Journal of the American Association of Nurse Practitioners最新文献_第8页

Transitions in care: Piloting a neurocritical care clinic with nurse practitioners and physician associates. 护理转型：与执业护士和医生合作，试点一家神经重症护理诊所。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000000950

Chloe Michaelis, Elizabeth Hundt, William Lombardi, Jill Howie Esquivel

{"title":"Transitions in care: Piloting a neurocritical care clinic with nurse practitioners and physician associates.","authors":"Chloe Michaelis, Elizabeth Hundt, William Lombardi, Jill Howie Esquivel","doi":"10.1097/JXX.0000000000000950","DOIUrl":"10.1097/JXX.0000000000000950","url":null,"abstract":"Abstract: The transition period from hospital to home is a vulnerable time for rehospitalization and adverse events for patients. Follow-up clinic visits within 7-14 days of discharge is an effective strategy for reducing hospital readmissions. Neurocritical care patients have a unique set of needs to safely transition to home. We evaluated the feasibility of a Neuroscience Rapid Follow-Up Clinic with nurse practitioners (NPs) and physician associates (PAs) to meet transitional care gaps in neurocritical care patients and prevent rehospitalization. Clinic procedures and documentation templates were customized for the pilot clinic. Five NPs and one PA underwent a brief training course for the ambulatory care setting. Eligible patients were tracked throughout the hospitalization and the team made follow-up appointments. The pilot clinic took place from October 2022 to January 2023. Nine patients were seen in the clinic approximately 8 days after discharge. The clinic attendance rate was 90%. Among the clinic attendees, 66% received referrals to a primary care provider or other services, one third received medication changes or refills and all received patient-specific education. There were no rehospitalizations among the clinic patients. Implementation of this pilot clinic was possible with the current departmental resources. This innovative model of care has the potential to reduce hospital readmissions.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41136881","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}

引用次数: 0

Diabetic myonecrosis: An easily overlooked cause of limb pain in diabetic patients. 糖尿病性肌坏死：糖尿病患者肢体疼痛的一个容易被忽视的原因。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000000962

Jennifer Wells, Stephen C Sorsby

引用次数: 0

A case for the health welfare of Texans-A nurse practitioner state regulation policy analysis. 得克萨斯州健康福利案例——执业护士州监管政策分析。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000000967

Laura A Ivey, Patrick Flavin, Katy Vogelaar, Jessica L Peck

{"title":"A case for the health welfare of Texans-A nurse practitioner state regulation policy analysis.","authors":"Laura A Ivey, Patrick Flavin, Katy Vogelaar, Jessica L Peck","doi":"10.1097/JXX.0000000000000967","DOIUrl":"10.1097/JXX.0000000000000967","url":null,"abstract":"Abstract: Restrictive nurse practitioner (NP) practice regulation at the state level continues to obstruct patient access to quality affordable care because primary care provider shortages heighten across the nation. Evidence-based research supports NPs as cost-effective providers without conceding quality of care. A patchwork of highly variable state policies subjectively determines the degree of collaborative oversight required for NPs to practice in each state. An objective review of policies influencing NP capacity to deliver care promotes evidence-informed policy adaptation. A policy analysis was completed using Bardach and Patashnik's framework to evaluate policy options for NP practice regulation in Texas. Full practice authority (FPA) policy effect was quantitively evaluated through difference-in-differences regression models using selected measures of all 50 states and the District of Columbia. Health welfare outcomes were calculated using emergency department utilization, average household health expenditures, poor physical health days, and NP-specific adverse action reports (AAR). Overall, FPA policy did not have a statistically significant effect on state-clustered emergency department utilization, average household health expenditures, or poor physical health days. Full practice authority was associated with decreased NP AAR. The analysis supports FPA as a viable policy option for states such as Texas and counters claims FPA policy adoption results in detrimental sequalae in the health of the population.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71424567","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}

引用次数: 0

Implementation of a postgraduate dermatology fellowship program for nurse practitioners. 为执业护士实施皮肤病研究生奖学金项目。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000000963

Sylvana Brickley, Shimika Barrolle, Alice Pentland

引用次数: 0

What the X? Understanding changes in buprenorphine prescribing regulation. 什么是 X？了解丁丙诺啡处方法规的变化。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000000942

