Pub Date : 2025-11-29DOI: 10.1016/j.nurpra.2025.105635
Laura Herbert, Margaret J. Selph, Jan Kubas
A 58-year-old Black man presented with chronic right hip pain and acute worsening left hip pain, impairing mobility and gait. His history included hypertension, lumbar spondylosis, cervical discectomy, long-term alcohol use, cigarette smoking, and intermittent steroid therapy. Initial examination was unremarkable except for bilateral hip pain. Radiologic studies revealed bilateral femoral head avascular necrosis with subchondral collapse. Risk factors included alcohol use, smoking, and glucocorticoid exposure. Orthopedic referral was initiated, and conservative management with physical therapy and nonsteroidal antiinflammatory drugs was chosen over surgical intervention. The patient returned to work without restrictions, with ongoing monitoring for symptom progression and blood pressure control.
{"title":"Bilateral Femoral Head Avascular Necrosis: A Case Report","authors":"Laura Herbert, Margaret J. Selph, Jan Kubas","doi":"10.1016/j.nurpra.2025.105635","DOIUrl":"10.1016/j.nurpra.2025.105635","url":null,"abstract":"<div><div>A 58-year-old Black man presented with chronic right hip pain and acute worsening left hip pain, impairing mobility and gait. His history included hypertension, lumbar spondylosis, cervical discectomy, long-term alcohol use, cigarette smoking, and intermittent steroid therapy. Initial examination was unremarkable except for bilateral hip pain. Radiologic studies revealed bilateral femoral head avascular necrosis with subchondral collapse. Risk factors included alcohol use, smoking, and glucocorticoid exposure. Orthopedic referral was initiated, and conservative management with physical therapy and nonsteroidal antiinflammatory drugs was chosen over surgical intervention. The patient returned to work without restrictions, with ongoing monitoring for symptom progression and blood pressure control.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105635"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693609","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 : 2025-11-27DOI: 10.1016/j.nurpra.2025.105612
Adam D. Kinsaul, Chris D. Roden, Tracie White
Total knee arthroplasty is commonly performed using medial parapatellar (MPP) or minimally invasive (MIS) surgical approaches. Adoption of MIS in orthopedics remains variable. We sought to compare MPP and MIS techniques, to support patient education and shared decision making, with a literature review of utilization, outcomes, complications, and clinical implications. MIS offers earlier recovery and reduced pain, whereas MPP ensures efficiency and consistency. Long-term outcomes converge within 12 months. The choice depends on surgeon expertise, efficiency, and access to instrumentation. Both approaches yield equivalent long-term outcomes. This equips NPs in guiding patient counseling, postoperative management, and education.
{"title":"Comparing Approaches in Total Knee Arthroplasty: Implications for NP Practice","authors":"Adam D. Kinsaul, Chris D. Roden, Tracie White","doi":"10.1016/j.nurpra.2025.105612","DOIUrl":"10.1016/j.nurpra.2025.105612","url":null,"abstract":"<div><div>Total knee arthroplasty is commonly performed using medial parapatellar (MPP) or minimally invasive (MIS) surgical approaches. Adoption of MIS in orthopedics remains variable. We sought to compare MPP and MIS techniques, to support patient education and shared decision making, with a literature review of utilization, outcomes, complications, and clinical implications. MIS offers earlier recovery and reduced pain, whereas MPP ensures efficiency and consistency. Long-term outcomes converge within 12 months. The choice depends on surgeon expertise, efficiency, and access to instrumentation. Both approaches yield equivalent long-term outcomes. This equips NPs in guiding patient counseling, postoperative management, and education.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105612"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623693","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 : 2025-11-27DOI: 10.1016/j.nurpra.2025.105617
Eren Watkins, Andrea N. Cimino, Amy Zhao, Seungyoung Hwang, Krishna Tangirala, James Li, Kevin Collins, Roy Brooks, Jennifer R. Amico
Bacterial vaginosis (BV) is a common vaginal infection that may complicate pregnancy. We assessed the prevalence and burden of BV among pregnant individuals in Delaware, Florida, and Mississippi with the Pregnancy Risk Assessment Monitoring System data (2016-2021). BV was reported in 6.71% of pregnancies and was more common among Black, unmarried, and low-income participants. Preterm birth rates were highest among Black individuals and those with multiple gestation, but were not significantly associated with BV. Because nurse practitioners are essential maternal care providers, these findings highlight opportunities for NPs to integrate BV education and risk-based management into practice.
