{"title":"Systemic barriers and facilitators to the transition of registered nurse to nurse practitioner in Canada: A scoping review.","authors":"Mohamed Toufic El Hussein, Calla Ha","doi":"10.1097/JXX.0000000000000724","DOIUrl":"10.1097/JXX.0000000000000724","url":null,"abstract":"<p><strong>Background: </strong>The scope of practice of nurse practitioners (NPs) is expanding, and an increasing number of registered nurses (RNs) are advancing their careers to become NPs. Nurse practitioners are prepared to improve access to high-quality care and enhance care standards. The barriers and facilitators in the transition of RNs to NPs have been seldom studied in the Canadian context.</p><p><strong>Objective: </strong>To conduct a scoping review to identify systemic barriers and facilitators affecting Canadian RN experience in transitioning to independent practice as NPs.</p><p><strong>Data sources: </strong>Four electronic databases were searched for primary studies, and several search engines were used to retrieve gray literature. Keywords included NP, transition, novice, Canada, barriers, obstacles, facilitators, and their variations. Eligible studies are those published from the inception of each respective database to 2021.</p><p><strong>Conclusions: </strong>Four research studies and one report in the gray literature were located. Three themes were identified from the literature review, including inconsistencies in education and the need for mentors, need for legislation supportive of NP practice, and inconsistent remuneration structures for NPs.</p><p><strong>Implications for practice: </strong>Addressing systemic barriers and employing systemic facilitators are likely to facilitate the transition of RNs to NPs. The lack of primary evidence to explore the factors that affect the transition process from an RN to an NP in Canada indicates that further research must be done. Findings from the future research are likely to furnish a better understanding of the transition process so that the integration of new NPs into the health care system can be achieved efficiently.</p>","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 1","pages":"792-801"},"PeriodicalIF":1.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42765866","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":"Antibiotic prescribing patterns and guideline-concordant management of acute respiratory tract infections in virtual urgent care settings.","authors":"Kelsey Turk, Julie Jacobson Vann, Sonda Oppewal","doi":"10.1097/JXX.0000000000000705","DOIUrl":"10.1097/JXX.0000000000000705","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic overprescribing for acute respiratory tract infections (ARTIs) commonly occurs and can lead to higher medical costs, antibiotic resistance, and health complications. Inappropriate prescribing of antibiotics for ARTIs has been shown to occur more frequently in urgent care than other outpatient settings. It is not clear whether antibiotic overprescribing varies between virtual and in-person urgent care.</p><p><strong>Objectives: </strong>Summarize published primary scientific literature on antibiotic prescribing patterns for ARTIs among adults in virtual urgent care settings.</p><p><strong>Data sources: </strong>We conducted a systematic review to compare antibiotic prescribing for ARTIs between virtual and in-person urgent care. Our review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We assessed risk of bias using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) assessment tool. We summarized study results from seven included retrospective cohort studies.</p><p><strong>Conclusions: </strong>Antibiotic prescribing frequency may be similar between virtual urgent care and in-person care for adult patients treated for ARTIs. However, variability existed in intervention characteristics, settings, and outcome measures. Additional studies are needed to better understand the conditions in which virtual care may be most effective.</p><p><strong>Implications for practice: </strong>Evidence suggests that giving providers direct access to evidence-based guidelines and electronic health records within the virtual visit may support diagnosis and management. Furthermore, practices that use telemedicine platforms for virtual urgent care visits should consider how to potentially improve diagnosis and management of conditions through the use of home-based point-of-care testing or accessory \"e-tools.\"</p>","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 1","pages":"813-824"},"PeriodicalIF":1.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43950291","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":"Noninvasive prenatal screening using cell-free DNA.","authors":"Christine Mladenka","doi":"10.1097/JXX.0000000000000710","DOIUrl":"10.1097/JXX.0000000000000710","url":null,"abstract":"<p><strong>Abstract: </strong>Noninvasive prenatal screening using cell-free DNA involves analysis of a sample of maternal blood for DNA fragments of fetal chromosomes from the fetal-placental unit to detect common chromosome abnormalities, trisomy 21, trisomy 13, trisomy 18, and sex chromosomes as early as 10 weeks' gestation when the fetal fraction is usually more than 4%. It is the most sensitive and specific prenatal screening option for these conditions. Because it is a screening test, false-positive and false-negative results can occur. Positive screen results necessitate further evaluation for diagnosis to confirm a medical condition, before critical decisions regarding pregnancy are made. Professional organizations provide clinical recommendations to providers regarding prescreen and postscreen counseling and management of results.</p>","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 1","pages":"789-791"},"PeriodicalIF":1.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49012354","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 technology to bridge the transition from pediatric to adult health care.","authors":"Cashmere Miller","doi":"10.1097/JXX.0000000000000700","DOIUrl":"10.1097/JXX.0000000000000700","url":null,"abstract":"<p><strong>Background: </strong>There are unique challenges presented during the transition from pediatric to adult health care for adolescents with chronic medical conditions, and many do not transition smoothly. Although there is little research on how mobile applications can influence the transition process specifically, research shows technology, in general, can be advantageous to the transition process for adolescents. Ample literature exists on how adolescents are avid users of technology.