Journal of the American Association of Nurse Practitioners最新文献

{"title":"A case study of hypophosphatasia: An underdiagnosed bone disorder characterized by low alkaline phosphatase.","authors":"Leslie Moro","doi":"10.1097/JXX.0000000000001099","DOIUrl":"10.1097/JXX.0000000000001099","url":null,"abstract":"<p><strong>Abstract: </strong>Hypophosphatasia (HPP) is a rare genetic metabolic bone disorder that is underdiagnosed. Although there are many forms of this disease, based on age of onset, symptoms, and severity, HPP is characterized by low serum alkaline phosphatase levels, bone fractures, and dental complications. Diagnosis of HPP is made from clinical, laboratory, and radiologic findings. Genetic testing for an ALPL gene variant responsible for causing HPP confirms a molecular diagnosis. Distinguishing HPP from other more common bone disorders, such as osteoporosis, is important as the treatment for these diseases differs greatly. Although there is no known cure for HPP, treatment should be holistic and multidisciplinary.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"189-195"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729153","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":"How people respond to their analgesic adverse drug event: A secondary data analysis.","authors":"","doi":"10.1097/JXX.0000000000001116","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001116","url":null,"abstract":"","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"37 3","pages":"158-159"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605452","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":"Working with conference planners for maximum efficiency.","authors":"Rodney W Hicks, Mary Ellen Roberts, Judith A Berg","doi":"10.1097/JXX.0000000000001079","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001079","url":null,"abstract":"<p><strong>Abstract: </strong>Successful conferences are more likely to occur when presenters actively collaborate with conference planners. Although no \"best practices\" were found, we share our experiences and recommendations to support this collaborative relationship. We emphasize timely communication and preparedness.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"37 3","pages":"139-141"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605465","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":"How people respond to their analgesic adverse drug event: A secondary data analysis.","authors":"Deborah Dillon McDonald, Yiming Zhang, Batool Almasri","doi":"10.1097/JXX.0000000000001073","DOIUrl":"10.1097/JXX.0000000000001073","url":null,"abstract":"<p><strong>Background: </strong>An individual's inability to self-identify or refusal to acknowledge an analgesic adverse drug event (ADE) lengthens the time to ADE treatment and resolution and may worsen the outcome.</p><p><strong>Purpose: </strong>The purpose was to describe how people who experienced an analgesic ADE during pain self-management respond to the event and to identify predictors of serious analgesic ADEs.</p><p><strong>Methodology: </strong>The design was a secondary data analysis. The sample consisted of 599 adult cases that had an analgesic ADE during pain self-management and reported their response to the ADE, the analgesic, a description of the ADE, demographic, and health data. Logistic regression was used to test predictors of serious versus nonserious analgesic ADEs.</p><p><strong>Results: </strong>Three-fourth (75.5%) of cases indicated the ADE was easy to connect to the analgesic. The majority (72.6%) stopped the medication. Most (71.9%) talked with their provider. Serious ADEs such as gastrointestinal bleeding occurred in 16.2% of cases. Significant predictors of serious analgesic ADEs included less than a baccalaureate degree, male gender, and a higher Analgesic Adverse Drug Event Measure score.</p><p><strong>Conclusions: </strong>Adults who experience an analgesic ADE generally respond in an injury prevention way. A smaller group of individuals who experienced a serious analgesic ADE did not seem to differentiate between serious and nonserious ADEs.</p><p><strong>Implications: </strong>To promote safe pain management when prescribing new analgesics, providers should highlight common serious ADEs and instruct patients to contact them if an ADE emerges and to seek immediate care if they suspect a serious ADE.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"149-157"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983967","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":"Medication reconciliation in the outpatient primary care setting: Barriers and opportunities.","authors":"Susan P Schriefer, Marcy Ainslie","doi":"10.1097/JXX.0000000000001101","DOIUrl":"10.1097/JXX.0000000000001101","url":null,"abstract":"<p><strong>Abstract: </strong>Increased complexity of the health care system has led to challenges of vital communications, such as a current and accurate patient medication list. Medication reconciliation aims to create the most comprehensive and accurate list of a patient's current medications by comparing it with their electronic health record. However, effectively gathering, organizing, and communicating this medication information across different stages of care is often complex and challenging. Fragmented provider groups and incompatible software systems can also lead to breaks in communication and contribute to medication discrepancies. Medication reconciliation is an evidence-based safety intervention that can decrease medication errors and patient harm. Primary care providers play a critical role in ensuring a patient's medication list is current and accurate.