{"title":"Understanding the Burden of Bacterial Vaginosis in Pregnancy With the Pregnancy Risk Assessment Monitoring System (PRAMS): A Cross-Sectional Study","authors":"Eren Watkins, Andrea N. Cimino, Amy Zhao, Seungyoung Hwang, Krishna Tangirala, James Li, Kevin Collins, Roy Brooks, Jennifer R. Amico","doi":"10.1016/j.nurpra.2025.105617","DOIUrl":"10.1016/j.nurpra.2025.105617","url":null,"abstract":"<div><div>Bacterial vaginosis (BV) is a common vaginal infection that may complicate pregnancy. We assessed the prevalence and burden of BV among pregnant individuals in Delaware, Florida, and Mississippi with the Pregnancy Risk Assessment Monitoring System data (2016-2021). BV was reported in 6.71% of pregnancies and was more common among Black, unmarried, and low-income participants. Preterm birth rates were highest among Black individuals and those with multiple gestation, but were not significantly associated with BV. Because nurse practitioners are essential maternal care providers, these findings highlight opportunities for NPs to integrate BV education and risk-based management into practice.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105617"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623691","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 : 2025-11-27DOI: 10.1016/j.nurpra.2025.105616
Justin Lyon, Annabelle Huntsman, Adriene Pavek, Nathan Shen, Jonathan Palmer, Kari L. Weiss, Lisa A. Barry, Jennifer L. Hamilton
This study explored the representation of diverse skin tones within the core content of NP education. Teaching photographs were defined as images of human skin to be used to educate. Surveys assessed student perceptions within the courses and were analyzed using descriptive statistics. Out of 408 teaching images, 75 depicted skin of color (18.4%) with Fitzpatrick types IV-VI. Twenty percent of students were dissatisfied with the level of skin of color representation within their teaching materials. There is a significant underrepresentation of individuals with darker skin tones in this institution’s NP 3Ps (pharmacology, pathophysiology, and physical assessment) course content.
{"title":"Assessing Representation of Diverse Skin Tones in NP Curricula","authors":"Justin Lyon, Annabelle Huntsman, Adriene Pavek, Nathan Shen, Jonathan Palmer, Kari L. Weiss, Lisa A. Barry, Jennifer L. Hamilton","doi":"10.1016/j.nurpra.2025.105616","DOIUrl":"10.1016/j.nurpra.2025.105616","url":null,"abstract":"<div><div>This study explored the representation of diverse skin tones within the core content of NP education. Teaching photographs were defined as images of human skin to be used to educate. Surveys assessed student perceptions within the courses and were analyzed using descriptive statistics. Out of 408 teaching images, 75 depicted skin of color (18.4%) with Fitzpatrick types IV-VI. Twenty percent of students were dissatisfied with the level of skin of color representation within their teaching materials. There is a significant underrepresentation of individuals with darker skin tones in this institution’s NP <em>3Ps</em> (pharmacology, pathophysiology, and physical assessment) course content.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105616"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623692","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 : 2025-11-25DOI: 10.1016/j.nurpra.2025.105610
Cara Cook, Sarah Bucic, Cristina Watkins, Sonya Alivio
Per- and polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals that are bioaccumulative and persistent in the environment. Current research links exposure to PFAS to human health harms, including increased cancer risk, developmental and reproductive harm, and decreased immune response. This article summarizes current clinical guidance, management, and prevention recommendations based on the best available evidence for reducing harm and exposures to PFAS. Policy recommendations at state and federal levels are provided. Advanced practice nurses have a role in advancing education and policy as it relates to exposures of patients and communities to PFAS and practices for exposure reduction.
