Journal of the American Association of Nurse Practitioners最新文献

{"title":"The lived experience of those who work with or hire Doctor of Nursing Practice-prepared nurses in practice: A phenomenological study.","authors":"Amy Manderscheid, Karen Kesten, Katherine Moran, Dianne Conrad, Catherine Corrigan, Susan Strouse","doi":"10.1097/JXX.0000000000001366","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001366","url":null,"abstract":"<p><strong>Background: </strong>Health care systems require strong practice leadership to address increasing complexity, workforce demands, and quality outcomes. Doctor of Nursing Practice (DNP) nurses are educated to lead evidence-based practice, quality improvement, and system-level change; however, variability in role clarity and organizational support limits full utilization, and qualitative evidence describing their impact remains limited.</p><p><strong>Purpose: </strong>To explore the lived experiences of those who hire or work with DNP-prepared nurses.</p><p><strong>Methodology: </strong>A qualitative phenomenological design was used with a purposive sample of 21 US-based participants recruited through prior study participation and professional networks. Virtual interviews were transcribed and analyzed using a modified Giorgi method, including identification of meaning units, structural statements, and thematic synthesis until data saturation was achieved.</p><p><strong>Results: </strong>Two themes emerged within each group and were synthesized into one overarching theme: DNP-prepared nurses drive value through leadership, competencies, and system-level impact when supported by organizational culture and structure. Participants described DNP nurses as influential leaders demonstrating advanced clinical reasoning and systems thinking; however, inconsistent role clarity and limited organizational support constrained full enactment of DNP-level capabilities.</p><p><strong>Conclusions: </strong>Doctor of Nursing Practice-prepared nurses are essential practice leaders capable of advancing quality outcomes and system performance. Their impact depends on organizational alignment, including clear role differentiation, leadership support, and structural investment.</p><p><strong>Implications: </strong>Institutions must cultivate cultures that provide protected time, clear role expectations, and leadership support to enable DNP-prepared nurses to practice at full scope. Without structural alignment, DNP competencies remain underused, reinforcing the need to treat organizational investment in DNP roles as a strategic priority.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"38 9","pages":"727-738"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912584","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":"Not so fast, I am serofast: Using actionable patient education to drive appropriate management of people with serofast syphilis serologies.","authors":"Dennis Kan, Molly Stenzel, Julie Thompson, Jennie De Gagne, Kara McGee","doi":"10.1097/JXX.0000000000001356","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001356","url":null,"abstract":"<p><strong>Background: </strong>An increase in syphilis cases in the United States and the global shortage of Benzathine Penicillin G (BPG) calls for evidence-based optimization. Confusing serologies and incomplete sexual history exacerbate the overprescription of BPG, especially for patients with \"serofast\" serologies.</p><p><strong>Purpose: </strong>The aim of this project was to reduce unindicated BPG administration while maintaining or improving appropriate BPG administration in people diagnosed with syphilis.</p><p><strong>Methodology: </strong>A longitudinal pre-post design was implemented where actionable education was delivered to patients who received BPG injection to treat syphilis.</p><p><strong>Results: </strong>Benzathine Penicillin G was administered 187 times (69 preintervention, 118 postintervention), and inappropriate administration declined by 7.9% relatively (10.1-9.3%). There was no difference in outcomes between the newly infected and reinfected patients.</p><p><strong>Conclusion: </strong>This project demonstrated modest improvements in the administration of appropriate BPG, although the results did not reach statistical significance.</p><p><strong>Implications: </strong>Future interventions should focus on automating patient education within the electronic health record. The growing prevalence of syphilis among non-traditional risk groups emphasizes the importance of sexual health screening and educational approaches to enable patients to advocate for appropriate syphilis management, especially when they are serofast.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873794","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":"Accreditation: The other faculty role.","authors":"Susan D Ruppert, Mary Ellen Roberts, Rodney W Hicks","doi":"10.1097/JXX.0000000000001302","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001302","url":null,"abstract":"<p><strong>Abstract: </strong>Accreditation is fundamental to nursing program quality, graduate/completer eligibility for licensure and certification, and admission to graduate study. Traditionally, faculty expectations have been organized around three pillars: teaching, scholarship, and service/practice. Although these categories remain essential, they no longer fully capture the scope of contemporary faculty responsibilities. This article proposes that accreditation activities constitute a fourth cornerstone of the faculty role, integral rather than supplementary to academic work. Nurse practitioner faculty often transition from clinical practice to academia without adequate preparation for accreditation. Yet accreditation requires active, ongoing faculty engagement across all program domains, including mission and governance, resources, curriculum, and outcomes. Faculty serve as subject-matter experts, aligning program design with accreditation standards, professional competencies, and regulatory requirements set by nursing program accreditors. When faculty engage meaningfully in accreditation, compliance becomes continuous quality improvement. Early introduction to accreditation standards and the accreditation process, guided by mentorship from experienced faculty, is an essential strategy for building this capacity among new faculty members. Integrating accreditation as an explicit faculty expectation strengthens program accountability, supports student success, and ensures alignment with evolving professional and regulatory standards. Recognizing accreditation as a core faculty responsibility reframes it as a faculty-driven commitment to excellence rather than a periodic administrative obligation.