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Evidence-Based Care Practices for Children Exposed to a Diabetes-Complicated Pregnancy 糖尿病并发症妊娠患儿的循证护理实践
The Journal for Nurse Practitioners
Pub Date : 2024-11-19 DOI: 10.1016/j.nurpra.2024.105254
Valerie C. Martinez, Jacqueline B. LaManna, Susan B. Quelly, Suzanne Hyer, Jean W. Davis, Carmen Giurgescu
This study investigated the frequency with which nurse practitioners (NPs) incorporate evidence-based primary care practices for children exposed to diabetes-complicated pregnancies (DCPs). Using a cross-sectional design, a sample of 21 NPs participated in a web-based survey. Findings indicate considerable variability in NP care practices, suggesting that primary care NPs inconsistently implement evidence-based health promotion and care management strategies with these children. Continuing education tailored to the specific care needs of children exposed to hyperglycemia in utero could bridge current practice gaps. Further research is needed to explore this issue in a larger, more geographically diverse sample to enhance care consistency.
本研究调查了执业护士（NPs）针对糖尿病并发症妊娠（DCPs）患儿采用循证初级护理实践的频率。通过横断面设计，21 名执业护士参与了一项网络调查。调查结果表明，全科医生的护理实践存在很大差异，这表明全科医生在对这些儿童实施循证健康促进和护理管理策略时并不一致。针对子宫内暴露于高血糖的儿童的特殊护理需求而定制的继续教育可以弥补目前的实践差距。还需要进一步研究，在更大范围、更多地域的样本中探讨这一问题，以提高护理的一致性。
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引用次数: 0
Gastroparesis: An Updated Overview of Diagnostics and Management 胃痉挛：诊断与管理的最新概述
The Journal for Nurse Practitioners
Pub Date : 2024-11-18 DOI: 10.1016/j.nurpra.2024.105231
Lauren Adams-Sanantonio, Andrea Wagner, Jean Fox
Gastroparesis (GP) is a rare debilitating gastrointestinal disorder characterized by delayed gastric emptying in the absence of mechanical obstruction. Etiologies include diabetes, postsurgical, medication, and idiopathic origins. Symptoms of GP include nausea, vomiting, epigastric pain, early satiety, postprandial fullness, abdominal distention, unintentional weight loss, malnourishment, and dehydration. These nonspecific symptoms often lead to delays in diagnosis. The gold standard diagnostic test for GP is gastric emptying scintigraphy. The current treatment of GP is challenging; therefore, the utilization of a multidisciplinary approach with nonpharmacologic, pharmacologic, nutritional support, and procedural interventions is necessary in the care of these patients.
胃轻瘫（GP）是一种罕见的使人衰弱的胃肠道疾病，其特点是在没有机械性梗阻的情况下胃排空延迟。病因包括糖尿病、手术后、药物治疗和特发性病因。GP 的症状包括恶心、呕吐、上腹痛、早饱、餐后饱胀、腹胀、无意中体重减轻、营养不良和脱水。这些非特异性症状往往导致诊断延误。胃排空闪烁扫描是诊断 GP 的金标准检测方法。目前，GP 的治疗极具挑战性；因此，在对这些患者进行护理时，有必要采用非药物、药物、营养支持和程序干预等多学科方法。
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引用次数: 0
Nurse Practitioner-Pharmacist Collaboration in Telehealth: Review of the Literature 远程医疗中的执业护士与药剂师合作：文献综述
The Journal for Nurse Practitioners
Pub Date : 2024-11-16 DOI: 10.1016/j.nurpra.2024.105250
Ashley Fenton, Fahim Faruque, Nicole Mollenkopf
Telehealth has the potential to improve access to care, address health disparities, and make health care more equitable by removing barriers and connecting patients to a variety of providers. Telehealth also connects health professionals who may not typically be working together. Although nurse practitioners (NPs) and pharmacists are increasingly working in collaborative telehealth care settings, it is not clear how to best integrate these health care professionals and whether telehealth can be adapted to optimize NP-pharmacist collaboration and patient outcomes. This review explored pharmacist-NP collaborative projects found in the literature to understand best practices.