{"title":"Advanced Practice Nurses' Role Addressing Per- and Polyfluoroalkyl Substances Exposures","authors":"Cara Cook, Sarah Bucic, Cristina Watkins, Sonya Alivio","doi":"10.1016/j.nurpra.2025.105610","DOIUrl":"10.1016/j.nurpra.2025.105610","url":null,"abstract":"<div><div>Per- and polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals that are bioaccumulative and persistent in the environment. Current research links exposure to PFAS to human health harms, including increased cancer risk, developmental and reproductive harm, and decreased immune response. This article summarizes current clinical guidance, management, and prevention recommendations based on the best available evidence for reducing harm and exposures to PFAS. Policy recommendations at state and federal levels are provided. Advanced practice nurses have a role in advancing education and policy as it relates to exposures of patients and communities to PFAS and practices for exposure reduction.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105610"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623686","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 : 2025-11-25DOI: 10.1016/j.nurpra.2025.105607
Katie Leiteritz
Substance use disorder is a highly stigmatized epidemic that affects how individuals are perceived, treated, access health care, and trust health care professionals. This single-cohort, quasi-experimental, evidence-based quality improvement project included primary care providers participating in self-reported surveys and an educational component. A statistically significant reduction in stigma from the presurvey to the postsurvey was found, and 10 of 15 participants (66.7%) noted an improvement in compassionate care for individuals with substance use disorder. Individuals with substance use disorder can be positively impacted if professionals reflect inwardly on their stigma and biases and apply the knowledge they have gained.
{"title":"Stigma in Substance Use Disorder","authors":"Katie Leiteritz","doi":"10.1016/j.nurpra.2025.105607","DOIUrl":"10.1016/j.nurpra.2025.105607","url":null,"abstract":"<div><div>Substance use disorder is a highly stigmatized epidemic that affects how individuals are perceived, treated, access health care, and trust health care professionals. This single-cohort, quasi-experimental, evidence-based quality improvement project included primary care providers participating in self-reported surveys and an educational component. A statistically significant reduction in stigma from the presurvey to the postsurvey was found, and 10 of 15 participants (66.7%) noted an improvement in compassionate care for individuals with substance use disorder. Individuals with substance use disorder can be positively impacted if professionals reflect inwardly on their stigma and biases and apply the knowledge they have gained.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105607"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623688","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 : 2025-11-25DOI: 10.1016/j.nurpra.2025.105596
Mariah K. Pankiewicz, Ashley Hardy
Shoulder injury related to vaccine administration (SIRVA) is a rare but debilitating adverse event with immunization administration caused primarily by improper intramuscular (IM) administration technique. SIRVA occurs when a deltoid IM immunization is inadvertently injected into surrounding tissues. Nurse practitioners in primary care hold capacity to diagnose, treat, and prevent SIRVA. Early treatment with corticosteroid injections has shown to be effective for management. Delayed diagnosis and treatment of SIRVA have been linked to further injuries, disability, and poor quality of life. Adhering to improved deltoid IM technique with appropriate needle size selection helps prevent SIRVA.
{"title":"Shoulder Injury Related to Vaccine Administration: Implications in Primary Care","authors":"Mariah K. Pankiewicz, Ashley Hardy","doi":"10.1016/j.nurpra.2025.105596","DOIUrl":"10.1016/j.nurpra.2025.105596","url":null,"abstract":"<div><div>Shoulder injury related to vaccine administration (SIRVA) is a rare but debilitating adverse event with immunization administration caused primarily by improper intramuscular (IM) administration technique. SIRVA occurs when a deltoid IM immunization is inadvertently injected into surrounding tissues. Nurse practitioners in primary care hold capacity to diagnose, treat, and prevent SIRVA. Early treatment with corticosteroid injections has shown to be effective for management. Delayed diagnosis and treatment of SIRVA have been linked to further injuries, disability, and poor quality of life. Adhering to improved deltoid IM technique with appropriate needle size selection helps prevent SIRVA.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105596"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623690","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 : 2025-11-25DOI: 10.1016/j.nurpra.2025.105597
Jennifer Wilbeck, Mindy Johnson, Travis McCall, Tony Smith
Emergency clinicians must be prepared for interprofessional care of multiple critically injured patients following mass-casualty incidents (MCIs). To support and assess professional competency attainment, a simulation requiring emergency nurse practitioner and critical care paramedic students collaboration for MCI patient care delivery in the emergency department setting was developed. This simulation supported diverse learners in the comprehensive demonstration of essential knowledge, skills, and interprofessional communication. Opportunities for competency evaluation of each learner group were embedded within the activity. This article details the development, implementation, and outcomes of this simulation over a 2-year period, along with strategies for replication and curricular integration.