</p><p><strong>Local problem: </strong>The Children's Medical Services program in a large urban county in the southern United States lacked an efficient system for transitioning the care of children with special needs to the adult health care setting.</p><p><strong>Methods: </strong>Qualitative semistructured interviews and pre-post tests were conducted with 23 adolescent participants with chronic medical conditions. Multiple choice questions elicited information from four categories: knowledge of medical condition, organization/health care system navigation, identified adult health care provider, and awareness of available resources.</p><p><strong>Interventions: </strong>A novel website and smartphone application designed to aid adolescents and young adults during transition were developed.</p><p><strong>Results: </strong>Gain scores from pre-post tests showed an increase in all 4 sections of the survey: knowledge of medical condition-21% increase, organization/health care system navigation-15.3% increase, identified health care provider-32% increase, and awareness of available resources-19.3% increase. All 23 adolescent participants reported that the application would be useful for managing their health information.</p><p><strong>Conclusions: </strong>Smartphone applications can be helpful for adolescents in their transition into adult health care. Such applications also have potential to increase confidence and independence in managing health care needs.</p>","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 1","pages":"850-858"},"PeriodicalIF":1.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44403237","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":"Inclusion of physical activity in nurse practitioner programs: A national perspective.","authors":"","doi":"10.1097/JXX.0000000000000726","DOIUrl":"https://doi.org/10.1097/JXX.0000000000000726","url":null,"abstract":"","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 5 1","pages":"720-721"},"PeriodicalIF":1.2,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45540669","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":"Genomics update 2022: Clinician and patient hot topics.","authors":"Kenneth Wysocki, D. Seibert","doi":"10.1097/JXX.0000000000000709","DOIUrl":"https://doi.org/10.1097/JXX.0000000000000709","url":null,"abstract":"ABSTRACT\u0000Advances in genomics research and clinical applications continue to accelerate. Coupled with the availability of direct-to-consumer (DTC) marketing of genetic testing and new discoveries, patients are increasingly coming into primary care with genomic questions. This article offers a snapshot of the kinds of questions patients are asking and that providers should be prepared to discuss such as what to do with DTC results or whether pharmacogenetics testing would help make sure \"the right\" medication is prescribed. Clinicians should understand the value of clinical guidelines (and where to find them), how to find a genetic specialist, what's happening with gene editing (to include gene sequencing), what's on the horizon in cancer care, and what the future might hold.","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 4 1","pages":"613-615"},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46756069","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":"Characteristics associated with neuropsychiatric symptoms in persons living with dementia and caregiver distress and diminished well-being.","authors":"","doi":"10.1097/JXX.0000000000000717","DOIUrl":"https://doi.org/10.1097/JXX.0000000000000717","url":null,"abstract":"","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 4 1","pages":"666-667"},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49620905","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 level of quality care nurse practitioners provide compared with their physician colleagues in the primary care setting: A systematic review: Erratum.","authors":"","doi":"10.1097/JXX.0000000000000718","DOIUrl":"10.1097/JXX.0000000000000718","url":null,"abstract":"","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 4 1","pages":"696"},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47086330","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 importance of defining and refining words.","authors":"K. Curry","doi":"10.1097/JXX.0000000000000716","DOIUrl":"https://doi.org/10.1097/JXX.0000000000000716","url":null,"abstract":"","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 4 1","pages":"611-612"},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43064223","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 danger of underdiagnosing coronary microvascular disease in women","authors":"L. Behnke","doi":"10.1097/JXX.0000000000000703","DOIUrl":"https://doi.org/10.1097/JXX.0000000000000703","url":null,"abstract":"ABSTRACT Heart disease is the number one killer of women in the United States. Part of the difficulty with diagnosing heart disease in women is related to a disease process called coronary microvascular disease (CMVD; previously called syndrome X). Also known as nonobstructive coronary artery disease, CMVD is challenging to identify because often there is a lack of convincing evidence of an acute problem during evaluation. In these patients, the epicardial coronary arteries do not have visible blockages, and stress tests often are interpreted as normal or false positive. Therefore, symptomatic patients often are left undiagnosed, frustrated, and at risk of adverse cardiac events. Frequently, the only method of diagnosis is treatment of the symptoms. This information is provided to help advanced practice nurses and other clinicians diagnose and treat CMVD.","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"34 1","pages":"780 - 783"},"PeriodicalIF":1.2,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44376519","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}