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"38 9","pages":"679-683"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912041","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":"Cyanosis without hypoxemia: Extensive infusaport-associated central venous thrombosis presenting as superior vena cava syndrome.","authors":"Tindu Arikupurathu, Jenna M Razeq, Aliza Khanam","doi":"10.1097/JXX.0000000000001350","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001350","url":null,"abstract":"<p><strong>Abstract: </strong>Superior vena cava (SVC) syndrome is a potentially life-threatening condition caused by impaired venous return from the head, neck, and upper extremities that can present with prominent facial cyanosis. This finding may be misleading, as it does not necessarily reflect impaired arterial oxygenation. We report a 68-year-old woman with metastatic colorectal cancer receiving chemotherapy through a right internal jugular implantable venous access port who presented with acute dyspnea, weakness, and progressive facial and perioral cyanosis 2 days after completing FOLFOX (A chemotherapy regimen consisting of folinic acid (leucovorin), fluorouracil (5-FU), and oxaliplatin. It is commonly used to treat colorectal cancer) chemotherapy. Given recent chemotherapy exposure, her presentation initially raised concern for hypersensitivity or anaphylactoid reaction. Despite the patient's striking cyanotic appearance, arterial blood gas analysis demonstrated normal oxygenation, whereas venous blood gas revealed marked desaturation with elevated deoxyhemoglobin. Imaging subsequently identified extensive catheter-associated thrombosis involving the bilateral internal jugular, subclavian, and brachiocephalic veins with complete occlusion of the SVC and extension into the right atrium. The patient was treated with systemic anticoagulation and urgent endovascular thrombectomy with the removal of the indwelling port, resulting in rapid clinical improvement. This case emphasizes that in SVC obstruction, visible cyanosis may reflect localized venous congestion rather than systemic hypoxemia. Recognition of discordant arterial and venous oxygenation can help avoid misdiagnosis and facilitate timely intervention, particularly in oncology patients with central venous devices.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873068","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":"Model for structuring competency-based education assessments for nurse practitioner students in a Doctor of Nursing Practice program.","authors":"Holly R Chitwood, Debra Hampton, Candice Falls, Julianne Z Ewen, Leslie Scott, Elizabeth Tovar, Holly Stith, Andrew Makowski, Angela B Grubbs, Jill M Clemmons, Sheila D Melander","doi":"10.1097/JXX.0000000000001342","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001342","url":null,"abstract":"<p><strong>Abstract: </strong>The 2021 American Association of Colleges of Nursing Essentials: Competencies for Professional Nursing Education, has required Colleges of Nursing to transition to implementation of competency-based education while redefining development and validation of competencies. It was essential for programs to structure assignments and activities with a focus on competency-based education assessments targeting end outcomes for practice-focused graduate nurse practitioner (NP) students. The purpose of this article is to provide a model for structuring competency-based assessments using an innovative, tiered approach for NP students in a Doctor of Nursing Practice program.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873039","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":"Educational strategies for preparing nurse practitioners for rural practice.","authors":"Joyce Knestrick, Melody R Wilkinson","doi":"10.1097/JXX.0000000000001357","DOIUrl":"10.1097/JXX.0000000000001357","url":null,"abstract":"<p><strong>Abstract: </strong>Rural communities experience health care workforce shortages, poorer health outcomes, and significant barriers related to health care access, transportation, behavioral health services, and other social drivers of health. Nurse practitioners (NPs) are well positioned to address these disparities; however, traditional NP education often emphasizes urban and suburban practice environments, leaving graduates underprepared for the realities of rural practice. Preparing NPs to serve rural populations requires competencies that extend beyond clinical care, including cultural humility, community engagement, telehealth delivery, interprofessional collaboration, ethical navigation of dual-role relationships, and an understanding of the structural factors that influence rural health. This article examines educational strategies that can strengthen NP preparation for rural practice and support the development of a sustainable rural health care workforce. Key considerations include rural culture, community strengths, social drivers of health, occupational and environmental health risks, and the contextual factors that shape health care delivery in rural communities. Educational approaches discussed include community-based learning, service-learning, distance education, telehealth training, rural immersion experiences, mentorship, and longitudinal rural exposure. Examples from established programs illustrate how academic-community partnerships and experiential learning opportunities can foster cultural humility, professional identity formation, community engagement, and resource-conscious clinical reasoning. These strategies align with the 2021 American Association of Colleges of Nursing Essentials and support the development of competencies in population health, systems-based practice, person-centered care, and professionalism. Preparing NPs for rural practice involves intentional educational experiences that help learners understand rural communities, build authentic partnerships, and the competencies necessary to advance health equity and improve health outcomes in underserved rural populations.