远程医疗可以消除障碍，将患者与各种医疗服务提供者联系起来，从而改善医疗服务的可及性，解决健康差距问题，使医疗服务更加公平。远程医疗还能将通常不在一起工作的医疗专业人员联系起来。虽然执业护士（NP）和药剂师越来越多地在远程医疗协作环境中工作，但目前还不清楚如何才能最好地整合这些医疗专业人员，以及远程医疗是否能适应于优化 NP-药剂师协作和患者疗效。本综述探讨了文献中发现的药师-NP 合作项目，以了解最佳实践。
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引用次数: 0
Patient Presents With Fatigue and Shortness of Breath 患者出现疲劳和气短症状
The Journal for Nurse Practitioners
Pub Date : 2024-11-14 DOI: 10.1016/j.nurpra.2024.105242
Gillian Crane Jackson, Sarah Grenon, Christina Leonard
Fatigue and shortness of breath are common presenting symptoms in primary care. There are multiple differentials to consider. This case study encourages the nurse practitioner to exercise focused diagnostic reasoning.
疲劳和气短是初级保健中常见的症状。需要考虑多种鉴别因素。本病例研究鼓励执业护士进行有针对性的诊断推理。
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引用次数: 0
Augmenting Gerontology Education in Family Nurse Practitioner Curriculum 在家庭执业护士课程中加强老年学教育
The Journal for Nurse Practitioners
Pub Date : 2024-11-14 DOI: 10.1016/j.nurpra.2024.105249
Dannica Callies, Brandi Pravecek, Robin Arends
The aging population and associated complexity of care require family nurse practitioners (FNP) to be adept at addressing geriatric care needs upon graduation. At a Midwest public university, graduate nursing faculty updated the curriculum to include essential geriatric competencies. Although most competencies were already present, some needed expansion to improve student proficiency in clinical settings. Uncovered topics were added, and each competency was integrated across the curriculum and assessed at multiple points. These enhancements address gaps in FNP education, resulting in graduates who are better prepared to deliver high-quality care to older adults with enhanced knowledge and skills.
人口老龄化和相关护理的复杂性要求家庭执业护士（FNP）在毕业时能够熟练应对老年护理需求。在美国中西部的一所公立大学，护理专业的研究生教师更新了课程设置，纳入了基本的老年医学能力。虽然大多数能力已经具备，但仍有一些能力需要扩展，以提高学生在临床环境中的熟练程度。我们增加了未涵盖的主题，并将每项能力整合到整个课程中，进行多点评估。这些改进弥补了全科护士教育中的不足，使毕业生能够更好地为老年人提供高质量的护理服务，并掌握更多的知识和技能。
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引用次数: 0
Intuitive Eating Group Interventions: Review and Guide for Best Practices 直觉饮食团体干预：最佳做法回顾与指南
The Journal for Nurse Practitioners
Pub Date : 2024-11-14 DOI: 10.1016/j.nurpra.2024.105248
Colleen King Goode, Ashley Fenton
Intuitive eating is an approach that focuses on body cues, hunger, and eating with intention to foster a healthier relationship with food. It has been shown to decrease disordered eating. The purpose of this review is to identify intuitive eating interventions, explore benefits, and provide guidance to develop intuitive eating programs for nurse practitioners. A review of the literature was conducted. Six studies were included in this review. Studies varied in length, methods, and outcomes. All showed improvements. Application exercises kept participants engaged and reinforce learning. One showed lasting effects. Nurse practitioners may use various formats to provide intuitive eating programs.
直觉进食是一种注重身体暗示、饥饿感和用心进食的方法，以促进与食物建立更健康的关系。事实证明，它可以减少饮食紊乱。本综述旨在确定直觉进食干预措施，探讨其益处，并为执业护士制定直觉进食计划提供指导。我们对文献进行了回顾。本综述包括六项研究。研究的长度、方法和结果各不相同。所有研究都显示了改善。应用练习让参与者参与其中并加强学习。其中一项研究显示了持久的效果。执业护士可采用各种形式提供直觉饮食计划。
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引用次数: 0
Understanding Recommendations From Various Breast Cancer Screening Guidelines 了解各种乳腺癌筛查指南的建议
The Journal for Nurse Practitioners
Pub Date : 2024-11-11 DOI: 10.1016/j.nurpra.2024.105238