Chandra Speight

引用次数: 0

Improving effective depression care in an outpatient psychiatric clinic. 改善精神科门诊有效的抑郁症护理。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000000975

Thomas Moore, Sharanna Johnson

{"title":"Improving effective depression care in an outpatient psychiatric clinic.","authors":"Thomas Moore, Sharanna Johnson","doi":"10.1097/JXX.0000000000000975","DOIUrl":"10.1097/JXX.0000000000000975","url":null,"abstract":"Background: With more than 20 million adults experiencing a major depressive episode in 2020, depression is one of the most widespread and costly illnesses in the United States.Local problem: An audit of medical records at an outpatient psychiatric clinic revealed that none of the patients (0/56) were receiving standardized depression screening at follow-up appointments.Methods: An 8-week rapid cycle Plan-Do-Study-Act model for change was used to spearhead a quality improvement (QI) project for effective depression care. The QI project comprised ongoing data collection through chart audit every 3 days, which drove tests of change (TOC). Team engagement surveys were also assessed for change in team engagement scores.Interventions: The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, and an effective care log (ECL) measured effective depression care. Every 2 weeks, a TOC was implemented, which guided further iterative changes throughout the project.Results: Effective depression care increased to 74% over the course of the project, surpassing the initial aim of 50%. Completion rates of the PHQ-9 (76%) and ECL (91%) increased. Team engagement (27.1) also increased over the course of the project.Conclusions: This project improved effective depression care. The success was largely due to the iterative TOCs, ECL, and team engagement.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71424572","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}

引用次数: 0

Nurse practitioner satisfaction with in-person versus telehealth chronic care delivery. 护士执业满意度面对面与远程医疗慢性护理交付。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000000964

Stephanie O Ibemere, Susan G Silva, Mary Lou Affronti, Rita Masese, Paula Tanabe

{"title":"Nurse practitioner satisfaction with in-person versus telehealth chronic care delivery.","authors":"Stephanie O Ibemere, Susan G Silva, Mary Lou Affronti, Rita Masese, Paula Tanabe","doi":"10.1097/JXX.0000000000000964","DOIUrl":"10.1097/JXX.0000000000000964","url":null,"abstract":"Background: The widespread use of telehealth and regulatory changes that enhanced nurse practitioner (NP) practice authority because of the SARS-CoV-2 pandemic offers an opportunity to assess postpandemic NP satisfaction with telehealth care delivery and perceptions of its feasibility compared with in-person visits.Purpose: Outpatient chronic care delivery satisfaction and preference were compared among NPs who provide care to adults through in-person and/or telehealth visits and examined NP demographic and clinical characteristics associated with overall satisfaction by care delivery type.Methodology: Data were collected using a cross-sectional, descriptive design through online dissemination of The Care Delivery Satisfaction Survey to a nationally representative sample of 586 NPs.Results: Compared with NPs using both visit types to deliver care, NPs delivering care in-person only had significantly lower satisfaction scores for interpersonal manner ( p = .0076) and communication ( p = .0108). NPs using telehealth only had significantly higher overall satisfaction and satisfaction subscale scores (all p < .01) compared with NPs using both visit types. Overall, 77% of NPs using both visit types preferred in-person delivery.Conclusions/implications: NPs delivering telehealth care only were more satisfied with chronic care delivery than NPs using both delivery types. NPs using both types were more satisfied with interpersonal manner and communication compared with NPs delivering in-person care only. Most NPs using both types preferred in-person care delivery. Given increased telehealth use, health systems, academic institutions, and insurance companies can use these study findings to inform policy on telehealth resources and infrastructure.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92154853","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}

引用次数: 0

What the X? Understanding changes in buprenorphine prescribing regulation. 什么是 X？了解丁丙诺啡处方法规的变化。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI: 10.1097/JXX.0000000000001008

引用次数: 0

Effect of telemonitoring and as-needed patient support on positive airway pressure therapy adherence. 远程监控和按需患者支持对坚持气道正压疗法的影响。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-02-29 DOI: 10.1097/JXX.0000000000001006

