Journal of the American Association of Nurse Practitioners最新文献

{"title":"Navigating the intersection of clinical and artificial intelligence in nurse practitioner practice.","authors":"Martha M Whitfield, Md Habibor Rahman, Kristopher Jackson","doi":"10.1097/JXX.0000000000001193","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001193","url":null,"abstract":"<p><strong>Abstract: </strong>This reflective commentary is a response to a recent publication in Artificial Intelligence (AI), Computer Science, and Robotics Technology, which evaluated ChatGPT's performance on nurse practitioner (NP) certification examination questions. The provocative framing questioning whether AI nurse practitioners may become a reality prompted this critical reflection on what truly defines NP expertise, particularly in an era of expanding AI capabilities. Our response challenges the notion that correct examination answers alone constitute clinical readiness and instead highlights the depth of contextual judgment, human connection, and advanced clinical reasoning-the capability we term clinical intelligence-that nurse practitioners uniquely bring to patient care. Although AI literacy is a growing part of essential NP knowledge, caution is needed around any assertion that large language models like ChatGPT can replicate or replace nursing roles of any kind.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958751","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":"Comparative Analysis of 2025 American College of Cardiology/American Heart Association/Multisociety and 2023 European Society of Cardiology Acute Coronary Syndrome Guidelines: Implications for Advanced Practice Registered Nurses.","authors":"Luis Enrique Farfan Medina","doi":"10.1097/JXX.0000000000001195","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001195","url":null,"abstract":"<p><strong>Abstract: </strong>This systematic comparative analysis examines the divergent approaches between the 2025 American College of Cardiology (ACC)/American Heart Association (AHA)/Multisociety (ACC/AHA/Multisociety) and the 2023 European Society of Cardiology guidelines for Acute Coronary Syndrome (ACS) management, with specific focus on implications for Advanced Practice Registered Nurses (APRNs). Despite sharing fundamental principles, these guidelines present significant variations in diagnostic thresholds, risk stratification methodologies, pharmacological interventions, and revascularization strategies that directly influence clinical decision-making processes. As APRNs assume increasingly autonomous roles in cardiovascular care delivery across various settings-from emergency departments to rehabilitation services-understanding these nuanced differences becomes essential for implementing evidence-based practice. This analysis methodically evaluates guideline variations across six domains: diagnostic criteria evolution, risk assessment tools, pharmacological management updates, interventional approaches, secondary prevention recommendations, and technological integration. Each section provides actionable recommendations for translating guideline updates into APRN practice while acknowledging jurisdictional variations in scope of practice. By elucidating these comparative differences, this analysis aims to enhance APRN clinical competency in navigating potentially conflicting international recommendations, ultimately optimizing patient-centered care delivery in accordance with the most current evidence-based standards in ACS management.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958646","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 psychometric evaluation of the Maslach burnout inventory in nurse practitioners.","authors":"Katie A Azama, Eunjung Lim","doi":"10.1097/JXX.0000000000001180","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001180","url":null,"abstract":"<p><strong>Background: </strong>Hawaii faces a critical shortage of health care providers, underscoring the vital role of nurse practitioners (NPs) in ensuring access to quality care. However, limited research exists on burnout and effective mitigation strategies in Hawaii NPs.</p><p><strong>Purpose: </strong>This study examined the psychometric properties of the Maslach Burnout Inventory (MBI) among Hawaii NPs, with a focus on dimensionality, internal consistency reliability, and criterion validity.</p><p><strong>Methodology: </strong>Survey data from 143 NPs in a large Hawaii health system were analyzed. Exploratory factor analysis (EFA) assessed dimensionality. An adapted 17-item MBI model was developed, and reliability was evaluated using Cronbach alpha. Analysis of variance tested demographic associations, and correlations with the Areas of Worklife Scale (AWS) assessed criterion validity.</p><p><strong>Results: </strong>Pairwise correlations were acceptable, and the EFA resulted in an adapted model containing 17 items (7 for Emotional Exhaustion, 5 for Personal Accomplishment, and 5 for Depersonalization). The adapted MBI and its three factors showed good reliability; gender showed significant associations, and factors were significantly correlated with AWS domains as anticipated.