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"145-148"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807110","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":"Hypertrophic cardiomyopathy overview: Genetics, screening, and treatment.","authors":"Mary Alison Smania","doi":"10.1097/JXX.0000000000001109","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001109","url":null,"abstract":"<p><strong>Abstract: </strong>Hypertrophic cardiomyopathy (HCM) is a common genetic cardiac disorder marked by unexplained asymmetrical left ventricular wall thickening. This condition exhibits histopathological hallmarks including enlarged heart cell muscles, fibrosis, and associated with left ventricular diastolic dysfunction and outflow tract obstruction. Hypertrophic cardiomyopathy results from sarcomere protein mutations and can cause significant cardiac symptoms, although some, especially young individuals, may remain asymptomatic or have mild symptoms. However, sudden cardiac death remains a significant risk for undiagnosed and diagnosed patients. Advancements in HCM's understanding have transformed screening and management protocols. Once the gene mutation is identified, monitoring can be accomplished with screening electrocardiogram, echocardiography, and cardiac magnetic resonance imaging. Targeted interventions include medications and other surgical and nonsurgical treatments. Furthermore, it is essential to conduct family screening and genetic analysis to aid in identifying other preclinical gene carriers. Timely diagnosis is crucial, given HCM's risk for sudden cardiac death, treatability, and potential for longevity.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"37 3","pages":"142-144"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605458","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":"Perceptions of the challenges facing nurse practitioners in providing care to children.","authors":"Ashleigh F Bowman, Kristin Hittle Gigli","doi":"10.1097/JXX.0000000000001114","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001114","url":null,"abstract":"<p><strong>Background: </strong>Pediatric nurse practitioners (NPs) play an essential role in achieving optimal child health. However, few studies have examined barriers to implementing pediatric NP roles.</p><p><strong>Purpose: </strong>The purpose of this study was to identify challenges in pediatric NPs' practice that limit their ability to provide care.</p><p><strong>Methodology: </strong>The authors conducted a secondary, qualitative analysis of survey data collected by the National Association of Pediatric Nurse Practitioners. The authors analyzed data from one open-ended question, \"What is the biggest challenge to the pediatric-focused NP role?\" An inductive thematic analysis resulted in discovery of 18 themes.</p><p><strong>Results: </strong>A total of 980 pediatric NPs responded, most (67.9%) were primary care pediatric NPs, and 15.2% were acute care pediatric NPs. Challenges aligned with four megathemes: who we are, what we can do, what we need, and what our patients need.</p><p><strong>Conclusions: </strong>Pediatric NPs identified barriers to role recognition that align with improving professional identity.</p><p><strong>Implications: </strong>Future research should address barriers to role recognition that can increase the ability of pediatric NPs to provide child health care.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365125","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":"Nurse practitioner and physician associate mentorship: Improving retention and employment experiences.","authors":"Boyon Yun, Adam C Gilbert, Hsin-Fang Li, James M Scanlan, Andrea L Coleman","doi":"10.1097/JXX.0000000000001093","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001093","url":null,"abstract":"<p><strong>Background: </strong>Clinician turnover is costly for health care organizations.</p><p><strong>Local problem: </strong>A retention strategy for newly hired nurse practitioners (NPs) and physician associates (PAs) was needed at our organization.</p><p><strong>Methods: </strong>A quality improvement project was conducted to determine whether a mentorship program could improve retention and employment experiences of newly hired NPs and PAs.</p><p><strong>Interventions: </strong>A one-to-one mentorship program was implemented for newly hired NPs and PAs. (a) Retention and productivity data were compared for mentee participants vs. nonparticipants. (b) Mentee and mentor participants completed two program evaluation surveys to examine the program's impact on their employment experiences.</p><p><strong>Results: </strong>Sixty-eight mentee-mentor pairs completed their mentoring relationship during the first 3 years of the program. Retention was higher among mentee participants vs. nonparticipants during their first (96% vs. 85%, p = .0332) and second year of employment (83% vs. 65%, p = .0480). Productivity during the first year was similar for mentee participants and nonparticipants (38th percentile vs. 37th percentile, p = .84). Most participants (≥69%) believed the program improved onboarding, personal and professional growth, work environment, and NP and PA community connection.