Journal of the American Association of Nurse Practitioners最新文献

{"title":"Meeting the needs of rural populations through a nurse practitioner-led integrated care program for student health.","authors":"Margaret R Emerson, Melissa Langenberg, Tyler S Szymanski, Wendy Schardt, Anne Lano, Kiphany Hof","doi":"10.1097/JXX.0000000000001154","DOIUrl":"10.1097/JXX.0000000000001154","url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders, particularly anxiety and depression, disproportionately affect young adults, creating significant barriers to academic success. Access to mental health care remains a critical challenge in rural university settings. Nurse practitioner (NP)-led integrated care programs (ICPs) offer a potential solution by integrating behavioral health into primary care to provide timely, accessible, and holistic care.</p><p><strong>Purpose: </strong>This study examines the implementation and outcomes of a NP-led ICP aimed at addressing mental health challenges among college students in a rural university setting.</p><p><strong>Methodology: </strong>Over a 9-month period, 61 students participated in the ICP. The program used validated screening tools, including the 9-item Patient Health Questionnaire-9 (PHQ-9) and 7-item Generalized Anxiety Disorder (GAD-7), to assess and monitor depression and anxiety severity. Data on program outcomes were collected through these assessments, provider collaboration reviews, and satisfaction surveys.</p><p><strong>Results: </strong>Participants demonstrated significant reductions in depression and anxiety severity, as measured by PHQ-9 and GAD-7 tools. Key findings included improved access to care, enhanced collaboration among providers, and high satisfaction rates among students and staff. However, challenges related to role clarity and the fit of behavioral health providers highlighted the need for targeted training and supervision.</p><p><strong>Conclusions: </strong>The study demonstrates that integrated care models can be successfully adapted to rural university environments, leading to improved mental health outcomes for college students.</p><p><strong>Implications: </strong>The findings support the broader application of ICPs in similar settings. Future work will focus on extending the program into surrounding communities to sustain and expand its impact.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"446-455"},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649719","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 case study of managing functional seizures and self-injurious behavior in a detention setting: A multidisciplinary approach.","authors":"Daniel Kashoofy","doi":"10.1097/JXX.0000000000001168","DOIUrl":"10.1097/JXX.0000000000001168","url":null,"abstract":"<p><strong>Abstract: </strong>Functional seizures, also known as psychogenic nonepileptic seizures (PNES), present a significant challenge in correctional settings, where stress and limited medical resources complicate management. This case study explores the evaluation and treatment of a 20-year-old man detainee with functional seizures and comorbid borderline personality disorder (BPD). Initially misdiagnosed with epilepsy and schizophrenia, he underwent extensive medical evaluations and hospitalizations, including intubation following a seizure episode. His history of self-injurious behaviors, particularly swallowing foreign objects, further complicated his care. A multidisciplinary approach was implemented, including gradual withdrawal of unnecessary antiseizure medications, targeted treatment of BPD symptoms with quetiapine, and intensive therapeutic engagement. Structured interactions, emotional regulation strategies, and nonpharmacological interventions were emphasized. Over time, the patient demonstrated significant improvement, with cessation of self-harming behaviors and a reduction in seizure episodes. This case highlights the complexities of managing functional seizures in detention centers and the importance of accurate diagnosis, individualized treatment plans, and the integration of psychiatric and behavioral interventions. A therapeutic environment, combined with appropriate pharmacologic and nonpharmacologic strategies, can lead to meaningful clinical improvements in patient with PNES and co-occuring personality disorders.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626644","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":"Professional nursing organization volunteerism: An investment in the future.","authors":"Susan D Ruppert","doi":"10.1097/JXX.0000000000001171","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001171","url":null,"abstract":"<p><strong>Abstract: </strong>Professional nursing organizations depend on a volunteer workforce to fulfill their mission and activities. Professional altruism and a desire to contribute to the profession motivate individuals to participate in volunteer activities that align with their personal interests, match their areas of expertise, and fit specific time commitments. Volunteerism benefits not only the profession and organization but also the individual volunteer and their employer. This column provides insight into the personal and professional advantages of purposeful engagement in roles, initiatives, and activities within professional organizations to support the growth and advancement of the profession. Various types of opportunities are often available to contribute time and talent and engage meaningfully within professional organizations.