</p><p><strong>Conclusions: </strong>The adapted MBI demonstrated strong reliability and meaningful correlations with AWS domains. Gender differences were significantly associated with burnout. These findings contribute to the growing body of research on the MBI's performance in diverse and understudied populations.</p><p><strong>Implications: </strong>Psychometric analysis of the adapted MBI among NPs in Hawaii demonstrated acceptable psychometric properties, supporting its suitability for assessing burnout in this population. Future research is recommended to further examine the MBI's psychometric performance, and validations studies are needed to test the adapted model.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958612","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":"Systematic review: The role of complete blood count components as diagnostic biomarkers in major depressive disorder.","authors":"Gryan Garcia, Christy Cotner","doi":"10.1097/JXX.0000000000001189","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001189","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) remains challenging to diagnose due to reliance on subjective clinical assessments, sparking interest in objective biological markers. Complete blood count (CBC) parameters reflect underlying biological processes, such as inflammation and oxygen transport dysfunction, both of which are implicated in MDD pathophysiology.</p><p><strong>Objectives: </strong>The purpose of this systematic review is to explore the potential role of CBC parameters as biomarkers for diagnosing and assessing the severity of MDD.</p><p><strong>Data sources: </strong>The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, analyzing studies published between 2014 and 2024. Databases searched included PubMed, CINAHL Complete, Scopus, PsycINFO, and Web of Science. A total of 22 studies met the inclusion criteria.</p><p><strong>Conclusions: </strong>The majority of studies (approximately 17 out of 22) found that low red blood cell indices and elevated neutrophil-to-lymphocyte ratio were associated with symptoms such as fatigue, cognitive impairment, and chronic inflammation. Although individual CBC parameters showed moderate diagnostic utility, composite CBC scores demonstrated promise in identifying patients with higher MDD severity. However, only a small number of longitudinal studies (5 of 22) examined CBC changes over time or in response to treatment, and findings were mixed. Therefore, although CBC parameters show potential for clinical integration, their predictive value for treatment outcomes remains inconclusive and warrants further investigation.</p><p><strong>Implications for practice: </strong>Standardizing CBC biomarker thresholds and further exploring the role of inflammation in MDD are essential for clinical integration. Complete blood count biomarkers hold promise for enhancing early detection and enabling personalized treatment approaches in primary care and psychiatric settings.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958685","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":"\"If people don't understand these are brain-based disorders… They don't understand the person who's in front of them:\" Substance use-related content for nurse practitioner curricula.","authors":"Brayden Kameg, Madeline Lepore, Ann Mitchell","doi":"10.1097/JXX.0000000000001159","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001159","url":null,"abstract":"<p><strong>Background: </strong>Substance use remains a public health crisis. Fewer than 25% of nurse practitioners report agreeing that they have the education and training needed to manage the care of patients with substance use disorders and often feel as though managing substance use disorders is beyond their scope of practice. Educational interventions during nurse practitioner education can improve knowledge and confidence related to treating substance use disorders, ultimately increasing the likelihood that nurse practitioners will choose to treat patients affected by substance use.</p><p><strong>Purpose: </strong>The purpose of this study was to explore what substance use-related content is essential to include in nurse practitioner curricula, focusing on emerging public health threats, knowledge and skills necessary to prepare nurse practitioners to manage substance use disorders, specific content necessary for substance use-inclusive curricula, and barriers to and facilitators of substance use-inclusive curricula.</p><p><strong>Methodology: </strong>A qualitative, descriptive design was used, leveraging individual, semistructured key informant interviews.