Myriam Jean Cadet, Geetha Ajay, Charles I. Drago, Jarek Stelmark
Breast cancer is the most common cancer and the second leading cause of death among women in the United States. Screening for breast cancer saves lives. However, the guidelines of professional organizations have ongoing controversies in clinical practice, including the optimal age of screening for mammograms or diagnostic imaging. In this report, we highlight the recommendations of breast cancer screening guidelines for average-risk female patients.
乳腺癌是最常见的癌症，也是美国妇女的第二大死因。乳腺癌筛查可以挽救生命。然而，专业组织的指南在临床实践中一直存在争议，包括乳房 X 光检查或诊断成像的最佳筛查年龄。在本报告中，我们重点介绍了针对普通风险女性患者的乳腺癌筛查指南建议。
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引用次数: 0
Implementation of a Screen Time Agreement for School Aged Children in a Federally Qualified Health Center: An Evidence-Based Quality Improvement Project 在联邦合格卫生中心实施学龄儿童屏幕时间协议：循证质量改进项目
The Journal for Nurse Practitioners
Pub Date : 2024-11-11 DOI: 10.1016/j.nurpra.2024.105251
Erin K. Milner, Rosemary Johnson, Kerry A. Milner
In this evidence-based quality-improvement project, screen time education and agreement were implemented at a Federally Qualified Health Center targeting the pediatric population. The initiative aimed to reduce excessive screen time among children and promote adherence to the American Academy of Pediatrics guidelines. Through education and signed agreements between health care providers, children, and their families, the project successfully decreased screen time. Postimplementation data showed a trend of reduced screen use, with more than half of children meeting American Academy of Pediatrics guidelines, suggesting that education and structured agreements can be part of an effective approach to promoting healthier screen habits in pediatric patients.
在这个以证据为基础的质量改进项目中，一家联邦合格卫生中心针对儿科人群实施了屏幕时间教育和协议。该项目旨在减少儿童过长的屏幕时间，促进他们遵守美国儿科学会的指导方针。通过教育以及医疗服务提供者、儿童及其家庭之间签署协议，该项目成功减少了屏幕时间。实施后的数据显示，屏幕使用呈减少趋势，超过一半的儿童符合美国儿科学会的指导方针，这表明教育和结构化协议可以成为促进儿科患者养成更健康的屏幕习惯的有效方法的一部分。
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引用次数: 0
Awareness and Acceptance 认识与接受
The Journal for Nurse Practitioners
Pub Date : 2024-11-11 DOI: 10.1016/j.nurpra.2024.105245
Denise Link
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引用次数: 0
Educating Providers on Proactive Smoking Cessation Treatments in Primary Care 教育医疗服务提供者在初级保健中积极主动地进行戒烟治疗
The Journal for Nurse Practitioners
Pub Date : 2024-11-11 DOI: 10.1016/j.nurpra.2024.105239
Paige Gilbert, Bree-Ann Dowd, Beverly W. Dabney, Mary Linton

Background

Smoking remains the leading cause of preventable death worldwide. Despite available treatments, quitting rates are low without proper support.

Problem

In a primary care setting, proactive smoking cessation interventions were not routinely provided.

Methods

A quality improvement project using quasi-experimental design focused on educating providers and actively engaging smoking patients.

Results

Post-intervention, there was a significant increase in the percentage of patients offered smoking cessation treatments (38.5% to 84.6%, P = .016). However, there was no significant change in treatment acceptance rates.

Conclusion

Educating providers increased treatment offers. Further research is needed to understand barriers to treatment acceptance.
背景吸烟仍然是全球可预防死亡的主要原因。问题在初级医疗机构中，没有常规提供积极的戒烟干预措施。方法一个采用准实验设计的质量改进项目，重点是教育医疗服务提供者并积极吸引吸烟患者。结果干预后，提供戒烟治疗的患者比例显著增加（从 38.5% 增加到 84.6%，P = .016）。然而，治疗接受率没有明显变化。需要进一步开展研究，以了解接受治疗的障碍。
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