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600786","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":"Expanding the horizon: The case for point-of-care ultrasound in all nurse practitioner practice settings.","authors":"Bryan Boling","doi":"10.1097/JXX.0000000000001163","DOIUrl":"10.1097/JXX.0000000000001163","url":null,"abstract":"<p><strong>Abstract: </strong>Point-of-care ultrasound (POCUS) has become a valuable diagnostic tool in emergency and critical care settings, but its potential extends far beyond those environments. For nurse practitioners (NPs) across all specialties-including primary care, women's health, and inpatient medicine-POCUS offers enhanced diagnostic accuracy, faster decision-making, and improved patient satisfaction. With growing access to affordable handheld devices and expanding educational opportunities, POCUS is becoming increasingly feasible for use in diverse clinical contexts. Its value is particularly pronounced in rural and resource-limited settings, where access to traditional imaging may be delayed or unavailable, helping reduce unnecessary transfers and improve timely care. Despite this, many NPs remain hesitant to incorporate POCUS into practice, citing barriers such as lack of training, equipment, or perceived utility. This editorial argues that POCUS represents the next evolution of the physical examination-much like the stethoscope once did-and that NPs should lead its broader integration into routine care. By highlighting real-world benefits and addressing common concerns, this article advocates for a shift in how NPs across all practice settings approach diagnostic imaging. It is time for NPs to embrace POCUS not as a luxury, but as an essential tool for modern, equitable, and high-quality patient care.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"430-432"},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584219","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":"DNA banking: Saving your genetic legacy for the future.","authors":"Laurie M Connors, Terri L Allison","doi":"10.1097/JXX.0000000000001156","DOIUrl":"10.1097/JXX.0000000000001156","url":null,"abstract":"<p><strong>Abstract: </strong>DNA banking is a clinical resource available to preserve an individual's information for genetic testing. DNA can be isolated from blood or tissue samples, then preserved and stored (banked) in a laboratory setting for future genetic testing. Nurse practitioners may include the option of DNA banking in discussions surrounding health care planning, end of life care, or when death is sudden and unexplained.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"433-435"},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591530","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":"Professional Academic Liaison: An impactful program for onboarding and retention of nursing faculty.","authors":"Debbie Cline, Lisa Thomas, Sydnee Lucas, Debbie McCrea, Sara Lewandowski, Ombola Oyeleye, Carole Mackavey, Kelly Kearney, Jessica Coviello, Susan D Ruppert","doi":"10.1097/JXX.0000000000001160","DOIUrl":"10.1097/JXX.0000000000001160","url":null,"abstract":"<p><strong>Abstract: </strong>Recruitment into faculty roles may involve hiring nurse practitioners and other specialized clinicians into academic roles they feel unprepared due to limited teaching experience. Lack of formal role preparation, role stress, and role strain are challenges new faculty face. This article explores methods of creating resources and implementing supportive processes for new faculty during the initial mentoring (onboarding) period. The Professional Academic Liaison (PAL) program standardizes topics to be discussed between a new faculty hire and mentor pair, along with milestones for evaluation. The assigned PAL introduces the new hire to academic culture and provides ongoing support during the 1st year of employment and aims to improve new faculty satisfaction, confidence, competency, and retention.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"511-516"},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584220","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":"Remediation in graduate nursing education: Strategies for supporting nurse practitioner students.","authors":"Rosie Zeno, Kelly Casler","doi":"10.1097/JXX.0000000000001157","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001157","url":null,"abstract":"<p><strong>Abstract: </strong>Nurse practitioner (NP) educators play a critical role in ensuring that students attain the competencies required for safe and effective independent practice. However, some students encounter challenges in mastering key competencies and require targeted remediation to address performance gaps. As health care delivery grows increasingly complex and competency-based education (CBE) becomes the standard in nursing curricula, the demand for evidence-based remediation strategies increases. Despite this need, faculty often hesitate to initiate remediation due to uncertainty about the process and the lack of widely accepted best practices in NP education. This article proposes a three-phase, evidence-informed framework for supporting underperforming students: (1) identifying and clarifying performance issues, (2) developing individualized plans for success, and (3) providing ongoing assessment and feedback. Grounded in CBE principles, this framework emphasizes the value of individualized remediation plans and advocates for further research to establish best practices in NP student remediation.