</p><p><strong>Results: </strong>Eight themes emerged, including diagnostic knowledge and neurobiology; substance use severity; nonpharmacological interventions; pharmacological treatment interventions; the importance of addressing provider characteristics; treatment access and quality; psychosocial and historical considerations; and emerging issues and special populations.</p><p><strong>Conclusions: </strong>Nurse practitioners can effectively address the substance use epidemic but must be adequately prepared with the knowledge and skills to do so. By adequately preparing nurse practitioners during their graduate education, nurse practitioners can mitigate gaps in substance use care, further advancing population health.</p><p><strong>Implications: </strong>Nurse practitioner educators should be aware of evolving topics essential to substance use-inclusive curricula.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958653","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":"TikTok as a teaching tool?","authors":"Suzanne S Prevost, Kacie Duncan, Heather Cole","doi":"10.1097/JXX.0000000000001194","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001194","url":null,"abstract":"<p><strong>Abstract: </strong>TikTok, a widely popular video-sharing platform, is increasingly being recognized as a valuable educational tool in nursing and health education. This platform supports delivery of engaging, concise and visually rich content, through a microlearning pedagogy, which can enhance learning and retention of health-related concepts in small, manageable units. This format caters to the preferences of digital-native learners, making it an enticing educational medium, especially for teaching adolescents and young adults. However, the brevity of the content may lead to superficial understanding of complex topics. Despite its popularity, TikTok faces criticism and regulatory challenges, including concerns over misinformation and data privacy. This study explores the advantages and disadvantages of using TikTok in nursing and health education, including examples of successful implementation. The authors advocate for the responsible use of TikTok-style videos, distributed through other social media platforms, to maximize the educational benefits, while navigating the challenges posed by the platform's current regulatory landscape.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958693","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":"HIV preexposure prophylaxis education in adult-gerontology primary care and family nurse practitioner programs: A cross-sectional study.","authors":"Kristopher Jackson, Starr Tomlinson, Ralph Klotzbaugh","doi":"10.1097/JXX.0000000000001177","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001177","url":null,"abstract":"<p><strong>Background: </strong>Engaging primary care providers in HIV prevention, particularly through the use of preexposure prophylaxis (PrEP), is essential to ending the HIV epidemic.</p><p><strong>Purpose: </strong>To assess the extent to which PrEP education is included in family nurse practitioner (FNP) and adult-gerontology primary care nurse practitioner (AGPCNP-AG) program curricula and the level of knowledge program leaders have regarding PrEP.</p><p><strong>Methodology: </strong>An internet survey was distributed between January and June 2024 to program leaders from 463 US institutions offering AGPCNP and/or FNP programs. The survey examined participants' familiarity with PrEP and whether PrEP was included in each program's curriculum. Participants rated their agreement with statements across 3 exploratory PrEP care domains: (1) effectiveness, impact, and access, (2) safety and risks, and (3) clinical practice and patient management.</p><p><strong>Results: </strong>Of the 188 institutions represented in the sample, 84% reported addressed PrEP in their curriculum. However, only 67% could correctly identify the clinical indications for PrEP, and just 18% identified all 3 Food and Drug Administration-approved PrEP medications. Exploratory analysis of Likert-style PrEP beliefs items revealed variability in perceptions of PrEP among faculty respondents that could affect curriculum.</p><p><strong>Conclusions: </strong>Although PrEP is addressed in U.S. FNP and AGPCNP-AG programs, gaps in faculty knowledge remain, particularly concerning its clinical indications and approved medications. These knowledge gaps could hinder the integration of PrEP into primary care practice.</p><p><strong>Implications: </strong>Freely available resources, such as online modules and expert-led webinars, could be an effective strategy to augment PrEP education in the classroom.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958778","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":"Thirty-five years of progress: Nurse practitioner presence and practice in United States hospitals.","authors":"Kristin Hittle Gigli","doi":"10.1097/JXX.0000000000001161","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001161","url":null,"abstract":"<p><strong>Background: </strong>Acute care comprises a significant amount of health care delivery, and demand for hospital care is forecasted to grow. Nurse practitioner (NP) roles evolved from primary care to meet patients' acute care needs. Nurse practitioners increasingly assume inpatient roles. Yet, growth of the acute care NP workforce is not widely described, and this knowledge can inform future workforce growth.