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"718-724"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818884","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":"Psychiatric mental health nurse practitioner outcomes after completion of a 1-year postgraduate fellowship.","authors":"Anna Pasternak, Hilary Gould, Alexandra Sietsma, Crystal Ross, Steve Koh","doi":"10.1097/JXX.0000000000001352","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001352","url":null,"abstract":"<p><strong>Abstract: </strong>Psychiatric mental health nurse practitioners (PMHNPs) are an essential and growing part of the health care workforce, especially in community settings. To address PMHNPs' increasing presence in community psychiatry, a 1-year postgraduate PMHNP fellowship in community psychiatry was developed with the goals of enhancing clinical competency and employment retention in underserved public sector settings. Data on 5 cohorts and 31 fellows are presented in this article. PMHNP fellows, preceptors, didactics, and clinical sites were evaluated across several time points including baseline and 6 and 12 months. The program has graduated 100% of fellows with largely positive feedback. Fellows reported significant improvements in competency across the domains of 1) assessment and diagnosis, 2) treatment, and 3) professionalism and leadership. These items were substantiated by clinical preceptors' ratings of fellows' clinical skills from 6-month and 12-month time points. Relatedly, clinical sites, preceptors, and didactics were all rated highly by fellows. After the program, 90.3% of graduates remained working in the public sector including correctional settings, community clinics, and safety net hospitals.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873770","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":"Strengthening advanced practice through the nurse practitioner clinician-scientist.","authors":"Hyunmin Yu, Lauren V Ghazal, Jason Saucier, Kathryn A Connell","doi":"10.1097/JXX.0000000000001316","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001316","url":null,"abstract":"<p><strong>Abstract: </strong>This commentary discusses the emerging role of nurse practitioner (NP) clinician-scientists and its implications for strengthening advanced practice within acute care health systems. Although NPs have transformed health care delivery in acute care settings, research describing their optimal deployment, system-level impact, and workforce sustainability remains limited. We argue that NP clinician-scientists, clinically active NPs with formal research training, are uniquely positioned to bridge frontline practice and rigorous scientific inquiry. Their embedded roles within Learning Health Systems enable pragmatic trials and workflow redesign that directly reflects real-world care delivery. We highlight the growth and impact of NPs in acute care settings, explain why NP clinician-scientists matter, and outline what they can uniquely contribute. Finally, we describe organizational and academic strategies to cultivate this emerging role. Intentional investment in NP clinician-scientists represents a strategic opportunity to generate actionable evidence, strengthen interdisciplinary care models, and advance quality and workforce sustainability in health systems.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873833","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":"From the AANP Board-Nurse practitioners and the regulatory process.","authors":"Valerie Fuller, Michelle Anderson","doi":"10.1097/JXX.0000000000001365","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001365","url":null,"abstract":"<p><strong>Abstract: </strong>In this segment, American Association of Nurse Practitioners Region 10 Director Dr. Michelle Anderson and I discuss how regulation shapes Nurse Practitioner (NP) practice and why every NP should understand the regulatory process.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"38 9","pages":"678"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912360","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":"Academic partnerships with clinical nurse scientist mentors improve the Doctor of Nursing Practice student experience.","authors":"Margaret A Gettis, Kelly Winter, Christina J Calamaro","doi":"10.1097/JXX.0000000000001367","DOIUrl":"10.1097/JXX.0000000000001367","url":null,"abstract":"<p><strong>Abstract: </strong>The Doctor of Nursing Practice (DNP) degree has become firmly established as the terminal practice degree for advanced practice registered nurses in the United States. A defining component of the DNP curriculum requires students to implement a scholarly project that addresses a clinical problem and improves patient or system outcomes. This article describes the development and implementation of a structured clinical-academic partnership between a university-based DNP nurse anesthesia program and a pediatric health care organization in the southeastern United States. Central to this collaboration was the establishment of the clinical Nurse Scientist Mentor (NSM) role designed to bridge academic and clinical environments. To develop high-level DNP student projects, the NSM and academic faculty connected the DNP student-employees to projects that improved patient, clinical, or system outcomes. The experience in this report suggests that structured clinical-academic partnerships can strengthen the quality, relevance, and sustainability of DNP scholarly work. In addition, the NSM is an innovative and viable model that can be replicated in health care systems where DNP projects are being implemented.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"705-709"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829795","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}