Pub Date : 2026-02-05DOI: 10.1016/j.nurpra.2026.105691
Laura Xanders, Jordan Mast, David Semel, Caroline Bezzubik, Fred Cohen
Given the long waiting times for appointments with neurologists or headache specialists and the shortage of these health care professionals in the United States, management of migraine is needed in the primary care setting. Here, we outline a primary care migraine toolkit that was developed for non–headache specialties and introduce the mnemonic RATE—Recognize, Assess, Treat, Evaluate—as a potential approach that primary care providers can use to help guide the diagnosis and management of patients presenting with migraine
{"title":"Migraine Management for Primary Care Providers: A Toolkit to Recognize, Assess, Treat, and Evaluate (RATE) Patients With Migraine","authors":"Laura Xanders, Jordan Mast, David Semel, Caroline Bezzubik, Fred Cohen","doi":"10.1016/j.nurpra.2026.105691","DOIUrl":"10.1016/j.nurpra.2026.105691","url":null,"abstract":"<div><div>Given the long waiting times for appointments with neurologists or headache specialists and the shortage of these health care professionals in the United States, management of migraine is needed in the primary care setting. Here, we outline a primary care migraine toolkit that was developed for non–headache specialties and introduce the mnemonic RATE—Recognize, Assess, Treat, Evaluate—as a potential approach that primary care providers can use to help guide the diagnosis and management of patients presenting with migraine</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 4","pages":"Article 105691"},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-05DOI: 10.1016/j.nurpra.2026.105698
Janina Gilo-Tomkins, Susan Renz
Subcutaneous allergen immunotherapy (SCIT) can reduce disease burden and improve outcomes for allergic disease. Barriers to treatment include limited access and gaps in anaphylaxis knowledge among health care providers. Veterans enrolled in a single-state federal health system had limited access to SCIT due to educational, geographical, and organizational barriers. An NP-led educational initiative was implemented to improve veteran access to SCIT and increase nurse competencies. By educating primary-care RNs, the number of SCIT-capable clinics increased by 250%. Virtual and in-person modalities were equally effective educational strategies.
{"title":"Improving Veteran-Centric Allergy Care With a Collaborative Nursing Education Initiative","authors":"Janina Gilo-Tomkins, Susan Renz","doi":"10.1016/j.nurpra.2026.105698","DOIUrl":"10.1016/j.nurpra.2026.105698","url":null,"abstract":"<div><div>Subcutaneous allergen immunotherapy (SCIT) can reduce disease burden and improve outcomes for allergic disease. Barriers to treatment include limited access and gaps in anaphylaxis knowledge among health care providers. Veterans enrolled in a single-state federal health system had limited access to SCIT due to educational, geographical, and organizational barriers. An NP-led educational initiative was implemented to improve veteran access to SCIT and increase nurse competencies. By educating primary-care RNs, the number of SCIT-capable clinics increased by 250%. Virtual and in-person modalities were equally effective educational strategies.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 4","pages":"Article 105698"},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 24-year-old gravida 1 para 0 woman presented with a positive home pregnancy test result despite having a Nexplanon (Organon) subdermal contraceptive device. She reported several weeks of nausea, vomiting, food aversions, and amenorrhea, prompting an evaluation. Her medical history includes generalized anxiety disorder, asthma, depressive disorder, irritable bowel syndrome, Ehlers-Danlos syndrome, and migraine headaches. This case highlights a rare but significant failure of the long-acting reversible contraception. The case study explores the safety profile, effectiveness, and potential complications of subdermal contraceptive devices as well as discuss studies showing evidence of effectiveness beyond the current 3-year device lifetime and clinician perception of extended use.
{"title":"Unintended Pregnancy With an Implantable Subdermal Contraceptive Device","authors":"Faith Ayer, Brittany Christopher, Farinaz Fahimipour","doi":"10.1016/j.nurpra.2026.105699","DOIUrl":"10.1016/j.nurpra.2026.105699","url":null,"abstract":"<div><div>A 24-year-old gravida 1 para 0 woman presented with a positive home pregnancy test result despite having a Nexplanon (Organon) subdermal contraceptive device. She reported several weeks of nausea, vomiting, food aversions, and amenorrhea, prompting an evaluation. Her medical history includes generalized anxiety disorder, asthma, depressive disorder, irritable bowel syndrome, Ehlers-Danlos syndrome, and migraine headaches. This case highlights a rare but significant failure of the long-acting reversible contraception. The case study explores the safety profile, effectiveness, and potential complications of subdermal contraceptive devices as well as discuss studies showing evidence of effectiveness beyond the current 3-year device lifetime and clinician perception of extended use.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 4","pages":"Article 105699"},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1016/j.nurpra.2026.105689
Mariana Da Costa, Brittany N. Hudgins-Graham, Jaclyn M. Bandell
The purpose of this article is to educate nurse practitioners on evidence-based best practices for managing pain during intrauterine device (IUD) insertion. Despite current practice patterns, evidence supports the routine use of both pharmacologic and nonpharmacologic strategies to reduce anxiety and pain before, during, and after IUD insertion, ultimately improving the patient experience and reducing barriers to care. Appropriate pain management strategies support patient-centered, trauma-informed, and equitable reproductive health care. By acknowledging the current deficits in both evidence and practice, nurse practitioners can facilitate transparent discussions around pain associated with IUD insertion, consider individual risk factors and patient preferences, and influence meaningful practice change.