</p><p><strong>Conclusions: </strong>The mentorship program improved first- and second-year retention of newly hired NPs and PAs and employment experiences of program participants. By our estimates, the program helped retain 15 NPs and PAs who would have otherwise left the organization, yielding potential organizational savings of $1.29M-$1.72M. A mentorship program can be an effective retention strategy for reducing health care turnover and related costs.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950699","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":"Relationships among health promotion behaviors, patient engagement, and the nurse practitioner-patient partnership.","authors":"Irene DeCelie, Bonnie Sturm","doi":"10.1097/JXX.0000000000001039","DOIUrl":"10.1097/JXX.0000000000001039","url":null,"abstract":"<p><strong>Background: </strong>Individuals adopting health promotion behaviors benefit from improved health and reduced risk of chronic diseases. Patient engagement and a strong provider-patient partnership may play a role in health promotion.</p><p><strong>Purpose: </strong>This study examined the relationships between patient engagement, the nurse practitioner-patient partnership and health promotion behaviors among adults in a primary care setting.</p><p><strong>Methodology: </strong>A descriptive correlational study using convenience sampling to recruit 85 participants from a nurse practitioner primary care practice. Participants completed questionnaires measuring health promotion behaviors (Health Promoting Lifestyle Profile II), the quality of the nurse practitioner-patient partnership (Patient Reactions Assessment), and a person's capacity to engage in their health care (Person Engagement Index).</p><p><strong>Results: </strong>Moderate to strong correlations were found among the main study variables. Multiple regression analysis found a person's capacity to engage in health care significantly predicted health promotion behaviors ( R2 = 0.362, p < .001) and explained 36.2% of the variance in health promotion behaviors.</p><p><strong>Conclusions: </strong>Patient engagement is a significant predictor of health promotion behaviors. The interactive care model can serve as a framework for nurse practitioners to build partnerships and facilitate patient engagement. Nurse practitioners can serve as a coach, navigator, collaborator, and trusted health care partner with their patients.</p><p><strong>Implications: </strong>Nurse practitioners in primary care may need to restructure the health care encounter to allow for adequate time to communicate, listen, educate, and enlist patients in the shared decision-making process. Nurse practitioners can provide the support patients need to engage in their health care as they accept greater responsibility for their health.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"8-18"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437091","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":"\"I never thought of it as payment\": Qualitative evaluation of workshops with advanced practice registered nurses on pharmaceutical industry payment reporting.","authors":"Quinn Grundy, Nancy Rudner, Tracy Klein, Elissa Ladd, Dana Hart, Meghan MacIsaac, Lisa Bero","doi":"10.1097/JXX.0000000000001077","DOIUrl":"10.1097/JXX.0000000000001077","url":null,"abstract":"<p><strong>Background: </strong>With the expansion of professional autonomy and prescriptive authority of advanced practice registered nurses (APRNs), interactions with industry are under greater scrutiny. As of July 1, 2021, pharmaceutical and medical device companies must publicly report all payments to APRNs through the Centers for Medicare and Medicaid Services' Open Payments website.</p><p><strong>Purpose: </strong>To gauge APRNs' familiarity with, and perceptions of the Open Payments database and discuss whether and how APRNs should respond.</p><p><strong>Methodology: </strong>Virtual workshops consisting of a didactic presentation and interactive exercises with APRNs recruited through professional networks, associations, and conferences. Transcripts were analyzed using a qualitative interpretive approach, grounded in an everyday ethics theoretical framework.</p><p><strong>Results: </strong>Thirty-six APRN clinicians, students, and faculty participated in nine workshops. Seeing sponsored meals reported in Open Payments as \"payments\" prompted participants to see familiar interactions in a new way. Participants valued the enhanced transparency as a way to identify risks of bias but were concerned that reporting might undermine public trust in APRNs. Emphasizing awareness as a precursor to action, participants desired greater preparation for ensuring independence in practice.</p><p><strong>Conclusions: </strong>The importance of tackling the ethical issues associated with industry interactions is heightened within the context of an existing climate of distrust within health care. However, many participants were concerned about the effects of transparency on public trust rather than how APRNs individually or collectively can be more trustworthy.</p><p><strong>Implications: </strong>Open Payments can serve as a useful tool to catalyze broader conversations about ethics, integrity in decision making, and health policy advocacy.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"51-60"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400589","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}