{"title":"Mass-Casualty Incident Simulations to Engage Interprofessional Emergency Care Learners","authors":"Jennifer Wilbeck, Mindy Johnson, Travis McCall, Tony Smith","doi":"10.1016/j.nurpra.2025.105597","DOIUrl":"10.1016/j.nurpra.2025.105597","url":null,"abstract":"<div><div>Emergency clinicians must be prepared for interprofessional care of multiple critically injured patients following mass-casualty incidents (MCIs). To support and assess professional competency attainment, a simulation requiring emergency nurse practitioner and critical care paramedic students collaboration for MCI patient care delivery in the emergency department setting was developed. This simulation supported diverse learners in the comprehensive demonstration of essential knowledge, skills, and interprofessional communication. Opportunities for competency evaluation of each learner group were embedded within the activity. This article details the development, implementation, and outcomes of this simulation over a 2-year period, along with strategies for replication and curricular integration.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105597"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623689","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 : 2025-11-25DOI: 10.1016/j.nurpra.2025.105606
Mindy B. Tinkle, Tamara J. Shannon, Anne D. Letocha
Osteogenesis imperfecta is a rare genetic connective tissue disorder characterized by bone fragility and recurrent low-trauma fractures. This case study describes the evaluation and management of Jordan, a 3-year-old male with type IV osteogenesis imperfecta caused by a de novo COL1A1 gene variant. Key distinguishing features include gray sclerae, limb bowing, diffuse osteopenia, and Wormian bones on radiographs. The case highlights diagnostic challenges, including differentiation from nonaccidental trauma and genetic complexities, particularly regarding germline mosaicism and reproductive decision-making. A multidisciplinary approach to care, including bisphosphonate therapy and surveillance, is essential for optimizing outcomes and supporting affected families.
{"title":"Osteogenesis Imperfecta: A Case Study","authors":"Mindy B. Tinkle, Tamara J. Shannon, Anne D. Letocha","doi":"10.1016/j.nurpra.2025.105606","DOIUrl":"10.1016/j.nurpra.2025.105606","url":null,"abstract":"<div><div>Osteogenesis imperfecta is a rare genetic connective tissue disorder characterized by bone fragility and recurrent low-trauma fractures. This case study describes the evaluation and management of Jordan, a 3-year-old male with type IV osteogenesis imperfecta caused by a de novo <em>COL1A1</em> gene variant. Key distinguishing features include gray sclerae, limb bowing, diffuse osteopenia, and Wormian bones on radiographs. The case highlights diagnostic challenges, including differentiation from nonaccidental trauma and genetic complexities, particularly regarding germline mosaicism and reproductive decision-making. A multidisciplinary approach to care, including bisphosphonate therapy and surveillance, is essential for optimizing outcomes and supporting affected families.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105606"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623687","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 : 2025-11-24DOI: 10.1016/j.nurpra.2025.105591
Amayaliz Vargas, Stephanie J. Campos
Migraine affects 6% to 8% of the population and is the leading cause of disability in women younger than 50 years old. Traditional treatments often rely on trial and error, whereas recent advancements offer a promising alternative: calcitonin gene-related peptide (CGRP) inhibitors. They have consistently demonstrated significant reductions in monthly migraine days with few adverse effects, leading to improved patient adherence. However, high costs and limitations of CGRP for use in pregnancy and in those with recent ischemic events remain a barrier to access. Overall, CGRP inhibitors demonstrate superior efficacy and safety, with rapid action onset for preventive and episodic migraine treatment.
{"title":"Evaluating Calcitonin Gene-Related Peptide Inhibitors: A Superior Option for Migraine Prevention?","authors":"Amayaliz Vargas, Stephanie J. Campos","doi":"10.1016/j.nurpra.2025.105591","DOIUrl":"10.1016/j.nurpra.2025.105591","url":null,"abstract":"<div><div>Migraine affects 6% to 8% of the population and is the leading cause of disability in women younger than 50 years old. Traditional treatments often rely on trial and error, whereas recent advancements offer a promising alternative: calcitonin gene-related peptide (CGRP) inhibitors. They have consistently demonstrated significant reductions in monthly migraine days with few adverse effects, leading to improved patient adherence. However, high costs and limitations of CGRP for use in pregnancy and in those with recent ischemic events remain a barrier to access. Overall, CGRP inhibitors demonstrate superior efficacy and safety, with rapid action onset for preventive and episodic migraine treatment.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105591"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623694","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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