have better outcomes compared with those in nonintegrated care models.</p><p><strong>Implications for practice: </strong>Improvements in care models are necessary to tackle provider shortages, stigma, and financial, geographic, and technological barriers. Addressing these issues will enhance nurse practitioners' ability to provide comprehensive and accessible care to this vulnerable population.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623488","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}