{"title":"Best Practices for Intrauterine Device Insertion: Improving the Patient Experience","authors":"Mariana Da Costa, Brittany N. Hudgins-Graham, Jaclyn M. Bandell","doi":"10.1016/j.nurpra.2026.105689","DOIUrl":"10.1016/j.nurpra.2026.105689","url":null,"abstract":"<div><div>The purpose of this article is to educate nurse practitioners on evidence-based best practices for managing pain during intrauterine device (IUD) insertion. Despite current practice patterns, evidence supports the routine use of both pharmacologic and nonpharmacologic strategies to reduce anxiety and pain before, during, and after IUD insertion, ultimately improving the patient experience and reducing barriers to care. Appropriate pain management strategies support patient-centered, trauma-informed, and equitable reproductive health care. By acknowledging the current deficits in both evidence and practice, nurse practitioners can facilitate transparent discussions around pain associated with IUD insertion, consider individual risk factors and patient preferences, and influence meaningful practice change.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 3","pages":"Article 105689"},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1016/j.nurpra.2026.105688
Karina Wilkerson, Kimberly Budisalich, Deva Sharma, Shikha S. Modi
Sickle cell disease (SCD) is a debilitating genetic disorder associated with severe complications, notably vaso-occlusive pain (VOP) that increases opioid use and emergency department visits. A clinical practice guideline was implemented to improve VOP management by introducing standardized SCD pain-treatment guidelines, which feature individualized pain action plans, incorporate disease-modifying therapies, and include routine depression screening. Of the 34 patients, from pre- to post-implementation, the mean Patient Health Questionnaire—9 score decreased by ∼ 39% (P < .001), and the mean number of emergency department visits decreased by ∼ 32% (P < .0001).
{"title":"Improving Vaso-occlusive Pain Through Standardized Sickle Cell Pain-Treatment Guidelines","authors":"Karina Wilkerson, Kimberly Budisalich, Deva Sharma, Shikha S. Modi","doi":"10.1016/j.nurpra.2026.105688","DOIUrl":"10.1016/j.nurpra.2026.105688","url":null,"abstract":"<div><div>Sickle cell disease (SCD) is a debilitating genetic disorder associated with severe complications, notably vaso-occlusive pain (VOP) that increases opioid use and emergency department visits. A clinical practice guideline was implemented to improve VOP management by introducing standardized SCD pain-treatment guidelines, which feature individualized pain action plans, incorporate disease-modifying therapies, and include routine depression screening. Of the 34 patients, from pre- to post-implementation, the mean Patient Health Questionnaire—9 score decreased by ∼ 39% (<em>P</em> < .001)<strong>,</strong> and the mean number of emergency department visits decreased by ∼ 32% (<em>P</em> < .0001).</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 3","pages":"Article 105688"},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19DOI: 10.1016/j.nurpra.2025.105685
Tori Boyer
Red blood cell transfusions are often prescribed to patients who are admitted to pediatric intensive care units irrespective of the established clinical practice guidelines. Nonadherence is thought to be related to insufficient knowledge of both the current standards and the unrecognized risks associated with liberal prescriptive practices. As prescribers advocating for evidence-based care and optimal outcomes, advanced practice registered nurses have the opportunity to play a unique role in hemovigilance. Advanced practice registered nurses are strategically positioned to disseminate knowledge regarding current recommendations and reduce unnecessary blood product administration when clinically appropriate, thereby reducing the potential for patient harm.
{"title":"The Advanced Practice Registered Nurse’s Role in Pediatric Hemovigilance","authors":"Tori Boyer","doi":"10.1016/j.nurpra.2025.105685","DOIUrl":"10.1016/j.nurpra.2025.105685","url":null,"abstract":"<div><div>Red blood cell transfusions are often prescribed to patients who are admitted to pediatric intensive care units irrespective of the established clinical practice guidelines. Nonadherence is thought to be related to insufficient knowledge of both the current standards and the unrecognized risks associated with <em>liberal</em> prescriptive practices. As prescribers advocating for evidence-based care and optimal outcomes, advanced practice registered nurses have the opportunity to play a unique role in hemovigilance. Advanced practice registered nurses are strategically positioned to disseminate knowledge regarding current recommendations and reduce unnecessary blood product administration when clinically appropriate, thereby reducing the potential for patient harm.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 3","pages":"Article 105685"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16DOI: 10.1016/j.nurpra.2025.105675
Monica Barfield
{"title":"Empowering Nurse Leadership in Public Office: Integrating Grassroots Advocacy and the Healing Politics Campaign School for Nurses and Midwives","authors":"Monica Barfield","doi":"10.1016/j.nurpra.2025.105675","DOIUrl":"10.1016/j.nurpra.2025.105675","url":null,"abstract":"","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 2","pages":"Article 105675"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-14DOI: 10.1016/j.nurpra.2025.105663
Maxine Victoria Wanzer, Luke Simmons, Daniel Zachary Adams
The benefits of integrating nurse practitioners and physician assistants into the critical care team have been previously described. There is a notable lack of formalized training for complex subspecialty units (eg, cardiac intensive care units). Limited information exists on integrating and training advanced practice providers into subspecialized areas using a dedicated curriculum. This article addresses this gap by detailing the steps taken by a medical intensive care unit team to develop and implement a structured training curriculum to prepare for the expansion of the advanced practice provider role into the hospital's new cardiac intensive care unit.