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326104","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":"Precision medicine in psychiatry: Case series on pharmacogenomic solutions for treatment-resistant depression.","authors":"Gryan Garcia, Christy Cotner, Robert Spano","doi":"10.1097/JXX.0000000000001158","DOIUrl":"10.1097/JXX.0000000000001158","url":null,"abstract":"<p><strong>Abstract: </strong>Treatment-resistant depression (TRD) is a persistent challenge in psychiatry, affecting approximately 30% of patients with major depressive disorder. Defined by the failure to achieve remission after two adequate trials of antidepressants at therapeutic doses, TRD significantly impairs quality of life, heightens suicide risk, and increases health care utilization and economic burden. Current treatment paradigms rely heavily on trial and error, often leading to delayed symptom relief and exposure to unnecessary side effects. This underscores the urgent need for personalized approaches to care. Pharmacogenomic testing has emerged as a transformative tool in addressing the complexities of TRD. By analyzing genetic polymorphisms, such as those in cytochrome P450 enzymes, serotonin transporter, and methylenetetrahydrofolate reductase, pharmacogenomics offers insights into drug metabolism, receptor sensitivity, and neurotransmitter synthesis. This precision approach enables clinicians to optimize antidepressant selection, dosing, and augmentation strategies, minimizing adverse effects and enhancing therapeutic outcomes. This case series highlights the clinical utility of pharmacogenomic testing in managing TRD. Three diverse cases illustrate how genetic insights guided tailored interventions, leading to significant improvements in depressive symptoms, enhanced adherence, and overall patient satisfaction. The findings underscore pharmacogenomics' potential to shift psychiatry from trial and error to precision medicine, improving outcomes for patients with complex treatment histories. Despite challenges, such as cost, accessibility, and the need for clinician training, integrating pharmacogenomics into routine practice represents a promising avenue for advancing the management of TRD and enhancing the quality of psychiatric care.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"471-476"},"PeriodicalIF":1.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289479","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":"Preventing the next stroke: The urgent need for guideline adherence-An integrative review with implications for practice.","authors":"Munachi Okpala, Rebecca Keele","doi":"10.1097/JXX.0000000000001147","DOIUrl":"10.1097/JXX.0000000000001147","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a major global health issue, causing significant morbidity, mortality, and economic burden. Approximately 11% of individuals experience a recurrence within a year of their initial stroke, resulting in substantial disability and increased health care costs. Secondary stroke prevention is essential in reducing the risk of recurrent strokes and improving patient outcomes, but adherence to prevention guidelines remains inconsistent.</p><p><strong>Purpose: </strong>This integrative review evaluates adherence to the American Heart Association/American Stroke Association (AHA/ASA) guidelines for secondary stroke prevention across various clinical settings. It identifies gaps in adherence, assesses the impact on patient outcomes, and provides insights for improving guideline implementation.</p><p><strong>Methodology: </strong>A comprehensive literature search was conducted across databases including PubMed, CINAHL, Ovid, and Embase. This integrative review used 5-stage framework of Whittemore and Knafl to synthesize findings from quantitative and qualitative research studies on using the guidelines in reducing recurrent stroke. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist served as the reporting guideline.</p><p><strong>Results: </strong>Twenty studies from 2019 to 2020 met inclusion criteria, showing substantial variability in adherence to secondary stroke prevention guidelines. Key findings include a significant proportion of patients not receiving optimal therapies, varying adherence rates across settings, and notable gaps in recommended practice implementation.</p><p><strong>Conclusions: </strong>Adherence to AHA/ASA guidelines for secondary stroke prevention is inconsistent, with several barriers affecting optimal implementation. Addressing these gaps is important in reducing recurrent stroke rates.</p><p><strong>Implications: </strong>Health care providers must stay updated on AHA/ASA guidelines and integrate them into practice to ensure optimal outcomes.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289480","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":"Using the genotype selection interface: a clinical case study for CYP2C19.","authors":"Crystal Dodson, Dorothy Dulko","doi":"10.1097/JXX.0000000000001140","DOIUrl":"10.1097/JXX.0000000000001140","url":null,"abstract":"<p><strong>Abstract: </strong>Pharmacogenetic testing is a rapidly evolving field that aims to improve the efficacy and safety of drugs by finding genetic links influencing how drugs are processed, their effectiveness, and toxicity. Due to the high incidence of adverse drug reactions (ADRs) associated with certain medications and the heterogeneity of drug responses among patients, pharmacogenetic testing has gained significant attention. Research has shown that many clinicians, including nurse practitioners (NPs), have limited knowledge and experience with pharmacogenomics and pharmacogenetic testing, highlighting the need for enhanced education in this area. Using pharmacogenetic information, NP can tailor medication regimens to personalize treatments to individual genetic profiles to improve results and reduce ADRs. This paper will apply the Genotype Selection Interface for pharmacogenetic testing and discuss its clinical application, including challenges, limitations, and future directions.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"422-426"},"PeriodicalIF":1.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266534","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}