</p><p><strong>Purpose: </strong>To describe the growth in the inpatient, acute care NP workforce.</p><p><strong>Methods: </strong>This study used a repeated cross-sectional design to analyze data from the US National Sample Survey of Registered Nurses (1988-2022) and the National Sample Survey of NPs (2012) to describe acute care NP workforce size, demographic, education, and practice characteristics. Descriptive statistical analyses accounted for the complex survey design and weighting and generated national workforce estimates.</p><p><strong>Results: </strong>The acute care NP workforce increased 836% (3,243-30,368 NPs) from 1988 to 2022. Yet, a growing proportion of inpatient NPs are not acute care certified. The workforce became more demographically diverse with advanced education. They also provide care in more wide-ranging clinical practice areas.</p><p><strong>Conclusion: </strong>Over the past 3 decades, a novel acute care NP role evolved into an essential role in inpatient settings. However, there are opportunities to increase the utilization of acute care NPs.</p><p><strong>Implications: </strong>This research highlights growth in the acute care NP workforce and opportunities for acute care NPs to improve access to care in inpatient settings. Educators, employers, and policymakers can support the ongoing integration of acute care NPs in inpatient care.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958708","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 march toward 750 hours: A call for thoughtful implementation.","authors":"Carolina D Tennyson, Joy L Coles","doi":"10.1097/JXX.0000000000001197","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001197","url":null,"abstract":"<p><strong>Abstract: </strong>The National Task Force Standards for Nurse Practitioner (NP) Education recommendation for NPs to complete a minimum of 750 patient-contact hours before certification has been met with some hesitation. As the profession discusses the evidence behind this change and resources needed, we anticipate the eventual adoption by nursing education, state boards of nursing, and national certifying bodies. This transition will require a planned and sequential rollout, beginning with the national NP certifying bodies. Here, we discuss the collective implications for students, faculty, and nurse leaders.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958736","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":"Open payments database general payments analysis to nurse practitioners from 2021 to 2022.","authors":"Lina M Adwer, Brooke J Fitzpatrick, Erik D Whiting, Collin E Dougherty, Juan A Santamaria-Barria","doi":"10.1097/JXX.0000000000001179","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001179","url":null,"abstract":"<p><strong>Introduction: </strong>The Centers for Medicare & Medicaid Services Open Payments Database (OPD) reports industry payments to health care providers, promoting transparency in financial relationships. In 2021, the OPD expanded to include nurse practitioners (NPs), who now number over 385,000 in the United States.</p><p><strong>Purpose: </strong>This study analyzed general industry payments to NPs from 2021 to 2022, focusing on payment nature, amounts, companies involved, and geographic distribution.</p><p><strong>Methodology: </strong>We queried the OPD for NPs identified as \"Nurse Practitioner\" under relevant taxonomy categories, analyzing data on payment nature, amount, company, covered product, and recipient location. Descriptive statistics summarized the data.</p><p><strong>Results: </strong>Between 2021 and 2022, 207,732, US NPs received $182,275,340 in 4,866,831 general payments. The median payment was $16.47. Most payments were for food and beverage (97%), which accounted for the highest dollar total ($102,218,684; 56%). Other payments included services other than consulting ($48,325,438; 27%) and travel/lodging ($11,478,596; 6%). Five companies-AbbVie, Allergan, Janssen, Novo Nordisk, and AstraZeneca-accounted for 32.6% of payments. Florida, Texas, and California received the highest payments.</p><p><strong>Conclusions: </strong>Nurse practitioners received substantial nonresearch payments, predominantly for food and beverage. Future research should explore factors like certification area and state practice authority that influence payment trends.</p><p><strong>Implications: </strong>Understanding industry payments to NP highlights areas of potential influence, emphasizing the importance of transparency and policies to mitigate conflicts of interest.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958682","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}