{"title":"Advancing Cardiac Intensive Care: A Curriculum for Advanced Practice Providers","authors":"Maxine Victoria Wanzer, Luke Simmons, Daniel Zachary Adams","doi":"10.1016/j.nurpra.2025.105663","DOIUrl":"10.1016/j.nurpra.2025.105663","url":null,"abstract":"<div><div>The benefits of integrating nurse practitioners and physician assistants into the critical care team have been previously described. There is a notable lack of formalized training for complex subspecialty units (eg, cardiac intensive care units). Limited information exists on integrating and training advanced practice providers into subspecialized areas using a dedicated curriculum. This article addresses this gap by detailing the steps taken by a medical intensive care unit team to develop and implement a structured training curriculum to prepare for the expansion of the advanced practice provider role into the hospital's new cardiac intensive care unit.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 2","pages":"Article 105663"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.1016/j.nurpra.2025.105669
Kathleen Armstrong, Heather Wade
Though rare, Addison's disease, or primary adrenal insufficiency, is life-threatening and requires timely diagnosis and treatment. Symptoms such as fatigue, nausea, vomiting, weight loss, hypotension, and hyperpigmentation are often nonspecific, increasing the risk of delayed care. Immediate treatment of adrenal crises with glucocorticoids and fluid replacement is critical. Education for patients and caregivers is essential and should include understanding crisis symptoms, wearing medical alert identification, carrying emergency glucocorticoids, and adhering to the prescribed treatment plan. Awareness and preparedness among both patients and providers are vital for improving outcomes in this uncommon but serious condition.
{"title":"Addison's Disease: The Critical Role of Timely Diagnosis","authors":"Kathleen Armstrong, Heather Wade","doi":"10.1016/j.nurpra.2025.105669","DOIUrl":"10.1016/j.nurpra.2025.105669","url":null,"abstract":"<div><div>Though rare, Addison's disease, or primary adrenal insufficiency, is life-threatening and requires timely diagnosis and treatment. Symptoms such as fatigue, nausea, vomiting, weight loss, hypotension, and hyperpigmentation are often nonspecific, increasing the risk of delayed care. Immediate treatment of adrenal crises with glucocorticoids and fluid replacement is critical. Education for patients and caregivers is essential and should include understanding crisis symptoms, wearing medical alert identification, carrying emergency glucocorticoids, and adhering to the prescribed treatment plan. Awareness and preparedness among both patients and providers are vital for improving outcomes in this uncommon but serious condition.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 2","pages":"Article 105669"},"PeriodicalIF":0.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.1016/j.nurpra.2025.105653
Jaypee Benitez Buhisan, Donna Martin, Elsie Duff, Terilyn Hunter
Patients with non–English language preference (NELP) delay accessing health care, which challenges primary care providers in their health promotion role. A narrative review of the literature was conducted to describe best practices in caring for patients with NELP in primary care. In this narrative review, facilitators and barriers to language-concordant care were identified. A key finding was the benefits of language-concordant care with professional language interpreters that included higher adherence to treatment plans, fewer emergency visits and hospitalizations, and lower morbidity and mortality rates. It is imperative that nurse practitioners offer professional language interpreter services to patients with NELP.
{"title":"Best Practices for Nurse Practitioners Caring for Patients With Non–English Language Preference: A Narrative Review","authors":"Jaypee Benitez Buhisan, Donna Martin, Elsie Duff, Terilyn Hunter","doi":"10.1016/j.nurpra.2025.105653","DOIUrl":"10.1016/j.nurpra.2025.105653","url":null,"abstract":"<div><div>Patients with non–English language preference (NELP) delay accessing health care, which challenges primary care providers in their health promotion role. A narrative review of the literature was conducted to describe best practices in caring for patients with NELP in primary care. In this narrative review, facilitators and barriers to language-concordant care were identified. A key finding was the benefits of language-concordant care with professional language interpreters that included higher adherence to treatment plans, fewer emergency visits and hospitalizations, and lower morbidity and mortality rates. It is imperative that nurse practitioners offer professional language interpreter services to patients with NELP.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 3","pages":"Article 105653"},"PeriodicalIF":0.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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