Saoirse Owens, Karl Doghramji

{"title":"Effect of telemonitoring and as-needed patient support on positive airway pressure therapy adherence.","authors":"Saoirse Owens, Karl Doghramji","doi":"10.1097/JXX.0000000000001006","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001006","url":null,"abstract":"Background: Obstructive sleep apnea (OSA) affects patient health and public welfare. Positive airway pressure (PAP) therapy is the preferred treatment of OSA, but therapy adherence rates remain suboptimal. Current literature demonstrates telemonitoring interventions to support improved PAP therapy adherence.Purpose: To evaluate the effect of interval telemonitoring of PAP therapy data at 2 and 4 weeks after treatment initiation in patients with moderate-to-severe obstructive sleep apnea with as-needed patient support and troubleshooting by telephone consultation.Methodology: Ninety-nine participants were enrolled in this study, 50 in the control group and 49 in the intervention group. Data were analyzed using descriptive and inferential statistics using SPSS 28.0 software. The primary outcome of interest was 90-day PAP adherence.Results: Mean PAP adherence scores diverged at 90 days after PAP initiation, with the intervention group having a significantly higher mean score (M = 49.24, SD = 38.18) relative to the control group (M = 36.38, SD = 37.69). Likewise, continued PAP usage at 90 days after therapy initiation diverged between participant groups, with the intervention group having a significantly higher mean score (M = 89.80, SD = 30.58) relative to the control group (M = 72.00, SD = 45.36).Conclusions: The intervention resulted in significantly higher mean PAP adherence and a greater percentage of participants demonstrating continued PAP usage at 90 days after therapy initiation but did not result in a statistically significant increase in what is considered and defined as \"good PAP adherence\" (adherence of ≥70%).Implications: Data-triggered telemonitoring protocols offer supplementary support to patients in need and improve PAP adherence.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990449","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}

引用次数: 0

Adherence to a reproductive health intervention for young adults with sickle cell. 坚持对患有镰状细胞的年轻成人进行生殖健康干预。

IF 1.2 4区医学

Journal of the American Association of Nurse Practitioners Pub Date : 2024-02-22 DOI: 10.1097/JXX.0000000000000997

Nyema T Eades-Brown, Anne O Oguntoye, Dalal Aldossary, Miriam O Ezenwa, Laurie Duckworth, Duane Dede, Versie Johnson-Mallard, Yingwei Yao, Agatha Gallo, Diana J Wilkie

{"title":"Adherence to a reproductive health intervention for young adults with sickle cell.","authors":"Nyema T Eades-Brown, Anne O Oguntoye, Dalal Aldossary, Miriam O Ezenwa, Laurie Duckworth, Duane Dede, Versie Johnson-Mallard, Yingwei Yao, Agatha Gallo, Diana J Wilkie","doi":"10.1097/JXX.0000000000000997","DOIUrl":"10.1097/JXX.0000000000000997","url":null,"abstract":"Background: The CHOICES intervention is tailored specifically for young adults with sickle cell disease (SCD) or sickle cell trait (SCT). The face-to-face (F2F) delivery format is feasible with efficacy for improving knowledge about reproductive health for those with SCD or SCT.Purpose: The purpose of the study was to compare the participant adherence to a remote online CHOICES intervention study (N = 107) and a F2F CHOICES intervention study (N = 234).Methodology: In both studies, participants with SCD or SCT were randomized into experimental or usual care control groups. Descriptive statistics were collected for all participants by group in both studies. Adherence was measured by retention at each data collection time point. Independent t-tests were conducted to compare mean participant adherence of the F2F and online studies postbaseline (6, 12, 18, and 24 months).Results: There was a significant difference in mean adherence postbaseline between the studies (p = .005). The results suggest that more research is necessary for proper online participant retention.Conclusion: Advance practice nurses that are well informed on CHOICES can transmit the availability of this evidence-based intervention to this special population. Special referral for the CHOICES intervention, which is tailored specifically for young adults with SCD or SCT, may increase adherence to the intervention if it comes from trusted health care providers.Implications: Nurse practitioners are educators in primary and acute care settings. Encounters with reproductive age populations with SCD or SCT can occur in both settings.","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972349","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}

引用次数: 0